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Knight, Ann
Alternative names
Publications (10 of 25) Show all publications
Eriksson, K., Eloranta, M.-L., Kozyrev, S. V., Dahlqvist, J., Nilsson, B., Knight, A. & Rönnblom, L. (2019). A case of systemic lupus erythematosus with C1q deficiency, increased serum interferon-a levels and high serum interferogenic activity [Letter to the editor]. Rheumatology, 58(5), 918-919
Open this publication in new window or tab >>A case of systemic lupus erythematosus with C1q deficiency, increased serum interferon-a levels and high serum interferogenic activity
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2019 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 58, no 5, p. 918-919Article in journal, Letter (Other academic) Published
Place, publisher, year, edition, pages
Oxford University Press, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-391433 (URN)10.1093/rheumatology/key419 (DOI)000475751700028 ()30608615 (PubMedID)
Funder
Swedish Research Council, D0283001Swedish Rheumatism AssociationKing Gustaf V Jubilee FundSwedish Society of Medicine
Note

Ann Knight and Lars Rönnblom contributed equally to the study

Available from: 2019-10-03 Created: 2019-10-03 Last updated: 2020-03-17Bibliographically approved
Lyons, P. A., Peters, J. E., Alberici, F., Liley, J., Coulson, R. M. R., Astle, W., . . . Smith, K. G. C. (2019). Genome-wide association study of eosinophilic granulomatosis with polyangiitis reveals genomic loci stratified by ANCA status. Nature Communications, 10, Article ID 5120.
Open this publication in new window or tab >>Genome-wide association study of eosinophilic granulomatosis with polyangiitis reveals genomic loci stratified by ANCA status
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2019 (English)In: Nature Communications, ISSN 2041-1723, E-ISSN 2041-1723, Vol. 10, article id 5120Article in journal (Refereed) Published
Abstract [en]

Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare inflammatory disease of unknown cause. 30% of patients have anti-neutrophil cytoplasmic antibodies (ANCA) specific for myeloperoxidase (MPO). Here, we describe a genome-wide association study in 676 EGPA cases and 6809 controls, that identifies 4 EGPA-associated loci through conventional case-control analysis, and 4 additional associations through a conditional false discovery rate approach. Many variants are also associated with asthma and six are associated with eosinophil count in the general population. Through Mendelian randomisation, we show that a primary tendency to eosinophilia contributes to EGPA susceptibility. Stratification by ANCA reveals that EGPA comprises two genetically and clinically distinct syndromes. MPO+ ANCA EGPA is an eosinophilic autoimmune disease sharing certain clinical features and an HLA-DQ association with MPO+ ANCA-associated vasculitis, while ANCA-negative EGPA may instead have a mucosal/barrier dysfunction origin. Four candidate genes are targets of therapies in development, supporting their exploration in EGPA.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-398078 (URN)10.1038/s41467-019-12515-9 (DOI)000495858500001 ()31719529 (PubMedID)
Available from: 2019-12-02 Created: 2019-12-02 Last updated: 2019-12-02Bibliographically approved
Hellbacher, E., Hjorton, K., Backlin, C., Enblad, G., Sundström, C., Baecklund, E. & Knight, A. (2019). Malignant lymphoma in granulomatosis with polyangiitis: subtypes, clinical characteristics and prognosis [Letter to the editor]. Acta Oncologica, 58(11), 1655-1659
Open this publication in new window or tab >>Malignant lymphoma in granulomatosis with polyangiitis: subtypes, clinical characteristics and prognosis
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2019 (English)In: Acta Oncologica, ISSN 0284-186X, E-ISSN 1651-226X, Vol. 58, no 11, p. 1655-1659Article in journal, Letter (Other academic) Published
Abstract [en]

Several autoimmune and inflammatory conditions, such as rheumatoid arthritis (RA) and primary Sjögrens’s syndrome (pSS), have repeatedly been linked to an increased risk of malignant lymphoma [1,2]. Certain inflammatory conditions are also associated with the development of specific lymphoma subtypes such as mucosa-associated lymphoid tissue (MALT) lymphoma in pSS and diffuse large B-cell lymphoma (DLBCL) in RA. The underlying mechanisms behind this association remain unclear. The highly increased risk of developing MALT lymphoma of the parotid gland in pSS indicates that local inflammatory processes can promote lymphoma development at the site of chronic inflammation [3]. In RA, an association between disease severity and risk of lymphoma has been shown.

