Rheumatology and Clinical Immunology Clinic
School Of Medicine, University Of Crete

Research

 

As a university clinic one of our main interest is medical research. To this end:

  • In collaboration with the Laboratory of Rheumatology, Autoimmunity and Inflammation at the Medical School, we perform studies in the pathogenesis of systemic autoimmune disease. We have a special interest in the pathogenesis of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). We use both animal models (CIA, NZB/NZW) and human tissues.
  • We are interested in the epidemiology, long term prognosis and effects of novel therapies (biologics) in patients with autoimmune diseases.
  • We are actively involved in several clinical trials (Phase II-IV)

 

Publications, Rheumatology and Clinical Immunology, University Hospital of Heraklion, Medical School (2012-2020)

 

  1. Thomas ML, Shaddick G, Charlton R, Cavill C, Holland R, Iannone F, Lapadula G, Lopriore S, Závada J, Uher M, Pavelka K, Szczukova L, Sidiropoulos P, Flouri I, Drosos A, Möller B, Nissen MJ, Müller RB, Scherer A, McHugh N* & Nightingale A*. Tumour Necrosis Factor Inhibitor monotherapy versus combination therapy for the treatment of psoriatic arthritis: combined analysis of European biologics databases.
  2. Fanouriakis A, Kostopoulou M, Cheema K, Anders HJ, Aringer M, Bajema I, Boletis J, Frangou E, Houssiau FA, Hollis J, Karras A, Marchiori F, Marks SD, Moroni G, Mosca M, Parodis I, Praga M, Schneider M, Smolen JS, Tesar V, Trachana M, van Vollenhoven RF, Voskuyl AE, Teng YKO, van Leew B, Bertsias G, Jayne D, Boumpas DT. 2019 Update of the Joint European League Against Rheumatism and European Renal Association-European Dialysis and Transplant Association (EULAR/ERA-EDTA) recommendations for the management of lupus nephritis. Ann Rheum Dis. 2020; doi: 10.1136/annrheumdis-2020-216924
  3. Frangou E, Georgakis S, Bertsias G. Update on the cellular and molecular aspects of lupus nephritis. Clin Immunol. 2020 Apr 25:108445. doi: 10.1016/j.clim.2020.108445.
  4. Yavuz S, Cansu DU, Nikolopoulos D, Bertsias G, Fanouriakis A, Rönnblom L. Lymphopenia as a risk factor for neurologic involvement and organ damage accrual in patients with systemic lupus erythematosus: A multi-center observational study. Semin Arthritis Rheum. 2020 Mar 4. pii: S0049-0172(20)30073-1. doi: 10.1016/j.semarthrit.2020.02.020
  5. Papadaki E, Kavroulakis E, Bertsias G, Fanouriakis A, Karageorgou D, Sidiropoulos P, Papastefanakis E, Boumpas DT, Simos P. Regional cerebral perfusion correlates with anxiety in neuropsychiatric SLE: evidence for a mechanism distinct from depression. Lupus. 2019. Dec;28(14):1678-1689. doi: 10.1177/0961203319887793. Epub 2019 Nov 13. PMID: 31718491
  6. Adamichou C, Nikolopoulos D, Genitsaridi I, Bortoluzzi A, Fanouriakis A, Papastefanakis E, Kalogiannaki E, Gergianaki I, Sidiropoulos P, Boumpas DT, Bertsias GK. In an early SLE cohort the ACR-1997, SLICC-2012 and EULAR/ACR-2019 criteria classify non-overlapping groups of patients: use of all three criteria ensures optimal capture for clinical studies while their modification earlier classification and treatment. Ann Rheum Dis. 2019 Nov 8. pii: annrheumdis-2019-216155. doi: 10.1136/annrheumdis-2019-216155. [Epub ahead of print] PMID: 31704720
  7. Panousis NI, Bertsias GK, Ongen H, Gergianaki I, Tektonidou MG, Trachana M, Romano-Palumbo L, Bielser D, Howald C, Pamfil C, Fanouriakis A, Kosmara D, Repa A, Sidiropoulos P, Dermitzakis ET, Boumpas DT. Combined genetic and transcriptome analysis of patients with SLE: distinct, targetable signatures for susceptibility and severity. Ann Rheum Dis. 2019 Aug;78(8):1079-1089. doi: 10.1136/annrheumdis-2018-214379. Epub 2019 Jun 5. PMID: 31167757.
