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Berlin, Germany

Van Der Heijde D.,Leiden University | Machado P.,Leiden University | Machado P.,University of Coimbra | Braun J.,Ruhr University Bochum | And 5 more authors.
Annals of the Rheumatic Diseases | Year: 2012

Objective: To investigate the relationship between MRI inflammation at the vertebral unit and the formation and growth of syndesmophytes at the same vertebral unit. Methods: An 80% random sample of the ASSERT database was analysed. MRI were scored using the ankylosing spondylitis (AS) spinal MRI activity score (at baseline, 24 and 102 weeks) and spinal x-rays were scored using the modified Stoke AS spine score (at baseline and 102 weeks). Data were analysed at the patient level and the vertebral unit level using a multilevel approach to adjust for within-patient correlation. Results: There was a slightly increased probability of developing syndesmophytes in vertebral units with MRI activity, which was maintained after adjustment for within-patient correlation (per vertebral unit level) and treatment, and after further adjustment for potential confounders, resulting in significant OR ranging from 1.51 to 2.26. Growth of existing syndesmophytes at the vertebral unit level was not associated with MRI activity. At the patient level only a trend for an association was observed. Conclusion: MRI inflammation in a vertebral unit slightly increases the propensity to form a new syndesmophyte in the same vertebral unit, but does not predict the growth of already existing syndesmophytes. Despite this association, the large majority of new syndesmophytes developed in vertebral units without inflammation. The subtle association at the vertebral unit level did not translate into an association at the patient level. Source


Hermann K.A.-G.,Charite Medical School | Bollow M.,Augusta Hospital
RoFo Fortschritte auf dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren | Year: 2014

Magnetic resonance imaging (MRI) of the sacroiliac joints (SIJs) has become established as a valuable modality for the early diagnosis of sacroiliitis in patients with inconclusive radiographic findings. Positive MRI findings have the same significance as a positive test for HLA-B27. Sacroiliitis is one of the key features of axial spondyloarthritis (SpA) in the classification proposed by the Assessments in Ankylosing Spondylitis (ASAS) group.Early signs of sacroiliitis include enthesitis of articular fibrocartilage, capsulitis, and osteitis. In more advanced disease, structural (chronic) lesions will be visible, including periarticular fatty deposition, erosions, subchondral sclerosis, and transarticular bone buds and bridges. In this article we describe magnetic resonance (MR) findings and provide histologic biopsy specimens of the respective disease stages. The predominant histologic feature of early and active sacroiliitis is the destruction of cartilage and bone by proliferations consisting of fibroblasts and fibrocytes, T-cells, and macrophages. Advanced sacroiliitis is characterized by new bone formation with enclosed cartilaginous islands and residual cellular infiltrations, which may ultimately lead to complete ankylosis. Knowledge of the morphologic appearance of the sacroiliac joints and their abnormal microscopic and gross anatomy is helpful in correctly interpreting MR findings. Citation Format: Hermann KGA, Bollow M. Magnetic Resonance Imaging of Sacroiliitis in Patients with Spondyloarthritis: Correlation with Anatomy and Histology. Fortschr Röntgenstr 2014; 186: 230-237.©Georg Thieme Verlag KG Stuttgart. Source


Matricardi P.M.,Charite Medical School
Current Opinion in Allergy and Clinical Immunology | Year: 2013

PURPOSE OF REVIEW: To summarize recent data on molecular profiles of IgE sensitization in allergic patients and discuss how they can influence our understanding of allergen specific immunotherapy. RECENT FINDINGS: In childhood, Immunoglobulin E (IgE) sensitization to grass pollen starts preclinically as a weak, mono or oligomolecular response and evolves rapidly to become strong, polymolecular and associated with clinical manifestations. This immunological phenomenon has been defined 'molecular spreading' and it makes the IgE sensitization profiles to complex allergenic sources highly heterogeneous in the population. SUMMARY: The recent findings raise new questions: do different molecular sensitization profiles (e.g. to grass pollen) underlie different clinical responses to allergen-specific immunotherapy? Should the allergen-specific immunological intervention be anticipated at earlier stages of the IgE sensitization process? Should the regulatory rules for molecularly designed allergen-specific immunotherapy preparations consider the extreme heterogeneity of sensitization profiles in populations? © 2013 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source


Schonfeld U.,Charite Medical School | Clarke A.H.,Charite Medical School
Acta Oto-Laryngologica | Year: 2011

Conclusion: The present study demonstrates that various response patterns of subjective visual vertical (SVV) can be identified during unilateral centrifugation (UC). It is proposed that these response types correspond to different degrees of compensation after disease. This is advantageous for monitoring the effect of rehabilitative measures and is useful in medico-legal issues. It also emerges that diagnosis of unilateral utricle function requires the determination not only of asymmetry ratio but also offset of SVV estimates. Objectives: A retrospective clinical study of SVV test results was performed to establish a classification and model of response types in patients with suspected otolith disorder. Methods: SVV measurements were made in 473 patients recruited from the dizziness clinic. A control group of healthy subjects (n = 43) was tested with the same protocol. Testing with bilateral stimulation (stationary upright, 15°, 30° tilt) and UC was performed. A mathematical model for the UC results was developed. Results: During UC testing 61% of the patients showed an asymmetric response indicating a unilateral utricular hypofunction/dysfunction. These results could be classified into three subgroups, indicating different degrees of compensation. The model parameters can be adapted to reflect this classification. © 2011 Informa Healthcare. Source


Hofmaier S.,Charite Medical School | Comberiati P.,University of Verona | Matricardi P.M.,Charite Medical School
European Annals of Allergy and Clinical Immunology | Year: 2014

Allergen-specific IgG antibodies play a significant role in allergen-specific tolerance, either naturally induced or generated by specific immunotherapy. Nevertheless, the underlying mechanisms are still debated, and allergen-specific IgG determinations are not recommended as a diagnostic tool in IgE-mediated allergy. This review summarizes the latest findings on the immunological and diagnostic role of IgG antibodies in respiratory and food allergies, and during allergen-specific immunotherapy. Source

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