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Introduction: Anti-PM/Scl (a-PM/Scl) antibodies are found in different systemic autoimmune diseases such as polymyositis, dermatomyositis, systemic sclerosis (SSc) and overlap syndromes. According to literature, they are detected in approx. 2% of SSc patients, but their presence is more common in SSc with myositis overlap. Objective: The aim of the study was to assess the prevalence of a-PM/Scl in patients with SSc and to identify differences in the clinical profile of the disease in patients with the presence of a-PM/Scl. Material and methods: The study was performed on 126 European Caucasian SSc patients (98 females and 28 males) hospitalized consecutively in the Department of Rheumatology and Connective Tissue Diseases. The study group was analyzed for the potential presence of a-PM/Scl using a commercial test - EUROLINE Systemic Sclerosis Profile. The detection and interpretation were carried out electronically using the specific Euroimmun - EUROLineScan programme. The subtype of SSc, incidence of internal organ involvement and serological profile were determined in the entire group. Due to the presence of a-PM/Scl, patients were divided into two groups: a-PM/Scl (+) SSc - 22 patients and a-PM/Scl (-) SSc - 104 patients. Results: A-PM/Scl was detected in 22/126 patients with SSc (17.5%). A strong correlation was found between a-PM/Scl and myalgia or myositis (p = 0.0379), hand joints contractures (p = 0.0002) and the prevalence of overlap syndrome (p = 0.0142). There were no relationships between the presence of a-PM/Scl and subtypes of SSc, other organ involvement, digital ulcers or calcinosis. Conclusions: Anti-PM/Scl antibodies are fairly common in patients with systemic sclerosis. In SSc, anti-PM/Scl antibodies are frequently associated with myalgia or myositis, hand joint contractures and an overlap syndrome. [ABSTRACT FROM AUTHOR]

Background. It is known that anti-citrullinated protein (a-CCP) antibodies and rheumatoid factor (RF) can be present in systemic sclerosis (SSc) patients, particularly with joint involvement. Objectives. The aim of the study was to assess the prevalence of a-CCP antibodies and immunoglobulin M class (IgM) RF, and the relationships between their presence and joint manifestations in patients with SSc. Material and methods. The study included 100 European Caucasian SSc patients hospitalized consecutively in the Department of Rheumatology and Connective Tissue Diseases (Lublin, Poland). Anti-citrullinated protein antibodies and IgM RF were determined using a commercial enzyme-linked immunosorbent assay (ELISA) test. Results. Anti-citrullinated protein antibodies were found in 10 out of 100 (10%) SSc patients and IgM RF in 71 out of 100 (71%) SSc patients. In the study, 90/100 (90%) SSc patients had joint manifestations (arthralgia or arthritis), 34/100 (34%) had arthritis and 6/100 (6%) had a systemic sclerosis-rheumatoid arthritis (SSc-RA) overlap syndrome. Significantly higher a-CCP antibody levels (p = 0.012), erythrocyte sedimentation rate (ESR) (p = 0.029) and C-reactive protein (CRP) levels (p = 0.020) were observed in the SSc group with arthritis. A significant correlation was found between the group with arthritis and the presence of a-CCP antibodies, and between the arthralgia group and the presence of IgM RF. Conclusions. The prevalence of RF and a-CCP antibodies is relatively high in SSc, and joint involvement occurs frequently. There was a significantly higher prevalence of IgM RF in the group with joint manifestations. About 1/3 of SSc patients had symptoms of arthritis. Arthritis is connected with the presence of a-CCP antibodies, while arthralgia is connected with the presence of IgM RF. [ABSTRACT FROM AUTHOR]

