High- density lipoprotein function is abnormal in idiopathic inflammatory myopathies
Abstract Objective Damage to the vascular endothelium is strongly implicated in the pathogenesis of idiopathic inflammatory myopathies (IIM). Normally, high‐density lipoprotein (HDL) protects the vascular endothelium from damage from oxidized phospholipids, which accumulate under conditions of oxida...
Gespeichert in:
| Veröffentlicht in: | Rheumatology (Oxford, England) England), 2020-11, Vol.59 (11), p.3515-3525 |
|---|---|
| Hauptverfasser: | , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3525 |
|---|---|
| container_issue | 11 |
| container_start_page | 3515 |
| container_title | Rheumatology (Oxford, England) |
| container_volume | 59 |
| creator | Bae, Sangmae Sharon Lee, Yuen Yin Shahbazian, Ani Wang, Jennifer Meriwether, David Golub, Ilana Oganesian, Buzand Dowd, Tyler Reddy, Srinivasa T Charles-Schoeman, Christina |
| description | Abstract
Objective
Damage to the vascular endothelium is strongly implicated in the pathogenesis of idiopathic inflammatory myopathies (IIM). Normally, high‐density lipoprotein (HDL) protects the vascular endothelium from damage from oxidized phospholipids, which accumulate under conditions of oxidative stress. The current work evaluated the antioxidant function of HDL in IIM patients.
Methods
HDL’s antioxidant function was measured in IIM patients using a cell-free assay, which assesses the ability of isolated patient HDL to inhibit oxidation of low-density lipoproteins and is reported as the HDL inflammatory index (HII). Cholesterol profiles were measured for all patients, and subgroup analysis included assessment of oxidized fatty acids in HDL and plasma MPO activity. A subgroup of IIM patients was compared with healthy controls.
Results
The antioxidant function of HDL was significantly worse in patients with IIM (n = 95) compared with healthy controls (n = 41) [mean (S.d.) HII 1.12 (0.61) vs 0.82 (0.13), P |
| doi_str_mv | 10.1093/rheumatology/keaa273 |
| format | Article |
| fullrecord | <record><control><sourceid>oup_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7590404</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><oup_id>10.1093/rheumatology/keaa273</oup_id><sourcerecordid>10.1093/rheumatology/keaa273</sourcerecordid><originalsourceid>FETCH-LOGICAL-c448t-3918420c8c6b4b3d6d6c6f06a393dcc9b8dc3e18a1166d3ab8b5d39af0ea5cb03</originalsourceid><addsrcrecordid>eNqNUMtOwzAQtBCIlsIfIJQfCLVjJ3UuSKjiJVXiUs7W-pHGkMSRnSDl70mVUpUbp92dnZldDUK3BN8TnNOlL01fQ-cqtxuWXwYgWdEzNCcsS2JMaXJ-7BM2Q1chfGKMU0L5JZrRhFOcrPAcbV_trowjbZpguyGqbOta7zpjm6joG9VZ10Q2RCAb52uoohG32roWutKqcSoqqPdf-CGqhwk24RpdFFAFc3OoC_Tx_LRdv8ab95e39eMmVozxLqY54SzBiqtMMkl1pjOVFTgDmlOtVC65VtQQDoRkmaYguUw1zaHABlIlMV2gh8m37WVttDJN56ESrbc1-EE4sOLvprGl2LlvsUpzzDAbDdhkoLwLwZviqCVY7FMWpymLQ8qj7O707lH0G-tIWE4E17f_s_wB6HyS4g</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype></control><display><type>article</type><title>High- density lipoprotein function is abnormal in idiopathic inflammatory myopathies</title><source>MEDLINE</source><source>Oxford University Press Journals All Titles (1996-Current)</source><source>Alma/SFX Local Collection</source><creator>Bae, Sangmae Sharon ; Lee, Yuen Yin ; Shahbazian, Ani ; Wang, Jennifer ; Meriwether, David ; Golub, Ilana ; Oganesian, Buzand ; Dowd, Tyler ; Reddy, Srinivasa T ; Charles-Schoeman, Christina</creator><creatorcontrib>Bae, Sangmae Sharon ; Lee, Yuen Yin ; Shahbazian, Ani ; Wang, Jennifer ; Meriwether, David ; Golub, Ilana ; Oganesian, Buzand ; Dowd, Tyler ; Reddy, Srinivasa T ; Charles-Schoeman, Christina</creatorcontrib><description>Abstract
Objective
Damage to the vascular endothelium is strongly implicated in the pathogenesis of idiopathic inflammatory myopathies (IIM). Normally, high‐density lipoprotein (HDL) protects the vascular endothelium from damage from oxidized phospholipids, which accumulate under conditions of oxidative stress. The current work evaluated the antioxidant function of HDL in IIM patients.
