Yazar "Shoenfeld, Yehuda" seçeneğine göre listele
Listeleniyor 1 - 20 / 20
Sayfa Başına Sonuç
Sıralama seçenekleri
Öğe Antiphospholipid syndrome in the era of covid-19 - two sides of a coin(2024) Mahroum, Naim; Habra, Mona; Alrifaai, Mohamad Aosama; Shoenfeld, YehudaIn addition to the respiratory symptoms associated with COVID-19, the disease has consistently been linked to many autoimmune diseases such as systemic lupus erythematous and antiphospholipid syndrome (APS). APS in particular was of paramount significance due to its devastating clinical sequela. In fact, the hypercoagulable state seen in patients with acute COVID-19 and the critical role of anticoagulant treatment in affected individuals shed light on the possible relatedness between APS and COVID-19. Moreover, the role of autoimmunity in the assumed association is not less important especially with the accumulated data available regarding the autoimmunity-triggering effect of SARS-CoV-2 infection. This is furtherly strengthened at the time patients with COVID-19 manifested antiphospholipid antibodies of different types following infection. Additionally, the severe form of the APS spectrum, catastrophic APS (CAPS), was shown to have overlapping characteristics with severe COVID-19 such as cytokine storm and multi-organ failure. Interestingly, COVID vaccine-induced autoimmune phenomena described in the medical literature have pointed to an association with APS. Whether the antiphospholipid antibodies were present or de novo, COVID vaccine-induced vascular thrombosis in certain individuals necessitates further investigations regarding the possible mechanisms involved. In our current paper, we aimed to focus on the associations mentioned, their implications, importance, and consequences.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 autonomic dysfunction syndromes: Potential involvement and pathophysiology related to complex regional pain syndrome, fibromyalgia, chronic fatigue syndrome, silicone breast implant–related symptoms and post-COVID syndrome(MDPI (Multidisciplinary Digital Publishing Institute), 2022) Mahroum, Naim; Shoenfeld, YehudaThe pathophysiological mechanisms involved in chronic disorders such as complex regional pain syndrome, fibromyalgia, chronic fatigue syndrome, silicone breast implant–related symptoms, and post-COVID syndrome have not been clearly defined. The course of the pain in some of the syndromes, the absence of evident tissue damage, and the predominance of alterations in the autonomic nervous system are shared similarities between them. The production of autoantibodies following a trigger in the syndromes was previously described, for instance, trauma in complex regional pain syndrome, infectious agents in fibromyalgia, chronic fatigue syndrome, and post-COVID syndrome, and the immune stimulation by silicone in women with breast implants. In fact, the autoantibodies produced were shown to be directed against the autonomic nervous system receptors, leading to the amplification of the perception of pain alongside various clinical symptoms seen during the clinical course of the syndromes. Therefore, we viewed autoantibodies targeting the autonomic nervous system resulting in autonomic dysfunction as likely the most comprehensive explanation of the pathophysiology of the disorders mentioned. Based on this, we aimed to introduce a new concept uniting complex regional pain syndrome, fibromyalgia, chronic fatigue syndrome, silicone breast implant–related symptoms, and post-COVID syndrome, namely “autoimmune autonomic dysfunction syndromes”. Due to its etiological, pathophysiological, and clinical implications, the suggested term would be more precise in classifying the syndromes under one title. The new title would doubtlessly facilitate both laboratory and clinical studies aimed to improve diagnosis and make treatment options more directed and precise.