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Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
1617901 Mud pack therapy in rheumatoid arthritis. 1992 Jun Twenty-eight patients with classical or definite rheumatoid arthritis were randomly divided into two groups of fourteen patients each. All patients were treated once a day with mud packs derived from the Dead Sea heated to 40 degrees C and applied over the four extremities, neck and back for 20 minutes. Group 1 was treated with the true mud packs and Group 2 with washed out and less concentrated mud packs. The study was double blind and of two weeks duration. All patients were evaluated by one rheumatologist both before treatment and two weeks later at the end of the treatment period. Follow-up evaluations were made one and three months after conclusion of the treatment. The clinical indices evaluated included duration of morning stiffness, hand-grip strength, activities of daily living, patient's own assessment of disease activity, number of active joints and the Ritchie index. A statistically significant improvement (p less than 0.01 or p less than 0.05) was observed in Group 1 only in most of the clinical indices, lasting between 1 to 3 months.
8808638 Expression of Fas antigen and Fas ligand in the rheumatoid synovial tissue. 1996 Oct To understand the role of apoptosis through Fas/Fas ligand (Fas-L) interaction in the pathogenesis of rheumatoid arthritis (RA), we examined the expression of Fas antigen, Fas-L, and apoptosis in synovial tissue obtained from eight patients with RA and five patients with osteoarthritis (OA). Immunohistochemical staining demonstrated the significant expression of Fas antigen and Fas-L in RA synovial tissue compared with that in OA synovial tissue. Immunohistochemical staining and the DNA nick end labeling (TUNEL) method were combined and revealed that approximately 10 to 30% of Fas antigen-expressing cells in the RA synovium showed DNA fragmentation characteristic for apoptosis. In double-staining analysis, Fas-L was expressed on up to 10% of CD45RO-, CD4-, CD8-, or CD56-positive mononuclear cells in RA synovial tissue. Our results suggest that activated T cells and natural killer cells infiltrating into the RA synovium may contribute to the induction of apoptosis of RA synovial and mononuclear cells through Fas/Fas-L interaction.
8680099 Nephrogenic diabetes insipidus induced by lobenzarit disodium treatment in patients with r 1996 Feb Nephrogenic diabetes insipidus (NDI) occurred in a 43-year-old woman who had received lobenzarit disodium for the treatment of rheumatoid arthritis (RA). Her urine output was initially 3 l/day and urine osmolarity was 203 mOsm/l. Based on a sodium chloride loading test and a vasopressin loading test, she was diagnosed as having lobenzarit-induced NDI. Seven days after the cessation of the use of lobenzarit disodium, polydipsia and polyuria disappeared, and the vasopressin test showed a normal response. These findings suggest that lobenzarit induces a reversible form of NDI as a side effect. The reports of lobenzarit-induced NDI in Japan during the past seven years are also reviewed.
8339124 Association of in vitro immune functions with the severity of the disease in rheumatoid ar 1993 Jul The production of immunoglobulins in vitro by lymphocytes from rheumatoid patients has been earlier shown to be defective. This report describes a 2-year follow up study which shows that this defect is associated with the severity of RA. Pokeweed mitogen and Staphylococcus aureus Cowan I were used to stimulate in vitro immunoglobulin production by lymphocytes from patients with recent onset RA, and the relationship of responses to clinical characteristics were studied. Impaired polyclonal IgM synthesis, already detectable at the onset of disease, associated with joint destructions observed after a 2-year follow up period. Further, phytohaemagglutinin-induced interleukin-2 (IL-2) release by the cells of patients with erosive disease was found to be reduced compared to cells from patients without eroded joints. The results indicate that altered immune functions--manifested as decreased production of IgM and IL-2--in RA are involved in the progression of the disease and affect the outcome of patients and, thus, represent an unfavourable prognostic feature.
8051581 Rheumatoid arthritis: a complication of interferon therapy. 1994 May A case report of rheumatoid arthritis developing during alpha-interferon therapy of chronic hepatitis C is reported. The rheumatoid arthritis was severe, being non-responsive to the use of nonsteroidal anti-inflammatory drugs, and persisted despite discontinuation of the interferon therapy. The literature relative to this case suggesting an association between rheumatoid arthritis and interferon therapy is presented. This case suggests that interferon therapy may precipitate subclinical rheumatoid arthritis in an individual without pre-existing clinical arthritis.