  8. Boumpas DT, Sidiropoulos P, Settas L, Szczypa P, Tsekouras V, Hernandez Daly AC. Health outcomes and unmet needs in patients with long-standing rheumatoid arthritis attending tertiary care in Greece: a cohort study. Health Qual Life Outcomes. 2019 Apr 29;17(1):73. doi: 10.1186/s12955-019-1127-8. PMID: 31036012
  9. Fanouriakis A, Kostopoulou M, Alunno A, Aringer M, Bajema I, Boletis JN, Cervera R, Doria A, Gordon C, Govoni M, Houssiau F, Jayne D, Kouloumas M, Kuhn A, Larsen JL, Lerstrøm K, Moroni G, Mosca M, Schneider M, Smolen JS, Svenungsson E, Tesar V, Tincani A, Troldborg A, van Vollenhoven R, Wenzel J, Bertsias G, Boumpas DT. 2019 update of the EULAR recommendations for the management of systemic lupus erythematosus. Ann Rheum Dis. 2019 Jun;78(6):736-745.
  10. Fanouriakis A, Bertsias G. Changing paradigms in the treatment of systemic lupus erythematosus. Lupus Sci Med. 2019 Feb 8;6(1):e000310.
  11. Gergianaki I, Fanouriakis A, Adamichou C, Spyrou G, Mihalopoulos N, Kazadzis S, Chatzi L, Sidiropoulos P, Boumpas DT, Bertsias G. Is systemic lupus erythematosus different in urban versus rural living environment? Data from the Cretan Lupus Epidemiology and Surveillance Registry. Lupus. 2019 Jan;28(1):104-113. doi: 10.1177/ Epub 2018 Dec 6. PMID: 30522399
  12. Fanouriakis A, Adamichou C, Koutsoviti S, Panopoulos S, Staveri C, Klagou A, Tsalapaki C, Pantazi L, Konsta S, Mavragani CP, Dimopoulou D, Ntali S, Katsikas G, Boki KA, Vassilopoulos D, Konstantopoulou P, Liossis SN, Elezoglou A, Tektonidou M, Sidiropoulos P, Erden A, Sfikakis PP, Bertsias G, Boumpas DT. Low disease activity-irrespective of serologic status at baseline-associated with reduction of corticosteroid dose and number of flares in patients with systemic lupus erythematosus treated with belimumab: A real-life observational study. Semin Arthritis Rheum. 2018 Dec;48(3):467-474. doi: 10.1016/j.semarthrit.2018.02.014. Epub 2018 Feb 23. PMID: 29555348.
  13. Gkirtzimanaki K, Kabrani E, Nikoleri D, Polyzos A, Blanas A, Sidiropoulos P, Makrigiannakis A, Bertsias G, Boumpas DT, Verginis P. IFNα Impairs Autophagic Degradation of mtDNA Promoting Autoreactivity of SLE Monocytes in a STING-Dependent Fashion. Cell Rep. 2018 Oct 23;25(4):921-933.e5. doi: 10.1016/j.celrep. 2018.09.001. PMID: 30355498.
  14. Gergianaki I, Bortoluzzi A, Bertsias G. Update on the epidemiology, risk factors, and disease outcomes of systemic lupus erythematosus. Best Pract Res Clin Rheumatol. 2018 Apr;32(2):188-205.
