Episodit
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In the final part of this series, Joseph Parambil, MD, walks us through the approach of managing pulmonary hypertension, reviews the pathophysiology and digs into the mechanisms and the differences in the medications.
Intro 0:12 In this episode 0:17 Interview with Joseph Parambil, MD 2:53 Reviewing and clarifying pathophysiology prior to initiating therapeutics 4:13 Evaluating patients in terms of their functional status and how does that play a role in initiating therapies 4:25 Vasoreactivity testing 10:21 The categories of medications 14:40 Endothelin receptor antagonists 37:07 TGF pathway 42:13 Scleroderma patient and treatment 50:19 Do patients get a repeat right-heart catheterization? 55:51 What about the TGF-beta? 56:55 Thank you, Dr. Parambil 58:34 Thanks for listening 59:17We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
Disclosures: Brown and Parambil report no relevant financial disclosures.
Joseph Parambil, MD, is a staff member in the Respiratory Institute and the director of the HHT Center of Excellence and the Vascular Anomalies Center at the Cleveland Clinic. He is associate professor of medicine at Cleveland Clinic’s Lerner College of Medicine. He is certified by the American Board of Internal Medicine with additional specialty certification in pulmonary medicine and critical care medicine.
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In this episode, we dive into the early therapies and how our understanding of vascular physiology drastically changed the management of pulmonary hypertension.
Intro 0:12 In this episode 0:18 Recap of part 1 & 2 0:31 What part 3 is about 2:31 WHO conference in 1975: Treating pulmonary hypertension 3:48 The Discovery of Non-Steroidal Anti-inflammatory Drugs (NSAIDs), Part 1 5:20 Epoprostenol 6:18 Prostacyclin 10:37 Endothelin antagonists 11:41 Phosphodiesterase type 5 (PDE5) inhibitors 14:08 Interaction of nerves and blood vessels 15:06 The Soups VS the Sparks 17:36 A dreamed experiment 19:06 Acetylcholine 23:23 Enter “the calabar bean” 24:45 Acetylcholine and vasodilation: 1976 26:01 Rabbit aorta 27:45 Nitric oxide 29:38 Why are we using nitric oxide to treat pulmonary hypertension? 31:31 Tachyphylaxis 33:48 TNT factories 35:09 Nitrous oxide and tachyphylaxis 36:52 Pfizer in the 1980s 38:06 Understanding the trigger of pulmonary hypertension 40:53 PDE5 and nitric oxide and pulmonary hypertension 43:07 The end of the ripping yarns 44:20 Coming up in part 4 46:17 Thanks for listening 47:29We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Bernard C. C R Soc Biol. 1851;3:163-164.
Furchgott RF, et al. Nature. 1980;doi:10.1038/288373a0.
Galiè N, et al. N Engl J Med. 2005;doi:10.1056/NEJMoa050010.
Ghofrani HA, et al. Nat Rev Drug Discov. 2006;doi:10.1038/nrd2030.
Giordano D, et al. Biochim Biophys Acta. 2001;doi:10.1016/s0167-4889(01)00086-6.
Guthrie F. Q J Chem Soc. 1859;doi:10.1039/QJ8591100245.
Higenbottam T, et al. Lancet. 1984;doi:10.1016/s0140-6736(84)91452-1.
Marsh N, et al. Clin Exp Pharmacol Physiol. 2000;doi:10.1046/j.1440-1681.2000.03240.x.
Montastruc JL, et al. Clin Auton Res. 1996;doi:10.1007/BF02281906.
Nejad SH, et al. Future Cardiol. 2024;doi:10.1080/14796678.2024.2367390.
Tansey EM. C R Biol. 2006;doi:10.10116/j.crvi.2006.03.012.
Warren JV. Trans Am Clin Climatol Assoc. 1988;99:10-6.Disclosures: Brown reports no relevant financial disclosures.
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Puuttuva jakso?
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In part 2, we dig into the history of pulmonary hypertension. How did this strange diagnosis first get recognized, what does it have to do with cows with thick necks and urinary catheters in the heart?
