1.Iron metabolism and arthritis: Exploring connections and therapeutic avenues
Dachun ZHUO ; Wenze XIAO ; Yulong TANG ; Shuai JIANG ; Chengchun GENG ; Jiangnan XIE ; Xiaobei MA ; Qing ZHANG ; Kunhai TANG ; Yuexin YU ; Lu BAI ; Hejian ZOU ; Jing LIU ; Jiucun WANG
Chinese Medical Journal 2024;137(14):1651-1662
Iron is indispensable for the viablility of nearly all living organisms, and it is imperative for cells, tissues, and organisms to acquire this essential metal sufficiently and maintain its metabolic stability for survival. Disruption of iron homeostasis can lead to the development of various diseases. There is a robust connection between iron metabolism and infection, immunity, inflammation, and aging, suggesting that disorders in iron metabolism may contribute to the pathogenesis of arthritis. Numerous studies have focused on the significant role of iron metabolism in the development of arthritis and its potential for targeted drug therapy. Targeting iron metabolism offers a promising approach for individualized treatment of arthritis. Therefore, this review aimed to investigate the mechanisms by which the body maintains iron metabolism and the impacts of iron and iron metabolism disorders on arthritis. Furthermore, this review aimed to identify potential therapeutic targets and active substances related to iron metabolism, which could provide promising research directions in this field.
2.Association of visceral adipose tissue with gout: Observational and Mendelian randomization analyses
Wenze XIAO ; Qi WANG ; Yining LIU ; Hui ZHANG ; Hejian ZOU
Chinese Medical Journal 2024;137(19):2351-2357
Background::The causal relationship between visceral adipose tissue (VAT) and gout is still unclear. We aimed to examine the potential association between them using observational and Mendelian randomization (MR) analyses.Methods::In the observational analyses, a total of 11,967 participants (aged 39.5 ± 11.5 years) were included from the National Health and Nutrition Examination Survey. Logistic regression models were used to investigate the association between VAT mass and the risk of gout. In two-sample MR analyses, 211 VAT mass-related independent genetic variants (derived from genome-wide association studies in 325,153 UK biobank participants) were used as instrumental variables. The random-effects inverse-variance weighted (IVW) method was used as the primary analysis. Additional sensitivity analyses were also performed to validate our results.Results::Observational analyses found that an increase in VAT mass (per standard deviation) was associated with a higher risk of gout after controlling for confounding factors (odds ratio [OR] = 1.27, 95% confidence intervals [CI] = 1.11–1.45). The two-sample MR analyses demonstrated a causal relationship between increased VAT mass and the risk of gout in primary analyses (OR = 1.78, 95% CI = 1.57–2.03). Sensitivity analyses also showed similar findings, including MR-Egger, weighted median, simple mode, weighted mode, and leave-one-out analyses.Conclusions::Observational analyses showed a robust association of VAT mass with the risk of gout. Meanwhile, MR analyses also provided evidence of a causal relationship between them. In summary, our findings suggested that targeted interventions for VAT mass may be beneficial to prevent gout.
3.Recommendations for the diagnosis and treatment of gout in China
Dong XU ; Xiaoxia ZHU ; Hejian ZOU ; He LIN ; Yan ZHAO
Chinese Journal of Internal Medicine 2023;62(9):1068-1076
Gout is a metabolic disease resulting from the accumulation of monosodium urate (MSU) in joints, leading to crystal-induced arthritis. In China, gout is common, but there is insufficient knowledge regarding standardized criteria for the diagnosis and treatment of this condition. Based on evidence and guidelines from China and other countries, the Chinese Rheumatology Association developed standardized criteria for the diagnosis and treatment of gout in China. The purpose was to standardize gout diagnosis methods as well as treatment opportunities and strategies in order to reduce misdiagnosis, missed diagnosis, and irreversible damage.
4.Clinical correlations with disease-associated auto-antibodies in a Chinese cohort with systemic sclerosis.
Sen YANG ; Minrui LIANG ; Chen CHEN ; Wenjing YE ; Xiaoxia ZHU ; Yu XUE ; Ning KONG ; Yiyun YU ; Dandan XUAN ; Shucong ZHENG ; Xue YANG ; Zaihua ZHU ; Tianyi ZHAO ; Weiguo WAN ; Hejian ZOU
Chinese Medical Journal 2022;135(15):1878-1880
5.Recommendations for diagnosis and treatment of systemic sclerosis in China
Hejian ZOU ; Xiaoxia ZHU ; Shengming DAI ; Xiaobing WANG ; Dongbao ZHAO ; Yan ZHAO
Chinese Journal of Internal Medicine 2022;61(8):874-882
Systemic sclerosis (SSc) is an autoimmune rheumatic disease that is characterized by skin fibrosis with multi-organ involvement. In China, the standardized diagnosis and treatment for SSc is still lacking. Based on the diagnosis criteria and guidelines from China and abroad, Chinese Rheumatology Association developed the current standardization of diagnosis and treatment for SSc. The purposes of this guideline are to standardize clinical management for SSc in China, to interpret the key evaluation tools for SSc, and to recommend therapeutic principle and strategies.
6.Recommendations of diagnosis and treatment of gout in China
Dong XU ; Xiaoxia ZHU ; Xuejun ZENG ; Hejian ZOU ; Jieruo GU ; Jingguo ZHOU ; Xiaofeng ZENG ; Yan ZHAO
Chinese Journal of Internal Medicine 2020;59(6):421-426
Gout is a crystal associated arthritis caused by monosodium urate (MSU) accumulating in joint, and it belongs to metabolic rheumatic disease. In China, gout is common but it is insufficient for education of standardized diagnosis and treatment for gout. Based on the evidence and guidelines from China and other countries, Chinese gout Collaborative Research Group developed standardization of diagnosis and treatment of gout in China. The purpose is to standardize the methods for diagnosis of gout, treatment opportunity and strategies in order to reduce misdiagnosis, missed diagnosis and irreversible damage.