  15. Fanouriakis A, Papalopoulos I, Gergianaki I, Spyrou G, Erden A, Rapsomaniki P, Terizaki M, Avgoustidis N, Repa A, Kougkas N, Bertsias G, Boumpas DT, Sidiropoulos PI. In early arthritis patients, high HAQ at baseline and DAS28 at three months predict suboptimal outcomes at two years: a retrospective cohort study. Clin Exp Rheumatol. 2018 Sep-Oct;36(5):806-813. Epub 2018 Feb 28. PMID: 29533750
  16. Kougkas N, Fanouriakis A, Papalopoulos I, Bertsias G, Avgoustidis N, Repa A, Sidiropoulos P. Canakinumab for recurrent rheumatic disease associated-pericarditis: a case series with long-term follow-up. Rheumatology (Oxford). 2018 Aug 1;57(8):1494-1495. doi: 10.1093/rheumatology/key077. PMID: 30060102
  17. Karademas EC, Dimitraki G, Papastefanakis E, Ktistaki G, Repa A, Gergianaki I, Bertsias G, Sidiropoulos P, Mastorodemos V, Simos P. Emotion regulation contributes to the well-being of patients with autoimmune diseases through illness-related emotions: A prospective study. J Health Psychol. 2018 Jul 1:1359105318787010. doi:10.1177/ 1359105318787010. [Epub ahead of print] PMID: 29992828
  18. Flouri ID, Markatseli TE, Boki KA, Papadopoulos I, Skopouli FN, Voulgari PV, Settas L, Zisopoulos D, Iliopoulos A, Geborek P, Drosos AA, Boumpas DT, Sidiropoulos P. Comparative Analysis and Predictors of 10-year Tumor Necrosis Factor Inhibitors Drug Survival in Patients with Spondyloarthritis: First-year Response Predicts Longterm Drug Persistence. J Rheumatol. 2018 Jun;45(6):785-794. doi: 10.3899/jrheum.170477. Epub 2018 Apr 1. PMID: 29606666.
  19. Karademas EC, Dimitraki G, Papastefanakis E, Ktistaki G, Repa A, Gergianaki I, Bertsias G, Sidiropoulos P, Simos P. Adaptation to inflammatory rheumatic disease: Do illness representations predict patients' physical functioning over time? A complex relationship. J Behav Med. 2018 Apr;41(2):232-242. doi: 10.1007/s10865-017-9889-0. Epub 2017 Sep 21. PMID: 28936564.
  20. Papadaki E, Fanouriakis A, Kavroulakis E, Karageorgou D, Sidiropoulos P, Bertsias G, Simos P, Boumpas DT. Neuropsychiatric lupus or not? Cerebral hypoperfusion by perfusion-weighted MRI in normal-appearing white matter in primary neuropsychiatric lupus erythematosus. Ann Rheum Dis. 2018 Mar;77(3):441-448. doi: 10.1136/ annrheumdis-2017-212285. Epub 2017 Dec 19. PMID: 29259047.
  21. Thomas K, Flouri I, Repa A, Fragiadaki K, Sfikakis PP, Koutsianas C, Kaltsonoudis E, Voulgari PV, Drosos AA, Petrikkou E, Sidiropoulos P, Vassilopoulos D. High 3-year golimumab survival in patients with rheumatoid arthritis, ankylosing spondylitis and psoriatic arthritis: real world data from 328 patients. Clin Exp Rheumatol. 2018 Mar-Apr;36(2):254-262. Epub 2017 Nov 9. PMID: 29148406.
  22. Papalopoulos I, Fanouriakis A, Kougkas N, Flouri I, Sourvinos G, Bertsias G, Repa A, Avgoustidis N, Sidiropoulos P. Liver safety of non-tumour necrosis factor inhibitors in rheumatic patients with past hepatitis B virus infection: an observational, controlled, long-term study. Clin Exp Rheumatol. 2018 Jan-Feb;36(1):102-109. Epub 2017 Aug 28. PMID: 28850029.
