Evaluation of Pulmonary Involvement and Prognosis in Vasculitis Associated with Anti-Neutrophil Cytoplasma Antibodies

Esra Aydın — 2025-08-10

Objective: No study has evaluated AAV's lung prognosis and the Vasculitis Damage Index (VDI). This study investigated lung involvement in AAV-associated disease activity, morbidity, and mortality rate.

Method: This retrospective analysis included 51 cases who were followed up in our institution's rheumatology outpatient clinic and diagnosed with AAV according to ARC and/or CHCC criteria. The patients were supposed to have lung (pulmonary) involvement at the beginning of the disease. Initial Birmingham Vasculitis Activity Scores (BVAS) and imaging findings were noted. Respiratory function test (PFT), 6-minute walk test (6MWT), thorax CT findings, and vasculitis damage index (VDI) scores were recorded.

Results: ANCA positivity was detected in 94% of patients with AAV (66% C-ANCA/anti-PR3, 34% p-ANCA/anti-MPO). The total follow-up period was recorded as 66.5±52 months. Initial total and BVAS were calculated as 22±7 and 4.6±2.8. BVAS findings were determined as 80% nodule/cavity, 56% infiltration, 24% AH/massive hemoptysis, 11% respiratory failure, 5% pleural effusion/pleurisy, and 3% endobronchial involvement. Radiological improvement was seen in 35%, regression in 12%, progression in 12%, and sequela changes in 30% of the patients. Cumulative VHI and lung VHI scores were calculated as 3.5±2.3 and 0.5±0.8. The frequency of VHI findings was 22% lung function disorder, 8% lung fibrosis, 6% chronic dyspnea, 4% chronic asthma, and 2% pulmonary hypertension. Serious pulmonary infections were seen in 44% (27% had >1 severe infection). VHI was higher in those with serious pulmonary infections (p=0.006).

Conclusion: Lung involvement with AAV causes high rates of lung damage and increased mortality in long-term follow-up.

Omental Incubation of Tissue-Engineered Small Intestine with Tubularized PLGA in a Rabbit Model

Ahmet Alptekin — 2025-09-01

Introduction and Objective: This study aimed to incubate the tissue-engineered small intestine (TESI) organoids in rabbit omentum with tubularized PLGA and to compare them with a control group.

Method: Twelve adult male white rabbits were equally divided into a study and control group. PLGA-formed 1-cm tubes were coated with 1:100 collagen type 1. Organoid units were isolated with full-thickness biopsies from the small intestine and were seeded onto PLGA polymer. Laparotomy was made by a midline incision and the omentum was prepared for implantation. A cell-seeded polymer tube was stented to secure the tubular structure, wrapped by the omentum, and fixed with unabsorbable sutures as the control group.

Results: Five animals (83.3%) survived both in the study and control groups. Examination of cell suspension on an inverted microscope revealed that the mesenchyme cell was surrounded by epithelial cells, cuboid cells with a centrally located nucleus and large cytoplasm, forming intestinal organoid units. The ratio of viable cells was 95% before seeding on polymers. The gross appearance of the tissue showed the formation of a sufficient vascular supply and an intact tubular structure. Examination of sections obtained from the study group, stained with H+E and Masson showed polymer fibers surrounding intestinal cells, epithelial cells located on the luminal surface, and enterocytes embedded in the connective tissue. Control group sections contained fibrotic tissue around intact polymer fibers.

Conclusion: TESI with orthotopic transplantation of the intestinal organoids provides a reasonable model to obtain intestinal function for the future of the procedure being investigated.

Europeanatolia Health Sciences Journal

Evaluation of Pulmonary Involvement and Prognosis in Vasculitis Associated with Anti-Neutrophil Cytoplasma Antibodies

Omental Incubation of Tissue-Engineered Small Intestine with Tubularized PLGA in a Rabbit Model