Intro 0:11 In this episode 0:17 Recap of part 1 0:26 How was pulmonary hypertension discovered? 2:38 1891 3:51 1901 5:07 1935 7:02 Hilar dance 12:58 Cardiac catheterization: 1929 15:03 When did cardiac catheterization become relevant? 20:10 1965: Aminorex 24:40 World Health Organization: 1975 26:37 1980s: toxic oil syndrome of Spain 28:20 Preview of part 3 33:15 Back to cardiac catheterization 34:08 Briskets disease 35:45 1947 37:56 Pulmonary physiology and prostaglandin therapies (in the next episode) 38:41 Schistosomiasis outbreaks in Egypt 1938 40:26 Chronic thromboembolism 45:03 Thanks for listening 48:16We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Barst RJ. Ann Thorac Med. 2008;doi:10.4103/1817-1737.37832.
Bodo R. J Physiol. 1928;doi:10.1113/jphysiol.1928.sp002447.
Dresdale DT, et al. Am J Med. 1951;doi:10.1016/0002-9343(51)90020-4.
Egypt. Stanford.edu. Published 2015. https://schisto.stanford.edu/pdf/Egypt.pdf.
Hewes JL, et al. Pulm Circ. 2020;doi:10.1177/2045894019892801.
Johnson S, et al. Am J Respir Crit Care Med. 2023;doi:10.1164/rccm.202302-0327SO.
Newman JH. Am J Respir Crit Care Med. 2005;doi:10.1164/rccm.200505-684OE.
Weir EK, et al. Circulation. 1996;doi:10.1161/01.cir.94.9.2216.
Disclosures: Brown reports no relevant financial disclosures.
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In this series, we dive into what rheumatologists should know about pulmonary hypertension, starting an interview with Joseph Parambil, MD, where we learn about the disease, when to suspect and how to work up!
Intro 0:11 In this episode 0:16 Preview of the four-part series 4:46 Interview with Joseph Parambil, MD 6:27 How did you become interested in pulmonary hypertension? 7:02 Brown and Parambil discuss the histology of pulmonary hypertension. 10:13 Brown and Parambil discuss a case of pulmonary hypertension. 12:26 What is pulmonary hypertension and what does that mean for a rheumatologist? Where is pulmonary hypertension happening? 13:25 Describe the different groups of pulmonary hypertension. 19:51 A note about Dr. Chatterjee 20:25 Brown and Parambil discuss the groups of pulmonary hypertension. 23:35 What should we know about evaluating patients with pulmonary hypertensions? 26:51 Brown and Parambil discuss bendopnea and other signs of pulmonary hypertension. 29:58 What about the heart sound? 33:06 What should we look for in patients who we suspect to have pulmonary hypertension? 36:52 What should we look for in the tricuspid jet? 38:18 Brown and Parambil discuss the use of echocardiograms in pulmonary hypertension. 39:28 Tell us about the threshold of diagnosis. 40:47 What is the difference between the mean pressure and the wedge pressure? 41:41 What about the role of the pulmonary function test? 43:55 Summary 46:41 Do you think the pulmonary hypertension in scleroderma and lupus are different entities? 48:37 Brown and Parambil discuss the connection of autoimmune disease and pulmonary hypertension. 50:49 Coming up in episode 91 51:50 Thanks for listening 52:25Disclosures: Brown and Parambil report no relevant financial disclosures.
Joseph Parambil, MD, is a staff member in the Respiratory Institute and the director of the HHT Center of Excellence and the Vascular Anomalies Center at the Cleveland Clinic. He is associate professor of medicine at Cleveland Clinic’s Lerner College of Medicine. He is certified by the American Board of Internal Medicine with additional specialty certification in pulmonary medicine and critical care medicine.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
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On this episode, hear the 2024 updates on COVID-19, long COVID and the latest developments in research in rheumatology. Hosted by Dr. Leonard Calabrese.
Intro 0:12 In this episode 0:21 Coming up on Healio Rheuminations 0:56 COVID-19, long COVID and the rheumatologist with Leonard Calabrese, DO 2:19 Questions 3:12 Long COVID 4:46 Calabrese’s bias 10:15 The evidence 13:08 Auto antibodies 14:54 Why does the body develop auto antibodies? 17:47 COVID-19 and epidemiologic association 22:25 New clinical entity 26:40 Therapeutic implications 31:00 In conclusion 32:00 Thanks for listening 33:18Leonard H. Calabrese, DO, is the chief medical editor, Healio Rheumatology, and professor of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer chair of clinical immunology at the Cleveland Clinic.