Öğe Autoimmune post-COVID vaccine syndromes: Does the spectrum of autoimmune/inflammatory syndrome expand(Springer London Ltd, 2022) Jara, Luis Javier; Vera-Lastra, Olga; Mahroum, Naim; Pineda, Carlos; Shoenfeld, YehudaTo date, around 60% of the world population has been protected by vaccines against SARS-CoV-2, significantly reducing the devastating effect of the pandemic and restoring social economic activity through mass vaccination. Multiple studies have demonstrated the effectiveness and safety of vaccines against COVID-19 in healthy populations, in people with risk factors, in people with or without SARS-CoV-2 infection, and in immunocompromised people. According to the criteria for post-vaccine adverse events established by the World Health Organization, a minority of individuals may develop adverse events, including autoimmune syndromes. The exact mechanisms for the development of these autoimmune syndromes are under study, and to date, a cause-effect relationship has not been established. Many of these autoimmune syndromes meet sufficient criteria for the diagnosis of Adjuvant-Induced Autoimmune Syndrome (ASIA syndrome). The descriptions of these autoimmune syndromes open new perspectives to the knowledge of the complex relationship between the host, its immune system, with the new vaccines and the development of new-onset autoimmune syndromes. Fortunately, most of these autoimmune syndromes are easily controlled with steroids and other immunomodulatory medications and are short-lived. Rheumatologists must be alert to the development of these autoimmune syndromes, and investigate the relationship between autoimmune/inflammatory symptoms and vaccination time, and assess their therapeutic response.Öğe Classic pityriasis rosea(NLM (Medline), 2022) Mahroum, Naim; Shoenfeld, YehudaP ityriasis rosea is an acute inflammatory skin disorder characterized by papulosquamous skin lesions that appear on the trunk and extremities. The disease affects children and adults, involving slightly more females than males [1]. Pityriasis rosea is known to complicate viral infections, especially human herpes virus type 7 (HHV-7) [2]. However, other viruses have been described, including influenza virus (H1N1) and more recently SARS-CoV-2 [3]. Skin manifestations in pityriasis rosea are generally preceded by a prodrome of headache and malaise. In most cases, skin eruption starts on the upper trunk (chest or back) with the so-called . A few days later, smaller round lesions appear on the rest of the trunk and extremities. Lesions are rarely itching in nature and the disease passes asymptomatically. Skin eruptions fade slowly in the course of days, leaving no or slight pigmentation of the skin. Complete disappearance of skin lesions may take several weeks, whereas skin dyspigmentation might last for weeks to months. The diagnosis of pityriasis rosea is straightforward and based mainly on clinical findings with suitable time course. There is no specific treatment for pityriasis rosea. A Cochrane based meta-analysis of 14 trials that evaluated the effects of treatment with antibiotics, antivirals, phototherapy, antihistamines, and Chinese medicines, found only moderate evidence supporting acyclovir treatment for improving itchingin comparison to placebo or no treatment [4]. In total 761 patients (age range 2–60 years) were included in the studies.Öğe Corrigendum to “The mosaic of autoimmunity - A taste for more. The 12th international congress of autoimmunity 2021 (AUTO12) virtual” [Autoimmunity Reviews, Volume 20 (2021) 102945](Elsevier, 2022) Mahroum, Naim; Damoiseaux, Jan; Zoubi, Magdi; Lavine, Noy; Ohayon, Aviran; Amital, Howard; Shoenfeld, Yehuda[Abstract Not Available]Öğe COVID-19 and SLE: Infection and autoimmunity at its best(SAGE Publications Ltd, 2023) Mahroum, Naim; Elsalti, Abdulrahman; Özkan, Mehmet Fatih; Shoenfeld, YehudaIf one had any doubts before the pandemic regarding the correlation between infections and autoimmunity, COVID-19 left us fascinated on the strong bond between the two entities. The immune and autoimmune reactions seen in patients infected with SARS-CoV-2 have served as a base for this assumption. Later on, the use of immunosuppressants such as systemic glucocorticoids, among other biological agents, turned this assumption to a fact. This was no different when it comes to the vaccines against COVID-19. Through several postulated mechanisms these vaccines, although generally considered safe, are thought to have the potential to result in autoimmune reactions making them not more innocent than the infection itself. When systemic lupus erythematous (SLE) is viewed as a classical autoimmune multisystemic disorder, the connection with SARS-CoV-2 infection and COVID-19 vaccination is of extreme importance. This is because early reports during the pandemic have shown increased rates of SARS-CoV-2 infection among patients known previously to have SLE and much more interestingly, cases of new-onset SLE after COVID-19 have been documented in the literature. Subsequently vaccines against COVID-19, those mRNA-based and adenovirus-vector based, were reported to induce new SLE cases, trigger immune thrombocytopenia or lupus nephritis, two common presentations of SLE, or exacerbate flares. In our paper, we concluded various aspects of available and recent data regarding SLE and COVID-19 as both an infection and vaccination.