Objectives: The course of systemic sclerosis (SSc) can differ in female and male patients. According to the literature the incidence rates of diffuse cutaneous SSc, scleroderma renal crisis and digital ulceration are higher in male patients. The aim of the study was to compare selected clinical and serological parameters in male and female patients with SSc. Material and methods: The study encompassed 101 European Caucasian patients with SSc, including 23 men, hospitalized in the Department of Rheumatology. Patients fulfilled the American Rheumatism Association (ARA) classification criteria for SSc. The study groups of men and women were assessed according to the SSc subtype, incidence of internal organ involvement and presence of antinuclear antibodies considered SSc markers. Results: Diffuse cutaneous (dc) SSc was observed more commonly in men than in women (13/23 vs. 25/78; p = 0.03). The time from the development of Raynaud's phenomenon to the diagnosis was significantly shorter in male compared to female patients (3.2 ±4.7 vs. 7.5 ±7.1; p = 0.01). The incidence of scleroderma renal crisis (SRC) was significantly higher (3/23 vs. 2/78; p = 0.04) and of other calcifications significantly lower in the male group compared to the female group (1/23 vs. 20/78; p = 0.02). Conclusions: We concluded that the incidence of dcSSc is higher in men compared to women. The time from the development of Raynaud's phenomenon to the diagnosis is shorter in the male compare to female group. The incidence of SRC is higher, whereas that of calcifications is lower in SSc men. The serological profiles of female and male patients with SSc are comparable. [ABSTRACT FROM AUTHOR]

Introduction: Anti-PM/Scl (a-PM/Scl) antibodies are found in different systemic autoimmune diseases such as polymyositis, dermatomyositis, systemic sclerosis (SSc) and overlap syndromes. According to literature, they are detected in approx. 2% of SSc patients, but their presence is more common in SSc with myositis overlap., Objective: The aim of the study was to assess the prevalence of a-PM/Scl in patients with SSc and to identify differences in the clinical profile of the disease in patients with the presence of a-PM/Scl., Material and Methods: The study was performed on 126 European Caucasian SSc patients (98 females and 28 males) hospitalized consecutively in the Department of Rheumatology and Connective Tissue Diseases. The study group was analyzed for the potential presence of a-PM/Scl using a commercial test - EUROLINE Systemic Sclerosis Profile. The detection and interpretation were carried out electronically using the specific Euroimmun - EUROLineScan programme. The subtype of SSc, incidence of internal organ involvement and serological profile were determined in the entire group. Due to the presence of a-PM/Scl, patients were divided into two groups: a-PM/Scl (+) SSc - 22 patients and a-PM/Scl (-) SSc - 104 patients., Results: A-PM/Scl was detected in 22/126 patients with SSc (17.5%). A strong correlation was found between a-PM/Scl and myalgia or myositis (p = 0.0379), hand joints contractures (p = 0.0002) and the prevalence of overlap syndrome (p = 0.0142). There were no relationships between the presence of a-PM/Scl and subtypes of SSc, other organ involvement, digital ulcers or calcinosis., Conclusions: Anti-PM/Scl antibodies are fairly common in patients with systemic sclerosis. In SSc, anti-PM/Scl antibodies are frequently associated with myalgia or myositis, hand joint contractures and an overlap syndrome.

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that results in uncontrolled immune system activation and overproduction of autoantibodies. The pathogenesis of the disease is complex and not fully understood, nevertheless, genetic and environmental factors play an important role. So far, about 30 genes have been identified to be involved in the SLE pathomechanism. However, not all genetically predisposed individuals develop the disease. This phenomenon can be associated with epigenetic changes that occur under the influence of environmental factors. They can affect gene expression and are potentially hereditary, but do not lead to changes in the nucleotide sequence. Epigenetic dysfunctions, identified in the course of the disease, lead to changes in the expression of genes that play a key role in maintaining the body's immune tolerance. Major mechanisms of epigenetic variability are: DNA methylation, histone protein modification, non-coding RNA expression, as well as gene imprinting. The major epigenetic dysfunctions affecting the pathogenesis of the disease are global hypomethylation on CD4+ T cells resulting from ERK signaling pathway regulation, histone hypoacetylation, histone H3 lysine methylation, and reactivation of inactive chromosome X. In lupus patients, various epigenetic mechanisms interact with each other, enhancing the expression or silencing of genes responsible for the production of pro-inflammatory and anti-inflammatory cytokines and activation of autoreactive B-lymphocytes.