Disclosures: Calabrese reports professional relationships with AbbVie, AstraZeneca, Bristol Myers Squibb, Galvani, Genentech, GlaxoSmithKline, Janssen, Novartis, Regeneron, Sanofi and UCB.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
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It's that time of year again, everyone rolling up their sleeves to get a flu shot. This throwback episode dives into the history of the struggles pinning down the causative agent of flu and the journey to the vaccine!
Intro 0:40 In this episode 1:11 The history of the flu: 1892 1:41 What do we know about viruses? 6:29 Rabies and dead virus 11:17 A Sickness in the Serum, Part 2 14:43 1918 16:44 Vaccines and trials 19:13 Pig influenza 23:12 Influenza: a filterable agent we can’t see 27:01 The trials of 1942 33:02 PS: 1918 influenza 38:57 Thanks for listening 47:42Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Hicks DJ, et al. Clin Exp Immunol. 2012;doi:10.1111/j.1365-2249.2012.04592.x.
Rosenau MJ. Experiments Upon Volunteers to Determine the Cause and Mode of Spread of Influenza, Boston, November and December, 1918. https://quod.lib.umich.edu/f/flu/3750flu.0016.573. Published February 1921. Accessed December 6, 2023.
Rosenau MJ, et al. JAMA. 1925;doi:10.1001/jama.1925.02670070040019.
Taubenberger JK, et al. Antivir Ther. 2007;12(4 Pt B):581-91.
Tobin J. The first flu shot. https://heritage.umich.edu/stories/the-first-flu-shot/. Accessed December 6, 2023.
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In the third episode of the NSAIDs saga, we focus on COX-2 inhibition! Did the hopes and dreams of selective COX-2 inhibition pan out? What can the rise and fall of VIOXX teach us about physiology?
Intro 0:11 Recap of part 1 & 2 0:28 In this episode 1:44 Cyclooxygenase 2 (COX-2) and the rat experiment 3:12 What do we know about the prostaglandins? And what about COX-2 7:54 What does prostacyclin do? 10:33 The first COX-2 inhibitor: VIOXX 10:56 What is COX-2 doing?: Pfizer and Merck 12:15 Two more NSAID studies: colon cancer, Alzheimer’s disease and COX-2 inhibitors 18:41 VIOXX: Why is myocardial infarction risk occurring? 22:34 Animal models and the Goldilocks theory of thromboxane and prostacyclin 23:49 PRECISION trial 30:25 Rheum + Boards 37:14 Thanks for listening 37:32We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Anderson GD, et al. J Clin Invest. 1996;doi:10.1172/JCI118717.
Funk CD, et al. J Cardiovasc Pharmacol. 2007;doi:10.1097/FJC.0b013e318157f72d.
Hennan JK, et al. Circulation. 2001;doi:10.1161/hc3301.092790.
Krumholz HM, et al. BMJ. 2007;doi:10.1136/bmj.39024.487720.68.
Nissen SE, et al. N Engl J Med. 2016;doi:10.1056/NEJMoa1611593.
Disclosures: Brown reports no relevant financial disclosures.
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In this episode, we dive into the story of aspirin and the development of ibuprofen, ending with the experiments that showed the mechanism of how aspirin actually works.
Intro 0:12 Review of part 1 0:28 In this episode 1:04 Blocking prostaglandins and willow leaves 2:26 Edward Stone 3:45 Johann Andreas Buchner 4:16 The chemical structure of salicylic acid and creating the synthetic compound 4:44 Dr. TJ MacLagan: The first trial in 1876 and treating acute rheumatism 5:16 Felix Hoffmann: manipulating salicylic acid and aspirin 8:47 How widespread was the use of aspirin for rheumatoid arthritis? 12:04 1938: problems with aspirin and endoscopies 14:58 1950s: long-term use of aspirin and chronic renal impairment 17:12 Dr. Lawrence Craven: the use of aspirin to treat myocardial infarction 18:13 Overview of what we’ve learned so far 20:48 Stewart Adams: the development of ibuprofen 21:40 A paper lost to time 23:29 How do you test if a drug is anti-inflammatory? 25:25 How do you make better aspirin? 26:55 1960: a trial comparing ibuprofen, baby aspirin and prednisone in patients with rheumatoid arthritis 30:03 Aspirin, ibuprofen and other NSAIDs 32:49 Nobel Prize winner Dr. John Vane 33:40 Dr. Vane: what triggered prostaglandin production? 35:42 Another guinea pig experiment 37:37 Nobel Prize winner Dr. Bengt Samuelsson 39:00 Interesting tidbits: early studies looking at the side effects of NSAIDs 40:01 1968: gastric ulcer formation and prostaglandins in rats 40:25 1973: renal blood flow and prostaglandins in dogs 41:53 1974: aspirin vs ibuprofen vs indomethacin for the heart 44:03 Aspirin vs ibuprofen vs indomethacin 44:20 On the next episode 46:09 Thanks for listening 46:37We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Adams SS. Inflammopharmacology. 1999;doi:10.1007/s10787-999-0002-3.
https://www.aspirin-foundation.com/history/the-aspirin-story/.