Methods
HDL’s antioxidant function was measured in IIM patients using a cell-free assay, which assesses the ability of isolated patient HDL to inhibit oxidation of low-density lipoproteins and is reported as the HDL inflammatory index (HII). Cholesterol profiles were measured for all patients, and subgroup analysis included assessment of oxidized fatty acids in HDL and plasma MPO activity. A subgroup of IIM patients was compared with healthy controls.
Results
The antioxidant function of HDL was significantly worse in patients with IIM (n = 95) compared with healthy controls (n = 41) [mean (S.d.) HII 1.12 (0.61) vs 0.82 (0.13), P < 0.0001]. Higher HII associated with higher plasma MPO activity [mean (S.d.) 13.2 (9.1) vs 9.1 (4.6), P = 0.0006] and higher oxidized fatty acids in HDL. Higher 5-hydroxyeicosatetraenoic acid in HDL correlated with worse diffusion capacity in patients with interstitial lung disease (r = −0.58, P = 0.02), and HDL’s antioxidant function was most impaired in patients with autoantibodies against melanoma differentiation-associated protein 5 (MDA5) or anti-synthetase antibodies. In multivariate analysis including 182 IIM patients, higher HII was associated with higher disease activity and DM diagnosis.
Conclusion
The antioxidant function of HDL is abnormal in IIM patients and may warrant further investigation for its role in propagating microvascular inflammation and damage in this patient population.</description><identifier>ISSN: 1462-0324</identifier><identifier>EISSN: 1462-0332</identifier><identifier>DOI: 10.1093/rheumatology/keaa273</identifier><identifier>PMID: 32830270</identifier><language>eng</language><publisher>England: Oxford University Press</publisher><subject>Adult ; Aged ; Amino Acyl-tRNA Synthetases - immunology ; Autoantibodies - immunology ; Case-Control Studies ; Chromatography, Liquid ; Clinical Science ; Dermatomyositis - drug therapy ; Dermatomyositis - immunology ; Dermatomyositis - metabolism ; Endothelium, Vascular ; Fatty Acids - metabolism ; Female ; Glucocorticoids - therapeutic use ; Humans ; Hydroxyeicosatetraenoic Acids - metabolism ; Immunologic Factors - therapeutic use ; Immunosuppressive Agents - therapeutic use ; Interferon-Induced Helicase, IFIH1 - immunology ; Lipoproteins, HDL - metabolism ; Lipoproteins, LDL - metabolism ; Lung Diseases, Interstitial - immunology ; Lung Diseases, Interstitial - metabolism ; Male ; Middle Aged ; Myositis - drug therapy ; Myositis - immunology ; Myositis - metabolism ; Myositis, Inclusion Body - drug therapy ; Myositis, Inclusion Body - immunology ; Myositis, Inclusion Body - metabolism ; Oxidation-Reduction ; Peroxidase - metabolism ; Polymyositis - drug therapy ; Polymyositis - immunology ; Polymyositis - metabolism ; Pulmonary Diffusing Capacity ; Spectrometry, Mass, Electrospray Ionization</subject><ispartof>Rheumatology (Oxford, England), 2020-11, Vol.59 (11), p.3515-3525</ispartof><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com 2020</rights><rights>The Author(s) 2020. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c448t-3918420c8c6b4b3d6d6c6f06a393dcc9b8dc3e18a1166d3ab8b5d39af0ea5cb03</citedby><cites>FETCH-LOGICAL-c448t-3918420c8c6b4b3d6d6c6f06a393dcc9b8dc3e18a1166d3ab8b5d39af0ea5cb03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,1578,27903,27904</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32830270$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Bae, Sangmae Sharon</creatorcontrib><creatorcontrib>Lee, Yuen Yin</creatorcontrib><creatorcontrib>Shahbazian, Ani</creatorcontrib><creatorcontrib>Wang, Jennifer</creatorcontrib><creatorcontrib>Meriwether, David</creatorcontrib><creatorcontrib>Golub, Ilana</creatorcontrib><creatorcontrib>Oganesian, Buzand</creatorcontrib><creatorcontrib>Dowd, Tyler</creatorcontrib><creatorcontrib>Reddy, Srinivasa T</creatorcontrib><creatorcontrib>Charles-Schoeman, Christina</creatorcontrib><title>High- density lipoprotein function is abnormal in idiopathic inflammatory myopathies</title><title>Rheumatology (Oxford, England)</title><addtitle>Rheumatology (Oxford)</addtitle><description>Abstract
Objective
Damage to the vascular endothelium is strongly implicated in the pathogenesis of idiopathic inflammatory myopathies (IIM). Normally, high‐density lipoprotein (HDL) protects the vascular endothelium from damage from oxidized phospholipids, which accumulate under conditions of oxidative stress. The current work evaluated the antioxidant function of HDL in IIM patients.