Objective: Introduction: Systemic lupus erythematosus (SLE) is an autoimmune disease leading to chronic inflammation of numerous tissues and organs. The search for clinically useful markers of its activity is ongoing. At present, it is suggested that serum free light chains (FLC) may be useful in assessing SLE activity. The aim of study: To investigate the relationship between serum levels of free light chains (FLC) and the activity of SLE., Patients and Methods: Material and methods: Eighty-four SLE patients (75 female; 9 men) aged 34.9±11.8 years, with the disease duration of 6.2±5.2 years, were included. The disease activity was assessed by: circulating C3 and C4 complement components levels, anti-double-stranded DNA (anti-DNA), SLEDAI-2K scale and levels of FLC. We also assessed the relationship between levels of FLC and clinical manifestations of SLE., Results: Results: Median serum levels of FLC κ and FLC λ were 25.9 ± 15.6mg/L and 21.2 ± 9.4 mg/L in SLE pts, respectively. Serum levels of FLC κ were positive in 60 SLE pts (71.4%) and FLC λ in 20 SLE pts (23.8%). The significant correlations were found between levels of FLC κ, FLC λ and of anti-dsDNA (p=0.01; r=0.27); (p=0.001; r=0.35), C3 complement (p<0.02; r= -0.25); (p<0.004; r= -0.31), C4 complement (p<0.04; r= -0.22); (p<0.006; r= -0.3) and SLEDAI -2K (p<0.009; r=0.28); (p<0.001; r=0.35). The SLE pts with arthritis / myositis and hematologic symptoms had significantly higher FLC levels than those without., Conclusion: Conclusion: Measurement of serum levels of FLC can help in the periodical assessment of the disease activity in SLE pts.

INTRODUCTION According to the literature, organ‑specific antibodies may be present in the course of systemic sclerosis (SSc). OBJECTIVES The aim of this study was to assess the prevalence of antithyroid antibodies (antithyroid peroxidase antibodies [anti‑TPO] and antithyroglobulin antibodies) and of antimitochondrial antibodies (AMAs), as well as to evaluate their clinical significance in patients with SSc. PATIENTS AND METHODS The study involved 86 consecutive in‑hospital patients with SSc (32 patients with diffuse cutaneous SSc [dcSSc] and 54 with limited cutaneous SSc [lcSSc]). Patients were observed for autoimmune thyroid diseases (ATDs) and primary biliary cirrhosis (PBC). Serum samples were obtained from each patient. RESULTS Positive antithyroid antibody titers were observed in 27 patients (31%) and positive AMA titers-in 11 patients (13%). ATD was diagnosed in 26 patients (30%) and PBC-in 10 patients (12%) with SSc. No significant differences in the prevalence of antithyroid antibodies were found between patients with dcSSc and those with lcSSc, but the prevalence of AMAs was significantly higher in patients with lcSSc compared with those with dcSSc. The prevalence of anti‑Ro‑52 antibodies was significantly higher in the SSc group with positive anti‑TPO antibody titers compared with the SSc group with negative anti‑TPO antibody titers. The prevalence of anticentromere antibodies (ACAs) was significantly higher in the SSc group with positive AMA titers compared with the SSc group with negative AMA titers. CONCLUSIONS The prevalence of organ‑specific antibodies in SSc patients is relatively high. The prevalence of AMAs is higher in patients with lcSSc than in those with dcSSc and is strongly associated with the presence of ACAs. Patients with SSc should be evaluated for coexisting ATDs and PBC.

