Publications by authors named "Carmen P Simeon Aznar"

Background: Systemic sclerosis (SSc) is a chronic autoimmune disease characterised by microvascular damage and fibrosis. Mortality in patients with SSc has significantly decreased. Consequently, patients with SSc have longer life expectancy, and health-related quality of life (HrQoL) has become more relevant in the comprehensive management of the disease.

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  • The study focused on creating a new test to detect specific autoantibodies in patients with systemic sclerosis (SSc) using RNA immunoprecipitation and massive parallel sequencing techniques.
  • Researchers analyzed serum samples from 307 SSc patients, with 57 undergoing detailed testing that identified 30,966 RNA molecules, ultimately narrowing down to 197 significant molecules linked to SSc-related autoantibodies.
  • The new assay demonstrated high sensitivity and specificity in detecting autoantibodies, revealing not only known targets but also potential new ones associated with different clinical aspects of SSc.
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  • * A study involving 69 patients found that a significant number (33%) had PPI-refractory esophagitis, which was notably more common among those with diffuse systemic sclerosis.
  • * Gastrointestinal dysmotility, linked to abnormal digestion processes, was independently associated with PPI-refractory esophagitis, while factors like absent esophageal contractility were not significant.
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Objectives: Autoantibodies targeting intracellular proteins are common in various autoimmune diseases. In the context of myositis, the pathologic significance of these autoantibodies has been questioned due to the assumption that autoantibodies cannot enter living muscle cells. This study aims to investigate the validity of this assumption.

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Background: The 2022 European Society of Cardiology/European Respiratory Society guidelines define pulmonary hypertension (PH) as a resting mean pulmonary artery pressure (mPAP) > 20 mm Hg at right heart catheterization (RHC). Previously, patients with an mPAP between 21 and 24 mm Hg were classified in a "gray zone" of unclear clinical significance.

Research Question: What is the diagnostic performance of the main parameters used for PH screening in detecting patients with systemic sclerosis (SSc) with an mPAP of 21 to 24 mm Hg at RHC?

Study Design And Methods: Patients with SSc from the European Scleroderma Trials and Research (EUSTAR) database with available tricuspid annular plane systolic excursion (TAPSE), systolic PAP (sPAP), and mPAP data were included.

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  • Myositis is an autoimmune muscle disease characterized by autoantibodies that target proteins within muscle cells, but their impact on disease development was previously unclear.* -
  • This study utilized confocal microscopy and bulk RNA sequencing on muscle biopsies to investigate the presence and effects of these autoantibodies, revealing they accumulate in muscle fibers and disrupt the normal function of their target proteins.* -
  • Findings showed that the internalization of these autoantibodies led to significant changes in gene expression and function, indicating that they play a crucial role in causing the pathology associated with myositis.*
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Objectives: To determine the diagnostic value of anti-interferon gamma inducible protein 16 (IFI16) autoantibodies in systemic sclerosis (SSc) patients negative for all tested SSc-specific autoantibodies (SSc-seronegative patients) and to evaluate the clinical significance of these autoantibodies, whether isolated or in the presence of anti-centromere autoantibodies (ACA).

Methods: Overall, 58 SSc-seronegative and 66 ACA-positive patients were included in the study. All patients were tested for anti-IFI16 autoantibodies by an in-house direct ELISA.

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Although previous studies have suggested a relationship between telomere shortening and systemic sclerosis (SSc), the association between these two traits remains poorly understood. The objective of this study was to assess the causal relationship between telomere length in leukocytes (LTL) and SSc using the two-sample Mendelian randomization approach, with the genome-wide association study data for both LTL and SSc. The results of inverse-variance weighted regression (OR = 0.

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  • The study aimed to identify new autoantibodies related to systemic sclerosis (SSc) using an innovative protein immunoprecipitation (IP) assay, which helps in diagnosing and predicting the prognosis of SSc patients.
  • Researchers collected serum samples and clinical data from 307 SSc patients and tested them for various autoantibodies, including a non-radioactive protein IP assay for those negative for known autoantibodies.
  • A novel autoantibody targeting nuclear valosin-containing protein-like (NVL) was discovered, which was associated with a higher prevalence of calcinosis and certain types of cancer among affected patients, identifying a distinctive clinical phenotype.
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Objectives: To assess the associations and prognostic value of scleroderma patterns by nailfold videocapillaroscopy (NVC) in patients with systemic sclerosis (SSc) and cutaneous subsets.

Methods: At baseline, 1356 SSc patients from the RESCLE registry were compared according to the scleroderma pattern as Late pattern and non-Late pattern, which included Early and Active patterns. Patient characteristics, disease features, survival time and causes of death were analysed.

