TY - JOUR AU - Kerekes, György AU - Kovács, Beáta TI - A felső végtagok mélyvénás thrombosisának diagnosztikája és akut ellátása JF - LEGE ARTIS MEDICINAE J2 - LEGE ART MED VL - 34 PY - 2024 IS - 3 SP - 101 EP - 109 PG - 9 SN - 0866-4811 DO - 10.33616/lam.34.0101 UR - https://m2.mtmt.hu/api/publication/34784014 ID - 34784014 AB - A felső végtagot érintő mélyvénás thrombosisok a vénás thromboemboliás betegségek szerény hányadát teszik ki, így az orvosi köztudatnak nem képezi szerves részét ezek patofiziológiai alapokon nyugvó speciális kezelése. Az összefoglaló közleményben ismertetésre kerülnek a betegség patofiziológiájának részletei, melyek alapján a kezelés szempontjából fontos szubcsoportok kialakítására van lehetőség. A diagnosztikus lehetőségek bemutatását követően részletesen kitér a közlemény a szubcsoport specifikus ellátási lehetőségeire, algoritmusszerûen kerül bemutatásra a fenti betegcsoportok akut ellátási sémája. Remény szerint ezen információk birtokában javítható a mellkaskimeneti szindrómán alapuló felső végtagi mélyvénás thrombosisban szenvedő betegek ellátásszervezése, mely egyre több megfelelő funkcionális állapotú felső végtagban, akár professzionális sportkarrierek eredményes folytatásában is megnyilvánulhat. Mind a centrális vénás kanülökhöz, mind a pacemaker-elektródákhoz társuló felső végtagi vénás thromboemboliás események is bemutatásra kerülnek az eszközök fenntartási igényének, az antikoaguláció és a vénás keringés szempontjainak is a figyelembevételével. LA - Hungarian DB - MTMT ER - TY - JOUR AU - Simon, Diána AU - Kacsándi, Dorottya AU - Karancsiné Pusztai, Anita AU - Soós, Boglárka AU - Végh, Edit AU - Kerekes, György AU - Czókolyová, Monika AU - Szamosi, Szilvia AU - Szűcs, Gabriella AU - Prohászka, Zoltán AU - Németh, Péter AU - Berki, Tímea AU - Szekanecz, Zoltán TI - Natural Autoantibodies in Biologic-Treated Rheumatoid Arthritis and Ankylosing Spondylitis Patients: Associations with Vascular Pathophysiology JF - INTERNATIONAL JOURNAL OF MOLECULAR SCIENCES J2 - INT J MOL SCI VL - 25 PY - 2024 IS - 6 PG - 14 SN - 1661-6596 DO - 10.3390/ijms25063429 UR - https://m2.mtmt.hu/api/publication/34745209 ID - 34745209 N1 - * Megosztott szerzőség AB - Cardiovascular (CV) morbidity and mortality have been associated with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). Natural autoantibodies (nAAb) are involved in innate immunity, as well as autoimmunity, inflammation, and atherosclerosis. There have not been any studies assessing the effects of biologics on nAAbs in RA and AS, also in relation to vascular pathophysiology. Fifty-three anti-TNF-treated RA and AS patients were included in a 12-month follow-up study. Anti-citrate synthase (CS) and anti-topoisomerase I fragment 4 (TOPO-F4) IgM and IgG levels were determined by ELISA. Ultrasonography was performed to assess brachial artery flow-mediated vasodilation (FMD), common carotid intima-media thickness (ccIMT), and arterial pulse-wave velocity (PWV). Other variables were also evaluated at baseline and 6 and 12 months after treatment initiation. Anti-TNF therapy improved FMD in RA and PWV in AS and stabilized ccIMT. TNF inhibition increased anti-CS IgM and IgG, and possibly also anti-TOPO-F4 IgG levels. Various correlation analyses revealed that nAAbs might be independently involved in autoimmunity as well as changes in inflammation and vascular pathology over time in biologic-treated patients (p < 0.05). We also found associations between anti-TOPO-F4 IgG and anti-Hsp60 IgG (p < 0.05). Baseline nAAb levels