8464961 [Psychosomatic aspects of rheumatic diseases]. 1993 Mar The spectrum of rheumatic diseases includes syndromes characterized solely by musculoskeletal pain and discomfort. Indeed, muskuloskeletal pain and dysfunction are experienced by almost everyone in the course of a lifetime. The rheumatic syndromes are diverse and often of unclear etiology. For many years, psychosomatic theories have been advanced as an attempt at explanation, especially in the case of chronic polyarthritis. This article discusses the meaning of risk factors viewed as relevant to the course of back pain syndromes in particular. Therapeutic and rehabilitative-psychological interventions for comprehensive treatment of chronic rheumatic pain-patients are presented, and the necessity for a well-coordinated psychosomatic-interdisciplinary approach is emphasized.
7551660 Effect of methotrexate alone or in combination with sulphasalazine on the production and c 1995 Aug In a recent study from our group, the combination of methotrexate and sulphasalazine (MTX + SASP) seemed superior to MTX alone in the treatment of rheumatoid arthritis (RA). To assess the impact of these therapies on the cytokine cascade, the in vitro production and circulating concentrations of several cytokines and endogenous cytokine antagonists were measured in 30 healthy controls and longitudinally in a subset of 26 patients enrolled in this study. Compared to controls, RA patients had significantly higher circulating concentrations of interleukin-6 (IL-6), soluble receptors for tumour necrosis factor (sTNFR), soluble receptors for interleukin-2 (sIL-2R) and interleukin-1 receptor antagonists (IL-1RA), and their peripheral blood mononuclear cells (PBMNC) showed a higher spontaneous production of interleukin-1 beta (IL-1 beta), tumour necrosis factor alpha (TNF alpha) and IL-1RA (both secreted and cell-associated) and a higher stimulated production of cell-associated TNF alpha, IL-1RA and (to a lesser extent) IL-1 beta. Treatment with MTX alone (n = 12) or combined with SASP (n = 14), resulted in significant reductions of circulating IL-6 and sIL-2R but did not alter IL-1 beta, TNF alpha or IL-1RA concentrations. Decreases in circulating levels of sTNFR and in the in vitro production of cell-associated IL-1 beta and IL-1RA after stimulation were only observed in patients treated with MTX + SASP. The concentrations of IL-1RA and sTNFR in the circulation exceeded moderately those of IL-1 beta and TNF alpha but this is probably insufficient to block IL-1 and TNF alpha activity. In conclusion, therapy with MTX alone or with SASP modulates IL-6 and sIL-2R concentrations in RA. Decreased production of IL-1 beta and IL-1RA and circulating sTNFR levels were only observed during therapy with MTX + SASP. Whether this relates to the better clinical effect observed with the combination therapy remains to be investigated. Circulating levels of IL-6, sIL-2R and sTNFR seem useful markers of disease activity in RA.
1377275 HLA associations with rheumatoid arthritis: a piece of the puzzle. 1992 Jan HLA molecules play a central role in the immune response by presenting processed antigenic peptides to T cells. In the case of rheumatoid arthritis (RA), a specific sequence present within the peptide binding cleft of HLA class II molecules has been implicated in genetic susceptibility to this disease. Several mechanisms could account for this finding. One possibility, designated determinant selection, rests on the possibility that HLA molecules associated with RA may bind a distinct set of foreign or self antigens that can trigger a T cell response in the joint. Alternatively, HLA molecules may predispose to RA by shaping the T cell repertoire during thymic differentiation in neonatal and early adult life. These 2 mechanisms are not mutually exclusive, and it must be remembered that several other susceptibility genes as well as environmental factors remain to be identified before a comprehensive understanding of RA is achieved.
8452768 New focus on treatment for rheumatoid arthritis. 1993 Mar Although the pathogenesis of rheumatoid arthritis increasingly continues to be well understood, therapeutic approaches to the disease remain relatively unsophisticated and based more on anecdote than scientific reasoning. During the past year, additional supportive data regarding the usefulness of front-line agents such as methotrexate and hydroxychloroquine were acquired, and novel potential interventions, such as pulse gammaglobulin and OM-8980 were identified. Animal model studies still support the prospect that genuine remission-inducing strategies will be realized in the future.
1596708 Methotrexate associated Peyronie's disease in the treatment of rheumatoid arthritis. 1992 Jun We describe two patients with rheumatoid arthritis treated with methotrexate (MTX) who developed Peyronie's disease during the course of their treatment. In one of the patients the penile fibrosis resolved on stopping the drug. The other patient's penile fibrosis partially resolved on stopping the drug. We suggest that Peyronie's disease can be a side-effect of MTX in the treatment of rheumatoid arthritis.