Buchanan WW, et al. J Rheumatol. 2002;29(6):1321-3.
Cryer B, et al. Gastroenterology. 1999;doi:10.1016/s0016-5085(99)70545-7.
Desborough MJR, et al. Br J Haematol. 2017;doi:10.1111/bjh.14520.
Halford GM, et al. Platelets. 2012;doi:10.3109/09537104.2011.632032.
Harris SC, Fosdick LS. Theoretical considerations of the mechanisms of antipyretic analgesia. NWU Bull. 1952;53: 6–9.
Jasani MK, et al. Ann Rheum Dis. 1968;doi:10.1136/ard.27.5.457.
Robert A, et al. Gastroenterology. 1968;55(4):481-7.
Disclosures: Brown reports no relevant financial disclosures.
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Humans have had an insatiable appetite for inhibiting production of prostaglandins for centuries! This series delves into the history of aspirin and NSAIDs, looking at the understanding of the prostaglandin pathway.
· Intro 0:12
· In this episode 0:23
· What are NSAIDs? 0:53
· Prostaglandins 5:50
· What are prostaglandins? 7:19
· Where do prostaglandins come from? 8:45
· So, what do we do with prostaglandins? 13:15
· How did they figure out prostaglandins? 13:55
· Naming the prostaglandin 21:25
· Phospholipids 24:46
· Arachidonic acid 25:28
· Arachidonic acid into prostaglandins: how do you prove it? 26:32
· How does arachidonic acid turn into prostaglandins? 27:27
· Cyclo-oxygenase 28:36
· mRNA and COX-2 32:50
· On the next episode 35:55
· Summary 36:38
· Thanks for listening 37:49
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Botting RM. Pharmacol Rep. 2010;doi:10.1016/s1734-1140(10)70308-x.
Flower RJ. Br J Pharmacol. 2006;doi:10.1038/sj.bjp.0706506.
Flower RJ. Br J Pharmacol. 2019;doi:10.1111/bph.14588.
Kurzrok R, et al. Exp Biol Med. 1930;doi:10.3181/00379727-28-5265.
https://www.nobelprize.org/prizes/medicine/1970/euler/biographical/.
von Euler US. J Physiol. 1936;doi:10.1113/jphysiol.1936.sp003433.
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This episode digs into the pathophysiology of urticaria vasculitis from anti-C1q to the story of bradykinin.
· Intro 0:11
· In this episode 0:22
· Review of episode 83 1:23
· Listen to previous episode, The Complement System for Dunces 4:09
· Anti-C1q antibodies 6:26
· Lupus, anti-C1q and lupus nephritis 9:33
· What happens when you inject anti-C1q in a mouse? 12:56
· The allergy component: anti-C1q, urticaria and angioedema 17:36
· Bradykinin-mediated angioedema and C1q deficiency 24:20
· What is the kinin kallikrein system? 26:21
· French researchers in 1909: human urine injected in dogs 27:30
· How is this relevant to urticarial vasculitis? 31:08
· SERPING1 gene mutation 31:23
· Summary 32:06
· COPD association with urticarial vasculitis 33:51
· Coming up in episode 85 35:28
· Thanks for listening 35:45
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Busse P, et al. J Allergy Clin Immunol Pract. 2022;doi:10.1016/j.jaip.2021.11.011.
Davis MDP, et al. J Allergy Clin Immunol Pract. 2018;doi:10.1016/j.jaip.2018.05.006.
Dorn JM, et al. Ann Allergy Asthma Immunol. 2023;doi:10.1016/j.anai.2023.06.014.
Marzano AV, et al. J Allergy Clin Immunol. 2022;doi:10.1016/j.jaci.2022.02.007.
Siegert CE, et al. Clin Immunol Immunopathol. 1993;doi:10.1006/clin.1993.1066.
