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Wang W.,Shanghai Traditional Chinese Medicine Integrated Hospital | Zhang Y.,Diasys Diagnostic Systems Shanghai Co. | Liao Y.,Peoples Hospital of Shiyan | Wu J.,Diasys Diagnostic Systems Shanghai Co. | And 5 more authors.
Clinical Laboratory | Year: 2014

Background: The different grading systems for diabetic foot disease pose a challenge in clinical decision making because each system fails to accurately reflect the individual course of disease progression. This study attempts to identify laboratory measurements for classifying diabetic foot disease to guide clinical treatment. Methods: The sera of 111 clinically graded diabetic foot patients were measured for several laboratory parameters including serum amyloid A (SAA), C-reactive protein (CRP), and apo A-I. By using the molar sum of CRP and SAA and then dividing by the molarity of apo A-I, an acute phase index was introduced to assess the inflammatory status of the patients. Results: Based on a newly defined acute phase index (API), diabetic foot patients were classified into 3 distinct groups that provide a diagnostic tool complementing the established Texas grading system for clinical decision making. Conclusions: The integration of the serum concentrations of SAA, CRP and apo A-I into an acute phase index (API) offers an opportunity to triage diabetic foot patients who may benefit from personalized medicine. © Copyright.

Wang J.,Fudan University | Guo X.,University of Houston | Yi L.,University of Houston | Yi L.,Gansu College of Traditional Chinese Medicine | And 12 more authors.
PLoS ONE | Year: 2014

Human leukocyte antigen DPB1 was reported to contain singly nucleotide polymorphisms conferring the strongest susceptibility to systemic sclerosis in Korean population. However, associations of specific DPB1 alleles with SSc vary in different ethnic populations. The aim of this study was to profile DPB1 alleles in Chinese population and to identify specific DPB1 alleles in association with SSc and clinical and serological features of SSc in Han Chinese. A cohort containing 338 patients with SSc and 480 gender-matched and unrelated controls were examined in the study. The HLA-DPB1 genotyping was performed with sequence-based typing method. Exact p-values were obtained (Fisher's test) from 2x2 tables of allele counts or allele carriers and disease status. Thirty eight DPB1 alleles were found in the cohort. DPB1*05:01 was the most common allele in this cohort. DPB1*03:01 and*13:01 were significantly increased in SSc. DPB1*13:01 association had already been described in other ethnic populations, whereas DPB1*03:01 was specific to Han Chinese patients with SSc. In addition, comparisons between SSc subsets indicated that patients carrying DPB1*03:01 were more likely to develop pulmonary fibrosis, DPB1*04 carriers were increased in SSc patients with anti-centromere autoantibodies and in contrast, SSc patients with homozygous DPB1*05:01 showed an opposite association with marginal significance. © 2014 Wang et al.

Wang J.,Fudan University | Assassi S.,University of Houston | Guo G.,Yiling Hospital | Tu W.,Shanghai Traditional Chinese Medicine Integrated Hospital | And 12 more authors.
Clinical Rheumatology | Year: 2013

Our goal was to study the prevalence of systemic sclerosis (SSc) subtypes, autoantibody profile, and pulmonary fibrosis in a large group of Han Chinese. Chinese SSc patients (n = 419) were recruited from a multicenter study including hospitals and outpatient clinics in China. All patients met the American College of Rheumatology classification criteria for SSc. Anti-topoisomerase (ATA), anti-centromere (ACA), anti-RNA polymerase III (anti-RNAP3), and anti-U1-ribonucleoprotein (anti-U1RNP) were detected utilizing commercially available kits. The clinical and autoantibody information in Chinese patients was compared to that in the US Caucasian patients (n = 834), recruited from the Genetics versus Environment in Scleroderma Outcome Study and Scleroderma Family Registry. Chi-square test was utilized for the abovementioned comparisons. Chinese patients showed 40.3 % limited (lcSSc) and 59.7 % diffuse (dcSSc) forms of SSc. ATA was found in 59.9 %, ACA in 13.4 %, anti-RNAP3 in 1.3 %, and anti-U1RNP in 18 % of Chinese SSc patients. Compared to US patients (65.1 % lcSSc, 34.9 % dcSSc, ATA in 18.7 %, ACA in 32.4 %, anti-RNAP3 in 17.4 %, and anti-U1RNP in 2.8 %), Chinese SSc patients are significantly higher in dcSSc and the frequencies of ATA and anti-U1RNP, but lower in ACA and anti-RNAP3. In addition, pulmonary fibrosis was observed in 78 % Chinese SSc patients and was strongly associated with the presence of ATA. The present study represents the first report of SSc features in a large group of Chinese patients. Clinical subtypes and the frequencies of SSc-related autoantibodies in Chinese SSc patients are significantly different from those in SSc patients of the US Caucasian descent. © 2012 Clinical Rheumatology.

