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Alenius, Gerd-Marie, Docent
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Publications (10 of 29) Show all publications
Lindquist, S., Alenius, G.-M., Berntson, L., Rantapää-Dahlqvist, S., Lundberg, L., Wang, Y. & Hernell, O. (2019). A novel target for treatment of inflammatory joint diseases. Paper presented at Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June 12-15, 2019. Annals of the Rheumatic Diseases, 78, 1525-1526
Open this publication in new window or tab >>A novel target for treatment of inflammatory joint diseases
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2019 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 78, p. 1525-1526Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

Background: The bile salt-stimulated lipase (BSSL) is a hitherto unrecognized player in inflammation. Animals devoid of BSSL (knockout mice) are protected from developing collagen induced arthritis (CIA) and collagen antibody induced arthritis (CAIA), and antibodies directed towards BSSL has been proven to prevent or mitigate arthritis in mouse and rat arthritis models1. In humans, BSSL is present in blood2 and accumulate at sites of inflammation. Patients with acute pancreatitis have significantly increased plasma BSSL levels compared to healthy controls. Whether BSSL in blood originates from pancreas, inflammatory cells, or both remains to be elucidated.

Objectives: To determine BSSL concentration in blood samples from patients with inflammatory joint disorders and to evaluate possible relationships between circulating BSSL levels and disease-activity variables.

Methods: BSSL concentrations in plasma or serum were determined in patients with rheumatoid arthritis (RA), psoriasis arthritis (PsA), and juvenile idiopathic arthritis (JIA) by a sandwich enzyme-linked immunosorbent assay (ELISA). Correlations between BSSL concentrations and disease activity score, erythrocyte sedimentation rate (ESR), blood levels of C-reactive protein (CRP), S100A8/9, leukocyte- and neutrophil counts, proinflammatory cytokines and chemokines were analyzed using Spearman rank-order correlation.

Results: Significant correlations between BSSL concentration in plasma and disease activity score (DAS28, rS=0.31, p=0.007), ESR (rS=0.58, p<0.000), CRP (rS=0.42, p=0.012), leukocytes (rS=0.66, p<0.000), and neutrophils (rS=0.71, p<0.000) were found in RA. The BSSL plasma concentration decreased with duration of treatment with the TNFα inhibitor infliximab, in parallel with decreasing DAS28 score.

BSSL concentration was significantly higher in sera from PsA patients with both oligo- and polyarthritis compared with healthy controls. Moreover, BSSL concentration in serum correlated significantly with S100A8/A9 and CRP concentrations (rS=0.54, p<0.001 and rS=0.49, p<0.001, respectively). No correlation between levels of BSSL and cytokines or chemokines were found in RA or PsA plasma or serum, respectively.

In JIA, levels of BSSL in serum correlated significantly with JIA disease activity score (JADAS27) (rS=0.26, p=0.007), ESR (rS=0.47, p<0.000), and leukocytes (rS=0.32, p<0.000).

Conclusion: BSSL concentration in serum and plasma correlated with disease activity in patients with inflammatory joint disorders, i.e. RA, PsA and JIA. These data in humans support the relevance of our previous studies in rodents and therefore also our hypothesis 1 that BSSL is a novel target for treatment of inflammatory diseases.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-161720 (URN)10.1136/annrheumdis-2019-eular.2165 (DOI)000472207104460 ()
Conference
Annual European Congress of Rheumatology (EULAR), Madrid, Spain, June 12-15, 2019
Available from: 2019-07-26 Created: 2019-07-26 Last updated: 2019-07-26Bibliographically approved
Lindqvist, U., Wernroth, M.-L. -., Husmark, T., Larsson, P., Geijer, M., Teleman, A., . . . Alenius, G.-M. (2017). DAPSA, DAS28 and MDA predict long-term treatment regime in psoriatic arthritis: the Swedish Early Psoriatic Arthritis Cohort. Clinical and Experimental Rheumatology, 35(6), 936-942
Open this publication in new window or tab >>DAPSA, DAS28 and MDA predict long-term treatment regime in psoriatic arthritis: the Swedish Early Psoriatic Arthritis Cohort
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2017 (English)In: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 35, no 6, p. 936-942Article in journal (Refereed) Published
Abstract [en]

