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001-es BibID:	BIBFORM120110
035-os BibID:	(WoS)001134013500010 (Scopus)85181176271
Első szerző:	Brito-Zerón, Pilar
Cím:	Exposure to air pollution as an environmental determinant of how Sjögren's disease is expressed at diagnosis / Brito-Zerón Pilar, Flores-Chávez Alejandra, Ng Wan-Fai, Fanny Horváth Ildiko, Rasmussen Astrid, Priori Roberta, Baldini Chiara, Armagan Berkan, Özkiziltas Burcugül, Praprotnik Sonja, Suzuki Yasunori, Quartuccio Luca, Hernandez-Molina Gabriela, Abacar Kerem, Bartoloni Elena, Rischmueller Maureen, Reis-de Oliveira Fabiola, Fernandes Moca Trevisani Virginia, Jurcut Ciprian, Fugmann Cecilia, Carubbi Francesco, Hofauer Benedikt, Valim Valeria, Pasoto Sandra G., Retamozo Soledad, Atzeni Fabiola, Fonseca-Aizpuru Eva, López-Dupla Miguel, Giacomelli Roberto, Nakamura Hideki, Akasbi Miriam, Thompson Kyle, Szántó Antónia, Farris A. Darise, Villa Martina, Bombardieri Stefano, Kilic Levent, Tufan Abdurrahman, Perdan Pirkmajer Katja, Fujisawa Yuhei, de Vita Salvatore, Inanc Nevsun, Ramos-Casals Manuel, Sjögren Big Data Consortium
Dátum:	2023
ISSN:	0392-856X 1593-098X
Megjegyzések:	Objectives: To analyse how the potential exposure to air pollutants can influence the key components at the time of diagnosis of Sjögren's phenotype (epidemiological profile, sicca symptoms, and systemic disease). Methods: For the present study, the following variables were selected for harmonization and refinement: age, sex, country, fulfilment of 2002/2016 criteria items, dry eyes, dry mouth, and overall ESSDAI score. Air pollution indexes per country were defined according to the OECD (1990-2021), including emission data of nitrogen and sulphur oxides (NO/SO), particulate matter (PM2.5 and 1.0), carbon monoxide (CO) and volatile organic compounds (VOC) calculated per unit of GDP, Kg per 1000 USD. Results: The results of the chi-square tests of independence for each air pollutant with the frequency of dry eyes at diagnosis showed that, except for one, all variables exhibited p-values <0.0001. The most pronounced disparities emerged in the dry eye prevalence among individuals inhabiting countries with the highest NO/SO exposure, a surge of 4.61 percentage points compared to other countries, followed by CO (3.59 points), non-methane (3.32 points), PM2.5 (3.30 points), and PM1.0 (1.60 points) exposures. Concerning dry mouth, individuals residing in countries with worse NO/SO exposures exhibited a heightened frequency of dry mouth by 2.05 percentage points (p<0.0001), followed by non-methane exposure (1.21 percentage points increase, p=0.007). Individuals inhabiting countries with the worst NO/SO, CO, and PM2.5 pollution levels had a higher mean global ESSDAI score than those in lower-risk nations (all p-values <0.0001). When systemic disease was stratified according to DAS into low, moderate, and high systemic activity levels, a heightened proportion of individuals manifesting moderate/severe systemic activity was observed in countries with worse exposures to NO/SO, CO, and PM2.5 pollutant levels. Conclusions: For the first time, we suggest that pollution levels could influence how SjD appears at diagnosis in a large international cohort of patients. The most notable relationships were found between symptoms (dryness and general body symptoms) and NO/SO, CO, and PM2.5 levels.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Sjögren's syndrome dryness systemic ESSDAI air pollution environment
Megjelenés:	Clinical And Experimental Rheumatology. - 41 : 12 (2023), p. 2448-2457. -
