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Öğe Artificial intelligence meets the world experts; updates and novel therapies in autoimmunity - the 14th international congress on autoimmunity 2024 (AUTO14), Ljubljana(2025) Mahroum, Naim; Elsalti, Abdulrahman; Al Shawaf, Maisam; Darkhabani, Mohammad; Alwani, Abdulrahman; Seida, Ravend; Ertaş, Muhammet Tayfur; Şimşek, Ayşe Gülnihan; Awad, Mustafa; Habra, Mona; Alrifaai, Mohamad Aosama; Bogdanos, Dimitrios; Shoenfeld, YehudaThe bi-annual international congress on autoimmunity is a huge opportunity for the medical community to discuss the latest updates in the field. During the 14th congress 2024 (AUTO14) in Ljubljana, artificial intelligence (AI) occupied special attention due to its recent and ongoing unequivocal role in various medical fields including autoimmunity. For instance, through a challenging debate between world-experts and the most popular AI bot used (ChatGPT), several clinical cases including a case of vasculitis were discussed in the plenary sessions. ChatGPT agreed with the clinical decisions made by the experts nevertheless, the bot added additional aspects related to the specific case. In this regard, ChatGPT emphasized the need for osteoporosis prophylaxis in a patient planned to be treated with systemic steroids for a long time. Furthermore, AUTO14 included the newest updates on most autoimmune disorders, distributed among tens of sessions. Among others, infection and autoimmunity, the sequalae of the pandemic of COVID-19, as well as COVID-19 vaccines were discussed as well. Due to the high numbers of the works presented, and for ensuring that important updates are not missed; we divided our paper into sections. The subtitles throughout the paper correspond to different sessions of the congress, all presenting new updates in the field. A figure aiding in navigating throughout the paper was also provided.Öğe Autoimmune/inflammatory syndrome induced by adjuvants (ASIA): past, present, and future implications(NLM (Medline), 2023) Alrais, Mahmoud; Seida, Ravend; Alwani, Abdulkarim; Kiyak, Zeynep; Elsalti, Abdulrahman; Esirgün, Şevval Nil; Abalı, Tunahan; Mahroum, NaimAdjuvants such as aluminum, mineral oils, and silicone are added to vaccines in order to trigger a stronger immune response. Autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was introduced in 2011 to address nonspecific symptoms and disorders appearing following vaccinations, which in fact were reported by many papers before the introduction of the syndrome. During the pandemic of COVID-19, a correlation between ASIA, COVID-19, and COVID-19 vaccines has been reported. Adjuvants, as the name indicates, are adjoined material aimed to assist in functioning as when added to vaccines they are meant to boost the effect and strongly stimulate the immune system. The response of the immune system can be unpredictable, and the autoimmune/inflammatory syndrome induced by adjuvants (ASIA) was developed to address possible adverse reactions of an autoimmune and inflammatory type that may be caused by adjuvants. While ASIA, as a syndrome, was coined and defined in 2011; reports describing patients with vague and nonspecific clinical symptoms following vaccinations appeared much earlier. In other words, ASIA came to define, arrange, and unite the variety of symptoms, related to autoimmunity, caused not by the vaccine itself, rather by the adjuvant part of the vaccine such as aluminum, among others. Accordingly, the introduction of ASIA enabled better understanding, proper diagnosis, and early treatment of the disorder. Furthermore, ASIA was shown to be associated with almost all body systems and various rheumatic and autoimmune diseases such as systemic lupus erythematosus, antiphospholipid syndrome, and systemic sclerosis. In addition, the correlation between COVID-19 and ASIA was noticed during the pandemic. In this review, we summarized the reported effects of adjuvants and medical literature before and after ASIA was defined, the several ways ASIA can manifest and impact different systems of the body, and the incidences of ASIA during the COVID-19 pandemic. It is important to clarify, that vaccines are among, if not the, most effective means of fighting infectious diseases however, we believe that vaccines manufacturing is not above criticism, particularly when it comes to added substances possessing a risk of side effects.