Introduction: Patients with rheumatoid arthritis (RA) and those with primary Sjögren's syndrome (pSS), beside non-specific antibodies, present with organ-specific autoantibodies, including those typical of celiac disease (CD). In the pathogenesis of CD, a role is played by anti-tissue transglutaminase, anti-endomysium, and anti-gliadin (AGA) antibodies. CD can be comorbid with RA and pSS. The aim of the study was to evaluate the prevalence of AGA in RA and pSS patients and discussion of their clinical significance., Material and Methods: The study included 121 patients with RA and 30 patients with pSS. IgG AGA were determined by ELISA method. Additionally, the presence of IgG antimitochondrial antibodies (AMA) was determined in all patients. A further observation included patients with AGA., Results: In the RA group, AGA were detected in five patients (4.1%), and in the pSS group - in two patients (6.7%). All patients in the pSS AGA (+) had AMA and autoimmune thyroid disease (AITD). These differences were statistically significant compared to the pSS AGA (-) and AMA (+) group (p=0.002) and the AGA (-) and AITD (+) group (p=0.003). At the time of the study, none of the patients had been diagnosed with CD., Conclusions: AGA, typical of CD, are significantly more frequently detected in patients with RA and pSS than in the general population. The presence of autoantibodies may have an impact on the clinical picture of the disease and further medical procedures. CD testing is warranted in selected patients.

Background: The introduction of tumor necrosis factor (TNF) antagonists (adalimumab, infliximab, and etanercept) was a major advance and was highly important and beneficial in most rheumatoid arthritis (RA) patients. The adverse effects of this treatment are infrequent, but include opportunistic intracellular infection (especially the reactivation of latent Mycobacterium tuberculosis); exacerbation of demyelinating disorders; and the production of various types of antibodies such as antinuclear antibodies (ANA) or double-stranded DNA autoantibodies (dsDNA) and antiphospholipid antibodies (aPL) such as anti-cardiolipin antibodies (aCL) and anti-B2GP-I antibodies (B2GP-I). The aim of the study was to determine the prevalence of aCL and B2GP-I in IgM and IgG classes, using ELISA tests, during 6 months of follow-up in patients with refractory RA successfully treated with infliximab., Material/methods: We determined the prevalence of aCL and B2GP-I in IgM and IgG classes, using ELISA tests, during 6 months of follow-up in patients with refractory RA successfully treated with infliximab., Results: We observed a statistically important increase only in the group of B2GP-I IgM (p<0.05). There are contradictory results concerning the ability of infliximab to induce aPL, but most authors confirm this phenomenon., Conclusions: Further investigations are needed to determine if the new aPL appears in patients with β2-GPI gene polymorphisms such as leucine-to-valine substitution at position 247, which can lead to a conformational changes in β2-GPI protein, leading to aPL synthesis. The role of aPL in pathogenesis of APS is still unclear, but we should remember the immunogenic aspect of TNF antagonist treatment. Therefore, we recommend early detection of aPL and observation of the patient, paying special attention to signs and symptoms of thromboembolism.

Introduction: Rheumatoid arthritis (RA) is known to be associated with a higher prevalence of antithyroid antibodies and autoimmune thyroid disease, but there have been few studies regarding the correlations between the presence of these antibodies and RA activity., Objectives: The aim of this study was to analyze the relationship between antithyroid antibody titers and selected parameters of RA activity., Patients and Methods: A total of 75 consecutive hospitalized patients with RA were enrolled into the study. Levels of antithyroid peroxidase antibodies (aTPO), antithyroglobulin antibodies (aTG), and antithyrotropin receptor antibodies (aTSH-R) were measured. The analysis of disease activity was based on the disease activity score with 28-joint count (DAS28), duration of morning stiffness, erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) and hemoglobin levels., Results: Antithyroid antibodies were present in 13.3% of the patients (n = 10), aTPO in 9.3% (n = 7), aTG in 8% (n = 6), and aTPO and aTG in 4% (n = 3); aTSH-R was not detected in any of the patients. Significant positive correlations (P <0.05) were observed between aTPO and DAS28 (r = 0.35, P = 0.002), aTG and ESR (r = 0.25, P = 0.02), and aTG and CRP (r = 0.23, P = 0.04). There were significant differences in the mean DAS28 between the aTPO‑positive and aTPO‑negative groups (5.35; 95% confidence interval [CI], 4.39-6.3 vs. 4.12, respectively; 95% Cl, 3.81-4.43; P = 0.017) and between the aTG-positive and aTG-negative groups (5.65; 95% Cl: 4.64-6.67 vs. 4.11; 95% Cl: 3.81-4.41; P = 0.005; respectively)., Conclusions: Our results suggest that RA activity may be associated with the presence of antithyroid antibodies. This finding could be useful in the clinical evaluation of RA patients.