Stojan G, et al. Lupus. 2016;doi:10.1177/0961203316645205.
Venzor J, et al. Clin Rev Allergy Immunol. 2002;doi:10.1385/CRIAI:23:2:201.
Wisnieski JJ, et al. Medicine. 1995;doi:10.1097/00005792-199501000-00003.
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Is it an allergy or an autoimmune vasculitis, or a little of both? Find out the story of urticarial vasculitis, how this disease was recognized and eventually sorted out from other types of urticaria.
· Intro 0:12
· In this episode 0:21
· Case study 1:22
· Chronic spontaneous urticaria, hives and nettles 7:57
· Dermatographism and witchcraft? 10:15
· Causes of urticaria 11:17
· Theory of inflammation and histamines 11:40
· Urticaria and treatments with histamines 12:09
· Types of urticaria 13:02
· Mayo Clinic study 13:39
· Chronic urticaria as a manifestation of necrotizing venulitis 16:10
· Connection between types of urticaria and leukocytoclastic vasculitis 20:02
· More case studies 20:38
· What do we know about treatments? 22:23
· In conclusion 24:15
· Coming up in part two 25:08
· Thanks for listening 25:47
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Czarnetzki BM. Int J Dermatol. 1989;doi:10.1111/j.1365-4362.1989.tb01314.x.
Kolkhir P, et al. J Allergy Clin Immunol. 2019;doi:10.1016/j.jaci.2018.09.007.
McDuffie FC, et al. Mayo Clin Proc. 1973;48(5):340-8.
Natbony SF, et al. J Allergy Clin Immunol. 1983;doi:10.1016/0091-6749(83)90096-9.
Soter NA. N Engl J Med. 1977;doi:10.1056/NEJM197706232962505.
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What should rheumatologists know about what we've learned about COVID-19 and long COVID in 2023? Hosted by Dr. Leonard Calabrese.
· Intro 0:11
· In this episode 0:21
· 2023: current status and controversies 0:35
· What is going on with COVID-19? 01:53
· What do we know about vaccine responses? What should we be telling our patients about vaccines in our immunocompromised population? 2:58
· Lancet Rheumatology MELODY study summary 3:08
· What about patients within the rheumatic and autoimmune disease space? 4:15
· Who is immunocompromised and why does it matter? 5:11
· What is the immunosuppression we are giving them? 6:39
· What to tell patients about getting vaccinated 8:56
· Long COVID 10:09
· What is long COVID? 10:26
· JAMA Network Open study on prevalence and characteristics associated with post-COVID conditions 14:19
· In the clinical arena, what should rheumatologists be thinking about? 16:38
· What about pathogenesis? What do we know about the controversies in this area? 18:58
· Autoimmunity: COVID-19 and autoimmune response 20:45
· What about therapies? 22:22
· The next generation of rheum agents: Immunomodulation with neonatal Fc receptor targeting? 24:40
· A question for the rheumatology community: do patients with immune mediated diseases get more long COVID than the control population? 25:40
· In conclusion 27:37
· Thanks for listening 28:38
Leonard H. Calabrese, DO, is the chief medical editor, Healio Rheumatology, and professor of medicine, Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, and RJ Fasenmyer chair of clinical immunology at the Cleveland Clinic.
Disclosures: Calabrese reports professional relationships with AbbVie, AstraZeneca, Bristol Myers Squibb, Galvani, Genentech, GlaxoSmithKline, Janssen, Novartis, Regeneron, Sanofi and UCB..
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
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It's that time of year again, everyone rolling up their sleeves to get a flu shot. This episode dives into the history of the struggles pinning down the causative agent of flu and the journey to the vaccine!
· Intro 0:12
· In this episode 0:17
· The history of the flu: 1892 3:10
· Rabies and dead virus 10:52
· A Sickness in the Serum, Part 2 14:31
· Vaccines and trials 19:13
· Pig influenza 23:21
· Influenza: a filterable agent we can’t see 27:10
· The trials of 1942 33:18
· PS: 1918 influenza 39:13
· Finding the 1918 influenza vaccine 39:54
· Thanks for listening 47:54
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Hicks DJ, et al. Clin Exp Immunol. 2012;doi:10.1111/j.1365-2249.2012.04592.x.