Objective: To describe treatment patterns in the Swedish early psoriatic arthritis cohort (SwePsA) of the mono-/oligo-arthritic (M/O) and polyarthritis (P) and identify early predictive factors for treatment with disease-modifying anti-rheumatic (DMARD), non-steroidal anti-inflammatory drugs (NSAID), and tumour necrosis factor inhibition (TNFi) after 5 years. Methods: Data for 198 M/O and P PsA were obtained within the programme for SwePsA. Multinomial and binary logistic regression analyses were used to assess the association between early predictive factors and treatment after 5 years adjusted for age at inclusion. The analysis of DMARD/NSAID was adjusted for medication at inclusion. Results: After inclusion visit, DMARD was prescribed in 30% of M/O and 56% of P PsA; mainly methotrexate. TNFi was not prescribed at inclusion, but 23 patients were treated at 5-year follow-up. The adjusted OR (95% CI) for treatment with both DMARD and NSAID after 5 years was 3.65 (1.34 - 9.89) (p=0.010) for Disease Activity Score 28 (DAS28) >3.2 and 2.90 (1.20-6.99) (p=0.038) for Disease Activity Index in Psoriatic Arthritis (DAPSA) >14 at inclusion. TNFi treatment was, after adjusting for age, associated with high erythrocyte sedimentation rate (p=0.0043), high C-reactive protein (p=0.013), DAPSA (p<0.001), not reaching minimal disease activity (p=0.001) high health assessment questionnaire (p=0.001), patient's overall assessment on the visual analogue scale (VAS) (p=0.009), high pain VAS (p=0.007), and high number of tender and swollen joints (p=0.031) at inclusion. Conclusion: Disease activity in early M/O and P PsA is to be considered in deciding the level of health care assessment and future pharmacological treatment. DAS28 >3.2 and DAPSA>14 early in the disease predict subsequent treatment with DMARD. For prediction of biological treatment, not reaching MDA at onset of disease, would be the composite index of choice.

Place, publisher, year, edition, pages
Clinical and Experimental Rheumatology, 2017
Keywords
DMARD, NSAID, TNF-inhibition, minimal disease activity, remission
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-143659 (URN)000418418300008 ()28628468 (PubMedID)
Available from: 2018-01-08 Created: 2018-01-08 Last updated: 2018-06-09Bibliographically approved
Hofstedt, O. E., Di Giuseppe, D., Alenius, G.-M., Stattin, N., Forsblad-d'Elia, H. & Ljung, L. (2017). Validation of internet-based reporting of patient reported outcomes within the swedish rheumatology quality register. Paper presented at Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN. Annals of the Rheumatic Diseases, 76, 444-445
Open this publication in new window or tab >>Validation of internet-based reporting of patient reported outcomes within the swedish rheumatology quality register
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2017 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, p. 444-445Article in journal, Meeting abstract (Other academic) Published
Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2017
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-142288 (URN)10.1136/annrheumdis-2017-eular.2590 (DOI)000413181401314 ()
Conference
Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN
Available from: 2017-11-29 Created: 2017-11-29 Last updated: 2018-06-09Bibliographically approved
Juneblad, K., Alenius, G.-M. & Rantapaa-Dahlqvist, S. (2016). Disease activity and increased risk of cardiovascular death among patients with psoriatic arthritis. Scandinavian Journal of Rheumatology, 45(Suppl. 128), 29-29, Article ID PP33.
Open this publication in new window or tab >>Disease activity and increased risk of cardiovascular death among patients with psoriatic arthritis
2016 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 45, no Suppl. 128, p. 29-29, article id PP33Article in journal, Meeting abstract (Refereed) Published
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-126550 (URN)000382578900050 ()
Available from: 2016-10-10 Created: 2016-10-10 Last updated: 2018-06-09Bibliographically approved
Juneblad, K., Rantapää-Dahlqvist, S. & Alenius, G.-M. (2016). Disease activity and increased risk of cardiovascular death among patients with psoriatic arthritis. Journal of Rheumatology, 43(12), 2155-2161
Open this publication in new window or tab >>Disease activity and increased risk of cardiovascular death among patients with psoriatic arthritis
2016 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 43, no 12, p. 2155-2161Article in journal (Refereed) Published
Abstract [en]

Objective: Recent studies indicate increased cardiovascular (CV) morbidity and mortality in patients with psoriatic arthritis (PsA), but results are inconsistent. This prompted our investigation of the mortality rate, cause of death, and incidence of acute CV events in patients from northern Sweden with PsA.

