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Medicina
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New Strategies for the Diagnosis and Treatment of Autoimmune and...
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New Strategies for the Diagnosis and Treatment of Autoimmune and Autoinflammatory Diseases

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Hematology and Immunology".

Deadline for manuscript submissions: closed (31 July 2024) | Viewed by 11150

Special Issue Editors

Dr. Katarzyna Fischer

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Guest Editor
Individual Laboratory for Rheumatologic Diagnostics, Pomeranian Medical University in Szczecin, Unii Lubelskiej 1, 71-252 Szczecin, Poland
Interests: immunology; immunochemistry; atherosclerosis; metabolic syndrome; vascular medicine; systemic connective tissue diseases
Prof. Dr. Zbigniew Żuber

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Guest Editor
Department of Pediatrics, Andrzej Frycz Modrzewski University, 30-705 Krakow, Poland
Interests: rheumatology; pediatric rheumatology; pediatrics; rare diseases
Special Issues, Collections and Topics in MDPI journals
Prof. Dr. Bogdan Batko

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Guest Editor
Department of Rheumatology and Immunology, Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski University, Kraków, Poland
Interests: personalized therapy and psychosocial management of patients with systemic autoimmune diseases; new and emerging therapies for patients with rheumatic autoimmune diseases; epidemiologic trends in rheumatic inflammatory musculoskeletal diseases; development of the hip joint from childhood into late adulthood; cardiovascular burden of inflammatory arthritis

Special Issue Information

Dear Colleagues,

Autoimmune and autoinflammatory diseases are very heterogenous in terms of frequency, clinical manifestations and pathogenic mechanisms. Epidemiologic data show that approximately 10% of the global population suffers from these disorders and the number of cases is increasing. More than 80 disease entities have been defined with a prevalence ranging from 1% to < 1/106. The peak incidence is usually between the ages of 40 and 50. These diseases are typically characterized by a chronic course with periods of exacerbation and remission, leading, in the most dramatic cases, to permanent disability or even death.

Autoimmune and autoinflammatory diseases are currently believed to be the result of interactions between causative factors (e.g., environmental factors), genetic predisposition, autoantigens, disturbances in self-antigen tolerance and the mechanisms of apoptosis.

Additionally, a very dynamic development of novel therapies has been observed in recent years which significantly influenced patients’ overall survival and quality of life.

However, taken to the immense heterogeneity of etiopathogenic mechanisms, diversity in terms of  susceptibility to the disease, clinical phenotype and disease progression as well as the response to applied drugs, there is an extreme need to individualize health care and therapeutic approach along with further studies to elucidate mechanisms underlying autoimmune and autoinflammatory diseases.

The aim of this Special Issue is to draw attention to current trends and milestones in the diagnosis, treatment, clinical course and progression assessment, as well as experimental studies on the etiopathogenesis, of these diseases.

We invite colleagues from all over the world to submit original and review papers as well as case reports.

Dr. Katarzyna Fischer
Prof. Dr. Zbigniew Żuber
Prof. Dr. Bogdan Batko
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Medicina is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • autoimmune diseases
  • autoinflammatory diseases
  • etiology
  • pathogenesis
  • diagnosis
  • organ involvement
  • cardiovascular risk
  • imaging diagnostics
  • therapeutic approaches

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Published Papers (6 papers)