Rosenau MJ. Experiments Upon Volunteers to Determine the Cause and Mode of Spread of Influenza, Boston, November and December, 1918. https://quod.lib.umich.edu/f/flu/3750flu.0016.573. Published February 1921. Accessed December 6, 2023.
Rosenau MJ, et al. JAMA. 1925;doi:10.1001/jama.1925.02670070040019.
Taubenberger JK, et al. Antivir Ther. 2007;12(4 Pt B):581-91.
Tobin J. The first flu shot. https://heritage.umich.edu/stories/the-first-flu-shot/. Accessed December 6, 2023.
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What is silica? How does it impact your risk of developing autoimmunity if you inhale it, inject it or even snort it up your nose? Listen and find out!
· Intro 0:12
· In the previous episodes 0:28
· The Ajax incident of 1979 1:15
· Silica and its association with autoimmune disease 4:11
· The history of silica and the health risks 5:21
· Rheumatoid scleroderma, etc. 8:14
· Cardiff pneumoconiosis medical panel 9:49
· Databases 12:51
· Silica exposure and the development of serologies 15:02
· What would happen if you injected silica into the veins? 16:51
· Anca vasculitis 18:33
· Thanks for listening 23:23
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Blanc PD, et al. Am J Med. 2015;doi:10.1016/j.amjmed.2015.05.001.
Boudigaard SH, et al. Int J Epidemiol. 2021;doi:10.1093/ije/dyaa287.
Conrad K, et al. Lupus. 1996;doi:10.1177/096120339600500112.
Hoy RF, et al. Allergy. 2020;doi:10.111/all.14202.
Klockars M, et al. Br Med J (Clin Res Ed). 1987;doi:10.1136/bmj.294.6578.997.
Park CG, et al. Environ Health Perspect. 1999;doi:10.1289/ehp.99107s5793.
Pollard KM. Front Immunol. 2016;doi:10.3389/fimmu.2016.00097.
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In this episode, we dig through the data of lupus in Africa and speak with experts on the Lupus Gradient, the impact of malaria and what we can learn from it all.
· Intro 0:12
· In the previous episode 0:30
· Lupus Gradient 2:01
· Back to Dr. Brian Greenwood 3:48
· Polyarthritis 4:04
· Rates of autoimmune diseases 6:00
· Malaria and mouse models 7:33
· Back to lupus 8:48
· First case of lupus 15:14
· Prevalence of lupus 17:15
· Papers on lupus 21:23
· Dr. Mickael Essouma 23:38
· Dr. Essouma, how did you conduct this study? 24:01
· Did you ever believe there was a gradient? 26:09
· Dr. Sandro Vento 30:56
· Dr. Vento, do you believe there was a lupus gradient? 31:51
· What are the connections to infectious disease? 38:51
· That’s a wrap! 43:04
· Coming up in part 4 44:55
· Thanks for listening 45:05
Disclosures: Brown reports no relevant financial disclosures. Healio could not confirm relevant financial disclosures for Essouma and Vento at the time of posting.
Mickael Essouma, MD, is physician from Cameroon specialized in internal medicine at the University of Yaounde I in Cameroon, with a complimentary certificate on rheumatology from the EULAR online course and a certificate on lupus from the European Lupus Society (SLEuro). He is an advocate of lupus and other autoimmune diseases in Africans.
Sandro Vento, MD, is the dean of faculty of medicine at the University of Puthisastra, Phnom Penh, Cambodia and a consultant and collaborating specialist at Mayo Clinic Center for Tuberculosis, WHO Collaborating Center.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Bae SC, et al. Arthritis Rheum. 1998;doi:10.1002/1529-0131(199812)41:123.0.CO;2-D.
Bryc K, et al. Am J Hum Genet. 2015;doi:10.1016/j.ajhg.2014.11.010.
Essouma M, et al. J Autoimmun. 2020;doi:10.1016/j.jaut.2019.102348.
Gilkeson GS, et al. Lupus. 2011;doi:10.1177/0961203311404915.
Micheletti SJ, et al. Am J Hum Genet. 2020;doi:10.1016/j.ajhg.2020.06.012.
Symmons DP. Lupus. 1995;doi:10.1177/096120339500400303.
Vento S, et al. Front Med. 2020;doi:10.3389/fmed.2020.00202.
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This episode delves into what we can learn about the impact of the environment on autoimmunity, digging into how rates of autoimmunity can vary drastically in different parts of the world.