Öğe COVID-19 vaccination can occasionally trigger autoimmune phenomena, probably via inducing age-associated B cells(Wiley, 2022) Mahroum, Naim; Shoenfeld, YehudaThe increasing numbers of vaccinated people against COVID-19 worldwide has permitted better visualization and understanding of possible adverse effects, particularly those related to autoimmune phenomena. In this regard, Sachinidis and Garyfallos have lately ad-dressed a possible explanation for these phenomena emphasizing the role of age-associated B cells.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 Herpes simplex virus and SLE: Though uncommon yet with significant implications(NLM (Medline), 2023) Mahroum, Naim; Elsalti, Abdulrahman; Shoenfeld, YehudaTo the Editor,The relation between infectious agents, particularly viruses, withautoimmunity and autoimmune diseases, has been extensivelystudied during the last decades. Recently, the association was shownto be even stronger during the pandemic of COVID?19, as thecausative virus, severe acute respiratory syndrome corona virus2 (SARS?CoV?2) has been linked to severe autoimmune sequela ininfected individuals. The concerned consequences in patients withCOVID?19 were documented during the acute viral infection,throughout the long recovery phase (so?called post?COVID syn-drome), as well as secondary to the vaccines of COVID?19.1Actually,the autoimmune nature of SARS?CoV?2 has been vastly reported inthe medical literature and it is beyond the scope of our currentpaper.2However, it shows the strong bond between infection andautoimmunity. Subsequently, with a deep interest in the field, weanalyzed the article of Chang et al.3concluding that there is nocorrelation between herpes simplex viral infections and systemiclupus erythematosus (SLE) in terms of causality using Mendelian randomization.Öğe In response to comment on "Autoimmune post-COVID vaccine syndromes: Does the spectrum of autoimmune/inflammatory syndrome expand?" by Jara LJ et al(Springer London Ltd, 2022) Jara, Luis Javier; Vera-Lastra, Olga; Mahroum, Naim; Pineda, Carlos; Shoenfeld, YehudaWe thank Dr. Kunal Chandwar for their interest in our article “Autoimmune post-COVID vaccine syndromes: does the spectrum of autoimmune/infammatory syndrome expand?” Indeed, we have included all of the COVID-19 vaccines, and we agree with you that they have diferent mechanisms of action but similar capabilities to protect against COVID19 to millions of people. Therefore, they also can induce adverse effects, including autoimmune syndromes, in a minority of people with genetic and environmental risk factors.Öğe Infection and Autoimmunity(Academic Press, 2024) Mahroum, Naim; Watad, Abdulla; Shoenfeld, YehudaIn 2020 we lost Noel Rose, co-editor of the classic Infection and Autoimmunity. To honor and respect his work, a group of experts in the field have taken the initiative to make this book perpetual. The third edition of Infection and Autoimmunity updates all the recent and leading papers on infection and autoimmunity, in addition to a dedicated section on to the correlation between SARS-CoV-2 infection and autoimmunity. From the very beginning of the COVID-19 pandemic, numerous papers have been published, including studies conducted by the editors and authors of the book, on COVID-19 and autoimmunity, and therefore this knowledge has been incorporated into this new edition. The addition and extended coverage on SARS-CoV-2/COVID-19 and autoimmunity are pivotal for the third edition of the book due to the COVID-19 pandemic. Medical students and practitioners, as well as academic staff in medical schools globally, are enthusiastic in searching for better understanding of the correlation between infection and autoimmunity in general, and the long-term effects of SARS-CoV-2 and COVID-19 on the immunce system in particular, especially in terms of autoimmunity related to the virus.