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Research

Jump to: Review, Other

11 pages, 306 KiB  
Article
Association of Dietary Inflammatory Index and Thyroid Function in Patients with Hashimoto’s Thyroiditis: An Observational Cross–Sectional Multicenter Study
by Sanja Klobučar, Gordana Kenđel Jovanović, Jadwiga Kryczyk-Kozioł, Maja Cigrovski Berković, Jelena Vučak Lončar, Nikolina Morić, Katarina Peljhan, Dario Rahelić, Dunja Mudri, Ines Bilić-Ćurčić and Tatjana Bogović Crnčić
Medicina 2024, 60(9), 1454; https://doi.org/10.3390/medicina60091454 - 5 Sep 2024
Viewed by 1933
Abstract
Background and Objectives: The available research suggests that dietary patterns with high inflammatory potential, as indicated by a high DII score, may exacerbate inflammation and potentially influence thyroid function. Therefore, the aim of this study was to investigate the associations between the inflammatory [...] Read more.
Background and Objectives: The available research suggests that dietary patterns with high inflammatory potential, as indicated by a high DII score, may exacerbate inflammation and potentially influence thyroid function. Therefore, the aim of this study was to investigate the associations between the inflammatory potential of a diet and thyroid function in adults with Hashimoto’s thyroiditis (HT). Materials and Methods: A total of 149 adults diagnosed with Hashimoto’s thyroiditis were enrolled in this observational, cross-sectional, multicenter study. The Dietary Inflammatory Index (DII®) was calculated using a 141-item food frequency questionnaire (FFQ). The serum levels of the thyroid-stimulating hormone (TSH), free thyroxine (fT4), thyroid peroxidase antibodies (TPO-Ab), and high-sensitivity C-reactive protein (hsCRP) were determined. Results: The DII® scores ranged from −3.49 (most anti-inflammatory) to +4.68 (most pro-inflammatory), whereas three DII® tertile ranges were defined as <−1.4, −1.39 to +1.20, and >+1.21, respectively. Participants in tertile 1 (more anti-inflammatory diet) had significantly higher levels of fT4 than those adhering to a more pro-inflammatory diet (p = 0.007). The levels of hsCRP and TSH appeared to increase with increasing the DII® score, but without statistical significance. A significant association was found between the DII® and TSH (β = 0.42, p < 0.001) and between DII® and free thyroxine (β = 0.19, p < 0.001). After adjustment for age, gender, energy intake, and physical activity, a significant positive correlation remained between the DII® and TSH (β = 0.33, p = 0.002) and between the DII® and body mass index (BMI) (β = 0.14, p = 0.04). Conclusions: Adherence to an anti-inflammatory diet appears to be beneficial in patients with Hashimoto’s thyroiditis, suggesting that dietary modification aimed at lowering DII® levels may be a valuable strategy to improve clinical outcomes in these patients. Full article
(This article belongs to the Special Issue New Strategies for the Diagnosis and Treatment of Autoimmune and Autoinflammatory Diseases)
12 pages, 4736 KiB  
Article
Diagnostic Value of Whole-Body MRI in Pediatric Patients with Suspected Rheumatic Diseases
by Joanna Ożga, Monika Ostrogórska, Wadim Wojciechowski and Zbigniew Żuber
Medicina 2024, 60(9), 1407; https://doi.org/10.3390/medicina60091407 - 28 Aug 2024
Viewed by 981
Abstract
Background and Objectives: The diagnosis of rheumatic diseases in children is challenging and requires the use of advanced imaging examinations such as whole-body magnetic resonance imaging (MRI). Whole-body MRI allows visualization of bone marrow edema (BME), muscle edema, joint effusion and changes [...] Read more.
Background and Objectives: The diagnosis of rheumatic diseases in children is challenging and requires the use of advanced imaging examinations such as whole-body magnetic resonance imaging (MRI). Whole-body MRI allows visualization of bone marrow edema (BME), muscle edema, joint effusion and changes in the soft tissues surrounding the joints. The aim of this study was to collect and compare whole-body MRI findings, laboratory results and clinical manifestations of pediatric patients with suspected rheumatic disease. Materials and methods: In this retrospective single-center study, 33 patients who underwent whole-body MRI were included. Their age ranged from 9 to 17 years, and 24 (72.73%) of the patients were female. Patients were diagnosed as follows: juvenile idiopathic arthritis (27.27%), juvenile idiopathic inflammatory myopathies (21.21%), chronic nonbacterial osteomyelitis (21.21%) and other medical conditions (30.30%), such as arthritis associated with infection, scleroderma, Takayasu arteritis, polyarteritis nodosa and joint damage. Results: The most common symptom reported by 26 (79.79%) patients was pain. On physical examination, the limitation of joint mobility was examined in 17 (51.51%), swelling of the joints was observed in 12 (36.36%) patients and decreased muscle strength was noticed in 11 (33.33%) patients. An increase in the C-reactive protein (12%), erythrocyte sedimentation rate (9%), leukocyte count (9%) and creatine kinase (CK) (18%) was observed. Whole-body MRI revealed myositis (30%), joint effusion (27%) and BME (24%). The statistical analysis showed a significant relationship between myositis and the elevated CK level (p < 0.05). Conclusions: The most common symptom in the studied population was pain, while the limitation of joint mobility was found in more than half of patients. Myositis was the most commonly imaged lesion on the whole-body MRI and it was related to an increase in the CK level. Full article
(This article belongs to the Special Issue New Strategies for the Diagnosis and Treatment of Autoimmune and Autoinflammatory Diseases)
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13 pages, 5543 KiB  
Article
Dapsone as a Current Option for the Treatment of Autoimmune Bullous Diseases with Autoimmunity to Non-Enzymes: A Retrospective Study from a Single Central European Referral Center
by Maciej Marek Spałek, Magdalena Jałowska, Natalia Welc, Monika Bowszyc-Dmochowska and Marian Dmochowski
Medicina 2024, 60(8), 1324; https://doi.org/10.3390/medicina60081324 - 15 Aug 2024
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Abstract
Background and Objectives: Dapsone (DP) is employed in the management of various skin conditions, including autoimmune bullous diseases to non-enzymes (n-eAIBDs). This study aimed to assess the advantages and safety profile of DP treatment in n-eAIBDs patients. The evaluation focused on clinical [...] Read more.
Background and Objectives: Dapsone (DP) is employed in the management of various skin conditions, including autoimmune bullous diseases to non-enzymes (n-eAIBDs). This study aimed to assess the advantages and safety profile of DP treatment in n-eAIBDs patients. The evaluation focused on clinical remission, reduction in glucocorticosteroid (GCS) usage, and adverse incidents during a 12-month observation in a dermatology department at a Central European university. Materials and Methods: Our retrospective study included forty-one patients who met the inclusion criteria, comprising nineteen with pemphigus vulgaris, nine with pemphigus foliaceus, four with bullous pemphigoid, and nine with mucous membrane pemphigoid, including one patient with Brunsting–Perry pemphigoid. Patients received 25–50 mg/day of DP along with oral GCSs for a year, with a subsequent dose reduction where feasible. Results: The mean decreases in prednisone-equivalent dosages across all groups after 2, 6, and 12 months of DP treatment were 45.66%, 65.77%, and 63.03%, respectively. Throughout the 12-month observation period, 21.62% of patients experienced a relapse, while the remaining patients attained either complete or partial remission with minimal therapy. Adverse incidents were observed in 29.27% of patients; these were mild or moderate, and no severe negative effects were observed. Conclusions: DP is an effective and affordable choice to support the treatment of n-eAIBDs, but it may not be sufficient for long-term management in certain patients with severe n-eAIBDs. Full article
(This article belongs to the Special Issue New Strategies for the Diagnosis and Treatment of Autoimmune and Autoinflammatory Diseases)
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Review