· Intro 0:12
· In this episode 0:16
· Dr. Brian Greenwood 0:22
· The geography of autoimmunity 7:01
· Type 1 diabetes 10:31
· Finland and type 1 diabetes 13:57
· Socioeconomics 17:59
· Genetics and autoimmune diseases 24:19
· Migration studies 24:53
· Denmark and multiple sclerosis 30:06
· Coming up in part 3 36:02
· Thanks for listening 38:16
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Bach JF. N Engl J Med. 2002;doi:10.1056/NEJMra020100.
Bodansky HJ, et al. BMJ. 1992;doi:10.1136/bmj.304.6833.1020.
Dean G, et al. J Neurol Neurosurg Psychiatry. 1997;doi:10.1136/jnnp.63.5.565.
Hammond SR, et al. Brain. 2000;doi:10.1093/brain/123.5.968.
Hawkes CH, et al. Mult Scler Relat Disord. 2019;doi:10.1016/j.msard.2019.08.001.
Karvonen M, et al. Diabetes Care. 1999;doi:10.2337/diacare.22.7.1066.
Kondrashova A, et al. Diabetes Care. 2007;doi:10.2337/dc06-0711.
Marciulionyte D, et al. Diabetologia. 2001;doi:10.1007/s001250051574.
Nielsen NM, et al. Brain. 2019;doi:10.1093/brain/awz088.
Patterson CC, et al. Diabetologia. 2012;doi:10.1007/s00125-012-2571-8.
Sandy JL, et al. Pediatr Diabetes. 2021;doi:10.1111/pedi.13191.
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This episode delves into the history of the hygiene hypothesis. What do we know about different exposures changing risk for asthma and allergies, and do these exposures have the same protection for autoimmunity?
· Intro 0:12
· In this episode 0:18
· Hygiene hypothesis 0:33
· Allergic rhinitis (or Hay fever) 2:32
· Pollen and the allergy skin test 8:58
· Exposure and cleanliness 10:22
· Allergic rhinitis and Cree Native Americans 11:51
· Appendicitis 13:10
· Family size and asthma 14:36
· Rural versus urban populations 17:41
· Dust 18:31
· Children, day care and infections 22:43
· The “old friends” theory 28:29
· Farming and allergies 30:07
· The Amish and the Hutterites 33:02
· Mice, dust and asthma 34:47
· Thanks for listening 37:40
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Emanuel MB. Clin Exp Allergy. 1988;doi:10.1111/j.1365-2222.1988.tb02872.x.
Flohr C, et al. Clin Exp Allergy. 2010;doi:10.1111/j.1365-2222.2009.03346.x.
Genuneit J. Pediatr Allergy Immunol. 2012;doi:10.1111/j.1399-3038.2012.01312.x.
Karvonen AM, et al. J Allergy Clin Immunol. 2019;doi:10.1016/j.jaci.2019.07.035.
Perkin MR, et al. Front Allergy. 2022;doi:10.3389/falgy.2022.1051368.
Rantala AK, et al. Epidemiol. 2020;doi:10.1097/EDE.000000000001163.
Sangrador CO, et al. Allergol Immunopathol (Madr). 2018;doi:10.1016/j.aller.2018.03.006.
Stein MM, et al. N Engl J Med. 2016;doi:10.1056/NEJMoa1508749.
Strachan DP. BMJ. 1989;doi:10.1136/bmj.299.6710.1259.
Weber J, et al. Am J Respir Crit Care Med. 2015;doi:10.1164/rccm.201410-1899OC.
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On this special episode of Rheuminations, I interview comedian and ophthalmologist William Flanary, MD, and Kristin Flanary, also known as the Glaucomfleckens, on hypermobility and physician burnout.
Kristen Flanary highlights what it's like to live with hypermobility, and Dr. William Flanary discusses his thoughts on physician burnout and using their podcast, Knock Knock, Hi, as comedy relief.