Öğe COVID-19 vaccination and the rate of immune and autoimmune adverse events following immunization: Insights from a narrative literature review(Frontiers Media S.A., 2022) Mahroum, Naim; Lavine, Noy; Ohayon, Aviran; Seida, Ravend; Alwani, Abdulkarim; Alrais, Mahmoud; Zoubi, Magdi; Bragazzi, Nicola LuigiDespite their proven efficacy and huge contribution to the health of humankind, vaccines continue to be a source of concern for some individuals around the world. Vaccinations against COVID-19 increased the number of distressed people and intensified their distrust, particularly as the pandemic was still emerging and the populations were encouraged to be vaccinated under various slogans like “back to normal life” and “stop coronavirus”, goals which are still to be achieved. As fear of vaccination-related adverse events following immunization (AEFIs) is the main reason for vaccine hesitancy, we reviewed immune and autoimmune AEFIs in particular, though very rare, as the most worrisome aspect of the vaccines. Among others, autoimmune AEFIs of the most commonly administered COVID-19 vaccines include neurological ones such as Guillain-Barre syndrome, transverse myelitis, and Bell’s palsy, as well as myocarditis. In addition, the newly introduced notion related to COVID-19 vaccines, “vaccine-induced immune thrombotic thrombocytopenia/vaccine-induced prothrombotic immune thrombotic thrombocytopenia” (VITT/VIPITT)”, is of importance as well. Overviewing recent medical literature while focusing on the major immune and autoimmune AEFIs, demonstrating their rate of occurrence, presenting the cases reported, and their link to the specific type of COVID-19 vaccines represented the main aim of our work. In this narrative review, we illustrate the different vaccine types in current use, their associated immune and autoimmune AEFIs, with a focus on the 3 main COVID-19 vaccines (BNT162b2, mRNA-1273, and ChAdOx1). While the rate of AEFIs is extremely low, addressing the issue in this manner, in our opinion, is the best strategy for coping with vaccine hesitancy.Öğe Ferritin – From iron, through inflammation and autoimmunity, to COVID-19(Academic Press, 2022) Mahroum, Naim; Alghory, Amal; Kıyak, Zeynep; Alwani, Abdulkarim; Seida, Ravend; Alrais, Mahmoud; Shoenfeld, YehudaWhile it took decades to arrive to a conclusion that ferritin is more than an indicator of iron storage level, it took a short period of time through the COVID-19 pandemic to wonder what the reason behind high levels of ferritin in patients with severe COVID-19 might be. Unsurprisingly, acute phase reactant was not a satisfactory explanation. Moreover, the behavior of ferritin in patients with severe COVID-19 and the subsequent high mortality rates in patients with high ferritin levels necessitated further investigations to understand the role of ferritin in the diseases. Ferritin was initially described to accompany various acute infections, both viral and bacterial, indicating an acute response to inflammation. However, with the introduction of the hyperferritinemic syndrome connecting four severe pathological conditions such as adult-onset Still's disease, macrophage activation syndrome, catastrophic antiphospholipid syndrome, and septic shock added another aspect of ferritin where it could have a pathogenetic role rather than an extremely elevated protein only. In fact, suggesting that COVID-19 is a new member in the spectrum of hyperferritinemic syndrome besides the four mentioned conditions could hopefully direct further search on the pathogenetic role of ferritin. Doubtlessly, improving our understanding of those aspects of ferritin would enormously contribute to better coping with severe diseases in terms of treatment and prevention of complications. The origin, history, importance, and the advances of searching the role of ferritin in various pathological and clinical processes are presented hereby in our article. In addition, the implications of ferritin in COVID-19 are addressed.Öğe Streptococcus pneumoniae and autoimmunity(Academic Press, 2024) Alghory, Amal; Alwani, Abdulkarim; Seida, Ravend; Alrais, Mahmoud; Alwani, Abdulrahman; Mahroum, NaimThe genus Streptococcus includes 49 species, 35 of which have been identified as a cause of infections in humans. Species of Streptococcus are divided into groups based on the antigenic structure of the cell wall alongside polysaccharides, which is known as the Lancefield antigen classification. Unlike Group A Streptococcus; Streptococcus pneumoniae does not yet have sufficient evidence as being a causative agent of autoimmune disease. However, cases in which autoimmune diseases are triggered or exacerbated by pneumococcal infection do exist. In addition, several autoimmune diseases were found to predispose to pneumococcal infection.Öğe The 13th international. congress on autoimmunity 2022 (AUTO13) Athens: An event as big as the topics(Israel Medical Association Journal, 2022) Etsatti, Abdutrahman; Atwani, Abdutkarim; Seida, İsa; Atrais, Mahmoud; Seida, Ravend; Esirgun, Sevvat Nit; Abalı, Tunahan; Kıyak, Zeynep; Mahroum, NaimThe gathering of the 13th International Congress on Autoimmunity 2022 (AUTO13) could not have been held at a place better than the beautiful city of Athens, Greece, at the Megaron Athens International Conference Center (MAICC), which is short distance from the Acropolis. With thousands of participants from more than 70 countries and five continents, the in-person meeting of AUTO13 was a huge success.