Search

Background Juvenile idiopathic arthritis (JIA) has been categorized into seven different categories according to the International League of Associations for Rheumatology (ILAR) criteria. Enthesitis-related arthritis (ERA) was found to represent the largest category in a Taiwanese cohort study. The aim in this study was to compare the clinical characteristics, treatments, and outcomes of ERA in a single tertiary center in Taiwan, as compared to those of other categories of JIA. Furthermore, we determined patients’ characteristics and risk factors that can help assess the outcomes in ERA. Methods A retrospective chart review of all patients with JIA referred to a pediatric rheumatology clinic in the National Taiwan University Hospital between 1993 and 2018 were identified according to ILAR criteria. Outcomes were assessed based on the Wallace criteria to categorize patients into active and non-active, including inactive, remission on medication, and remission off medication, groups. A subset of samples was further tested by DNA sequencing to identify HLA-B27 subtypes. Results One-hundred and eighty-three patients were included in the study, with a mean of 8 years’ follow-up. ERA was the single largest category of JIA (39.9%); psoriasis and undifferentiated JIA were both the least common type (0.5%). ERA was male predominant (86%), had a late age of onset (11.0 ± 3.2 years), and the majority of ERA patients was HLA-B27-positive (97%). Of 25 HLA-B27-positive ERA patients checked by HLA-B27 sequencing, 23 were B*27:04 and 2 were B*27:05. ERA patients were significantly less likely to achieve non-active status compared to patients with persistent oligoarthritis (P = 0.036). In terms of treatment response to TNF-α inhibitors in methotrexate-refractory ERA, 26 patients remained active and only 11 patients (30%) achieved a non-active status. Sacroiliitis was a risk factor contributing to poorer treatment response in ERA (P = 0.006). Conclusion ERA represented the most common category of JIA in Taiwan. Those ERA patients with sacroiliitis were likely to have persistent active disease and may require a more aggressive treatment strategy to improve their outcomes.

Background Juvenile idiopathic arthritis (JIA) has been categorized into seven different subtypes according to International League of Associations for Rheumatology system (ILAR) criteria [1]. Enthesitis-related arthritis (ERA) has represented the largest subtype in Taiwanese cohort study [2]. Objectives The aim was to compare the clinical characteristics, treatments and outcomes of ERA in one of tertiary medical center in Taiwan to other subtypes of JIA. Further, to determine patients’ characteristics and risk factors help to predict the development of active and non-active treatment outcomes in ERA. Methods Retrospective review of patients diagnosed with JIA between March 1993 and December 2018 at a pediatric rheumatology clinic in National Taiwan University Hospital (NTUH), Taipei, Taiwan were enrolled. The outcome assessments were based on Wallace criteria to categorize patient into active and non-active (inactive, remission on medication and remission off medication) group. Results One hundred and eighty-three patients were included for 8 years mean follow up duration. Distribution of JIA subtypes in Figure 1 shown ERA was the single largest category of JIA (39.89%) in Taiwan. The demographic details of ERA patients in Table 1 revealed: male predominant (86%), late onset age (11.1±3.2 yrs), majority with HLA-B27 positive (92%), sacroiliac join or lumbosacral involvement (16%) and anterior uveitis (10%). Category specific outcomes in Table 2 showed ERA and extensive oligoarthritis were less likely to achieve non-active treatment response compared to persistent oligoarthritis. Among risk factors contributed to poorer treatment response in ERA were any clinical signs of sacroiliitis with P value of significant (0.0057). Conclusion ERA has represented the most common subtype of JIA in Taiwanese cohort study and has poorer treatment responses when compared to other JIA subtypes. To identify risk factors that contributing to poorer ERA treatment response might help more aggressive therapeutic strategy and improve outcome of ERA. References [1] Ravelli, A. and A. Martini, Juvenile idiopathic arthritis. The Lancet, 2007. 369(9563): p. 767-778. [2] Shen, C.C., et al., Clinical features of children with juvenile idiopathic arthritis using the ILAR classification criteria: a community-based cohort study in Taiwan. J Microbiol Immunol Infect, 2013. 46(4): p.288-94. Disclosure of Interests None declared

Knowledge of the central role of high-risk human papillomavirus (HPV) in cervical carcinogenesis, coupled with an emerging need to monitor the efficacy of newly introduced HPV vaccines, warrant development and evaluation of type-specific, quantitative HPV detection methods. In the present study, a prototype PCR and mass spectroscopy (PCR-MS)-based method to detect and quantitate 13 high-risk HPV types is compared to the Hybrid Capture 2 High-Risk HPV DNA test (HC2; Digene Corp., Gaithersburg, MD) in 199 cervical scraping samples and to DNA sequencing in 77 cervical tumor samples. High-risk HPV types were detected in 76/77 (98.7%) cervical tumor samples by PCR-MS. Degenerate and type-specific sequencing confirmed the types detected by PCR-MS. In 199 cervical scraping samples, all 13 HPV types were detected by PCR-MS. Eighteen (14.5%) of 124 cervical scraping samples that were positive for high-risk HPV by HC2 were negative by PCR-MS. In all these cases, degenerate DNA sequencing failed to detect any of the 13 high-risk HPV types. Nearly half (46.7%) of the 75 cervical scraping samples that were negative for high-risk HPV by the HC2 assay were positive by PCR-MS. Type-specific sequencing in a subset of these samples confirmed the HPV type detected by PCR-MS. Quantitative PCR-MS results demonstrated that 11/75 (14.7%) samples contained as much HPV copies/cell as HC2-positive samples. These findings suggest that this prototype PCR-MS assay performs at least as well as HC2 for HPV detection, while offering the additional, unique advantages of type-specific identification and quantitation. Further validation work is underway to define clinically meaningful HPV detection thresholds and to evaluate the potential clinical application of future generations of the PCR-MS assay.

Psychrobacter 273-4 was isolated from a 20,000-40,000-year-old Siberian permafrost core, which is characterized by low temperature, low water activity, and high salinity. To explore how 273-4 survives in the permafrost environment, proteins in four 273-4 samples cultured at 4 and 22 degrees C in media with and without 5% sodium chloride were profiled and comparatively studied using 2-D HPLC and MS. The method used herein involved fractionation via a pH gradient using chromatofocusing followed by nonporous silica (NPS) RP-HPLC and on-line electrospray mass mapping. It was observed that 33 proteins were involved in the adaptation to low temperature in the cells grown in the nonsaline media while there were only 14 proteins involved in the saline media. There were 45 proteins observed differentially expressed in response to salt at 22 degrees C while there were 22 proteins at 4 degrees C. In addition, 5% NaCl and 4 degrees C showed a combination effect on protein expression. A total of 56 proteins involved in the adaptation to low temperature and salt were identified using MS and database searching. The differentially expressed proteins were classified into different functional categories where the response of the regulation system to stress appears to be very elaborate. The evidence shows that the adaptation of 273-4 is based primarily on the control of translation and transcription, the synthesis of proteins (chaperones) to facilitate RNA and protein folding, and the regulation of metabolic pathways.