Your SlideShare is downloading. ×
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Wei as databank in taiwan 2011
Upcoming SlideShare
Loading in...5
×

Thanks for flagging this SlideShare!

Oops! An error has occurred.

×
Saving this for later? Get the SlideShare app to save on your phone or tablet. Read anywhere, anytime – even offline.
Text the download link to your phone
Standard text messaging rates apply

Wei as databank in taiwan 2011

541

Published on

Wei as databank in taiwan 2011

Wei as databank in taiwan 2011

0 Comments
0 Likes
Statistics
Notes
  • Be the first to comment

  • Be the first to like this

No Downloads
Views
Total Views
541
On Slideshare
0
From Embeds
0
Number of Embeds
0
Actions
Shares
0
Downloads
0
Comments
0
Likes
0
Embeds 0
No embeds

Report content
Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
No notes for slide
  • Dr Wei, Tsai and Chou published a highly-citated paper showing that HLA-B60 and B61 are strongly associated with B27-negative AS in Taiwan.
  • Dr Wei and colleagues in Chung Shan medical university had set up an AS databank to investigate the association of AS genotype and clinical phenotype. They had found that MMP-3/ TIMP alleles correlate to disease activity and functional index of AS.
  • They also collaborated with Prof Brown in Australia and found that IL1 gene complex was associated with AS in Taiwanese Chinese.
  • Moreover, investigators from Taiwan, China and Prof David Yu in UCLA had close collaboration to discover candidate biomarker for spondyloarthritis by microarray and rt-PCR.
  • They had found RGS1 as candidate biomarker for USpA, as well as NR4A2, IL-8…etc.
  • Transcript