Methods: Patients with established PsA (464) were included. To calculate standardized mortality ratio (SMR) and standardized incidence ratio (SIR) for CV events, data were extracted from the National Causes of Death Register and the National Inpatient Care Register in Sweden, and compared with the general population. The study period was 1995-2011. To study the effect of inflammatory activity, a composite disease activity index (DAI) was used.

Results: The SMR (95% CI) for overall mortality and diseases of the circulatory system (International Classification of Diseases, 10th edition; I00-I99) was 1.22 (0.89-1.63) and 1.64 (1.02-2.52), respectively. In regression analysis, DAI was significantly associated with death (OR 1.99, 95% CI 1.41-2.80) when adjusted for age and sex (p < 0.001), and remained significant after stratifying patients into the 2 major causes of death: diseases of the circulatory system and malignant neoplasms. Peripheral and axial disease was associated with death (OR 4.02, 95% CI 1.84-8.84, p < 0.001) compared with peripheral disease only. The SIR (95% CI) for a CV event (myocardial infarction or stroke) was 0.597 (0.40-0.86); this association was only significant in men.

Conclusion: Patients with PsA had a small but significant increase in SMR for death due to diseases of the circulatory system compared with the general population. Among patients, death was associated with DAI, as well as axial involvement in combination with peripheral disease, indicating more aggressive disease phenotypes.

Keywords
cardiovascular diseases, disease activity, epidemiology, mortality, psoriatic arthritis
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-150942 (URN)10.3899/jrheum.160070 (DOI)000390237400012 ()27909142 (PubMedID)2-s2.0-85002909173 (Scopus ID)
Available from: 2018-08-20 Created: 2018-08-20 Last updated: 2018-08-22Bibliographically approved
Bowes, J., Loehr, S., Budu-Aggrey, A., Uebe, S., Bruce, I. N., Feletar, M., . . . Barton, A. (2015). PTPN22 is associated with susceptibility to psoriatic arthritis but not psoriasis: evidence for a further PsA-specific risk locus. Annals of the Rheumatic Diseases, 74(10), 1882-1885
Open this publication in new window or tab >>PTPN22 is associated with susceptibility to psoriatic arthritis but not psoriasis: evidence for a further PsA-specific risk locus
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2015 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 74, no 10, p. 1882-1885Article in journal (Refereed) Published
Abstract [en]

Objectives Psoriatic arthritis (PsA) is a chronic inflammatory arthritis associated with psoriasis; it has a higher estimated genetic component than psoriasis alone, however most genetic susceptibility loci identified for PsA to date are also shared with psoriasis. Here we attempt to validate novel single nucleotide polymorphisms selected from our recent PsA Immunochip study and determine specificity to PsA. Methods A total of 15 single nucleotide polymorphisms were selected (P-Immunochip <1x10(-4)) for validation genotyping in 1177 cases and 2155 controls using TaqMan. Meta-analysis of Immunochip and validation data sets consisted of 3139 PsA cases and 11 078 controls. Novel PsA susceptibility loci were compared with data from two large psoriasis studies (WTCCC2 and Immunochip) to determine PsA specificity. Results We found genome-wide significant association to rs2476601, mapping to PTPN22 (p=1.49x10(-9), OR=1.32), but no evidence for association in the psoriasis cohort (p=0.34) and the effect estimates were significantly different between PsA and psoriasis (p=3.2x10(-4)). Additionally, we found genome-wide significant association to the previously reported psoriasis risk loci; NOS2 (rs4795067, p=5.27x10(-9)). Conclusions For the first time, we report genome-wide significant association of PTPN22 (rs2476601) to PsA susceptibility, but no evidence for association to psoriasis.

