Browsing by Author "Gutierrez, Miguel A."
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- ItemClinical and genetic features of hereditary periodic fever syndromes in Hispanic patients: the Chilean experience(2012) Vergara, Cristian; Borzutzky, Arturo; Gutierrez, Miguel A.; Iacobelli, Sergio; Talesnik, Eduardo; Martinez, Maria E.; Stange, Lilith; Basualdo, Javier; Maluje, Viviana; Jimenez, Renato; Wiener, Roberto; Tinoco, Javier; Jarpa, Elena; Arostegui, Juan I.; Yaguee, Jordi; Alvarez-Lobos, ManuelHereditary periodic fever syndromes (HPFS) are rare genetic diseases characterized by recurrent episodes of inflammation. Little information is available concerning HPFS in Latin American Hispanic population. The purpose of this study was to determine the clinical and genetic features of HPFS in Chilean population. A multicenter retrospective study of Hispanic Chilean patients with genetically confirmed HPFS was performed. We included 13 patients, 8 with familial Mediterranean fever (FMF) and 5 with TNF receptor-associated periodic syndrome (TRAPS), evaluated at rheumatology or pediatric rheumatology clinics between January 2007 and December 2010. Median age of symptoms onset was 8 years (range 1-35) and 8 years (range 0.3-21) for FMF and TRAPS, respectively. Median duration of fever was 3 days (range 2.5-15) for FMF and 21 days (range 9.5-30) for TRAPS. Genotyping of the MEFV gene in FMF patients revealed a homozygous M694V missense mutation in one patient, and heterozygous missense mutations in seven patients: M694V (n = 3), E148Q, R717H, A744S, and A511V. Sequencing of the TNFRSF1A gene in TRAPS patients revealed heterozygous missense mutations in four patients: T50M, C30R, R92Q, and IVS3+30:G -> A, and a two-base pair deletion (IVS2-17_18del2bpCT) in one patient. Mutation in MEFV R717H and mutations in TNFRSF1A IVS2-17_18del2bpCT and IVS3+30:G -> A are novel and have not been described previously. This study reports the largest series of genetically confirmed HPFS in Latin America, and adds evidence regarding the clinical and genetic characteristics of patients with FMF and TRAPS in Hispanic population. Mutations identified in MEFV and TNFRSF1A genes include defects reported in other ethnicities and novel mutations.
- ItemClinical and Serological Features in Latin American IgG4-Related Disease Patients Differ According to Sex, Ethnicity, and Clinical Phenotype(2022) Martin-Nares, Eduardo; Federico Baenas, Diego; Cuellar Gutierrez, Maria Carolina; Hernandez-Molina, Gabriela; Christian Ortiz, Alberto; Neira, Oscar; Gutierrez, Miguel A.; Calvo, Romina; Jose Saad, Emanuel; Elgueta Pinochet, Sergio; Gallo, Jesica; Herrera Moya, Alejandra; Mansilla Aravena, Bellanides Agustina; Crespo Espindola, Maria Elena; Cairoli, Ernesto; Maria Bertoli, Ana; Cordoba, Mercedes; Wurmann Kiblisky, Pamela; Basualdo Arancibia, Washington Javier; Badilla Pineiro, Maria Natalia; Andrea Gobbi, Carla; Ariel Berbotto, Guillermo; Pisoni, Cecilia N.; Juarez, Vicente; Ana Cosatti, Micaela; Aste, Nora Maria; Airoldi, Carla; Llanos, Carolina; Vergara Melian, Cristian Fabian; Erlij Opazo, Daniel; Goecke, Annelise; Pastenes Montano, Paula Andrea; Tate, Patricio; Pablo Pirola, Juan; Stange Nunez, Lilith; Burgos, Paula, I; Mezzano Robinson, Maria Veronica; Michalland, Susana H.; Silva Labra, Francisco; Labarca Solar, Cristian Humberto; Veronica Lencina, Maria; Izquierdo Loaiza, Jorge Hernan; Del Castillo Gil, David Julian; Caeiro, Francisco; Paira, SergioBackground/Objective Data on IgG4-related disease (IgG4-RD) come almost exclusively from cohorts from Asia, Europe, and North America. We conducted this study to describe the clinical presentation, phenotype distribution, and association with sex, ethnicity, and serological markers in a large cohort of Latin American patients with IgG4-RD. Methods We performed a multicenter medical records review study including 184 Latin American IgG4-RD patients. We assigned patients to clinical phenotypes: group 1 (pancreato-hepato-biliary), group 2 (retroperitoneal/aortic), group 3 (head and neck-limited), group 4 (Mikulicz/systemic), and group 5 (undefined). We focused the analysis on how sex, ethnicity, and clinical phenotype may influence the clinical and serological presentation. Results The mean age was 50.8 +/- 15 years. Men and women were equally affected (52.2% vs 48.8%). Fifty-four patients (29.3%) were assigned to group 1, 21 (11.4%) to group 2, 57 (30.9%) to group 3, 32 (17.4%) to group 4, and 20 (10.8%) to group 5. Male sex was associated with biliary tract (odds ratio [OR], 3.4; 95% confidence interval [CI], 1.36-8.26), kidney (OR, 3.4; 95% CI, 1.28-9.25), and retroperitoneal involvement (OR, 5.3; 95% CI, 1.45-20). Amerindian patients presented more frequently with atopy history and gallbladder involvement. Group 3 had a female predominance. Conclusions Latin American patients with IgG4-RD were younger, and men and women were equally affected compared with White and Asian cohorts. They belonged more commonly to group 1 and group 3. Retroperitoneal and aortic involvement was infrequent. Clinical and serological features differed according to sex, ethnicity, and clinical phenotype.
