Publications by authors named "Irene Cecchi"
Background: Limited research exists on breastfeeding among women with systemic lupus erythematosus, despite known benefits of human milk.
Research Aim: To investigate reasons for breastfeeding avoidance among postpartum women with systemic lupus erythematosus.
Methods: This is a descriptive study, conducted in January 2023, combining retrospective pregnancy outcome data collection with a structured telephone questionnaire.
JAK inhibitors (JAKi) are small molecules that interact with JAK proteins, modulating the JAK-STAT signaling pathway, which plays a significant, though not yet fully understood, role in immune regulation. Due to the breadth of their mechanism of action, JAKi have shown promising results in the treatment of various immune-mediated diseases across different fields such as rheumatology or dermatology, and may represent a valuable therapeutic option for patients with multiple coexisting immune-mediated conditions. However, recent years have seen growing concerns regarding their use due to an observed increase in cardiovascular and thromboembolic events compared to anti-TNF drugs, which may complicate administration in patients with additional associated risk factors.
View Article and Find Full Text PDFObjectives: To update the existing European Alliance of Associations for Rheumatology (EULAR) points to consider (PtC) for use of antirheumatic drugs in reproduction, pregnancy, and lactation, including additional drugs and adverse outcomes as well as paternal drug safety.
Methods: According to the EULAR standardised operating procedures, an international task force (TF) defined the questions for a systematic literature review, followed by formulation of the updated statements. A predefined voting process was applied to each overarching principle and statement.
Objectives: This study aimed to summarise and update evidence to inform the 2024 update of the European Alliance of Associations for Rheumatology recommendations for the use of antirheumatic drugs in reproduction, pregnancy, and lactation.
Methods: A systematic literature review (SLR) was performed, including keywords on reproduction, adverse pregnancy outcomes (APOs), and lactation. Two appraised SLRs were the basis for the SLR on drug safety in men.
Background/objectives: Inflammation and immunological dysregulation are central to systemic lupus erythematosus (SLE), a complex autoimmune disease. Recently, there has been increasing interest in the potential role of dietary factors in SLE. This study aimed to explore the relationship between diet and SLE by addressing patient needs, conducting a systematic review, and providing guidance to the patient community.
View Article and Find Full Text PDFArticle Synopsis
- - This study examined the occurrence and effects of antinuclear antibodies (ANA) in patients with antiphospholipid antibodies (aPL) but without other systemic autoimmune diseases, using data from the APS ACTION Registry.
- - Among the 430 analyzed patients, 56% tested positive for ANA, revealing significant links between ANA positivity and various autoimmune features like hematologic issues and joint involvement.
- - Despite the presence of these autoimmune characteristics in ANA-positive patients, the study found no connection between ANA status and complications related to thrombosis or pregnancy; interestingly, ANA-negative patients had more pregnancies and live births.
Article Synopsis
- The study investigates the role of the type I interferon (IFN-I) pathway in patients with antiphospholipid antibodies, including those with antiphospholipid syndrome (APS) and other related conditions.
- Researchers evaluated gene expression in 112 individuals, categorizing them into different groups, including aPL carriers and patients with various types of APS.
- Findings revealed significant activation of the IFN-I pathway in all groups, with varying levels and patterns that could help identify unique signatures linked to clinical outcomes across these subsets.
Prompt disease control of flares in patients with systemic lupus erythematosus (SLE) is a priority in treatment strategy planning. However, the long-term dosage-related collateral effects of glucocorticoids (GCs) have pushed researchers towards the identification and utilization of novel biological agents that could both induce and maintain low disease activity and remission, especially in the context of lupus nephritis (LN). This scoping review aims at assessing the current evidence of the potential steroid-sparing effect of biologic therapies by reviewing phase II and phase III randomized, placebo-controlled trials involving SLE/LN patients.
View Article and Find Full Text PDF2023 ACR/EULAR classification criteria in existing research cohorts: an international study.
Rheumatology (Oxford)
October 2024
Objective: To assess the impact of the updated ACR/EULAR APS classification criteria on two large research cohorts.
Methods: Consecutive patients who tested persistently positive for at least one aPL in the last three years were enrolled. The first APS Sydney index event was considered and computed for the comparison between Sydney and 2023 APS criteria.
Article Synopsis
- Antiphospholipid syndrome (APS) is an autoimmune disease that leads to blood clots and can cause issues during pregnancy due to the presence of antiphospholipid antibodies.
- A case study is presented involving a patient who faced recurrent venous thrombosis and skin ulcerations, which did not improve with standard anticoagulant treatment.
- The patient eventually showed significant improvement with immunomodulatory therapy, highlighting the need to consider APS in young patients with unexplained blood clots and the importance of testing for antiphospholipid antibodies.