7.Ethics Committee' s Management of Noncompliance/Violation or Protocol Deviation Report in Clinical Research
Cuiyun WU ; Guoying CAO ; Rong WU ; Hejian ZOU
Chinese Medical Ethics 2018;31(3):328-331
With the promulgation of a series of laws and regulations in our country, the requirement for stand-ardized management of clinical research process are gradually clear, and higher requirements on the following-up review management of ethics committee also are put forward. Through concluding and summarizing 128 noncompli-ance/violation or protocol deviation reports accepted by a hospital in recent two years, this paper analyzed four main problems including that the researchers at management level failed to report or report timely; the researchers reported in irregular filling;the same type of violation/deviation program happened repeatedly and the rectification to the review opinions of ethics committee was ineffective, and also put forward the corresponding suggestions, in order to strengthen and perfect the standard management of noncompliance/violation or protocol deviation report.
8.The role of B-cell scaffold protein with ankyrin repeats 1 in collagen-induced arthritis
Ning KONG ; Jie REN ; Hejian ZOU ; Weiguo WAN ; Jie YANG
Chinese Journal of Rheumatology 2018;22(1):29-33,后插2
Objective To analyze the roles of B-cell ccaffold protein with ankyrin repeats 1 (BANK1) in collagen-induced arthritis (CIA) murine model and the correlation with disease severity.Methods CIA murine model were established and evaluated.In different disease stages,the serum levels of anti-C Ⅱ auto-antibodies and BANK1 were detected by electrochemiluminescence immunoassay(ELISA).Moreover,the expression of BANK1 mRNA in peripheral blood cells were detected by real-time polymerase chain reaction (PCR) and its correlation with clinical scores was analyzed.Then the percentage of BANK1 expression in B cells in spleen and draining lymph nodes were detected by flow cytometry and the level of BANK1 protein in spleen was detected by Western blotting according to the results afore mentioned.The data was analyzed by Statistical Product and Service Solutions (SPSS) Stastistics 21.0 and figures were made with Graph Pad Prism 6.Repeated measure ANOVA was used to assess differences between the two groups.Correlations were analyzed by Spearman correlation analysis.Linear regression analysis was done when a correlation was identified.Results The incidence of CIA was over 90%.The clinical scores of arthritic mice was positively correlated with the serum levels of anti C Ⅱ total IgG antibody (r=0.717 5,P <0.01),anti C] IgG2a antibody (r=0.675 3,P<0.01) and anti C Ⅱ IgG2b antibody (r=0.889 4,P<0.01) respectively.The BANK1 level in the serum and the BANK1 mRNA expression were significantly decreased in different disease stages in CIA mice when compared with normal mice.The negative correlation between the BANK1 mRNA expression and clinical scores (r=-0.485 4,P<0.01) was observed.The percentage of BANK1 +CD19+ cells in spleen and draining lymph nodes and the level of BANK1 protein in spleen were reduced in CIA as well.Conclusion Along with the disease progress in CIA,BNK1 expression is declined,which weakens the negative regulation of BANK1 on B cells.This change goes hand in hand with the severity of arthritis.
9.Copy number variants of ABCF1, IL17REL, and FCGR3A are associated with the risk of gout.
Zheng DONG ; Yuan LI ; Jingru ZHOU ; Shuai JIANG ; Yi WANG ; Yulin CHEN ; Dongbao ZHAO ; Chengde YANG ; Qiaoxia QIAN ; Yanyun MA ; Hongjun HE ; Hengdong JI ; Yajun YANG ; Xiaofeng WANG ; Xia XU ; Yafei PANG ; Hejian ZOU ; Li JIN ; Feng ZHANG ; Jiucun WANG
Protein & Cell 2017;8(6):467-470
10.Follow-up of hepatitis reactivation in hepatitis B virus-infected patients with rheumatic diseases after different immunosuppressive therapy
Yiqi YU ; Dandan XUAN ; Jiali WANG ; Lingyun SHAO ; Wenhong ZHANG ; Hejian ZOU
Chinese Journal of Rheumatology 2015;19(4):261-266
Objective To observe hepatitis B virus (HBV) reactivation in 12 patients with rheumatic disease undergoing immunosuppressive therapy and to evaluate whether preemptive antiviral therapy is necessary for patients receiving disease-modifying anti-rheumatic drugs (DMARDs).Methods From January 2008 to March 2012,a total of 12 HBV-infected patients with rheumatic diseases were consecutively enrolled into this long-term follow-up study.Liver function and serum levels of HBV DNA were tested during the follow-up.Results The medium duration of follow-up was 41 months (range 16-48).Four patients received steroid treatment,and among them two patients without pre-emptive antiviral therapy developed HBV reactivation.After administr-ation of LAM or ETV,HBV replication was controlled in both patients.Five patients were treated with disease-modifying anti-rheumatic drugs and the other three patients received tumor necrosis factor-alpha-blocking agents.None of these patients received pre-emptive antiviral therapy.HBV reactivation did not occur in any of them.Conclusion HBV reactivation does occur in HBV-infected patients with rheumatoid diseases after immunosuppressive therapy.Pre-emptive antiviral therapy should be administered in patients who are receiving steroid therapy for rheumatic diseases.In contrast,DMARDs and TNFBA are relatively safe for HBV-infected patients with rheumatic diseases.Close monitoring of HBV DNA and ALT levels is necessary to the mana-gement of HBV reactivation.

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