Granulomatosis with polyangiitis (GPA), formerly Wegener’s granulomatosis, is a systemic small vessel vasculitis associated with the presence of anti-neutrophil cytoplasmic antibodies (ANCA) and characterized by granulomatous inflammation and necrotizing vasculitis of the airways and kidneys but possibly affecting any organ system. An increased risk of lymphoma in patients with GPA has been reported in several epidemiological studies [4,5]. However, very little is known about risk factors for lymphoma development in this group, possible relation to disease severity, treatment and lymphoma subtypes or the prognosis for the lymphomas. This is the first published study on GPA and lymphoma, giving detailed information on the GPA characteristics and possible risk factors for lymphoma and also lymphoma subtypes treatment and survival.

National Category
Cancer and Oncology Clinical Laboratory Medicine
Research subject
Pathology
Identifiers
urn:nbn:se:uu:diva-398532 (URN)10.1080/0284186X.2019.1634833 (DOI)000481027700001 ()31407922 (PubMedID)
Funder
Swedish Cancer Society
Available from: 2019-12-06 Created: 2019-12-06 Last updated: 2020-01-08Bibliographically approved
Turesson, C., Börjesson, O., Larsson, K., Mohammad, A. J. & Knight, A. (2019). Swedish Society of Rheumatology 2018 guidelines for investigation, treatment, and follow-up of giant cell arteritis. Scandinavian Journal of Rheumatology, 48(4), 259-265
Open this publication in new window or tab >>Swedish Society of Rheumatology 2018 guidelines for investigation, treatment, and follow-up of giant cell arteritis
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2019 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 48, no 4, p. 259-265Article, review/survey (Refereed) Published
Abstract [en]

Objective: To develop evidence-based guidelines for the management of giant cell arteritis (GCA) as a complement to guidelines in other areas of rheumatology, issued by the Swedish Society of Rheumatology.

Methods: A working group selected key areas for recommendations, reviewed the available evidence, and wrote draft guidelines. These were discussed and revised according to standard procedures within the Swedish Society of Rheumatology, including a one-day meeting open to all members. For key recommendations, the quality of evidence was assessed according to GRADE. The final guidelines were approved by the Society board in March 2018.

Results: The guidelines include recommendations on diagnostic procedures, pharmacological treatment, follow-up, and adjuvant treatment. Ultrasonography is complementary to temporal artery biopsy (TAB) in the diagnostic work-up. Other imaging techniques (magnetic resonance imaging and positron emission tomography/computed tomography) are important in evaluating large-vessel involvement. Glucocorticoids (oral, or intravenous in cases with ischaemic complications) remain the first line treatment for GCA. Addition of tocilizumab is recommended for patients with relapsing disease who meet five criteria, representing active disease that has been objectively verified by TAB or imaging. Tocilizumab may also be considered in patients with newly diagnosed GCA who are at major risk of severe glucocorticoid side effects. Based on current evidence, tocilizumab treatment for >1 year cannot be recommended.

Conclusion: These guidelines are based on current evidence and consensus within Swedish rheumatology. Following major developments in diagnostics and treatment of GCA, such guidelines are important for clinical practice, and should be updated on a regular basis.

Place, publisher, year, edition, pages
TAYLOR & FRANCIS LTD, 2019
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-394725 (URN)10.1080/03009742.2019.1571223 (DOI)000482282100001 ()30838907 (PubMedID)
Funder
Swedish Rheumatism Association
Available from: 2019-10-11 Created: 2019-10-11 Last updated: 2019-10-11Bibliographically approved
Sohrabian, A., Mathsson Alm, L., Hansson, M., Knight, A., Lysholm, J., Cornillet, M., . . . Rönnelid, J. (2018). Number of individual ACPA reactivities in synovial fluid immune complexes, but not serum anti-CCP2 levels, associate with inflammation and joint destruction in rheumatoid arthritis. Annals of the Rheumatic Diseases, 77(9), 1345-1353
Open this publication in new window or tab >>Number of individual ACPA reactivities in synovial fluid immune complexes, but not serum anti-CCP2 levels, associate with inflammation and joint destruction in rheumatoid arthritis
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2018 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 77, no 9, p. 1345-1353Article in journal (Refereed) Published
Abstract [en]

Introduction: Individual patients with rheumatoid arthritis (RA) show divergent specific anti-citrullinated protein/peptide antibodies (ACPA) patterns, but hitherto no individual ACPA specificity has consistently been linked to RA pathogenesis. ACPA are also implicated in immune complexes (IC)-associated joint pathology, but until now, there has been no method to investigate the role of individual ACPA in RA IC formation and IC-associated pathogenesis.

Methods: We have developed a new technique based on IC binding to C1q-coated magnetic beads to purify and solubilise circulating IC in sera and synovial fluids (SF) from 77 patients with RA. This was combined with measurement of 19 individual ACPA in serum, SF and in the IC fractions from serum and SF. We investigated whether occurrence of individual ACPA as well as number of ACPA in these compartments was related to clinical and laboratory measures of disease activity and inflammation.