További szerzők:	Flores-Chávez, Alejandra Ng, Wan Fai Horváth Ildikó Fanny (1980-) (belgyógyász, allergológus, klinikai immunológus) Rasmussen, Astrid Priori, Roberta Baldini, Chiara Armagan, Berkan Özkiziltaș, Burcugül Praprotnik, Sonja Suzuki, Yasunori Quartuccio, Luca Hernandez-Molina, Gabriela Abacar, Kerem Bartoloni, Elena Rischmueller, Maureen Reis-de Oliveira, Fabiola Fernandes Moça Trevisani, Virginia Jurcut, Ciprian Fugmann, Cecilia Carubbi, Francesco Hofauer, Benedikt Valim, Valeria Pasoto, Sandra Retamozo, Soledad Atzeni, Fabiola Fonseca-Aizpuru, Eva López-Dupla, Miguel Giacomelli, Roberto Nakamura, Hideki Akasbi, Miriam Thompson, Kyle Szántó Antónia (1977-) (belgyógyász, allergológus és klinikai immunológus) Farris, Darise Villa, Martina Bombardieri, Stefano Kilic, Levent Tufan, Abdurrahman Perdan Pirkmajer, Katja Fujisawa, Yuhei Vita, Salvatore de Inanc, Nevsun Ramos-Casals, Manuel Sjögren Big Data Consortium
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001-es BibID:	BIBFORM115775
035-os BibID:	(cikkazonosító)102062 (scopus)85164311201 (wos)001040655800001
Első szerző:	Brito-Zerón, Pilar
Cím:	Mortality risk factors in primary Sjögren syndrome : a real-world, retrospective, cohort study / Brito-Zerón Pilar, Flores-Chávez Alejandra, Horváth Ildiko Fanny, Rasmussen Astrid, Li Xiaomei, Olsson Peter, Vissink Arjan, Priori Roberta, Armagan Berkan, Hernandez-Molina Gabriela, Praprotnik Sonja, Quartuccio Luca, Inanc Nevsun, Özkiziltas Burcugül, Bartoloni Elena, Sebastian Agata, Romao Vasco C., Solans Roser, Pasoto Sandra G., Rischmueller Maureen, Galisteo Carlos, Suzuki Yasunori, Trevisani Virginia Fernandes Moca, Fugmann Cecilia, González-García Andrés, Carubbi Francesco, Jurcut Ciprian, Shimizu Toshimasa, Retamozo Soledad, Atzeni Fabiola, Hofauer Benedikt, Melchor-Díaz Sheila, Gheita Tamer, López-Dupla Miguel, Fonseca-Aizpuru Eva, Giacomelli Roberto, Vázquez Marcos, Consani Sandra, Akasbi Miriam, Nakamura Hideki, Szántó Antónia, Farris A. Darise, Wang Li, Mandl Thomas, Gattamelata Angelica, Kilic Levent, Pirkmajer Katja Perdan, Abacar Kerem, Tufan Abdurrahman, de Vita Salvatore, Bootsma Hendrika, Ramos-Casals Manuel, Sjögren Big Data Consortium
Dátum:	2023
ISSN:	2589-5370
Megjegyzések:	Background: What baseline predictors would be involved in mortality in people with primary Sjögren syndrome (SjS) remains uncertain. This study aimed to investigate the baseline characteristics collected at the time of diagnosis of SjS associated with mortality and to identify mortality risk factors for all-cause death and deaths related to systemic SjS activity measured by the ESSDAI score. Methods: In this international, real-world, retrospective, cohort study, we retrospectively collected data from 27 countries on mortality and causes of death from the Big Data Sjögren Registry. Inclusion criteria consisted of fulfilling 2002/2016 SjS classification criteria, and exclusion criteria included chronic HCV/HIV infections and associated systemic autoimmune diseases. A statistical approach based on a directed acyclic graph was used, with all-cause and Sjögren-related mortality as primary endpoints. The key determinants that defined the disease phenotype at diagnosis (glandular, systemic, and immunological) were analysed as independent variables. Findings: Between January 1st, 2014 and December 31, 2023, data from 11,372 patients with primary SjS (93.5% women, 78.4% classified as White, mean age at diagnosis of 51.1 years) included in the Registry were analysed. 