Keywords
Rheumatic Diseases
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-109790 (URN)10.1136/annrheumdis-2014-207187 (DOI)000361043200018 ()25923216 (PubMedID)
Available from: 2015-10-08 Created: 2015-10-06 Last updated: 2018-06-07Bibliographically approved
Geijer, M., Lindqvist, U., Husmark, T., Alenius, G.-M., Larsson, P. T., Teleman, A. & Theander, E. (2015). The Swedish Early Psoriatic Arthritis Registry 5-year Followup: Substantial Radiographic Progression Mainly in Men with High Disease Activity and Development of Dactylitis. Journal of Rheumatology, 42(11), 2110-2117
Open this publication in new window or tab >>The Swedish Early Psoriatic Arthritis Registry 5-year Followup: Substantial Radiographic Progression Mainly in Men with High Disease Activity and Development of Dactylitis
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2015 (English)In: Journal of Rheumatology, ISSN 0315-162X, E-ISSN 1499-2752, Vol. 42, no 11, p. 2110-2117Article in journal (Refereed) Published
Abstract [en]

Objective: To describe early radiographic findings in patients from the Swedish psoriatic arthritis (SwePsA) registry, progression of destruction, correlations with clinical disease variables, and predictors of destruction.

Methods: Hand and foot radiographs were available for 72 of 197 SwePsA patients followed for 5 years. Clinical data were collected according to the SwePsA protocol.

Results: Disease characteristics and clinical improvement were similar in men and women. Radiographic abnormalities were more pronounced in men. Total Wassenberg radiographic score at baseline was 0 in 45% of men and 51% of women. One man and one woman had a score > 10. At 5 years, total score was 0 in 14% of men and 40% of women (p = 0.018); 17% of men and 7% of women had scores > 10. Mean total scores for men and women had increased. Baseline erythrocyte sedimentation rate was associated with baseline total radiographic score. In men, swollen joint count was positively, and in women tender joint count negatively, correlated to total radiographic score. After 5 years, only male scores, mainly hand scores, significantly correlated with 28-joint Disease Activity Score and Disease Activity Index for Psoriatic Arthritis scores, swollen joint count, and dactylitis. Achieving remission or minimal disease activity after 5 years protected against structural damage, mainly in men.

Conclusion: Radiographic progression in early PsA was generally slow but substantial. Male sex appears to be a risk factor for early radiographic damage while the presence of baseline radiographic damage and dactylitis developing during followup seem to predict further destruction. Hand and foot radiograph scoring cannot be substituted with clinical signs.

Keywords
psoriatic arthritis, radiography, destruction, joint erosions, outcome, disease activity
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-113450 (URN)10.3899/jrheum.150165 (DOI)000365221400017 ()26472410 (PubMedID)
Available from: 2015-12-18 Created: 2015-12-18 Last updated: 2018-06-07Bibliographically approved
Lindqvist, U., Theander, E., Husmark, T., Larsson, P., Teleman, A., Alenius, G.-M. & Geijer, M. (2015). The Swedish Early Psoriatic Arthritis (SWEPSA) registry 5-year follow-up: Slow radiographic progression with highest scores in male feet and patients with baseline x-ray abnormalities. Paper presented at 4th World Psoriasis and Psoriatic Arthritis Conference on Psoriasis - New Insights and Innovations, Stockholm, Sweden, October, 2015. Journal of Investigative Dermatology, 135(Suppl. 3), S1-S1
Open this publication in new window or tab >>The Swedish Early Psoriatic Arthritis (SWEPSA) registry 5-year follow-up: Slow radiographic progression with highest scores in male feet and patients with baseline x-ray abnormalities
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2015 (English)In: Journal of Investigative Dermatology, ISSN 0022-202X, E-ISSN 1523-1747, Vol. 135, no Suppl. 3, p. S1-S1Article in journal, Meeting abstract (Other academic) Published
Abstract [en]

The aim is to describe early X-ray findings in psoriatic arthritis (PsA) from the SwePsA registry using the Wassenberg score, evaluate progression of structural damage, analyze correlations to clinical disease parameters and identify predictors of progressive radiographic joint disease.

