Does the intestinal flora aggravate osteoarthritis? Cyclophosphamide cures disease or causes cancer? A week of "wind" clouds.

One week "wind" cloud provides you with the latest research and new information in the field of rheumatic immunity. Welcome to pay attention! There is a correlation between intestinal flora and knee pain in OA. There are gender differences in axial spondylitis. Cyclophosphamide treatment of systemic necrotizing vasculitis increases the risk of malignant tumor. Intestinal flora is associated with knee pain in OA. Knee osteoarthritis (OA) is also known as "knee degenerative arthritis" and "knee abrasion" arthritis.the main characteristics of the disease are knee stiffness, swelling deformity, effusion, pain, walking difficulties, etc.recently, an article published in Nature Reviews rhaumatology showed that there was a certain correlation between intestinal flora and knee joint pain in OA.in a study involving 1427 patients with OA, the relative and absolute abundance of Streptococcus species in fecal microbiota samples were associated with the severity of OA disease and the increased knee pain associated with OA.the higher the relative abundance and absolute abundance, the more severe OA, and increased the degree of OA related knee pain.why does this association occur? Is it caused by smoking and drinking? The effect of intestinal microflora on OA and OA associated knee pain was not associated with smoking, drinking or body mass index, the researchers said.to a large extent, intestinal flora affects the health of host through immune regulation, and immune regulation such as inflammatory response is closely related to the process of OA.it is still necessary to confirm whether intestinal flora influences OA through innate immune system.the streptococci mentioned in the study are widely distributed in the feces of human and animals in nature and the nasopharynx of healthy people, but most of them are not pathogenic.the most important Streptococcus in medicine are Streptococcus pyogenes, Streptococcus viridis, Streptococcus pneumoniae, Streptococcus agalactiae, etc.in our daily life, we should try our best to avoid contact with patients with Streptococcus infection, ensure indoor ventilation and exercise more! At present, more and more studies support the viewpoint that the homeostasis, population and quantity of intestinal microflora have a certain impact on the progress of OA, which brings a new breakthrough point for the treatment of OA.02. There are gender differences in patients with axial spondylarthritis. Is it more likely that men or women are more likely to suffer from it? What are the differences in symptoms between men and women? In general, there are less changes in imaging in women than in men, but the prevalence is higher in women.this difference may be caused by the specific effect of sex hormones on the immune system.studies have found that men with axial spondylitis have higher levels of tumor necrosis factor (TNF - α), C-reactive protein (CPR) and interleukin-17, and have stronger immunity than women.the researchers also indicated that the activation of related genes by sex hormones can also affect the progression of the disease, which may change the genetic load of patients.through mRNA analysis, we further explored the gene expression differences between men and women with axial spondylitis, and found that some genes were specifically expressed in men with ankylosing spondylitis.in terms of symptoms, female patients with axial spondylitis often have more peripheral symptoms, such as joint pain. in male patients, low back pain was the main cause, and peripheral organs were less involved. at the same time, female patients are more likely to have encephalitis and inflammatory bowel disease. the researchers say the disease may be more severe in women because women can tolerate higher pain than men. the difference of symptoms makes most female patients fail to get early diagnosis. a 2016 meta-analysis found that the delay in diagnosis was 8.8 years for women and 6.5 years for men. in daily life, women can not ignore the symptoms of low back pain, morning stiffness, myalgia and so on, so they can be found and treated as soon as possible. at the same time, doctors should also pay attention to judge the patient's condition in clinical diagnosis and avoid misdiagnosis and mistreatment! Cyclophosphamide: treatment and carcinogenesis cyclophosphamide increases the risk of cancer is an old topic, how to balance the efficacy of cyclophosphamide and the risk of cancer is a great challenge for clinicians. in order to explore the risk of systemic necrotizing vasculitis (SNV) and malignant tumor, French scholars conducted a study. a total of 733 patients from 1993 to 2012 were included in the study. During the observation period, 39 (5.3%) patients developed malignant tumors, including 34 solid cancers (4.6%) and 5 hematological malignancies (0.7%). the average time interval from the time the patients were enrolled to the diagnosis of malignant tumors was 4.1 years. among the solid cancers, there were 9 (26.5%) gastrointestinal cancers, 8 (23.5%) urogenital cancers, 7 (20.6%) non melanoma skin cancers (NMSC), 6 (17.6%) lung cancers, 2 (5.9%) breast cancers, brain tumors and unknown primary cancers. hematological malignancies included 2 cases of myelodysplastic syndrome, 1 case of multiple myeloma, 1 case of myelodysplastic syndrome and 1 case of renal lymphoma. during the follow-up period, 19 patients with malignant tumor died. There was a certain correlation between malignant tumor and overall survival rate of patients. however, conventional immunosuppressive regimens were still associated with a higher risk of malignancies. The combination of cyclophosphamide as an inducer and rituximab as maintenance therapy was not significantly associated with the occurrence of malignant tumors (HR 2.65; P = 0.262). cyclophosphamide is widely used in the field of rheumatic immunity. Do you have any experience or questions about the use of cyclophosphamide? Welcome to the comments area for discussion! References: [1] Sarah onura, gut microbiome linked with OA knee pain, Nature Reviews rhaumatology 16,2 (2020) [2] Ruth Jessen Hickman, men, women & amp; medical differences in axial spondyloarthropathy, October 24, 2019. A, Joseph a, et, risk of malignancy in patients treated for systemic necrotizing vasculitis.BMJ ,2019, 11.25.doi：10.1136 / annrheumdis-2019-216452