Methods
HDL’s antioxidant function was measured in IIM patients using a cell-free assay, which assesses the ability of isolated patient HDL to inhibit oxidation of low-density lipoproteins and is reported as the HDL inflammatory index (HII). Cholesterol profiles were measured for all patients, and subgroup analysis included assessment of oxidized fatty acids in HDL and plasma MPO activity. A subgroup of IIM patients was compared with healthy controls.
Results
The antioxidant function of HDL was significantly worse in patients with IIM (n = 95) compared with healthy controls (n = 41) [mean (S.d.) HII 1.12 (0.61) vs 0.82 (0.13), P < 0.0001]. Higher HII associated with higher plasma MPO activity [mean (S.d.) 13.2 (9.1) vs 9.1 (4.6), P = 0.0006] and higher oxidized fatty acids in HDL. Higher 5-hydroxyeicosatetraenoic acid in HDL correlated with worse diffusion capacity in patients with interstitial lung disease (r = −0.58, P = 0.02), and HDL’s antioxidant function was most impaired in patients with autoantibodies against melanoma differentiation-associated protein 5 (MDA5) or anti-synthetase antibodies. In multivariate analysis including 182 IIM patients, higher HII was associated with higher disease activity and DM diagnosis.
Conclusion
The antioxidant function of HDL is abnormal in IIM patients and may warrant further investigation for its role in propagating microvascular inflammation and damage in this patient population.</description><subject>Adult</subject><subject>Aged</subject><subject>Amino Acyl-tRNA Synthetases - immunology</subject><subject>Autoantibodies - immunology</subject><subject>Case-Control Studies</subject><subject>Chromatography, Liquid</subject><subject>Clinical Science</subject><subject>Dermatomyositis - drug therapy</subject><subject>Dermatomyositis - immunology</subject><subject>Dermatomyositis - metabolism</subject><subject>Endothelium, Vascular</subject><subject>Fatty Acids - metabolism</subject><subject>Female</subject><subject>Glucocorticoids - therapeutic use</subject><subject>Humans</subject><subject>Hydroxyeicosatetraenoic Acids - metabolism</subject><subject>Immunologic Factors - therapeutic use</subject><subject>Immunosuppressive Agents - therapeutic use</subject><subject>Interferon-Induced Helicase, IFIH1 - immunology</subject><subject>Lipoproteins, HDL - metabolism</subject><subject>Lipoproteins, LDL - metabolism</subject><subject>Lung Diseases, Interstitial - immunology</subject><subject>Lung Diseases, Interstitial - metabolism</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myositis - drug therapy</subject><subject>Myositis - immunology</subject><subject>Myositis - metabolism</subject><subject>Myositis, Inclusion Body - drug therapy</subject><subject>Myositis, Inclusion Body - immunology</subject><subject>Myositis, Inclusion Body - metabolism</subject><subject>Oxidation-Reduction</subject><subject>Peroxidase - metabolism</subject><subject>Polymyositis - drug therapy</subject><subject>Polymyositis - immunology</subject><subject>Polymyositis - metabolism</subject><subject>Pulmonary Diffusing Capacity</subject><subject>Spectrometry, Mass, Electrospray Ionization</subject><issn>1462-0324</issn><issn>1462-0332</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2020</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNUMtOwzAQtBCIlsIfIJQfCLVjJ3UuSKjiJVXiUs7W-pHGkMSRnSDl70mVUpUbp92dnZldDUK3BN8TnNOlL01fQ-cqtxuWXwYgWdEzNCcsS2JMaXJ-7BM2Q1chfGKMU0L5JZrRhFOcrPAcbV_trowjbZpguyGqbOta7zpjm6joG9VZ10Q2RCAb52uoohG32roWutKqcSoqqPdf-CGqhwk24RpdFFAFc3OoC_Tx_LRdv8ab95e39eMmVozxLqY54SzBiqtMMkl1pjOVFTgDmlOtVC65VtQQDoRkmaYguUw1zaHABlIlMV2gh8m37WVttDJN56ESrbc1-EE4sOLvprGl2LlvsUpzzDAbDdhkoLwLwZviqCVY7FMWpymLQ8qj7O707lH0G-tIWE4E17f_s_wB6HyS4g</recordid><startdate>20201101</startdate><enddate>20201101</enddate><creator>Bae, Sangmae Sharon</creator><creator>Lee, Yuen Yin</creator><creator>Shahbazian, Ani</creator><creator>Wang, Jennifer</creator><creator>Meriwether, David</creator><creator>Golub, Ilana</creator><creator>Oganesian, Buzand</creator><creator>Dowd, Tyler</creator><creator>Reddy, Srinivasa