Results: The majority of individual ACPA reactivities were enriched in SF as compared with in serum, and levels of ACPA in IC were regulated independently of levels in serum and SF. No individual ACPA reactivity in any compartment showed a dominating association to clinical and laboratory measures of disease activity and severity. Instead, the number of individual ACPA reactivities in the IC fraction from SF associated with a number of markers of joint destruction and inflammation.

Conclusions: Our data highlight the polyclonality of ACPA in joint IC and the possibility that a broad ACPA repertoire in synovial fluid IC might drive the local inflammatory and matrix-degrading processes in joints, in analogy with antibody-induced rodent arthritis models.

Keywords
ant-ccp, autoantibodies, rheumatoid arthritis, synovial fluid
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-363389 (URN)10.1136/annrheumdis-2017-212627 (DOI)000445051300025 ()29895567 (PubMedID)
Funder
Swedish Research CouncilSwedish Rheumatism AssociationThe King Gustaf V's Jubilee Foundation
Available from: 2018-10-17 Created: 2018-10-17 Last updated: 2019-06-26Bibliographically approved
Knight, A., Pauksen, K., Nordmark, G. & Eva, K. (2017). Fatal outcome of tick-borne encephalitis in two patients with rheumatic disease treated with rituximab. Rheumatology, 56(5), 855-856
Open this publication in new window or tab >>Fatal outcome of tick-borne encephalitis in two patients with rheumatic disease treated with rituximab
2017 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 56, no 5, p. 855-856Article in journal (Refereed) Published
Place, publisher, year, edition, pages
Oxford University Press, 2017
National Category
Rheumatology and Autoimmunity
Research subject
Medical Science
Identifiers
urn:nbn:se:uu:diva-318795 (URN)10.1093/rheumatology/kew495 (DOI)000402143000027 ()28130421 (PubMedID)
Available from: 2017-03-28 Created: 2017-03-28 Last updated: 2019-02-27Bibliographically approved
Hellbacher, E., Hjorton, K., Sundström, C., Baecklund, E. & Knight, A. (2017). Malignant Lymphoma In Granulomatosis With Polyangiitis. Rheumatology, 56
Open this publication in new window or tab >>Malignant Lymphoma In Granulomatosis With Polyangiitis
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2017 (English)In: Rheumatology, ISSN 1462-0324, E-ISSN 1462-0332, Vol. 56Article in journal (Refereed) Published
Place, publisher, year, edition, pages
OXFORD UNIV PRESS, 2017
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-320970 (URN)000397054900398 ()
Available from: 2017-04-27 Created: 2017-04-27 Last updated: 2017-04-27Bibliographically approved
Sohrabian, A., Mathsson Alm, L., Hansson, M., Lysholm, J., Cornillet, M., Knight, A., . . . Rönnelid, J. (2017). Number Of Peptide-Specific Anti-Citrullinated Peptide Antibodies In Synovial Fluid And In Synovial Fluid Immune Complexes Associate With Degree Of Radiological Destruction And Response To Triamcinolone Hexacetonide For Knee Synovitis In Rheumatoid Arthritis. Paper presented at Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN. Annals of the Rheumatic Diseases, 76, 509-510
Open this publication in new window or tab >>Number Of Peptide-Specific Anti-Citrullinated Peptide Antibodies In Synovial Fluid And In Synovial Fluid Immune Complexes Associate With Degree Of Radiological Destruction And Response To Triamcinolone Hexacetonide For Knee Synovitis In Rheumatoid Arthritis
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2017 (English)In: Annals of the Rheumatic Diseases, ISSN 0003-4967, E-ISSN 1468-2060, Vol. 76, p. 509-510Article in journal, Meeting abstract (Other academic) Published
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-346630 (URN)10.1136/annrheumdis-2017-eular.3222 (DOI)000413181401485 ()
Conference
Annual European Congress of Rheumatology, JUN 14-17, 2017, Madrid, SPAIN
Available from: 2018-03-21 Created: 2018-03-21 Last updated: 2018-03-21Bibliographically approved
Weitoft, T., Larsson, A., Saxne, T., Manivel, V. A., Lysholm, J., Knight, A. & Rönnelid, J. (2017). Pentraxin 3 in serum and synovial fluid of patients with rheumatoid arthritis with and without autoantibodies. Scandinavian Journal of Rheumatology, 46(5), 346-352
Open this publication in new window or tab >>Pentraxin 3 in serum and synovial fluid of patients with rheumatoid arthritis with and without autoantibodies
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2017 (English)In: Scandinavian Journal of Rheumatology, ISSN 0300-9742, E-ISSN 1502-7732, Vol. 46, no 5, p. 346-352Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES:

Pentraxin 3 (PTX3) is a locally produced multifunctional protein involved in inflammation, matrix deposition, and immunity. As patients with seropositive rheumatoid arthritis (RA) have a more severe disease course and higher risk of joint destruction than seronegative patients, the aim of the present study was to examine differences in PTX3 in synovial fluid (SF) (and serum) in seropositive compared to seronegative RA, and other local markers of inflammation and destruction.