or nAAb level changes might determine changes in CRP, disease activity, FMD, PWV, and ccIMT over time (p < 0.05). The interplay between arthritis and inflammatory atherosclerosis, as well as the effects of anti-TNF biologics on these pathologies, might independently involve nAAbs. LA - English DB - MTMT ER - TY - JOUR AU - Kerekes, György AU - Bodoki, Levente AU - Hamar, Attila AU - Karancsiné Pusztai, Anita AU - Tajti, Gábor AU - Katkó, Mónika AU - Végh, Edit AU - Pethő, Zsófia AU - Bodnár, Nóra AU - Horváth, Ágnes AU - Soós, B. AU - Szamosi, Szilvia AU - Hascsi, Z. AU - Harangi, Mariann AU - Panyi, György AU - Szűcs, Gabriella AU - Szekanecz, Zoltán TI - AB0237 EFFECTS OF ONE-YEAR TOFACITINIB THERAPY ON ANGIOGENIC BIOMARKERS IN RHEUMATOID ARTHRITIS JF - ANNALS OF THE RHEUMATIC DISEASES J2 - ANN RHEUM DIS VL - 82 PY - 2023 IS - S1 SP - 1303 EP - 1303 PG - 1 SN - 0003-4967 DO - 10.1136/annrheumdis-2023-eular.2331 UR - https://m2.mtmt.hu/api/publication/34775337 ID - 34775337 LA - English DB - MTMT ER - TY - JOUR AU - Sütő, Renáta AU - Pócsi, Marianna AU - Szabó, Zsolt AU - Fejes, Zsolt AU - Ivády, Gergely AU - Kerekes, György AU - Fagyas, Miklós AU - Nagy, Attila Csaba AU - Szentkereszty, Zoltán AU - Kappelmayer, János AU - Nagy, Béla TI - Elevated level of serum human epididymis protein 4 (HE4) predicts disease severity and mortality in COVID-19 pneumonia JF - BMC PULMONARY MEDICINE J2 - BMC PULM MED VL - 23 PY - 2023 IS - 1 SN - 1471-2466 DO - 10.1186/s12890-023-02811-y UR - https://m2.mtmt.hu/api/publication/34441246 ID - 34441246 LA - English DB - MTMT ER - TY - JOUR AU - Kerekes, György AU - Czókolyová, Monika AU - Hamar, Attila AU - Karancsiné Pusztai, Anita AU - Tajti, Gábor AU - Katkó, Mónika AU - Végh, Edit AU - Pethő, Zsófia AU - Bodnár, Nóra AU - Horváth, Ágnes AU - Soós, Boglárka AU - Szamosi, Szilvia AU - Hascsi, Zsolt AU - Harangi, Mariann AU - Hodosi, Katalin AU - Panyi, György AU - Seres, Tamás AU - Szűcs, Gabriella AU - Szekanecz, Zoltán TI - Effects of 1-year tofacitinib therapy on angiogenic biomarkers in rheumatoid arthritis JF - RHEUMATOLOGY (UNITED KINGDOM) J2 - RHEUMATOLOGY VL - 62 PY - 2023 IS - SI3 SP - SI304 EP - SI312 SN - 1462-0324 DO - 10.1093/rheumatology/kead502 UR - https://m2.mtmt.hu/api/publication/34215318 ID - 34215318 LA - English DB - MTMT ER - TY - JOUR AU - Kacsándi, Dorottya AU - Fagyas, Miklós AU - Horváth, Ágnes AU - Végh, Edit AU - Pusztai, Anita AU - Czókolyová, Monika AU - Soós, Boglárka AU - Szabó, Attila Ádám AU - Hamar, Attila AU - Pethő, Zsófia AU - Bodnár, Nóra AU - Kerekes, György AU - Hodosi, Katalin AU - Szamosi, Szilvia AU - Szűcs, Gabriella AU - Papp, Zoltán AU - Szekanecz, Zoltán TI - Effect of tofacitinib therapy on angiotensin converting enzyme activity in rheumatoid arthritis JF - FRONTIERS IN MEDICINE J2 - FRONT MED VL - 10 PY - 2023 SN - 2296-858X DO - 10.3389/fmed.2023.1226760 UR - https://m2.mtmt.hu/api/publication/34185575 ID - 34185575 LA - English DB - MTMT ER - TY - JOUR AU - Nóra, Obajed Al-Ali AU - Sára, Rebeka Tóth AU - Váróczy, László AU - Pinczés, László Imre AU - Soltész, Pál AU - Szekanecz, Zoltán AU - Kerekes, György TI - One step back from bedside to the bench - How do different arterial stiffness parameters behave in relation to peripheral resistance? JF - DIAGNOSTICS J2 - DIAGNOSTICS VL - 13 PY - 2023 IS - 18 PG - 14 SN - 2075-4418 DO - 10.3390/diagnostics13182897 UR - https://m2.mtmt.hu/api/publication/34129873 ID - 34129873 LA - English DB - MTMT ER - TY - JOUR AU - Szekanecz, Zoltán AU - Kerekes, György AU - Shoenfeld, Yehuda TI - Atherosclerosis in autoimmune rheumatic diseases JF - EUROPEAN JOURNAL OF INTERNAL MEDICINE J2 - EUR J INTERNAL MED VL - 115 PY - 2023 SP - 46 EP - 47 PG - 2 SN - 0953-6205 DO - 10.1016/j.ejim.2023.07.032 UR - https://m2.mtmt.hu/api/publication/34084596 ID - 34084596 LA - English DB - MTMT ER - TY - JOUR AU - Soos, Boglarka AU - Hamar, Attila AU - Karancsiné Pusztai, Anita AU - Czókolyová, Monika AU - Végh, Edit AU - Szamosi, Szilvia AU - Pethő, Zsófia AU - Gulyás, Katalin AU - Kerekes, György AU - Szántó, Sándor Zoltán AU - Szűcs, Gabriella AU - Christians, Uwe AU - Klawitter, Jelena AU - Seres, Tamas AU - Szekanecz, Zoltán TI - Effects of tofacitinib therapy on arginine and methionine metabolites in association with vascular pathophysiology in rheumatoid arthritis: A metabolomic approach JF - FRONTIERS IN MEDICINE J2 - FRONT MED VL - 9 PY - 2022 PG - 16 SN - 2296-858X DO - 10.3389/fmed.2022.1011734 UR - https://m2.mtmt.hu/api/publication/33457576 ID - 33457576 N1 - Department of Rheumatology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Intensive Care Unit, Department of Internal Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Department of Sports Medicine, Faculty of Medicine, University of Debrecen, Debrecen, Hungary Department of Anesthesiology, University of Colorado Anschutz Medical Campus, Aurora, CO, United States Export Date: 4 January 2023 Correspondence Address: Szekanecz, Z.; Department of Rheumatology, Hungary; email: szekanecz.zoltan@med.unideb.hu AB - IntroductionRheumatoid arthritis (RA) has been associated with changes in lipid, arginine and NO metabolism with increased cardiovascular (CV) risk. The aim of this study is to evaluate the effect of tofacitinib, a Janus kinase (JAK) inhibitor, on arginine and methionine metabolism in correlation with inflammation, functional and pathological vascular changes during one-year treatment of patients with RA. Materials and methodsThirty RA patients with active disease were treated with either 5 mg bid or 10 mg bid tofacitinib for 12 months. We determined DAS28, CRP, IgM rheumatoid factor (RF) and anti-cyclic citrullinated peptide (CCP) levels. We assessed brachial artery flow-mediated vasodilation (FMD), carotid intima-media thickness (IMT) and pulse-wave velocity (PWV) by ultrasound at baseline and after 6 and 12 months. We also determined plasma L-arginine, L-citrulline, L-ornithine, inducible nitric oxide synthase (iNOS), asymmetric (ADMA) and symmetric dimethylarginine (SDMA), L-N-monomethyl-arginine (L-NMMA), cysteine, homocysteine, and methionine levels at these time points. ResultsTwenty-six patients (13 on each arm) completed the study. CRP, ESR and DAS28 decreased significantly during one-year treatment with tofacitinib. Arginine and ADMA showed a negative univariate correlation with CRP but not with FMD, PWV or IMT. Tofacitinib at 10 mg bid significantly increased L-arginine, L-ornithine, iNOS and methionine levels after 12 months. ADMA and SDMA levels did not change in our study. Methionine showed negative correlation with FMD at baseline and positive correlation with PWV after 12 months. No change was observed in FMD and PWV but a significant increase was measured in IMT at 6 and 12 months. Multivariate analysis indicated variable correlations of L-arginine, L-citrulline, ADMA, L-NMMA, homocysteine and methionine with DAS28, CRP, ESR and RF but not with anti-CCP after one-year treatment. With respect to vascular pathophysiology, only PWV and methionine correlated with each other. ConclusionOne-year