    • 1. 台灣僵直性脊椎炎資料庫 Ankylosing Spondylitis Databank Project in Taiwan 魏 正 宗  James Cheng-Chung Wei, M.D., Ph.D.   中山醫學大學附設醫院過敏免疫風濕科主任 Director, Division of Allergy, Immunology & Rheumatology Chung Shan Medical University Hospital, Taichung, Taiwan Chairman, Taiwan AS caring society
    • 2. AS in Taiwan
      • Normal population: 23 M
      • Estimated AS prevalence: 0.2-0.4 %
      • National Health Insurance
      • TNF blockers reimbursed for severe refractory AS
        • BASDAI>6, ESR>28, CRP>1 mg/dl, B27+
      • AS caring society since 1998
    • 3. AS caring society in Taiwan www.ascare.org.tw
    • 4. Ankylosing Spondylitis Databank Project in Taiwan Backgrounds / Aims
      • There are still many unmet needs in the pathogenesis and management of AS.
      • To setup a research collaboration network in Taiwan.
      • A comprehensive AS translational database including clinical parameters and tissue samples is crucial and essential for future researches.
    • 5. Methods
      • Collected since 2003, still ongoing in CSMUH, Taichung, Taiwan.
      • Other cohorts in Taipei and Kaoshiung.
      • All first visit AS patients and some other SpA.
      • Comprehensive 10 pages epidemiological questionnaire
      • Psochometric validation of the Chinese version of Bath indices : Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Bath Ankylosing Spondylitis Functional Index (BASFI), and Bath Ankylosing Spondylitis Global Index (BAS-G
    • 6. Chinese version of Bath indices Reliability of BASDAI 、 BASFI 、 BAS-G James Cheng-Chung Wei , Ruey-Hong Wong,Jun-Huang Huang, Chen-Tung Yu, Chung-Tei Chou, Ming-Shiou Jan, Gregory J. Tsay, Ming-Chih Chou, Hong-Shen Lee. Clin Rheumatol 2007;26:1685-1691 BASDAI BASFI BAS-G Number of items in Scale 6 10 2 Cronbach’s coefficient Alpha 0.85 0.94 0.91 ICC Test/Retest 0.93 0.92 0.94
    • 7. BASDAI 活性量表 Bath Ankylosing Spondylitis Activity Index James Cheng-Chung Wei, Ruey-Hong, Ming-Chih Chou, Hong-Shen Lee. Clin Rheumatol (2007) 26:1685–1691
    • 8.  
    • 9. BAS-G 整體量表 Bath Ankylosing Spondylitis Patients’ Global Assessment
    • 10. Physical examination
      • Finger to floors
      • Modified Schober test
      • Occipital-to-wall
      • Lateral bending test
      • Shoulder and hip examination
    • 11. AS Tissue Bank in Taiwan
      • Inflammatory markers: Erythrocyte sedimentation rate (ESR) , Hypersensitive C-reactive protein (hs-CRP) and Immunoglobulin A (IgA) .
      • Serum were separated within 2 hours and stocked into -80 degree.
      • Peripheral blood mononuclear cells (PBMC) were separated and stored in liquid nitrogen.
      • DNA and RNA were extracted and stocked into -20 degree refrigerators.
      • HLA-B27 by PCR
      • HLA-B27subtyping by PCR-SSO methods.
      • HLA-ABC typing by lymphocytotoxicity assay.
    • 12. Results Taichung CSMUH Cohort Ankylosing Spondylitis Databank Project in Taiwan
    • 13. Taiwan AS databank
      • 3000+ visits and samples from AS patients, including
        • 1500 first-visit patients
        • 2000+ follow up visits
      • 1500 DNA samples were collected.
      • 130 RNA from peripheral mononuclear cell
      • Some synovial fluid, synovium, enthesis, and bone.
    • 14. CSMUH cohort
      • Mean age was 34.28  11.21
      • Sex ratio (M:F) was 2.82 : 1.
      • Disease duration of 5.10  6.45 years
      • Delay diagnosis time lag was 5.91  6.64 years.
      • 42.59 % patients have known family history
      JC Wei. Ankylosing spondylitis databank in Taiwan , PhD thesis, 2007
    • 15. Bath Indices
      • Average BASDAI was 3.99  2.26,
      • BASFI 2.13  2.17 and
      • BAS-G 4.27  2.82 cm in 10-cm scale.
      • 61% were disease-active ( BASDAI>3 )
      • 27% were functional disabled ( BASFI>2 )
    • 16. Physical examinations Finger to floor distance, > 10 cm (%) (AS, n=820) 499 (60.85) Schober’s test, < 15cm (%) (n=818) 783 (95.72) Chest expansion test, < 5cm (%) (n=815) 532 (65.28) L’t lateral bending test, < 10cm (%) (n=812) 247 (30.42) Occiput to wall distance, > 0 cm (%) (n=814) 143 (17.57) Shoulder pain or limitation of motion (n=779) 197 (25.29)
    • 17. Clinical manifestations Variables Patient number (%) History of the buttock pains and back, no. (%) 755 (93.44) History of peripheral arthritis, no. (%) 518 (64.43) History of uveitis, no. (%) 195 (24.19) History of psoriasis, no. (%) 112 (13.90) History of hematuria no. (%) 55 (6.86) History of oral ulcer, no. (%) (n=805) 94 (11.68) Onset symptom, no. ( peripheral arthristis / enteritis / back pain / uveitis) (%) ( 21.55 /2.96/50.56/2.54) HLA-B27 positive 91.2 % Family history of spondyloarthritis 349 (43.35)
    • 18. HS-CRP Variable HS-CRP- p value HSCRP- r BASDAI 0.0005 0.15117 BASFI 0.0002 * 0.16228 BAS-G 0.0001 * 0.22709
    • 19. HLA-B27 in Taiwan
      • 91% of AS patients have HLA-B27.
      • 5-9% in whole population in Taiwan
      • HLA-B27 subtyping: 89% B2704 in Taiwan
      2704 2705 2706 2707 Total AS 108 3 0 0 111 Normal 72 4 5 3 84
    • 20.  
    • 21. Annals of the Rheumatic Diseases. 2009;68:1781–1786.
      • Results:
      • MMP-3/TIMP-1 alleles showed that 6A/C (OR = 3.23, 95% CI 1.50 to 6.95) and 6A/T (OR = 2.55, 95% CI 1.17 to 5.54) had a significantly greater risk of AS than the 5A/T alleles.
      • MMP-3/TIMP-1 5A/T alleles had the lowest BASDAI (p = 0.02), BASFI (p = 0.05) and BAS-G (p = 0.02) among all MMP-3/TIMP-1 alleles.
    • 22. SNP vs Phenotype study
    • 23.  
    • 24. SNP of OPG in AS JH Huang, JC Wei. Rheumatology 2010
    • 25.  
    • 26. Arthritis &rheumatism 2009;60(11),3269–79. (J. Gu and JCC Wei and Yu-Ling Wei contributed equally)
    • 27. Identification of RGS1 as a Candidate Biomarker for Undifferentiated Spondylarthritis J. Gu, JCC Wei ,Yu-Ling Wei, D. Yu. Arthritis & rheumatism 2009;60(11),3269–79.
    • 28. Future works
      • More works on genotype and phenothype
      • Micro-RNA studies
      • Registry database for AS patients under TNF blockers therapy
        • Focus on hepatitis B and TB
      • International collaboration
    • 29. Conclusions
      • Our Chinese versions of the BASDAI, BASFI, and BAS-G showed good reliability, validity, and responsiveness .
      • We had established a comprehensive clinical and tissue database of AS in Taiwan.
      • This database can be used for further researches, medical practice and education.
    • 30.  
    • 31. Thank you James Cheng-Chung Wei, M.D., Ph.D. [email_address] +886 975 128095 Chung Shan Medical University Hospital Chinese Medicine Clinical Trial Center

    ×