· Intro 0:11
· In this episode 0:45
· Interview with Dr. William and Kristin Flanary, also known as Doctor and Lady Glaucomflecken 2:49
· Rheumatology and ophthalmology overlap 3:11
· Can you tell me a few things about yourselves? 7:48
· Kristin Flanary, MA: when did you notice your hypermobility and when did you start having complications from it? 12:19
· Do you ever fully dislocate or do you kind of feel like you’re about to? 19:53
· Chest compressions and William Flanary 25:23
· Have you done any bracing? 26:24
· Dr. Linda Bluestein, @hypermobilityMD, on the Glaucomfleckens podcast 30:24
· William Flanary, MD: can you talk about your experience with physician burnout? And are you optimistic about AI solving the physician burnout problem? 31:16
· Artificial Intelligence with Cardiologist Dr. Eric Topol | Knock Knock, Hi with the Glaucomfleckens, @EricTopol 37:01
· Can you tell us more about your podcast, Knock Knock, Hi? 41:06
· Thank you 44:59
Disclosures: Brown and the Flanarys report no relevant financial disclosures.
William E. Flanary, MD, is an ophthalmologist and part-time comedian, also known as Dr. Glaucomflecken. You can follow him on Twitter @DGlaucomflecken.
Kristin Flanary, MA, is a marketing and communications specialist, also known as Lady Glaucomflecken. You can follow her on Twitter @LGlaucomflecken.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
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Was your psoriasis caused by the Black Death? Learn more than you might have wanted to know about the Black Death and delve into the data on the immunologic/autoimmune ramifications of wiping out nearly half of Europe.
· Intro 0:11
· In this episode 1:09
· The Black Death 1:24
· The History of IV Immunoglobulin episode 2:07
· How the Black Death happened 4:07
· How many people died from the Black Death? 6:49
· Record keeping 6:53
· The modern immune system, the Black Death and HIV 8:43
· What is CCR5? 8:55
· Current data on autoimmune diseases 10:35
· ERAP2 15:55
· How yersinia pestis kills you 21:04
· The inflammasome 22:03
· The Inflammasome for Dunces episode 22:09
· Mediterranean fever and mouse model 24:49
· Takeaways 30:20
· Summary 30:59
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Wheelis M. Emerg Infect Dis. 2002;doi:10.3201/eid0809.100536.
Ratner D, et al. PLoS Pathog. 2016;doi:10.1371/journal.ppat.1006035.
Park YH, et al. Nat Immunol. 2020;doi:10.1038/s41590-020-0705-6.
Patin E. Nat Immunol. 2020;doi:10.1038/s41590-020-0724-3.
Galvani AP, et al. Proc Natl Acad Sci USA. 2003;doi:10.1073/pnas.2435085100.
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In this episode we explore ways in which the extracellular matrix can be manipulated, including the story of doxycycline, TGF-beta in Marfan syndrome and whether beta blockers can reduce vascular events in vascular EDS.
· Intro 0:12
· Review of previous episode 0:28
· In this episode 2:26
· The pressure against the vessels 4:06
· The pressure against the wall 8:44
· Matrix metalloproteinases 10:16
· Tadpole study – collagen breakdown 10:35
· Tetracycline antibiotics 14:05
· Rat model – periodontal disease and hydroxyproline 14:24
· Chemically modified tetracyclines 20:14
· Mouse model – tetracycline use 22:00
· Tetracyclines and other autoimmune conditions 23:22
· Marfan syndrome 24:45
· Fibrillin and Marfan syndrome 28:48
· TGF-beta 29:36
· Mouse model – Marfan syndrome and fibrillin 31:14
· ARBs and TGF-beta 33:51
· TGF-beta and vascular EDS 37:25
· Back to the mouse model 38:38
· Protein kinase C 39:56
· Summary 40:26
Disclosures: Brown reports no relevant financial disclosures.
We’d love to hear from you! Send your comments/questions to Dr. Brown at [email protected]. Follow us on Twitter @HRheuminations @AdamJBrownMD @HealioRheum.
References:
Bowen CJ, et al. J Clin Invest. 2020;130:686-698.
Brooke BS. Lancet. 2010;doi:10.1016/S0140-6736(10)61155-5
Dietz HC, et al. Am J Med Genet C Semin Med Genet. 2005;doi:10.1002/ajmg.c.30068.
Dubacher N, et al. Cardiovasc Res. 2020;116:457-465.
Golub LM, et al. SAGE. 1998;doi:10.1177/08959374980120010501.
Gross J, et al. PNAS. 1962;doi:10.1073/pnas.48.6.1014
Habashi JP, et al. Science. 2006;312:117-121.
Morissette R, et al. Circ Cardiovasc Genet. 2014;7:80-88.
Mullen M, et al. Lancet. 2019;394:2263-2270.
Neptune ER, et al. Nat Genet. 2003;33:407-411.
- Näytä enemmän