8140505 [Acquired factor VIII inhibitor in a patient with rheumatoid arthritis]. 1993 Oct In the present report we describe a 66 year-old-woman, diagnosed of rheumatoid arthritis, who suffered a severe haemorrhagic syndrome caused by the presence of a circulating inhibitor to factor VIII. Inhibitor quantitation was measured with Bethesda test. After treatment with corticosteroids and high-dose immunoglobulin, a good clinical response was obtained; factor VIII:C activity increased with the disappearance of detectable inhibitor. This response was observed more effectively and rapidly than with prednisone treatment alone.
8478870 A method for achieving consensus on rheumatoid arthritis outcome measures: the OMERACT con 1993 Mar We describe the process used during the international Conference on Outcome Measures in Rheumatoid Arthritis Clinical Trials (OMERACT). The objectives of the conference were (1) to broaden consensus on the minimum number of outcome measures to be included in all RA clinical trials in rheumatoid arthritis (RA); (2) to achieve consensus on criteria for (a) minimum clinically important improvement in patients with RA and (b) minimum important differences between treatment groups in RA clinical trials; and (3) to decide whether aggregate outcome measures (indices) are useful in the assessment of patients and trials. A combination of plenary sessions and structured nominal groups were employed during the conference. Simulated patient profiles and clinical trial profiles were used to generate discussion. The objective of the nominal group exercises was to capture each participant's judgments of the relative importance of each outcome measure and the degree of change required to indicate clinical improvement. Considerable discussion ensued on the content of the core set of outcome measures. An electronic interactive voting machine was used to obtain participants' views on a core set of outcome measures and methodological issues. To permit further discussion of outcome measures, the group explored the use of aggregate outcome measures (indices) in patient care and trials only in a preliminary way. A final plenary session dealt with patient perceptions of minimum important differences, a new classification of antirheumatic drugs, and a repeat of part of the preconference questionnaire. Concluding statements and future plans were developed at the conclusion of the meeting.
8304246 Inhibition of metalloproteinase activity of rheumatoid arthritis synovial cells by a new i 1993 Jul The effect of a new metalloproteinase (MP) inhibitor [BE16627B; L-N-(N-hydroxy-2-isobutylsuccinamoyl)-seryl-L-valine, MW: 375.2] isolated from Streptomyces sp. was evaluated by using primary cultures of synovial cells from rheumatoid arthritis patients. BE16627B selectively inhibited MPs such as human stromelysin and 92 kD gelatinase. After the cells were cultured with BE16627B for 5 days, BE16627B inhibited MP activity in the primary culture supernatants from synovial cells in a dose-dependent fashion without showing apparent cytotoxicity or affecting the production and secretion of MPs. Its IC50 for active collagenolysis before activation by trypsin was 25 microM.
1413678 [The indices of thrombocyte coagulating and fibrinolytic activity in rheumatoid arthritis 1992 Mar Blood coagulation values (thrombocyte count, adhesive-aggregation thrombocytic activity, coagulographic data) were analysed in 90 patients with rheumatoid arthritis (RA). Increase of plasma coagulation activity was observed in all coagulation activity grades. The anticoagulation activity was most pronounced in grade III RA activity. Thrombocytes of RA patients possessed procoagulant properties and lost significantly their fibrinolytic activity most expressed in grade II RA. This increased the thrombophilic tendency of the plasma potential creating favourable conditions for intravascular coagulation and microthrombus formation, resulting in deterioration of the rheological properties of the blood and the course of the rheumatoid synovitis.
9082588 [Combined immunomodulating therapy in rheumatoid arthritis]. 1996 Monotherapy with methotrexate (MT) was compared to combined therapy MT+tactivin (T) in a 2-year clinical trial including 127 patients with rheumatoid arthritis (RA). MT was given to 88 patients in a weekly dose 7.5 mg. In 39 patients this dose was given in combination with subcutaneous injections of T (100 micrograms two times a week for a months, then once a week). Both treatments induced a significant decline in severity of arthralgia, in the number of joints with inflammation, in the level of C-reactive protein and in ESR. Morning stiffness and pains in the joints at palpation were achieved after MT+T combination. Side effects were similar in both treatments.