Wang J.,Fudan University | Yi L.,University of Houston | Guo X.,University of Houston | Liu M.,University of Houston | And 9 more authors.
International journal of immunopathology and pharmacology | Year: 2014

Systemic sclerosis (SSc) is a complex disease involving multiple genetic factors. An association of the IRF5 polymorphism with SSc was reported in Caucasian populations of Europe and North America, as well as in Japanese populations. The present study aimed to examine whether the SSc-associated SNP rs2004640 of IRF5 gene confer susceptibility to SSc and clinical features of SSc in a Han Chinese population. A Han Chinese cohort consisting of 424 SSc patients and 502 healthy controls were examined in the study. TaqMan assays were carried out to examine the SNP. Exact p-values were obtained (Fisher’s test) from 2x2 tables of allele counts and disease status. SSc patients of Han Chinese showed increased homozygous TT genotype of the rs2004640 (p = 0.027, odds ratio (OR) = 1.4, CI =1.03-1.93), which was significantly associated with pulmonary fibrosis of SSc and ATA-positive SSc of Han Chinese. The lcSSc and ACA-positive SSc of Han Chinese appeared also in association with the increased T allele frequency. However, the Chinese dcSSc did not show any association with the rs2004640. The results were consistent with previous reports in other ethnic populations in supporting the notion that polymorphisms of IRF5 may play an important role in susceptibility to SSc.

He D.,University of Houston | He D.,Chinese Academy of Sciences | Wang J.,Fudan University | Yi L.,Gansu College of Traditional Chinese Medicine | And 16 more authors.
PLoS ONE | Year: 2014

Multiple alleles of the Human leukocyte antigen (HLA) DRB1 have been strongly associated with systemic sclerosis (SSc) and its clinical or serological subsets. However, the associations vary in different ethnic populations. To define SSc-risk and/or - protective alleles of HLA-DRB1 in Chinese population, we studied a Han Chinese cohort containing 585 patients with SSc and 458 gender-matched, unrelated controls. The HLA-DRB1 genotyping was performed with sequence-based typing method. Exact p-values were obtained (Fisher's test) from 2x2 tables of allele frequency and disease status. The major SSc-risk allele subtypes of HLA-DRB1 are the DRB1∗15:02 and∗16:02 in this Chinese cohort. Particularly, DRB1∗15:02 was most significantly associated with anti-centromere autoantibodies (ACA) positive, and DRB1∗16:02 with anti-topoisomerase I autoantibodies (ATA) positive patients. On the other hand, DRB1∗01:01 and∗04:06 were strong SSc-protective alleles in Chinese, especially in patients who were ACA positive and had diffuse cutaneous SSc (dcSSc), respectively. In addition, DRB1∗11 and∗07:01 also showed significant association with SSc as a risk for and protection from SSc, respectively, and which is consistent with the studies of Spanish, US Caucasian and Hispanic populations. DRB1∗15 was associated with ATA positive Chinese SSc that is consistent with Black South African and Korean SSc. These findings of HLA-DRB1 alleles in association with Chinese SSc provide the growing knowledge of genetics of SSc, and indicate that the genetic heterogeneity among ethnicities may significantly impact the complex trait of SSc. © 2014 He et al.

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