Öğe The mosaic of autoimmunity – Finally discussing in person. The 13th international congress on autoimmunity 2022 (AUTO13) Athens(Elsevier B.V., 2022) Mahroum, Naim; Elsalti, Abdulrahman; Alwani, Abdulkarim; Seida, İsa; Alrais, Mahmoud; Seida, Ravend; Esirgün, Şevval Nil; Abalı, Tunahan; Kıyak, Zeynep; Zoubi, Magdi; Shoenfeld, YehudaWhile autoimmunity is a branch of medicine linked to every single organ system via direct and indirect pathways, meeting in person to discuss autoimmunity during the 13th international congress on autoimmunity (AUTO13) with participants from all over the world had a very good reason. The mechanisms involved in autoimmune diseases are of extreme importance and in fact critical in understanding the course of diseases as well as selecting proper therapies. COVID-19 has served as a great example of how autoimmunity is deeply involved in the disease and directly correlated to severity, morbidity, and mortality. For instance, initially the term cytokine storm dominated, then COVID-19 was addressed as the new member of the hyperferritinemic syndrome, and also the use of immunosuppressants in patients with COVID-19 throughout the pandemic, all shed light on the fundamental role of autoimmunity. Unsurprisingly, SARS-CoV-2 was called the “autoimmune virus” during AUTO13. Subsequently, the correlation between autoimmunity and COVID-19 vaccines and post-COVID, all were discussed from different autoimmune aspects during the congress. In addition, updates on the mechanisms of diseases, autoantibodies, novel diagnostics and therapies in regard to autoimmune diseases such as antiphospholipid syndrome, systemic lupus erythematosus, systemic sclerosis and others, were discussed in dedicated sessions. Due to the magnificence of the topics discussed, we aimed to bring in our article hereby, the pearls of AUTO13 in terms of updates, new aspects of autoimmunity, and interesting findings. While more than 500 abstract were presented, concluding all the topics was not in reach, hence major findings were summarized.Öğe Triggers and regulation: The gut microbiome in rheumatoid arthritis(Taylor and Francis Ltd., 2023) Mahroum, Naim; Seida, Ravend; Shoenfeld, YehudaIntroduction Rheumatoid arthritis is a chronic inflammatory disease marked by systemic symptoms and joint degeneration. Interestingly, the development and progression of rheumatoid arthritis have been linked to the microbiome, notably the gut microbiome. Dysbiosis, an alteration in the gut microbiome, has been connected to the etiology and pathogenesis of rheumatoid arthritis. For instance, dysbiosis increases intestinal permeability and promotes the movement of bacteria and their products, which in turn triggers and aggravates systemic inflammation.Areas covered The correlation between the gut microbiome and RA. Triggers of RA including dysbiosis. The therapeutic potential of the gut microbiome in RA due to its critical function in influencing the immune response. The fecal microbiota transplantation (FMT), a therapeutic strategy that involves the transfer of healthy fecal microbiota from a donor to a recipient, has produced encouraging results in the treatment of several autoimmune illnesses, including rheumatoid arthritis.Expert opinion The role of the gut microbiome in RA is critical and serves as a basis for etiology and pathogenesis, as well as having therapeutic implications. In our opinion, FMT is an excellent example of this correlation. Still, more investigations and well-designed studies are needed in order to make firm conclusions and recommendations.Öğe Vaccines and autoimmunity—From side effects to ASIA syndrome(MDPI, 2023) Seida, İsa; Seida, Ravend; Elsalti, Abdulrahman; Mahroum, NaimSince vaccines are in fact manufactured chemical compounds such as drugs, the appearance of side effects following their use is not surprising. Similarly, as the main goal of vaccines is to stimulate the immune system bringing out the production of protective antibodies, autoimmune-related side effects as a consequence of increased immune activity do not seem irrational. Fortunately, the rate of such side effects is low; however, the importance of reporting adverse events following vaccinations, understanding the mechanisms behind their appearance, making early diagnosis, and appropriate treatment cannot be overemphasized. In fact, autoimmune-related side effects of vaccines, particularly those based on adjuvants, were reported long before the introduction of the autoimmune/inflammatory syndrome induced by adjuvants (ASIA). Nevertheless, ASIA gathered and united the side effects of vaccines under one title, a step which helped organize the research and call for better immune stimulators than adjuvants. New technologies and methods of making vaccines were clearly noticed during the pandemic of COVID-19 after the introduction of mRNA-based vaccines. In our current paper, we introduce the notion of side effects to vaccines, particularly those of autoimmune nature, the mechanisms of ASIA, and the main vaccines linked with the syndrome including the recent COVID-19 vaccines. The transition from side effects to ASIA is the main idea behind our work.