  23. Gergianaki I, Fanouriakis A, Repa A, Tzanakakis M, Adamichou C, Pompieri A, Spirou G, Bertsias A, Kabouraki E, Tzanakis I, Chatzi L, Sidiropoulos P, Boumpas DT, Bertsias GK. Epidemiology and burden of systemic lupus erythematosus in a Southern European population: data from the community-based lupus registry of Crete, Greece. Ann Rheum Dis. 2017 Dec;76(12):1992-2000. doi: 10.1136/annrheumdis-2017-211206. Epub 2017 Aug 5. PMID: 28780511.
  24. Karademas EC, Ktistaki G, Dimitraki G, Papastefanakis E, Mastorodemos V, Repa A, Gergianaki I, Bertsias G, Sidiropoulos P, Simos P. Patient and partner dispositional optimism as a long-term predictor of illness representations in autoimmune diseases. J Health Psychol. 2017 Nov;22(13):1691-1700. doi: 10.1177/1359105316633287. Epub 2016 Mar 8. PMID: 26962131
  25. Latsoudis H, Mashreghi MF, Grün JR, Chang HD, Stuhlmüller B, Repa A, Gergiannaki I, Kabouraki E, Vlachos GS, Häupl T, Radbruch A, Sidiropoulos P, Doukoumetzidis K, Kardassis D, Niewold TB, Boumpas DT, Goulielmos GN. Differential Expression of miR-4520a Associated With Pyrin Mutations in Familial Mediterranean Fever (FMF). J Cell Physiol. 2017 Jun;232(6):1326-1336. doi: 10.1002/jcp.25602. Epub 2016 Dec 20. PMID: 27636101.
  26. Myrthianou E, Zervou MI, Budu-Aggrey A, Eliopoulos E, Kardassis D, Boumpas DT, Kougkas N, Barton A, Sidiropoulos P, Goulielmos GN. Investigation of the genetic overlap between rheumatoid arthritis and psoriatic arthritis in a Greek population. Scand J Rheumatol. 2017 May;46(3):180-186. doi: 10.1080/03009742.2016.1199734. Epub 2016 Jul 20. PMID: 27440135.
  27. Detorakis EE, Magkanas E, Lasithiotaki I, Sidiropoulos P, Boumpas DT, Gourtsoyiannis N, Antoniou K, Raissaki M. Evolution of imaging findings, laboratory and functional parameters in rheumatoid arthritis patients after one year of treatment with anti-TNF-α agents. Clin Exp Rheumatol. 2017 Jan-Feb;35(1):43-52. Epub 2016 Oct 27. PMID: 27908307.
  28. Boubouchairopoulou N, Flouri I, Drosos AA, Boki K, Settas L, Zisopoulos D, Skopouli FN, Papadopoulos I, Iliopoulos A, Kyriopoulos J, Boumpas DT, Athanasakis K, Sidiropoulos P. Treatment with the first TNF inhibitor in rheumatoid arthritis patients in the Hellenic Registry of Biologic Therapies improves quality of life especially in young patients with better baseline functional status. Clin Exp Rheumatol. 2016 Nov-Dec;34(6):999-1005. Epub 2016 Oct 7. PMID: 27749220.
  29. Papadaki G, Kambas K, Choulaki C, Vlachou K, Drakos E, Bertsias G, Ritis K, Boumpas DT, Thompson PR, Verginis P, Sidiropoulos P. Neutrophil extracellular traps exacerbate Th1-mediated autoimmune responses in rheumatoid arthritis by promoting DC maturation. Eur J Immunol. 2016 Nov;46(11):2542-2554. doi: 10.1002/eji.201646542. Epub 2016 Oct 5. PMID: 27585946.
  30. Bertsias G, Karampli E, Sidiropoulos P, Gergianaki I, Drosos A, Sakkas L, Garyfallos A, Tzioufas A, Vassilopoulos D, Tsalapaki C, Sfikakis P, Panopoulos S, Athanasakis K, Perna A, Psomali D, Kyriopoulos J, Boumpas D. Clinical and financial burden of active lupus in Greece: a nationwide study. Lupus. 2016 Oct;25(12):1385-94. doi: 10.1177/0961203316642310. Epub 2016 Apr PMID: 27055520.