Öğe Infection and autoimmunity – an ıntroductory note(Academic Press, 2024) Mahroum, Naim; Shoenfeld, YehudaAlmost every infectious agent was linked in one way or another to various responses from the immune system. The responses range from normal reaction to a vast majority of autoimmune manifestations. Led by molecular mimicry, the mechanisms by which an autoimmune phenomena appears in correlation with infection are numerous including bystander activation and superantigens, among others. The recent pandemic of COVID-19 has strengthened the importance of autoimmunity in the context of infection. Nevertheless, historical examples such as acute rheumatic fever is critical for this understanding as well.Öğe SARS-CoV-2 infection provoking autoimmunity(Oxford University Press, 2023) Mahroum, Naim; Shoenfeld, YehudaFor decades, infections have been recognized as strong stimulators of the immune system and subsequently serve as a trigger for autoimmunity and autoimmune diseases. While infection is a very broad term, infectious agents such as bacteria, viruses and parasites, but particularly viruses present a key player in this regard and have been considered a classical example for this correlation.Öğe Shared pathogenicity features and sequences between EBV, SARS-CoV-2, and HLA class I molecule-binding motifs with a potential role in autoimmunity(Springer, 2023) Adıgüzel, Yekbun; Mahroum, Naim; Muller, Sylviane; Blank, Miri; Halpert, Gilad; Shoenfeld, YehudaEpstein-Barr virus (EBV) and severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are extraordinary in their ability to activate autoimmunity as well as to induce diverse autoimmune diseases. Here we reviewed the current knowledge on their relation. Further, we suggested that molecular mimicry could be a possible common mechanism of autoimmunity induction in the susceptible individuals infected with SARS-CoV-2. Molecular mimicry between SARS-CoV-2 and human proteins, and EBV and human proteins, are present. Besides, relation of the pathogenicity associated with both coronavirus diseases and EBV supports the notion. As a proof-of-the-concept, we investigated 8mer sequences with shared 5mers of SARS-CoV-2, EBV, and human proteins, which were predicted as epitopes binding to the same human leukocyte antigen (HLA) supertype representatives. We identified significant number of human peptide sequences with predicted-affinities to the HLA-A*02:01 allele. Rest of the peptide sequences had predicted-affinities to the HLA-A*02:01, HLA-B*40:01, HLA-B*27:05, HLA-A*01:01, and HLA-B*39:01 alleles. Carriers of these serotypes can be under a higher risk of autoimmune response induction upon getting infected, through molecular mimicry-based mechanisms common to SARS-CoV-2 and EBV infections. We additionally reviewed established associations of the identified proteins with the EBV-related pathogenicity and with the autoimmune diseases.Öğe Systematic review and meta-analysis of tocilizumab therapy versus standard of care in over 15,000 COVID-19 pneumonia patients during the first eight months of the pandemic(MDPI, 2021) Mahroum, Naim; Watad, Abdulla; Bridgewood, Charlie; Mansour, Muhammad; Nasr, Ahmad; Hussein, Amr; Khamisy-Farah, Rola; Farah, Raymond; Gendelman, Omer; Lidar, Merav; Shoenfeld, Yehuda; Amital, Howard; Kong, Jude Dzevela; Wu, Jianhong; Bragazzi, Nicola Luigi; McGonagle, DennisBackground. Tocilizumab is an anti-IL-6 therapy widely adopted in the management of the so-called "cytokine storm" related to SARS-CoV-2 virus infection, but its effectiveness, use in relation to concomitant corticosteroid therapy and safety were unproven despite widespread use in numerous studies, mostly open label at the start of the pandemic. Methods: We performed a systematic review and meta-analysis of case-control studies utilising tocilizumab in COVID-19 on different databases (PubMed/MEDLINE/Scopus) and preprint servers (medRxiv and SSRN) from inception until 20 July 2020 (PROSPERO CRD42020195690). Subgroup analyses and meta-regressions were performed. The impact of tocilizumab and concomitant corticosteroid therapy or tocilizumab alone versus standard of care (SOC) on the death rate, need for mechanical ventilation, ICU admission and bacterial infections were assessed. Results. Thirty-nine studies with 15,531 patients (3657 cases versus 11,874 controls) were identified. Unadjusted estimates (n = 28) failed to demonstrate a protective effect of tocilizumab on survival (OR 0.74 ([95%CI 0.55-1.01], p = 0.057), mechanical