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Ítem B lymphocytes: development, tolerance, and their role in autoimmunity-focus on systemic lupus erythematosus.(Elsevier, 2013-01-01) Cañas Dávila, Carlos AlbertoB lymphocytes are the effectors of humoral immunity, providing defense against pathogens through different functions including antibody production. B cells constitute approximately 15% of peripheral blood leukocytes and arise from hemopoietic stem cells in the bone marrow. It is here that their antigen receptors (surface immunoglobulin) are assembled. In the context of autoimmune diseases defined by B and/or T cell autoreactive that upon activation lead to chronic tissue inflammation and often irreversible structural and functional damage, B lymphocytes play an essential role by not only producing autoantibodies but also functioning as antigen-presenting cells (APC) and as a source of cytokines. In this paper, we describe B lymphocyte functions in autoimmunity and autoimmune diseases with a special focus on their abnormalities in systemic lupus erythematosus.Ítem Clinical utility of 18F-fluorodeoxyglucose positron emission tomography/computed tomography in Takayasu arteritis -- a report of 3 demonstrative cases.(Journal of Rheumatology, 2013-12-01) Cañas Dávila, Carlos AlbertoTakayasu arteritis (TA) is a granulomatous disease affecting aorta and its main branches1. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG-PET/CT) may be useful in assessing disease activity of TA. We describe 3 demonstrative cases. In case 1, a 44-year-old man was admitted with a fever of unknown origin. The levels of acute phase reactants (APR) were elevated. Pulse in the left upper arm was undetectable and the …Ítem ¿Son las enfermedades autoinmunes predecibles?(Elsevier Science BV, 2012-02-01) Cañas Dávila, Carlos AlbertoAutoimmune diseases are complex diseases resulting of the interaction between both genetics and environmental factors over time. Different phases in the development of autoimmune diseases are characterized by the detection of serum autoantibodies several months or years before the onset of clinical manifestations and subsequent diagnosis. In addition to serum antibodies, genetic susceptibility factors may predict the future development of the disease. Currently, prediction in type 1 diabetes is the most accurate, with the analysis of genetic susceptibility factors in first-degree relatives of patients and several autoantibody tests. In the future, multiple antibodies test, in combination with the analysis of genetics, epigenetics and immunological anomalies in fine models may allow the precise prediction in autoimmune diseases. Prevention measures might thus be introduced as an attempt to avoid or delay the disease.Ítem Autoinmunidad y autoinflamación(Asociación Colombiana de Medicina Interna, 2011-04-01) Cañas Dávila, Carlos AlbertoObjetivo: exponer los aspectos que tienen en común o aquellos que diferencien las condiciones autoinmunes y autoinflamatorias, con énfasis en los mecanismos relacionados con la inmunidad innata. Métodos: se realiza una revisión sistemática de la literatura médica expuesta en la base de datos Medline (en lo que respecta a trabajos originales y revisiones de tema de los autores de dichos trabajos), de aspectos de la inmunidad innata y su relación con las enfermedades autoinmunes y autoinflamatorias, utilizando términos “MESH” como “autoimmuny diseases, autoinflammatory diseases, periodic fever syndromes, Toll-like receptor, NOD-like receptor” y otros que fuesen necesarios para lograr el objetivo de la revisión. Se procede luego a la consecución de los artículos completos, a su lectura, complementación con artículos referenciados relevantes, y luego se procede al ordenamiento, clasificación y posterior redacción del textoÍtem Hiperparatiroidismo primario asociado a pancreatitis autoinmune, colangitis esclerosante y posible hipoglucemia autoinmune(2012-01-01) Cañas Dávila, Carlos AlbertoSe informa el caso de una mujer de 42 años quien desarrolla pancreatitis autoinmune, colangitis esclerosante y probable hipoglucemia autoinmune, asociada con hiperparatiroidismo primario.Ítem Local cartilage trauma as a pathogenic factor in autoimmunity (one hypothesis based on patients with relapsing polychondritis triggered by cartilage trauma).(Elsevier, 2012-01-01) Bonilla Abadía, FabioIn the recent years, it has been of great interest to study the binding mechanism between the innate and adaptive immune responses as interrelated processes for the development of multiple autoimmune diseases. Infection has been a well-known trigger of autoimmunity and trauma has been related as well too. Cryptogenic antigens release, recognition of pathogenic structure, and metabolic changes generated by both stimuli begin an inflammatory process which in turn activates the immune system amplifying T and B cell responses. The development of relapsing polychondritis after trauma may have a direct association with these events and in turn probably trigger autoimmune phenomena.Ítem Drug-induced lupus in anti-TNF-alpha therapy and its treatment with rituximab(Springer Heidelberg, 2012-10-01) Vallejo, SantiagoWe report three patients with rheumatoid arthritis (RA) who were treated with anti-TNF-α agents and who developed drug-induced lupus (DIL). Two of them received etanercept and the remainder adalimumab. We also present the favorable response observed with the withdrawal of the anti-TNF-alpha agents and the introduction of rituximab. Through this intervention, we observed a very good control of the activity of both DIL and RA without additional adverse reactions.Ítem Efficacy and safety of anti-interleukin 6 receptor monoclonal antibody (tocilizumab) in Colombian patients with Takayasu arteritis.(Lippincott, Williams & Wilkins, 2014-04-01) Cañas Dávila, Carlos AlbertoPurpose: The aim of this study was to describe the efficacy and safety of anti–interleukin 6 receptor antibody (tocilizumab [TCZ]) in patients with severe or refractory Takayasu arteritis (TA). Methods: We describe 8 Colombian patients with severe and/or refractory TA treated with TCZ during a period of at least 9 months. Clinical, radiological, biological, and associated treatments were evaluated before, during, and after TCZ infusions. Results: The median age at evaluation was 31 years (12–43 years). All patients were female and experienced clinical and biological improvement, in addition to a corticosteroid-sparing effect from a median dose of 50 mg/d at baseline (30–60 mg/d) to 6.25 mg/d (2.5–10 mg/d) at 9 months. In 4 cases, in which imaging studies were available, an improvement was observed.Ítem Multiple endovascular stent-graft implantations in a patient with aortic thoracic and abdominal aneurysms due Takayasu arteritis.(Springer Verlag, 2014-05-01) Echeverri, Andrés FelipeWe report an adult female patient with Takayasu arteritis (TA) receiving conventional medical treatment and anti-TNF therapy, which developed progressive thoracic and abdominal aortic aneurysms. She developed imminent rupture of the thoracic aneurysm and an endovascular stent-graft (EVSG) was emergency implanted and a year after this procedure the abdominal aneurysm increased in size requiring reoperation and placement of another EVSG. Both procedures had a very good outcome. This case shows the effectivity and security of multiple EVSG implantations in multiple aortic aneurisms in patients with TA.Ítem Patients with relapsing polychondritis and previous cartilage trauma present more autoimmunity phenomena(Springer Verlag, 2012-02-01) Cañas Dávila, Carlos AlbertoRelapsing polychondritis (RP) is an autoimmune disease characterized by inflammation and destruction of all type of body cartilage, and the cartilage trauma may be a trigger of the disease in a susceptible person. We describe the clinical and laboratory findings in a group of 18 patients with RP with (7 cases) or without (11 cases) anteceding cartilage trauma. The mean age was 41 years in the group with cartilage trauma and 55 years in the group without cartilage trauma. For both groups, female gender was predominant. All patients presented with auricular chondritis. Systemic manifestations and autoimmunity were more common in patients with anteceding trauma. © 2011 Springer-Verlag.