Place, publisher, year, edition, pages
New York: Nature Publishing Group, 2015
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-109793 (URN)000361160500002 ()
Conference
4th World Psoriasis and Psoriatic Arthritis Conference on Psoriasis - New Insights and Innovations, Stockholm, Sweden, October, 2015
Note

Meeting Abstract: P001

Available from: 2015-10-08 Created: 2015-10-06 Last updated: 2018-06-07Bibliographically approved
Theander, E., Husmark, T., Alenius, G.-M., Larsson, P. T., Teleman, A., Geijer, M. & Lindqvist, U. R. (2014). Early psoriatic arthritis: short symptom duration, male gender and preserved physical functioning at presentation predict favourable outcome at 5-year follow-up. Results from the Swedish Early Psoriatic Arthritis Register (SwePsA). Annals of the Rheumatic Diseases, 73(2), 407-413
Open this publication in new window or tab >>Early psoriatic arthritis: short symptom duration, male gender and preserved physical functioning at presentation predict favourable outcome at 5-year follow-up. Results from the Swedish Early Psoriatic Arthritis Register (SwePsA)
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2014 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 73, no 2, p. 407-413Article in journal (Refereed) Published
Abstract [en]

Objective The Swedish Early Psoriatic Arthritis Register describes the course of early psoriatic arthritis (PsA) in a real life clinical setting in Sweden. The aim of this study was to obtain information on predictors of clinical outcomes over a 5-year period with special focus on effects of gender, joint patterns, diagnostic delay and initial disease activity.

Methods In six centres, patients with signs suggestive of PsA were included in the Swedish Early Psoriatic Arthritis Register within 2 years of symptom onset. CASPAR (classification for psoriatic arthritis) criteria were fulfilled by 197 patients who had passed the 5-year follow-up. Disease activity was measured by the Disease Activity Score including 28 joints (DAS28) and the Disease Activity Index for Psoriatic Arthritis (DAPSA). Remission and minimal disease activity (MDA) were used as outcome measures.

Results Mean age at inclusion was 46 years, younger in male than female patients (43 vs 48 years). Mean DAS28 was 3.7 and 3.0 at inclusion and 2.8 and 2.1 at follow-up for women and men, respectively-significantly higher in women at both visits. Likewise, DAPSA scores were significantly higher in women. The degree of improvement (change in DAS28 and DAPSA) was similar. Men achieved MDA or remission (50% vs 33%, 25% vs 13%, respectively) more often, and women had significantly more polyarthritis at inclusion (49% vs 27%) and after 5 years (25% vs 15%). Axial or mono/oligoarticular disease was predominant in men. Independent predictors of MDA at the 5-year follow-up were: shorter symptom duration; greater general wellbeing (global visual analogue scale); and low Health Assessment Questionnaire at inclusion.

Conclusions In early PsA, short delay between onset of symptoms and diagnosis, preserved function, and male gender are the most important predictors of favourable clinical outcome at the 5-year follow-up. Early recognition of PsA and active treatment may be important, particularly in women with polyarticular disease.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-85695 (URN)10.1136/annrheumdis-2012-201972 (DOI)000329488000017 ()
Available from: 2014-02-20 Created: 2014-02-10 Last updated: 2018-06-08Bibliographically approved
Juneblad, K. & Alenius, G.-M. (2014). Mortality and cardiovascular comorbidity in psoriatic arthritis. Clinical and Experimental Rheumatology, 32(5), 796-796
Open this publication in new window or tab >>Mortality and cardiovascular comorbidity in psoriatic arthritis
2014 (English)In: Clinical and Experimental Rheumatology, ISSN 0392-856X, E-ISSN 1593-098X, Vol. 32, no 5, p. 796-796Article in journal, Meeting abstract (Other academic) Published
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:umu:diva-96517 (URN)000343633200121 ()
Available from: 2014-12-01 Created: 2014-11-21 Last updated: 2018-06-07Bibliographically approved
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