ventilation prevention (OR 2.21 [95%CI 0.53-9.23], p = 0.277) or prevention of ICU admission (OR 3.79 [95%CI 0.38-37.34], p = 0.254). Considering studies with adjusted, estimated, tocilizumab use was associated with mortality rate reduction (HR 0.50 ([95%CI 0.38-0.64], p < 0.001) and prevention of ICU admission (OR 0.16 ([95%CI 0.06-0.43], p < 0.001). Tocilizumab with concomitant steroid use versus SOC was protective with an OR of 0.49 ([95%CI 0.36-0.65], p < 0.05) as was tocilizumab alone versus SOC with an OR of 0.59 ([95%CI 0.34-1.00], p < 0.001). Risk of infection increased (2.36 [95%CI 1.001-5.54], p = 0.050; based on unadjusted estimates). Conclusion: Despite the heterogeneity of included studies and large number of preprint articles, our findings from the first eight of the pandemic in over 15,000 COVID-19 cases suggested an incremental efficacy of tocilizumab in severe COVID-19 that were confirmed by subsequent meta-analyses of large randomized trials of tocilizumab. This suggests that analysis of case-control studies and pre-print server data in the early stages of a pandemic appeared robust for supporting incremental benefits and lack of major therapeutic toxicity of tocilizumab for severe COVID-19.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 The mosaic of autoimmunity-A taste for more. The 12th international congress of autoimmunity 2021 (AUTO12) virtual(Elsevier, 2021) Mahroum, Naim; Zoubi, Magdi; Lavine, Noy; Ohayon, Aviran; Amital, Howard; Shoenfeld, YehudaNotwithstanding the fact that the 12th international congress of autoimmunity (AUTO12) was held virtual this year, the number of the abstracts submitted and those presented crossed the thousand marks. Leading investigators and researchers from all over the world presented the latest developments of their research in the domain of autoimmunity and its correlation with various diseases. In terms of mechanisms of autoimmunity, an update on the mechanisms behind the association of autoimmunity with systemic diseases focusing on hyperstimulation was presented during AUTO12. In addition, a new mechanism of ASIA syndrome caused by an intrauterine contraceptive device was revealed demonstrating a complete resolution of symptoms following device removal. In regard to the correlation between autoimmunity and neurogenerative diseases, the loss of structural protein integrity as the trigger of immunological response was shown. Schizophrenia as well, and its correlation to pro-inflammatory cytokines was also addressed. Furthermore, and as it was said AUTO12 virtual due to COVID-19 pandemic, various works were dedicated to SARS-CoV-2 infection and COVID-19 in terms of autoimmune mechanisms involved in the pathogenesis, treatment and complications of COVID-19. For instance, the correlation between autoimmunity and the severity of COVID-19 was viewed. Moreover, the presence and association of autoantibodies in COVID-19 was also demonstrated, as well as the clinical outcomes of COVID-19 in patients with rheumatic diseases. Finally, immune-mediated reactions and processes secondary to SARS-CoV-2 vaccination was displayed. Due to the immense importance of all of the topics addressed and while several hundreds of works were presented which cannot be summed up in one paper, we aimed hereby to highlight some of the outstanding abstracts and presentations during AUTO12.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 Vaccine-induced strain replacement: theory and real-life implications(2024) Mahroum, Naim; Karaoğlan, Birnur Sinem; Uluçam, Enes Sedat; Shoenfeld, YehudaThe value of preventive medicine is superior to treatment with vaccinations occupying high priority. Nevertheless, heavy pressure has started to form in regard to strains not included in vaccines contributing to the changing epidemiology of pathogen subtypes leading to ‘vaccine-induced strain replacement’. Among other mechanisms, increasing fitness of nonvaccine strains and metabolic shifts in the subtypes have been described. Classical examples include pneumococcal infections and viral diseases, such as the human papilloma virus. Recently, it has been described in SARS-CoV-2, leading to the emergence of new subtypes, such as Omicron and Delta variants. The phenomenon has also been reported in Mycobacterium tuberculosis, Neisseria meningitidis and rotavirus. This study addresses the concepts, examples and implications of this phenomenon.