  31. Fanouriakis A, Pamfil C, Rednic S, Sidiropoulos P, Bertsias G, Boumpas DT. Is it primary neuropsychiatric systemic lupus erythematosus? Performance of existing attribution models using physician judgment as the gold standard. Clin Exp Rheumatol. 2016 Sep-Oct;34(5):910-917. Epub 2016 Jul 26. PMID: 27463840.
  32. Simos P, Ktistaki G, Dimitraki G, Papastefanakis E, Kougkas N, Fanouriakis A, Gergianaki I, Bertsias G, Sidiropoulos P, Karademas EC. Cognitive deficits early in the course of rheumatoid arthritis. J Clin Exp Neuropsychol. 2016 Sep;38(7):820-9. doi: 10.1080/13803395.2016.1167173. Epub 2016 May PMID: 27133019.
  33. Fanouriakis A, Pamfil C, Sidiropoulos P, Damian L, Flestea A, Gusetu G, Rednic S, Bertsias G, Boumpas DT. Cyclophosphamide in combination with glucocorticoids for severe neuropsychiatric systemic lupus erythematosus: a retrospective, observational two-centre study. Lupus. 2016 May;25(6):627-36. doi: 10.1177/0961203315622821. Epub 2015 Dec 21. PMID: 26692040.
  34. Vlachou K, Mintzas K, Glymenaki M, Ioannou M, Papadaki G, Bertsias GK, Sidiropoulos P, Boumpas DT, Verginis P. Elimination of Granulocytic Myeloid-Derived Suppressor Cells in Lupus-Prone Mice Linked to Reactive Oxygen Species-Dependent Extracellular Trap Formation. Arthritis Rheumatol. 2016 Feb;68(2):449-61. doi: 10.1002/art.39441. PMID: 26414650.
  35. Karademas EC, Ktistaki G, Dimitraki G, Papastefanakis E, Kougkas N, Fanouriakis A, Gergianaki I, Bertsias G, Sidiropoulos P, Simos P. Adaptation to an autoimmune disorder: Does mental flexibility impact illness-related selfregulation? Psychol Health. 2016;31(3):276-91. doi: 10.1080/08870446.2015.1083568. Epub 2015 Sep 14. PMID: 26286095
  36. Choulaki C, Papadaki G, Repa A, Kampouraki E, Kambas K, Ritis K, Bertsias G, Boumpas DT, Sidiropoulos P. Enhanced activity of NLRP3 inflammasome in peripheral blood cells of patients with active rheumatoid arthritis. Arthritis Res Ther. 2015 Sep 19;17:257. doi: 10.1186/s13075-015-0775-2.PMID: 26385789.
  37. Repa A, Bertsias GK, Petraki E, Choulaki C, Vassou D, Kambas K, Boumpas DT, Goulielmos G, Sidiropoulos P. Dysregulated production of interleukin-1β upon activation of the NLRP3 inflammasome in patients with familial Mediterranean fever. Hum Immunol. 2015 Jul;76(7):488-95. doi:10.1016/j.humimm.2015.06.007. Epub 2015 Jun PMID: 26074413.
  38. Pamfil C, Fanouriakis A, Damian L, Rinzis M, Sidiropoulos P, Tsivgoulis G, Rednic S, Bertsias G, Boumpas DT. EULAR recommendations for neuropsychiatric systemic lupus erythematosus vs usual care: results from two European centres. Rheumatology (Oxford). 2015 Jul;54(7):1270-8. doi: 10.1093/rheumatology/keu482. Epub 2015 Jan 30. PMID: 25638807.
  39. Putrik P, Ramiro S, Kvien TK, Sokka T, Uhlig T, Boonen A; Equity in Clinical Eligibility Criteria for RA treatment Working Group. Variations in criteria regulating treatment with reimbursed biologic DMARDs across European countries. Are differences related to country's wealth? Ann Rheum Dis. 2014 Nov;73(11):2010-21. doi: 10.1136/annrheumdis-2013-203819. Epub 2013 Aug 12. PMID: 23940213
  40. Fanouriakis A, Mastorodemos V, Pamfil C, Papadaki E, Sidiropoulos P, Plaitakis A, Amoiridis G, Bertsias G, Boumpas DT. Coexistence of systemic lupus erythematosus and multiple sclerosis: Prevalence, clinical characteristics, and natural history. Semin Arthritis Rheum. 2014 Jun;43(6):751-8.