876 (7.7%) deaths were recorded after a mean follow-up of 8.6 years (SD 7.12). Univariate analysis of prognostic factors for all-cause death identified eight Sjögren-related variables (ocular and oral tests, salivary biopsy, ESSDAI, ANA, anti-Ro, anti-La, and cryoglobulins). The multivariate CPH model adjusted for these variables and the epidemiological features showed that DAS-ESSDAI (high vs no high: HR = 1.68; 95% CI, 1.27-2.22) and cryoglobulins (positive vs negative: HR = 1.72; 95% CI, 1.22-2.42) were independent predictors of all-cause death. Of the 640 deaths with available information detailing the specific cause of death, 14% were due to systemic SjS. Univariate analysis of prognostic factors for Sjögren-cause death identified five Sjögren-related variables (oral tests, clinESSDAI, DAS-ESSDAI, ANA, and cryoglobulins). The multivariate competing risks CPH model adjusted for these variables and the epidemiological features showed that oral tests (abnormal vs normal results: HR = 1.38; 95% CI, 1.01-1.87), DAS-ESSDAI (high vs no high: HR = 1.55; 95% CI, 1.22-1.96) and cryoglobulins (positive vs negative: HR = 1.52; 95% CI, 1.16-2) were independent predictors of SjS-related death. Interpretation: The key mortality risk factors at the time of SjS diagnosis were positive cryoglobulins and a high systemic activity scored using the ESSDAI, conferring a 2-times increased risk of all-cause and SjS-related death. ESSDAI measurement and cryoglobulin testing should be considered mandatory when an individual is diagnosed with SjS.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Cardiovascular Infection Lymphoma Mortality Sjögren syndrome Systemic disease
Megjelenés:	eClinicalMedicine. - 61 (2023), p. 1-16. -
További szerzők:	Flores-Chávez, Alejandra Horváth Ildikó Fanny (1980-) (belgyógyász, allergológus, klinikai immunológus) Rasmussen, Astrid Li, Xiaomei Olsson, Peter Vissink, Arjan Priori, Roberta Armagan, Berkan Hernandez-Molina, Gabriela Praprotnik, Sonja Quartuccio, Luca Inanc, Nevsun Özkiziltaș, Burcugül Bartoloni, Elena Sebastian, Agata Romão, Vasco C. Solans, Roser Pasoto, Sandra Rischmueller, Maureen Galisteo, Carlos Suzuki, Yasunori Trevisani, Virginia Fernandes Moça Fugmann, Cecilia González-García, Andrés Carubbi, Francesco Jurcut, Ciprian Shimizu, Toshimasa Retamozo, Soledad Atzeni, Fabiola Hofauer, Benedikt Melchor Díaz, S. Gheita, Tamer A. López-Dupla, Miguel Fonseca-Aizpuru, Eva Giacomelli, Roberto Vázquez, Marcos Consani, Sandra Akasbi, Miriam Nakamura, Hideki Szántó Antónia (1977-) (belgyógyász, allergológus és klinikai immunológus) Farris, Darise Wang, Li Mandl, Thomas Gattamelata, Angelica Kilic, Levent Pirkmajer, Katja Perdan Abacar, Kerem Tufan, Abdurrahman Vita, Salvatore de Bootsma, Hendrika Ramos-Casals, Manuel Sjögren Big Data Consortium
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001-es BibID:	BIBFORM100733
035-os BibID:	(WOS)000731864300009 (Scopus)85122843135
Első szerző:	Brito-Zerón, Pilar
Cím:	Post-COVID-19 syndrome in patients with primary Sjögren's syndrome after acute SARS-CoV-2 infection / P. Brito-Zerón, N. Acar-Denizli, V. C. Romão, B. Armagan, R. Seror, F. Carubbi, S. Melchor, R. Priori, V. Valim, S. Retamozo, S. G. Pasoto, V. F. M. Trevisani, B. Hofauer, A. Szántó, N. Inanc, G. Hernández-Molina, A. Sebastian, E. Bartoloni, V. Devauchelle-Pensec, M. Akasbi, F. Giardina, M. Bandeira, A. Sisó-Almirall, M. Ramos-Casals, Sjögren Big Data Consortium
Dátum:	2021
ISSN:	0392-856X
Megjegyzések:	OBJECTIVES: To analyse the frequency and characteristics of post-COVID-19 syndrome in patients with primary Sjögren's syndrome (pSS) affected by acute SARS-CoV-2 infection. METHODS: By the first week of April 2021, all centres included in the Big Data Sjögren Consortium were contacted asking for patients included in the Registry diagnosed with SARSCoV-2 infection according to the ECDC guidelines. According to the NICE definitions, symptoms related to COVID-19 were classified as acute COVID-19 (signs and symptoms for up to 4 weeks), ongoing symptomatic COVID-19 (presence of signs and symptoms from 4 to 12 weeks) and post-COVID-19 syndrome (signs and symptoms