METHOD:

Ninety-seven RA patients with knee effusion were included. Serum and SF levels of PTX3, as well as serum levels of anti-citrullinated protein antibody and rheumatoid factor of immunoglobulin A and M subclasses, and markers of inflammation and potential destruction in SF: white blood cell counts, tumour necrosis factor, interleukin-6, vascular endothelial growth factor, metalloproteinase 3, and cartilage oligomeric matrix protein, were analysed. In addition, a radiographic knee examination was performed.

RESULTS:

Seropositive patients had significantly higher PTX3 levels in SF than seronegative patients, whereas there was no difference for serum levels. SF-PTX3 levels correlated with disease activity and with local inflammatory markers, especially polymorphonuclear cells, and with autoantibody levels. There was no correlation between PTX3 levels in serum and SF.

CONCLUSION:

The correlation of disease activity and autoantibody levels with SF-PTX3 levels in antibody-positive patients suggests a role for PTX3 in the inflammatory process specifically in seropositive RA joints, and supports the hypothesis that seropositive and seronegative RA are different disease entities. Polymorphonuclear granulocytes may be an important source of PTX3 in RA SF.

National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-310944 (URN)10.1080/03009742.2016.1244288 (DOI)000411129500002 ()27973973 (PubMedID)
Available from: 2016-12-20 Created: 2016-12-20 Last updated: 2018-02-27Bibliographically approved
Chatzidionysiou, K., Turesson, C., Teleman, A., Knight, A., Lindqvist, E., Larsson, P., . . . Heimbürger, M. (2016). A multicentre, randomised, controlled, open-label pilot study on the feasibility of discontinuation of adalimumab in established patients with rheumatoid arthritis in stable clinical remission. RMD Open, 2, Article ID e000133.
Open this publication in new window or tab >>A multicentre, randomised, controlled, open-label pilot study on the feasibility of discontinuation of adalimumab in established patients with rheumatoid arthritis in stable clinical remission
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2016 (English)In: RMD Open, E-ISSN 2056-5933, Vol. 2, article id e000133Article in journal (Refereed) Published
Abstract [en]

Objectives: Treatment with tumour necrosis factor (TNF) blockers, once started as therapy for rheumatoid arthritis (RA), is usually continued indefinitely. The aim of this trial was to assess the possibility of discontinuing treatment with adalimumab (ADA) while maintaining remission in patients with RA with established disease in stable remission on combination therapy with ADA and methotrexate (MTX).

Methods: In a randomised, controlled, open-label pilot study of patients with RA in stable remission treated with ADA+MTX, patients were randomised in a 1:1 ratio to continue with ADA plus MTX (arm AM) or MTX monotherapy (arm M) for 52 weeks. Flare was defined as Disease Activity Score (DAS28) >= 2.6 or a change in DAS28 (Delta DAS28) of >1.2 from baseline at any time. Patients in arm M with a flare restarted ADA. The primary end point was the proportion of patients in remission at week 28.

Results: 31 patients were enrolled in the study and randomised to arm AM (n=16) or arm M (n=15). At 28 weeks, 15/16 patients (94%) and 5/15 patients (33%) in arms AM and M, respectively, were in remission (p=0.001). During the first 28 weeks, 50% (8/16) in the AM arm and 80% (12/15) in the M arm had a flare (p=0.08). The number of patients in the AM and M arms with >1 Delta DAS28 >1.2 during the first 28 weeks was 1/16 (6%) and 8/15 (53%), respectively (p=0.005).

Conclusions: In this study, remission was rarely maintained in patients with long-standing disease who discontinued ADA. Discontinuation may be feasible in only a minority of patients with established RA in stable clinical remission.

Place, publisher, year, edition, pages
BMJ PUBLISHING GROUP, 2016
National Category
Rheumatology and Autoimmunity
Identifiers
urn:nbn:se:uu:diva-400181 (URN)10.1136/rmdopen-2015-000133 (DOI)000443521500021 ()26819752 (PubMedID)
Available from: 2019-12-18 Created: 2019-12-18 Last updated: 2019-12-18Bibliographically approved
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