- ItemGender differences among patients with primary ankylosing spondylitis and spondylitis associated with psoriasis and inflammatory bowel disease in an iberoamerican spondyloarthritis cohort(2016) Landi, Margarita; Maldonado-Ficco, Hernan; Perez-Alamino, Rodolfo; Maldonado-Cocco, Jose A.; Citera, Gustavo; Arturi, Pablo; Sampaio-Barros, Percival D.; Alvarado, Diana E. Flores; Burgos-Vargas, Ruben; Santos, Elena; Palleiro, Daniel; Gutierrez, Miguel A.; Vieyra-Sousa, Elsa; Pimentel-Santos, Fernando; Paira, Sergio O.; Berman, Alberto; Barrezueta, Claudia Vera; Vazquez-Mellado, Janitzia; Collantes-Estevez, EduardoThe aim of the study was to compare clinical manifestations, disease activity, functional capacity, spinal mobility, and radiological findings between men and women from a multicenter, multiethnic Ibero-American cohort of patients with Spondyloarthritis (SpA).
- ItemGenetic and pharmacological modulation of dendritic cell-T cell interactions as a therapeutic strategy for systemic lupus erythematosus.(2011) Llanos, Carolina; Carreno, Leandro J.; Gutierrez, Miguel A.; Riedel, Claudia A.; Jacobelli, Sergio H.; Kalergis, Alexis M.Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by an excessive production of auto-antibodies against double-stranded DNA, nucleosomes, ribonucleoproteins and other nuclear components. Accumulation of self-reactive antibodies leads to immune complex deposition in blood vessels, activation of macrophages and complement, inflammation and subsequent tissue damage in several organs, such as the heart, kidneys, lungs and central nervous system. Although significant progress has been made in the past 30 years of research, no effective specific treatments are currently available. The course of this disease remains unpredictable and patients diagnosed with SLE face long-term treatments with the subsequent economic, social and health burden. From the immunological perspective, SLE is a genetic- and environment-controlled disease that involves almost every constituent of the immune system, including both innate and adaptive immunity. Therefore, several immune cell types and molecules could be susceptible for intervention and modulation to develop more effective and specific treatments. More importantly, such therapies are likely not to induce complete immunosuppression and show reduced side effects on patients. In this article we discuss recent work in the field of SLE pathogenesis with a focus on data that provide clues for therapy design and new treatments.
- ItemHaem oxygenase 1 expression is altered in monocytes from patients with systemic lupus erythematosus(WILEY, 2012) Herrada, Andres A.; Llanos, Carolina; Mackern Oberti, Juan P.; Carreno, Leandro J.; Henriquez, Carla; Gomez, Roberto S.; Gutierrez, Miguel A.; Anegon, Ignacio; Jacobelli, Sergio H.; Kalergis, Alexis M.Systemic lupus erythematosus (SLE) is an autoimmune disease characterized by multiple functional alterations affecting immune cells, such as B cells, T cells, dendritic cells (DCs) and monocytes. During SLE, the immunogenicity of monocytes and DCs is significantly up-regulated, promoting the activation of self-reactive T cells. Accordingly, it is important to understand the contribution of these cells to the pathogenesis of SLE and the mechanisms responsible for their altered functionality during disease. One of the key enzymes that control monocyte and DC function is haem oxygenase-1 (HO-1), which catalyses the degradation of the haem group into biliverdin, carbon monoxide and free iron. These products possess immunosuppressive and anti-inflammatory capacities. The main goal of this work was to determine HO-1 expression in monocytes and DCs from patients with SLE and healthy controls. Hence, peripheral blood mononuclear cells were obtained from 43 patients with SLE and 30 healthy controls. CD14+ monocytes and CD4+ T cells were sorted by FACS and HO-1 expression was measured by RT-PCR. In addition, HO-1 protein expression was determined by FACS. HO-1 levels in monocytes were significantly reduced in patients with SLE compared with healthy controls. These results were confirmed by flow cytometry. No differences were observed in other cell types, such as DCs or CD4+ T cells, although decreased MHC-II levels were observed in DCs from patients with SLE. In conclusion, we found a significant decrease in HO-1 expression, specifically in monocytes from patients with SLE, suggesting that an imbalance of monocyte function could be partly the result of a decrease in HO-1 expression.