tofacitinib treatment suppressed systemic inflammation and improved functional status in RA. FMD, PWV have not been affected by one-year tofacitinib treatment., while IMT increased further despite treatment. Increased arginine and methionine might contribute to the anti-inflammatory effects of tofacitinib. Increased arginine availability with no changing ADMA may protect FMD and PWV from deterioration. The increase of IMT in the anti-inflammatory environment cannot be explained by arginine or methionine metabolism in this study. LA - English DB - MTMT ER - TY - JOUR AU - Czókolyová, Monika AU - Hamar, Attila AU - Karancsiné Pusztai, Anita AU - Tajti, Gábor AU - Végh, Edit AU - Pethő, Zsófia AU - Bodnár, Nóra AU - Horváth, Ágnes AU - Boglárka, Soós AU - Szamosi, Szilvia AU - Szentpéteri, Anita AU - Seres, Ildikó AU - Harangi, Mariann AU - Paragh, György AU - Kerekes, György AU - Bodoki, Levente AU - Katalin, Hodosi AU - Tamás, Seres AU - Panyi, György AU - Szekanecz, Zoltán AU - Szűcs, Gabriella TI - Effects of One-Year Tofacitinib Therapy on Lipids and Adipokines in Association with Vascular Pathophysiology in Rheumatoid Arthritis JF - BIOMOLECULES J2 - BIOMOLECULES VL - 12 PY - 2022 IS - 10 SN - 2218-273X DO - 10.3390/biom12101483 UR - https://m2.mtmt.hu/api/publication/33153228 ID - 33153228 AB - Background: Cardiovascular (CV) morbidity, mortality and metabolic syndrome are associated with rheumatoid arthritis (RA). A recent trial has suggested increased risk of major CV events (MACE) upon the Janus kinase (JAK) inhibitor tofacitinib compared with anti-tumor necrosis factor α (TNF-α) therapy. In our study, we evaluated lipids and other metabolic markers in relation to vascular function and clinical markers in RA patients undergoing one-year tofacitinib therapy. Patients and methods: Thirty RA patients treated with either 5 mg or 10 mg bid tofacitinib were included in a 12-month follow-up study. Various lipids, paraoxonase (PON1), myeloperoxidase (MPO), thrombospondin-1 (TSP-1) and adipokine levels, such as adiponectin, leptin, resistin, adipsin and chemerin were determined. In order to assess flow-mediated vasodilation (FMD), common carotid intima-media thickness (IMT) and arterial pulse-wave velocity (PWV) ultrasonography were performed. Assessments were carried out at baseline, and 6 and 12 months after initiating treatment. Results: One-year tofacitinib therapy significantly increased TC, HDL, LDL, APOA, APOB, leptin, adipsin and TSP-1, while significantly decreasing Lp(a), chemerin, PON1 and MPO levels. TG, lipid indices (TC/HDL and LDL/HDL), adiponectin and resistin showed no significant changes. Numerous associations were found between lipids, adipokines, clinical markers and IMT, FMD and PWV (p < 0.05). Regression analysis suggested, among others, association of BMI with CRP and PWV (p < 0.05). Adipokines variably correlated with age, BMI, CRP, CCP, FMD, IMT and PWV, while MPO, PON1 and TSP-1 variably correlated with age, disease duration, BMI, RF and PWV (p < 0.05). Conclusions: JAK inhibition by tofacitinib exerts balanced effects on lipids and other metabolic markers in RA. Various correlations may exist between metabolic, clinical parameters and vascular pathophysiology during tofacitinib treatment. Complex assessment of lipids, metabolic factors together with clinical parameters and vascular pathophysiology may be utilized in clinical practice to determine and monitor the CV status of patients in relation with clinical response to JAK inhibition. LA - English DB - MTMT ER -