7544768 TNF alpha blockade in rheumatoid arthritis: rationale, clinical outcomes and mechanisms of 1995 Feb Tumor necrosis factor alpha (TNF alpha) is a cytokine with many biological functions of relevance to inflammatory disease. Although only one of several inflammatory mediators produced in abundance in rheumatoid arthritis (RA), experimental data suggest that it is in a dominant position within a cytokine hierarchy and is therefore a prime target for directed immunotherapy in this disease. We have targeted TNF alpha in vivo using a chimerised monoclonal anti-TNF alpha antibody and have now demonstrated beneficial responses to treatment in three different clinical trials. The results confirm that TNF alpha is of central importance in the inflammatory process in RA and define a new treatment strategy in this disease.
8356409 Low serum vitamin D metabolites in women with rheumatoid arthritis. 1993 The etiology of osteoporosis associated with rheumatoid arthritis (RA) is unknown. We studied the calcium and vitamin D metabolism in 143 women with RA (mean age 50.7 years). Albumin corrected serum calcium was normal. Serum alkaline phosphatase was increased in 29 percent of cases. Serum vitamin D levels were frequently very low. In 16 percent of the RA patients serum 25(OH)D concentration was below 12.5 nmol/L, which is arbitrarily considered as the limit of vitamin D deficiency osteomalacia. In the winter season 73 percent of the patients had serum 1,25(OH)2D levels below the seasonally adjusted normal range. The lowest values were found in patients with high disease activity. We suggest that there is a disturbance in vitamin D metabolism in RA. This might play a role in osteoporosis associated with RA.
8856614 HLA-DRB1 and DQB typing of Hispanic American patients with rheumatoid arthritis: the "shar 1996 Aug OBJECTIVE: To determine whether the association of particular MHC class II alleles and the DRB1 "shared epitope" with disease susceptibility and severity in rheumatoid arthritis (RA) applies to ethnic groups other than Caucasian Americans. METHODS: 67 Hispanic American patients with RA and a similar number of ethnically matched controls were typed for DRB1 using polymerase chain reaction methods. DR4 subtype and DQB1 type were determined for the subjects positive for DR4. Disease severity in the patients with RA was assessed by clinical, radiographic and laboratory variables. RESULTS: The frequency of DR4 was significantly increased in the subjects with RA compared to the control group. However, the "shared" DRB1 amino acid sequence was relatively infrequent in the Hispanic American patients with RA, and there was no association of specific DR4 or DQ alleles with more severe disease or extraarticular manifestations. CONCLUSION: The HLA markers that predict poor prognosis and suggest that more aggressive clinical management may be appropriate in Caucasian American patients with RA may not be useful in other ethnic groups.
8040494 Differential relationships between stress and disease activity for immunologically distinc 1994 May Immunologically distinct subgroups of patients with rheumatoid arthritis (RA)--those with the autoantibody rheumatoid factor (seropositive RA) and those without (seronegative RA)--were compared on a variety of clinical and self-report measures in a consecutive series of women with disease of 7 years' or less duration. The groups were comparable on clinical, pain, functional, and psychosocial variables. However, the seronegative RA group reported elevated levels of preonset negative life event stress. Postonset life event stress and disease activity were significantly correlated for the seronegative RA group, but not for the seropositive RA group. Results suggest that stress factors may be more important in the etiology and maintenance of seronegative RA and that the seronegative RA group may possibly derive particular benefit from psychological techniques to enhance stress management skills.
7797961 Radiological evolution of the rheumatoid wrist after radio-lunate arthrodesis. 1995 Apr Radio-lunate arthrodesis of the rheumatoid wrist is an established technique which has been in use for more than 12 years. The evolution of 26 operated wrists and 20 non-operated wrists has been studied with a mean follow-up of 5 years. The results show that although radio-lunate arthrodesis can prevent dislocation of an unstable wrist, it cannot prevent deterioration. Collapse, ulnar translation, tilt of the lunate, and the inter-carpal instability continued with time, whether the wrists were operated on or not. The speed of deterioration was dependent on the type of rheumatoid arthritis and is faster in the disintegration type than in the osteoarthritis or the ankylosis type. The technique is applicable to the osteoarthritis type of rheumatoid arthritis, in the middle stage (2 to 4a according to the Larsen-Alnot classification). At that stage, the ankylosis type and the disintegration type, and the osteoarthritis type at an advanced stage, are better treated by total arthrodesis or total prosthetic arthroplasty.