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49 pages, 1603 KiB  
Review
Nanomedicine in Neuroprotection, Neuroregeneration, and Blood–Brain Barrier Modulation: A Narrative Review
by Antea Krsek, Ana Jagodic and Lara Baticic
Medicina 2024, 60(9), 1384; https://doi.org/10.3390/medicina60091384 - 24 Aug 2024
Viewed by 2674
Abstract
Nanomedicine is a newer, promising approach to promote neuroprotection, neuroregeneration, and modulation of the blood–brain barrier. This review includes the integration of various nanomaterials in neurological disorders. In addition, gelatin-based hydrogels, which have huge potential due to biocompatibility, maintenance of porosity, and enhanced [...] Read more.
Nanomedicine is a newer, promising approach to promote neuroprotection, neuroregeneration, and modulation of the blood–brain barrier. This review includes the integration of various nanomaterials in neurological disorders. In addition, gelatin-based hydrogels, which have huge potential due to biocompatibility, maintenance of porosity, and enhanced neural process outgrowth, are reviewed. Chemical modification of these hydrogels, especially with guanidine moieties, has shown improved neuron viability and underscores tailored biomaterial design in neural applications. This review further discusses strategies to modulate the blood–brain barrier—a factor critically associated with the effective delivery of drugs to the central nervous system. These advances bring supportive solutions to the solving of neurological conditions and innovative therapies for their treatment. Nanomedicine, as applied to neuroscience, presents a significant leap forward in new therapeutic strategies that might help raise the treatment and management of neurological disorders to much better levels. Our aim was to summarize the current state-of-knowledge in this field. Full article
(This article belongs to the Special Issue New Strategies for the Diagnosis and Treatment of Autoimmune and Autoinflammatory Diseases)
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Other