- ItemInhibition of nuclear factor-κB enhances the capacity of immature dendritic cells to induce antigen-specific tolerance in experimental autoimmune encephalomyelitis(AMER SOC PHARMACOLOGY EXPERIMENTAL THERAPEUTICS, 2006) Iruretagoyena, Mirentxu I.; Sepulveda, Sofia E.; Lezana, J. Pablo; Hermoso, Marcela; Bronfman, Miguel; Gutierrez, Miguel A.; Jacobelli, Sergio H.; Kalergis, Alexis M.Autoimmune disorders develop as a result of deregulated immune responses that target self-antigens and cause destruction of healthy host tissues. Because dendritic cells (DCs) play an important role in the maintenance of peripheral immune tolerance, we are interested in identifying means of enhancing their therapeutic potential in autoimmune diseases. It is thought that during steady state, DCs are able to anergize potentially harmful T cells bearing T cell receptors that recognize self-peptide-major histocompatibility complexes. The tolerogenic capacity of DCs requires an immature phenotype, which is characterized by a reduced expression of costimulatory molecules. On the contrary, activation of antigen-specific naive T cells is enhanced by DC maturation, a process that involves expression of genes controlled by the transcription factor nuclear factor (NF)-kappa B. We evaluated the capacity of drugs that inhibit NF-kappa B to enhance the tolerogenic properties of immature DCs in the experimental autoimmune encephalomyelitis (EAE) model. We show that andrographolide, a bicyclic diterpenoid lactone, and rosiglitazone, a peroxisome proliferator-activated receptor gamma agonist, were able to interfere with NF-kappa B activation in murine DCs. As a result, treated DCs showed impaired maturation and a reduced capacity to activate antigen-specific T cells. Furthermore, NF-kappa B-blocked DCs had an enhanced tolerogenic capacity and were able to prevent EAE development in mice. The tolerogenic feature was specific for myelin antigens and involved the expansion of regulatory T cells. These data suggest that NF-kappa B blockade is a potential pharmacological approach that can be used to enhance the tolerogenic ability of immature DCs to prevent detrimental autoimmune responses.
- ItemModulation of nuclear factor-kappa B activity can influence the susceptibility to systemic lupus erythematosus(WILEY-BLACKWELL PUBLISHING, INC, 2009) Kalergis, Alexis M.; Iruretagoyena, Mirentxu I.; Barrientos, Magaly J.; Gonzalez, Pablo A.; Herrada, Andres A.; Leiva, Eduardo D.; Gutierrez, Miguel A.; Riedel, Claudia A.; Bueno, Susan M.; Jacobelli, Sergio H.P>Autoimmune diseases, such as systemic lupus erythematosus (SLE), result from deficiencies in self-antigen tolerance processes, which require regulated dendritic cell (DC) function. In this study we evaluated the phenotype of DCs during the onset of SLE in a mouse model, in which deletion of the inhibitory receptor Fc gamma RIIb leads to the production of anti-nuclear antibodies and glomerulonephritis. Splenic DCs from Fc gamma RIIb-deficient mice suffering from SLE showed increased expression of co-stimulatory molecules. Furthermore, diseased mice showed an altered function of the nuclear factor-kappa B (NF-kappa B) transcription factor, which is involved in DC maturation. Compared with healthy animals, expression of the inhibitory molecule I kappa B-alpha was significantly decreased in mice suffering from SLE. Consistently, pharmacological inhibition of NF-kappa B activity in Fc gamma RIIb-deficient mice led to reduced susceptibility to SLE and prevented symptoms, such as anti-nuclear antibodies and kidney damage. Our data suggest that the occurrence of SLE is significantly influenced by alterations of NF-kappa B function, which can be considered as a new therapeutic target for this disease.