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Objectives: To address the prevalence of audiovestibular disorders in patients with primary Raynaud's Phenomenon (RP). A series of patients with primary RP and secondary RP in the context of systemic sclerosis (SSc) were compared with healthy controls.

Methods: A prospective multicenter observational cross-sectional study was conducted in several Otolaryngology and Rheumatology Divisions of tertiary referral hospitals, recruiting 57 patients with RP and 57 age- and gender-matched controls.

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  • The study focuses on creating an automated system using a deep learning algorithm to analyze nailfold videocapillaroscopy (NVC) images for diagnosing systemic sclerosis (SSc) and Raynaud's phenomenon (RP).
  • A total of 1,164 NVC images from RP patients were analyzed, achieving a consensus among trained capillaroscopists on 86.9% of the images and demonstrating a high rate of accuracy by the algorithm, which correctly predicted the conditions in 75.8% of cases.
  • The algorithm showed strong predictive values (over 80% for microhaemorrhages and abnormal capillaries), making it a potentially valuable tool for timely diagnosis and management of patients with SSc, RP
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Anti-nuclear (ANA) are present in approximately 90% of systemic sclerosis (SSc) patients and are key biomarkers in supporting the diagnosis and determining the prognosis of this disease. In addition to the classification criteria autoantibodies for SSc [i.e.

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Copy number (CN) polymorphisms of complement C4 play distinct roles in many conditions, including immune-mediated diseases. We investigated the association of C4 CN with systemic sclerosis (SSc) risk. Imputed total C4, C4A, C4B, and HERV-K CN were analyzed in 26,633 individuals and validated in an independent cohort.

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Objective: The objective of this study was to analyse the clinico-serological and histological phenotypes of patients with SSc with associated myopathy.

Methods: From November 2002 to September 2020, 52 patients with SSc underwent a muscle biopsy for suspected myopathy. We established two subgroups according to the histological findings based on the presence of isolated fibrosis or fibrosis together with significant inflammation.

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  • The study investigates left ventricular diastolic dysfunction (LVDD) in patients with Systemic Sclerosis (SSc) to understand its prevalence and the factors linked to it.
  • Out of 1,517 SSc patients, 21% were found to have LVDD, with associations identified relating to older age, longer diagnosis time, presence of telangiectasia, and specific treatments.
  • LVDD in SSc patients correlates with higher mortality rates and worse survival outcomes, though it wasn’t deemed an independent death risk factor.
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To assess severity markers and outcomes of patients with systemic sclerosis (SSc) with or without pulmonary arterial hypertension (PAH-SSc/non-PAH-SSc), and the impact of interstitial lung disease (ILD) on PAH-SSc. Non-PAH-SSc patients from the Spanish SSc registry and PAH-SSc patients from the Spanish PAH registry were included. A total of 364 PAH-SSc and 1589 non-PAH-SSc patients were included.

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Objectives: Although classification systems and scores for capillaroscopy interpretation have been published, there is a lack of homogenization for the procedure, especially in the way and place the images are taken, the counting of the capillaries and the measuring of their size. Our objective is to provide a deep learning-based software to obtain objective and exhaustive data for the whole nailfold without increasing the time or effort needed to do the examination, or requiring expensive equipment.

Methods: An automated software to count nailfold capillaries has been designed, through an exploratory image dataset of 2,713 images with 18,000 measurements of 3 different types.

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Background: Endothelial dysfunction is central to PAH. In this study, we simultaneously analysed circulating levels of endothelial microvesicles (EMVs) and progenitor cells (PCs) in PAH and in controls, as biomarkers of pulmonary endothelial integrity and evaluated differences among PAH subtypes and as a response to treatment.

Methods: Forty-seven controls and 144 patients with PAH (52 idiopathic, 9 heritable, 31 associated with systemic sclerosis, 15 associated with other connective tissue diseases, 20 associated with HIV and 17 associated with portal hypertension) were evaluated.

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Objective: The greatest genetic effect reported for systemic sclerosis (SSc) lies in the major histocompatibility complex (MHC) locus. Leveraging the largest SSc genome-wide association study, we aimed to fine-map this region to identify novel human leucocyte antigen (HLA) genetic variants associated with SSc susceptibility and its main clinical and serological subtypes.

Methods: 9095 patients with SSc and 17 584 controls genome-wide genotyped were used to impute and test single-nucleotide polymorphisms (SNPs) across the MHC, classical HLA alleles and their composite amino acid residues.

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