Introduction: It is still unclear how important the presence of antiphospholipid antibodies (aPL) is in patients with rheumatoid arthritis (RA)., Objectives: The aim of the study was to assess the prevalence of selected aPL in RA patients and their correlation with the presence of markers for RA antibodies and with disease activity., Patients and Methods: The study group consisted of 97 patients with RA who had never been treated with biological agents. In all patients, serum anticardiolipin antibodies (aCL), anti‑β2‑glycoprotein I antibodies (a‑β2‑GPI), lupus anticoagulant (LAC), immunoglobulin M (IgM) rheumatoid factor (RF), and anticyclic citrullinated peptide antibodies (anti‑CCP) were measured and disease activity was assessed., Results: The presence of aPL was observed in 27 patients (27.8%): aCL in 20 patients (20.6%), a‑β2‑GPI in 12 patients (12.4%), and LAC in 1 patient (1%). Positive aCL of low or medium levels were detected in the IgM class in 11 patients (11.3%) and in the IgG class in 12 patients (12.5%). Positive a‑β2‑GPI of low and medium levels were found only in the IgM class. The presence of LAC was associated with aCL‑IgM and a‑β2‑GPI‑IgM. A significant correlation was observed between the presence of anti‑CCP and different types of aPL. There was no correlation between aPL and IgM‑RF or disease activity markers., Conclusions: The prevalence of aPL in patients with RA is relatively high. There is a relationship between the prevalence of aPL and anti‑CCP-serological marker of RA, but there are no significant correlations between disease activity and the presence of aPL.

Unlabelled: Anaemia is a common hematological abnormality in systemic lupus erythematosus (SLE). Autoimmune hemolytic anaemia (AHA) is one of the types of anaemia in SLE. Other reasons of anaemia in SLE are: chronic inflammatory diseases, insufficient level of elements necessary for erythropoiesis and chronic renal disease. The aim of the study was to examine the relations between severity of anemia and presence of certain antiphospholipid antibodies (aPL) in SLE. The study group consisted of 24 patients (one man and 23 women) with active lupus. Anticardiolipin antibodies (aCL), anti-02 glycoprotein I antibodies (anti-beta2 GPI IgM and IgG) and red cell parameters: haemoglobin level (Hb), erythrocytes (RBC), mean corpuscular volume (MCV), mean corpuscular haemoglobin mass (MCH), mean corpuscular haemoglobin concentration (MCHC) and ferritin level were measured before beginning or intensification of treatment. The activity of SLE was measured by SLEDAI and C3 complements. The patients were divided into two subgroups: subgroup with aCL-IgG above 20 u/ml and below 20 u/ml. In patients with aCL-IgG above 20 u/ml the mean Hb level was lower, and the mean ferritin level was significantly higher than in patients with aCL-IgG level below 20 u/ml. We observed a negative, significant correlations between Hb and aCL-IgG (p = 0.01; R = -0.47) and between Hb and anti-32 GPI IgG (p = 0,0003; R = -0,67) and a negative correlation between Hb and activity of SLE estimated by SLEDAI (p = 0.02; R = -0.45) and positive between Hb and C3 complement (p = 0.02; R = +0.5)., In Conclusion: antiphospholipid antibodies presence in patients with SLE can influence the severity of anaemia.