that continue for > 12 weeks not explained by an alternative diagnosis after a protocolized study). RESULTS: We identified 132 patients who were followed a mean follow-up of 137.8 days (ranging from 5 days to 388 days) after being diagnosed with COVID-19. In the last visit, 75 (57%) patients remained symptomatic: 68 (52%) remained symptomatic for more than 4 weeks fulfilling the NICE definition for ongoing symptomatic post-COVID-19, and 38 (29%) remained symptomatic for more than 12 weeks fulfilling the definition of post-COVID-19 syndrome. More than 40% of pSS patients reported the persistence of four symptoms or more, including anxiety/depression (59%), arthralgias (56%), sleep disorder (44%), fatigue (40%), anosmia (34%) and myalgias (32%). Age-sex adjusted multivariate analysis identified raised LDH levels (OR 10.36), raised CRP levels (OR 7.33), use of hydroxychloroquine (OR 3.51) and antiviral agents (OR 3.38), hospital admission (OR 8.29), mean length of hospital admission (OR 1.1) and requirement of supplemental oxygen (OR 6.94) as factors associated with a higher risk of developing post-COVID-19 syndrome. A sensitivity analysis including hospital admission in the adjusted model confirmed raised CRP levels (OR 8.6, 95% CI 1.33-104.44) and use of hydroxychloroquine (OR 2.52, 95% CI 1.00-6.47) as the key independent factors associated with an enhanced risk of developing post-COVID-19 syndrome. CONCLUSIONS: This is the first study that analyses the frequency and characteristics of post-COVID-19 syndrome in patients affected by a systemic autoimmune disease. We found that 57% of patients with pSS affected by COVID-19 remain symptomatic after a mean follow-up of 5 months. The risk of developing post-COVID-19 syndrome in patients who required hospitalisation was 8-times higher than in non-hospitalised patients, with baseline raised CRP levels and the use of hydroxychloroquine being independent risk factors for post-COVID-19.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk post-COVID-19 syndrome primary Sjögren's syndrome SARS-CoV-2 long COVID-19 hydroxychloroquine hospital admission
Megjelenés:	Clinical and Experimental Rheumatology. - 39 : 6 (2021), p. 57-65. -
További szerzők:	Acar-Denizli, Nihan Romão, Vasco C. Armagan, Berkan Seror, Raphaele Carubbi, Francesco Melchor, Sheila Priori, Roberta Valim, Valeria Retamozo, Soledad Pasoto, Sandra Trevisani, Virginia Fernandes Moça Hofauer, Benedikt Szántó Antónia (1977-) (belgyógyász, allergológus és klinikai immunológus) Inanc, Nevsun Hernandez-Molina, Gabriela Sebastian, Agata Bartoloni, Elena Devauchelle-Pensec, Valerie Akasbi, Miriam Giardina, Federico Bandeira, M. Sisó-Almirall, Antoni Ramos-Casals, Manuel Sjögren Big Data Consortium
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001-es BibID:	BIBFORM119113
035-os BibID:	(scopus)85181178127 (WoS)001134013500012
Első szerző:	Flores-Chávez, Alejandra
Cím:	Influence of exposure to climate-related hazards in the phenotypic expression of primary Sjögren's syndrome / Flores-Chávez Alejandra, Brito-Zerón Pilar, Ng Wan-Fai, Szántó Antónia, Rasmussen Astrid, Priori Roberta, Baldini Chiara, Armagan Berkan, Özkiziltas Burcugül, Praprotnik Sonja, Suzuki Yasunori, Quartuccio Luca, Hernández-Molina Gabriela, Inanc Nevsun, Bartoloni Elena, Rischmueller Maureen, Reis-de Oliveira Fabiola, Fernandes Moca Trevisani Virginia, Jurcut Ciprian, Nordmark Gunnel, Carubbi Francesco, Hofauer Benedikt, Valim Valeria, Pasoto Sandra G., Retamozo Soledad, Atzeni Fabiola, Fonseca-Aizpuru Eva, López-Dupla Miguel, Giacomelli Roberto, Nakamura Hideki, Akasbi Miriam, Thompson Kyle, Fanny Horváth Ildiko, Farris A. Darise, Simoncelli Edoardo, Bombardieri Stefano, Kilic Levent, Tufan Abdurrahman, Perdan Pirkmajer Katja, Fujisawa Yuhei, De Vita Salvatore, Abacar Kerem, Ramos-Casals Manuel, Sjögren Big Data Consortium
