Cytotoxic T Lymphocyte-associated Antigen 4 Ig-induced Asthma in the Treatment of Rheumatoid Arthritis
Bibliographic record
Abstract
To the Editor: The CD28-CD80/CD86 costimulatory pathway is essential in enhancing and optimizing T cell activation and cytokine production in rheumatoid arthritis (RA). Cytotoxic T lymphocyte-associated antigen 4 (CTLA4) is a homolog of CD28. It can competitively bind to CD80/CD86 and downregulate naive and memory T cell proliferation, cytokine production, and humoral immune response. Its human soluble fusion protein, CTLA4-Ig, was approved for the treatment of active RA by the US Food and Drug Administration in 20051. Several animal studies suggest benefits of CTLA4-Ig in other immunologic diseases such as asthma. However, we describe here 2 cases of RA complicated with relapse of asthma while undergoing CTLA4-Ig therapy. A 53-year-old Chinese woman had a 9-year history of refractory RA, and was treated with methotrexate (MTX) 7.5 mg per week and prednisone 3 mg daily. She had started CTLA4-Ig 10 mg/kg in combination with stable dosages of MTX and prednisone on August 20, 2009, because of her high RA activity. Four days later, … Address correspondence to Dr. J. Bao; E-mail: baojun{at}smmu.edu.cn
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.007 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.002 |
| Open science | 0.002 | 0.000 |
| Research integrity | 0.013 | 0.011 |
| Insufficient payload (model declined to judge) | 0.002 | 0.002 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".