Publications

Stromal cells (SCs) establish the compartmentalization of lymphoid tissues critical to the immune response. However, the full diversity of lymph node (LN) SCs remains undefined. Using droplet-based single-cell RNA sequencing, we identified nine peripheral LN non-endothelial SC clusters. Included are the established subsets, Ccl19 T-zone reticular cells (TRCs), marginal reticular cells, follicular dendritic cells (FDCs), and perivascular cells. We also identified Ccl19 TRCs, likely including cholesterol-25-hydroxylase cells located at the T-zone perimeter, Cxcl9 TRCs in the T-zone and interfollicular region, CD34 SCs in the capsule and medullary vessel adventitia, indolethylamine N-methyltransferase SCs in the medullary cords, and Nr4a1 SCs in several niches. These data help define how transcriptionally distinct LN SCs support niche-restricted immune functions and provide evidence that many SCs are in an activated state.

BACKGROUND

We aimed to determine whether obesity in women with systemic lupus erythematosus (SLE) independently associates with worse patient-reported outcomes (PROs).

METHODS

Data derive from a prospective study of adult women who carried a diagnosis of SLE verified by medical record review. Two established definitions for obesity were used: fat mass index (FMI) ≥ 13 kg/m and BMI ≥ 30 kg/m . Dependent variables included 4 validated PROs: disease activity via Systemic Lupus Activity Questionnaire (SLAQ), depressive symptoms via Center for Epidemiologic Studies Depression Scale (CES-D), pain via Short Form 36 Health Survey (SF-36) Pain Subscale, and fatigue via SF-36 Vitality Subscale. We used multivariable linear regression to evaluate the associations of obesity with PROs while controlling for potential confounders (age, race, education, income, smoking, disease duration, disease damage, and prednisone use).

RESULTS

The analysis included 148 participants; 32% were obese. In the multivariate regression model, obesity associated with worse scores on each PRO. Mean adjusted scores for SLAQ and CES-D comparing obese versus non-obese participants were 14.8 versus 11.1 (p=0.01) and 19.8 versus 13.1 (p<0.01), respectively. The obese group also reported worse mean adjusted scores for pain (38.7 vs. 44.2, p<0.01) and fatigue (39.6 vs. 45.2, p=0.01).

CONCLUSION

In a representative sample of women with SLE, obesity (by FMI and BMI) independently associated with worse patient reported outcomes, including disease activity, depressive symptoms, and symptoms of pain and fatigue. Obesity may represent a modifiable target for improving outcomes in this patient population. This article is protected by copyright. All rights reserved.

Cancer therapeutics-related cardiac dysfunction (CTRCD) is a well-established adverse effect resulting from a number of cancer therapeutics. Newer immunotherapy has been associated with cardiomyopathy and myocarditis making comprehensive imaging useful for early recognition. Cardiac MRI (CMR) offers a comprehensive evaluation to detect CTRCD. Established guidelines for monitoring left ventricular ejection fraction for potential cardiotoxicity have recently incorporated CMR. We will review the utility of CMR in contemporary evaluation for potential oncologic cardiotoxicity.