Complement levels during the first trimester predict disease flare and adverse pregnancy outcomes in systemic lupus erythematosus: A network meta-analysis on 532 pregnancies.
Autoimmun Rev
December 2023
Article Synopsis
- The study explored the role of complement levels (C3 and C4) as potential biomarkers for monitoring disease activity and risks during pregnancies in women with systemic lupus erythematosus (SLE).
- Data from 532 lupus patients showed that complement levels generally rise during pregnancy but are notably lower in those with prior lupus nephritis and flares, particularly in the first trimester.
- Lower or minimal increases in C3 and C4 levels during early pregnancy were linked to higher rates of complications and gestational flares, suggesting these complement levels could help predict risks for SLE patients.
Safety and efficacy of pre-exposure prophylaxis with tixagevimab/cilgavimab (Evusheld) in patients with glomerular diseases who received rituximab.
Clin Kidney J
September 2023
Article Synopsis
- * After administering the treatment to 22 patients, none developed symptomatic SARS-CoV-2 infections during the observation period, while 39.3% of the control group experienced symptomatic infections, highlighting the treatment's potential benefits.
- * Overall, the findings suggest that tixagevimab/cilgavimab is a safe option that may significantly reduce the risk of symptomatic COVID-19 infections for vaccinated individuals with GD on anti-CD20 therapy.
Daratumumab monotherapy for refractory lupus nephritis.
Nat Med
August 2023
Article Synopsis
- Treatment-refractory lupus nephritis (LN) can lead to serious health complications, and a case series involving six patients (one male and five females) showcased a treatment using daratumumab, an anti-CD38 monoclonal antibody.
- After 12 months of treatment, five out of six patients showed significant improvement in disease activity, protein levels, and kidney function.
- Findings also indicated changes in immune response markers, suggesting that daratumumab could be a promising monotherapy for managing refractory LN, warranting further research.
New Frontiers in Autoimmune Diagnostics: A Systematic Review on Saliva Testing.
Int J Environ Res Public Health
May 2023
Article Synopsis
- Immunological laboratory testing is complex and often performed in specialized centers, facing challenges like limited resources and difficulties in blood sample collection, especially in vulnerable populations.
- A systematic review was conducted to explore the feasibility of using saliva samples for immunological testing, analyzing 170 articles where 18 studies were relevant.
- Results indicated that saliva collection via passive drooling was common, with ELISA being the main detection method; there is evidence of good correlation between saliva and serum results, suggesting saliva testing could be a reliable alternative for diagnosing autoantibodies.
Introduction: Significant heterogeneity still exists in the nomenclature of renal involvement in antiphospholipid syndrome (APS).
Methods: We applied a hierarchical cluster analysis to determine subgroups of patients according to clinical, laboratory, and renal histology characteristics in a cohort of subjects with confirmed antiphospholipid antibodies (aPL) positivity and biopsy proven aPL-related renal injuries. Kidney outcomes were then assessed at 12 months.
Article Synopsis
- Immune-mediated glomerulonephritis with a membranous pattern and masked IgG-Kappa deposits (MGMID) is not well understood, especially regarding the nature of its deposits.
- A case study of a 33-year-old woman showed continuous proteinuria and high levels of SSA antibodies, leading to a kidney biopsy that revealed characteristics of MGMID.
- The study provides the first immunohistochemical evidence of Ro52 positivity in kidney tissues, which may contribute to a better understanding of this condition and its association with autoimmune disorders.
Article Synopsis
- * From six reviewed articles, we found that out of 386 pediatric patients, a significant portion (65%) were females and many (50%) also had systemic lupus erythematosus (SLE), with high rates of thrombosis and "extra-criteria manifestations" like hematologic and neurologic involvement.
- * Our registry revealed 17 pediatric cases of APS, with deep vein thrombosis being the most common presentation and a notable prevalence of 2.5 per 100,000 people
Article Synopsis
- Urinary and serological markers are crucial for diagnosing autoimmune diseases, but reliable biomarkers for Behçet's disease (BD) are still missing, complicating patient management.
- A systematic review of 111 studies over 25 years found that most research (99%) focused on serological markers, with very few (2%) exploring urinary biomarkers.
- While studies highlight inflammatory and pro-oxidant changes in BD, a significant gap remains in identifying consistent diagnostic and prognostic markers, indicating the need for continued international research efforts.
Article Synopsis
- * Recent research highlights the importance of interstitial fibrosis and tubular atrophy in lupus nephritis (LN), shifting focus from solely glomerular injury to these markers for assessing kidney damage and treatment outcomes.
- * Understanding the mechanisms of renal fibrosis in LN and the role of the chronicity index could help identify patients at risk for severe kidney disease and improve treatment strategies.