T</creator><creator>Charles-Schoeman, Christina</creator><general>Oxford University Press</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>5PM</scope></search><sort><creationdate>20201101</creationdate><title>High- density lipoprotein function is abnormal in idiopathic inflammatory myopathies</title><author>Bae, Sangmae Sharon ; Lee, Yuen Yin ; Shahbazian, Ani ; Wang, Jennifer ; Meriwether, David ; Golub, Ilana ; Oganesian, Buzand ; Dowd, Tyler ; Reddy, Srinivasa T ; Charles-Schoeman, Christina</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c448t-3918420c8c6b4b3d6d6c6f06a393dcc9b8dc3e18a1166d3ab8b5d39af0ea5cb03</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2020</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Amino Acyl-tRNA Synthetases - immunology</topic><topic>Autoantibodies - immunology</topic><topic>Case-Control Studies</topic><topic>Chromatography, Liquid</topic><topic>Clinical Science</topic><topic>Dermatomyositis - drug therapy</topic><topic>Dermatomyositis - immunology</topic><topic>Dermatomyositis - metabolism</topic><topic>Endothelium, Vascular</topic><topic>Fatty Acids - metabolism</topic><topic>Female</topic><topic>Glucocorticoids - therapeutic use</topic><topic>Humans</topic><topic>Hydroxyeicosatetraenoic Acids - metabolism</topic><topic>Immunologic Factors - therapeutic use</topic><topic>Immunosuppressive Agents - therapeutic use</topic><topic>Interferon-Induced Helicase, IFIH1 - immunology</topic><topic>Lipoproteins, HDL - metabolism</topic><topic>Lipoproteins, LDL - metabolism</topic><topic>Lung Diseases, Interstitial - immunology</topic><topic>Lung Diseases, Interstitial - metabolism</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myositis - drug therapy</topic><topic>Myositis - immunology</topic><topic>Myositis - metabolism</topic><topic>Myositis, Inclusion Body - drug therapy</topic><topic>Myositis, Inclusion Body - immunology</topic><topic>Myositis, Inclusion Body - metabolism</topic><topic>Oxidation-Reduction</topic><topic>Peroxidase - metabolism</topic><topic>Polymyositis - drug therapy</topic><topic>Polymyositis - immunology</topic><topic>Polymyositis - metabolism</topic><topic>Pulmonary Diffusing Capacity</topic><topic>Spectrometry, Mass, Electrospray Ionization</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Bae, Sangmae Sharon</creatorcontrib><creatorcontrib>Lee, Yuen Yin</creatorcontrib><creatorcontrib>Shahbazian, Ani</creatorcontrib><creatorcontrib>Wang, Jennifer</creatorcontrib><creatorcontrib>Meriwether, David</creatorcontrib><creatorcontrib>Golub, Ilana</creatorcontrib><creatorcontrib>Oganesian, Buzand</creatorcontrib><creatorcontrib>Dowd, Tyler</creatorcontrib><creatorcontrib>Reddy, Srinivasa T</creatorcontrib><creatorcontrib>Charles-Schoeman, Christina</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>Rheumatology (Oxford, England)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Bae, Sangmae Sharon</au><au>Lee, Yuen Yin</au><au>Shahbazian, Ani</au><au>Wang, Jennifer</au><au>Meriwether, David</au><au>Golub, Ilana</au><au>Oganesian, Buzand</au><au>Dowd, Tyler</au><au>Reddy, Srinivasa T</au><au>Charles-Schoeman, Christina</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>High- density lipoprotein function is abnormal in idiopathic inflammatory myopathies</atitle><jtitle>Rheumatology (Oxford, England)</jtitle><addtitle>Rheumatology (Oxford)</addtitle><date>2020-11-01</date><risdate>2020</risdate><volume>59</volume><issue>11</issue><spage>3515</spage><epage>3525</epage><pages>3515-3525</pages><issn>1462-0324</issn><eissn>1462-0332</eissn><abstract>Abstract
Objective
Damage to the vascular endothelium is strongly implicated in the pathogenesis of idiopathic inflammatory myopathies (IIM). Normally, high‐density lipoprotein (HDL) protects the vascular endothelium from damage from oxidized phospholipids, which accumulate under conditions of oxidative stress. The current work evaluated the antioxidant function of HDL in IIM patients.