Dátum:	2023
ISSN:	0392-856X 1593-098X
Megjegyzések:	OBJECTIVES: To analyse how the key components at the time of diagnosis of the Sjögren's phenotype (epidemiological profile, sicca symptoms, and systemic disease) can be influenced by the potential exposure to climate-related natural hazards. METHODS: For the present study, the following variables were selected for harmonisation and refinement: age, sex, country, fulfilment of 2002/2016 criteria items, dry eyes, dry mouth, and overall ESSDAI score. Climate-related hazards per country were defined according to the OECD and included seven climate-related hazard types: extreme temperature, extreme precipitation, drought, wildfire, wind threats, river flooding, and coastal flooding. Climatic variables were defined as dichotomous variables according to whether each country is ranked among the ten countries with the most significant exposure. RESULTS: After applying data-cleaning techniques and excluding people from countries not included in the OECD climate rankings, the database study analysed 16,042 patients from 23 countries. The disease was diagnosed between 1 and 3 years earlier in people living in countries included among the top 10 worst exposed to extreme precipitation, wildfire, wind threats, river flooding, and coastal flooding. A lower frequency of dry eyes was observed in people living in countries exposed to wind threats, river flooding, and coastal flooding, with a level of statistical association being classified as strong (p<0.0001 for the three variables). The frequency of dry mouth was significantly lower in people living in countries exposed to river flooding (p<0.0001) and coastal flooding (p<0.0001). People living in countries included in the worse climate scenarios for extreme temperature (p<0.0001) and river flooding (p<0.0001) showed a higher mean ESSDAI score in comparison with people living in no-risk countries. In contrast, those living in countries exposed to worse climate scenarios for wind threats (p<0.0001) and coastal flooding (p<0.0001) showed a lower mean ESSDAI score in comparison with people living in no-risk countries. CONCLUSIONS: Local exposure to extreme climate-related hazards plays a role in modulating the presentation of Sjögren across countries concerning the age at which the disease is diagnosed, the frequency of dryness, and the degree of systemic activity.
Tárgyszavak:	Orvostudományok Klinikai orvostudományok idegen nyelvű folyóiratközlemény külföldi lapban folyóiratcikk Sjögren's syndrome dryness systemic ESSDAI climate epidemiology
Megjelenés:	Clinical And Experimental Rheumatology. - 41 : 12 (2023), p. 2437-2447. -
További szerzők:	Brito-Zerón, Pilar Ng, Wan Fai Szántó Antónia (1977-) (belgyógyász, allergológus és klinikai immunológus) Rasmussen, Astrid Priori, Roberta Baldini, Chiara Armagan, Berkan Özkiziltaș, Burcugül Praprotnik, Sonja Suzuki, Yasunori Quartuccio, Luca Hernandez-Molina, Gabriela Inanc, Nevsun Bartoloni, Elena Rischmueller, Maureen Reis-de Oliveira, Fabiola Fernandes Moça Trevisani, Virginia Jurcut, Ciprian Nordmark, Gunnel Carubbi, Francesco Hofauer, Benedikt Valim, Valeria Pasoto, Sandra Retamozo, Soledad Atzeni, Fabiola Fonseca-Aizpuru, Eva López-Dupla, Miguel Giacomelli, Roberto Nakamura, Hideki Akasbi, Miriam Thompson, Kyle Horváth Ildikó Fanny (1980-) (belgyógyász, allergológus, klinikai immunológus) Farris, Darise Simoncelli, Edoardo Bombardieri, Stefano Kilic, Levent Tufan, Abdurrahman Perdan Pirkmajer, Katja Fujisawa, Yuhei Vita, Salvatore de Abacar, Kerem Ramos-Casals, Manuel Sjögren Big Data Consortium
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