  41. Flouri I, Markatseli TE, Voulgari PV, Boki KA, Papadopoulos I, Settas L, Zisopoulos D, Skopouli FN, Iliopoulos A, Bertsias GK, Geborek P, Drosos AA, Boumpas DT, Sidiropoulos P. Comparative effectiveness and survival of infliximab, adalimumab, and etanercept for rheumatoid arthritis patients in the Hellenic Registry of Biologics: Low rates of remission and 5-year drug survival. Semin Arthritis Rheum. 2014 Feb;43(4):447-57.
  42. Putrik P, Ramiro S, Kvien TK, Sokka T, Pavlova M, Uhlig T, Boonen A; Working Group «Equity in access to treatment of rheumatoid arthritis in Europe». Inequities in access to biologic and synthetic DMARDs across 46 European countries. Ann Rheum Dis. 2014 Jan;73(1):198-206.
  43. Souliotis K, Papageorgiou M, Politi A, Ioakeimidis D, Sidiropoulos P. Barriers to accessing biologic treatment for rheumatoid arthritis in Greece: the unseen impact of the fiscal crisis--the Health Outcomes Patient Environment (HOPE) study. Rheumatol Int. 2014 Jan;34(1):25-33. doi: 10.1007/s00296-013-2866-1. 
  44. Zervou MI, Myrthianou E, Flouri I, Plant D, Chlouverakis G, Castro-Giner F, Rapsomaniki P, Barton A, Boumpas DT, Sidiropoulos P, Goulielmos GN. Lack of association of variants previously associated with anti-TNF medication response in rheumatoid arthritis patients: results from a homogeneous Greek population. PLoS One. 2013 Sep 10;8(9).
  45. Cobb JE, Plant D, Flynn E, Tadjeddine M, Dieudé P, Cornélis F, Ärlestig L, Dahlqvist SR, Goulielmos G, Boumpas DT, Sidiropoulos P, Krintel SB, Ørnbjerg LM, Hetland ML, Klareskog L, Haeupl T, Filer A, Buckley CD, Raza K, Witte T, Schmidt RE, FitzGerald O, Veale D, Eyre S, Worthington J. Identification of the tyrosine-protein phosphatase non-receptor type 2 as a rheumatoid arthritis susceptibility locus in europeans. PLoS One. 2013 Jun 20;8(6):e66456. doi: 10.1371/journal.pone.0066456.
  46. Vazgiourakis VM, Zervou MI, Eliopoulos E, Sharma S, Sidiropoulos P, Franek BS, Myrthianou E, Melissourgaki M, Niewold TB, Boumpas DT, Goulielmos GN. Implication of VEGFR2 in systemic lupus erythematosus: a combined genetic and structural biological approach. Clin Exp Rheumatol. 2013 Jan-Feb;31(1):97-102.
  47. Nakou M, Papadimitraki ED, Fanouriakis A, Bertsias GK, Choulaki C, Goulidaki N, Sidiropoulos P, Boumpas DT.Interleukin-21 is increased in active systemic lupus erythematosus patients and contributes to generation of plasma B cells. Clin Exp Rheumatol. 2013 Mar-Apr;31(2):172-9
  48. Stagakis I, Bertsias G, Karvounaris S, Kavousanaki M, Virla D, Raptopoulou A, Kardassis D, Boumpas DT, Sidiropoulos PI. Anti-tumor necrosis factor therapy improves insulin resistance, beta cell function and insulin signaling in active rheumatoid arthritis patients with high insulin resistance. Arthritis Res Ther. 2012 Jun 12;14(3):R141