Methods
HDL’s antioxidant function was measured in IIM patients using a cell-free assay, which assesses the ability of isolated patient HDL to inhibit oxidation of low-density lipoproteins and is reported as the HDL inflammatory index (HII). Cholesterol profiles were measured for all patients, and subgroup analysis included assessment of oxidized fatty acids in HDL and plasma MPO activity. A subgroup of IIM patients was compared with healthy controls.
Results
The antioxidant function of HDL was significantly worse in patients with IIM (n = 95) compared with healthy controls (n = 41) [mean (S.d.) HII 1.12 (0.61) vs 0.82 (0.13), P < 0.0001]. Higher HII associated with higher plasma MPO activity [mean (S.d.) 13.2 (9.1) vs 9.1 (4.6), P = 0.0006] and higher oxidized fatty acids in HDL. Higher 5-hydroxyeicosatetraenoic acid in HDL correlated with worse diffusion capacity in patients with interstitial lung disease (r = −0.58, P = 0.02), and HDL’s antioxidant function was most impaired in patients with autoantibodies against melanoma differentiation-associated protein 5 (MDA5) or anti-synthetase antibodies. In multivariate analysis including 182 IIM patients, higher HII was associated with higher disease activity and DM diagnosis.
Conclusion
The antioxidant function of HDL is abnormal in IIM patients and may warrant further investigation for its role in propagating microvascular inflammation and damage in this patient population.</abstract><cop>England</cop><pub>Oxford University Press</pub><pmid>32830270</pmid><doi>10.1093/rheumatology/keaa273</doi><tpages>11</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 1462-0324 |
| ispartof | Rheumatology (Oxford, England), 2020-11, Vol.59 (11), p.3515-3525 |
| issn | 1462-0324 1462-0332 |
| language | eng |
| recordid | cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_7590404 |
| source | MEDLINE; Oxford University Press Journals All Titles (1996-Current); Alma/SFX Local Collection |
| subjects | Adult Aged Amino Acyl-tRNA Synthetases - immunology Autoantibodies - immunology Case-Control Studies Chromatography, Liquid Clinical Science Dermatomyositis - drug therapy Dermatomyositis - immunology Dermatomyositis - metabolism Endothelium, Vascular Fatty Acids - metabolism Female Glucocorticoids - therapeutic use Humans Hydroxyeicosatetraenoic Acids - metabolism Immunologic Factors - therapeutic use Immunosuppressive Agents - therapeutic use Interferon-Induced Helicase, IFIH1 - immunology Lipoproteins, HDL - metabolism Lipoproteins, LDL - metabolism Lung Diseases, Interstitial - immunology Lung Diseases, Interstitial - metabolism Male Middle Aged Myositis - drug therapy Myositis - immunology Myositis - metabolism Myositis, Inclusion Body - drug therapy Myositis, Inclusion Body - immunology Myositis, Inclusion Body - metabolism Oxidation-Reduction Peroxidase - metabolism Polymyositis - drug therapy Polymyositis - immunology Polymyositis - metabolism Pulmonary Diffusing Capacity Spectrometry, Mass, Electrospray Ionization |
| title | High- density lipoprotein function is abnormal in idiopathic inflammatory myopathies |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-01-25T01%3A31%3A46IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-oup_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=High-%20density%20lipoprotein%20function%20is%20abnormal%20in%20idiopathic%20inflammatory%20myopathies&rft.jtitle=Rheumatology%20(Oxford,%20England)&rft.au=Bae,%20Sangmae%20Sharon&rft.date=2020-11-01&rft.volume=59&rft.issue=11&rft.spage=3515&rft.epage=3525&rft.pages=3515-3525&rft.issn=1462-0324&rft.eissn=1462-0332&rft_id=info:doi/10.1093/rheumatology/keaa273&rft_dat=%3Coup_pubme%3E10.1093/rheumatology/keaa273%3C/oup_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_id=info:pmid/32830270&rft_oup_id=10.1093/rheumatology/keaa273&rfr_iscdi=true |