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9 pages, 1141 KiB  
Case Report
Acute Heart Failure in the Course of Macrophage Activation Syndrome Due to Newly Diagnosed Systemic Lupus Erythematosus: Case Presentation and Literature Review
by Jakub Kuna, Grzegorz Chmielewski, Łukasz Jaśkiewicz and Magdalena Krajewska-Włodarczyk
Medicina 2024, 60(3), 392; https://doi.org/10.3390/medicina60030392 - 26 Feb 2024
Viewed by 1548
Abstract
Macrophage activation syndrome is an uncommon yet dangerous and potentially fatal complication of many rheumatic diseases, inducing multiple organ failure, including, although rarely, acute heart failure. In the following paper, we present a case of a 37-year-old woman who, in a short period [...] Read more.
Macrophage activation syndrome is an uncommon yet dangerous and potentially fatal complication of many rheumatic diseases, inducing multiple organ failure, including, although rarely, acute heart failure. In the following paper, we present a case of a 37-year-old woman who, in a short period of time after a gynecological procedure due to fetal death, developed full-blown lupus erythematosus leading to early stages of macrophage activation syndrome with acute heart failure as its main clinical manifestation. We also include herein a brief literature review of the current understanding of diverse macrophage populations and their functions in various organs (focusing especially on the heart muscle), as well as a summary of different attempts at composing concise criteria for diagnosing macrophage activation syndrome. Full article
(This article belongs to the Special Issue New Strategies for the Diagnosis and Treatment of Autoimmune and Autoinflammatory Diseases)
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6 pages, 585 KiB  
Case Report
Recurrent Acute Disseminated Encephalomyelitis Presenting as Conus Medullaris Syndrome: A Case Report
by Dae-Wook Lee, Seok Kang and Nackhwan Kim
Medicina 2024, 60(1), 188; https://doi.org/10.3390/medicina60010188 - 22 Jan 2024
Viewed by 1854
Abstract
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that typically follows an infection or recent vaccination. Symptoms such as encephalopathy and focal neurological deficits appear weeks after the initial illness, leading to swift and progressive neurological decline. While ADEM in the brain [...] Read more.
Acute disseminated encephalomyelitis (ADEM) is an inflammatory demyelinating disorder that typically follows an infection or recent vaccination. Symptoms such as encephalopathy and focal neurological deficits appear weeks after the initial illness, leading to swift and progressive neurological decline. While ADEM in the brain has been well documented, reports of ADEM, specifically in the spinal cord, are relatively limited. A 58-year-old male presented with rapidly progressive bilateral lower extremity tingling, numbness, and mild gait disturbance approximately two days prior to visiting the emergency room. Spinal magnetic resonance imaging revealed a diffuse, longitudinal, high-signal lesion with mild enlargement of the conus and proximal cauda equina. The lesions were predominantly localized in the distal conus and cauda equina, and serial electrodiagnostic studies showed that the lesions progressed toward the proximal conus in tandem with symptom evolution and lacked clear lateralization. The patient was subsequently treated with high-dose steroids for seven days (intravenous methylprednisolone, 1 mg/kg). The patient’s lower extremity weakness gradually improved and he was able to walk independently under supervision three weeks after symptom onset. In this case of spinal ADEM in a middle-aged adult, high-dose steroid treatment led to outstanding neurological recovery from both the initial occurrence and subsequent attacks. Full article
(This article belongs to the Special Issue New Strategies for the Diagnosis and Treatment of Autoimmune and Autoinflammatory Diseases)
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