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ID PMID Title PublicationDate abstract
8296637 Antibodies to neutrophil cytoplasmic antigens in rheumatoid arthritis. 1993 In this study we examined the sera from 42 randomly selected patients with RA. ANCA was demonstrated by indirect immunofluorescence on human granulocytes in 10 patients with active disease and in none of the patients with inactive disease. ELISA's for the detection of specific antigens showed the presence of anti-myeloperoxidase in 3 patients, and anti-lactoferrin in 1 patient. The specificity of the remaining antibodies was unidentified. All 3 patients with antibodies to myeloperoxidase had vasculitis.
7704460 Responsiveness of Keitel functional index compared with laboratory measures of disease act 1995 Feb This study compares functional changes to change in measures of disease activity following the introduction of slow-acting anti-rheumatic drugs (SAARD) in patients with active rheumatoid arthritis (RA). Clinical and laboratory variables were simultaneously monitored at 6-monthly intervals, over approximately 18 months. Function was measured by a performance testing, the Keitel function index (KFI), which was divided into sections representing small and large joints [hand (HFI); wrist (WFI) and limb function index (LFI)]. One-hundred-and-fifteen patients were studied, of whom 21 were male. The mean age of the subjects was 49 yr (S.D. +/- 12) and mean duration of disease 7 yr (S.D. +/- 7). The mean KFI at entry was 38 (S.D. +/- 18) while at the end of the study it was 31 (S.D. +/- 17) (P < 0.0001). The change in KFI following therapy correlated with the change in Ritchie articular index (RAI) (r = 0.4; P < 0.0001), early morning stiffness (EMS) (r = 0.3; P = 0.004), swollen joint count (JC) (r = 0.4; P = 0.0005), C-reactive protein (CRP) (r = 0.2; P < 0.05) and Lansbury systemic index (LSI) (r = 0.35; P = 0.002), but not with change in Westergren erythrocyte sedimentation rate (ESR) or change in time to onset of fatigue. Multiple regression analysis showed that 32% of the variation in KFI at the end of the study could be predicted by a combination of ESR, sulphasalazine therapy, RAI, disease duration and chloroquine treatment at onset (P < 0.05).(ABSTRACT TRUNCATED AT 250 WORDS)
8609431 Functional differentiation of dendritic cells in rheumatoid arthritis: role of CD86 in the 1996 Apr 15 Dendritic cells (DC) are the major APC in human peripheral blood (PB) and rheumatoid synovium. We previously identified in PB a population of CD33dim-CD14dim DC precursors, as well as a smaller population of CD33bright CD14dim mature DC. Neither PB DC population expressed the CD28/CTLA4 ligands, suggesting that additional signals are required for full functional DC differentiation. Because rheumatoid synovium is characterized by an ongoing immune response, the expression and function of CD80, CD86, and other markers of DC differentiation by rheumatoid arthritis synovial APC were examined. The phenotype of a large subset of freshly isolated rheumatoid arthritis synovial fluid (SF) DC resembled that of the mature PB DC. These DC expressed CD45R0, CD11c, CMRF-44, and high levels of CD33. Whereas CD80 expression by rheumatoid SF DC and monocytes was minimal, CD86 was expressed by a subset of SF monocytes and by CMRF-44+SF DC. Furthermore, sorted CD86- SF DC spontaneously up-regulated CD86 in vitro. CD80 was expressed diffusely and at low levels by rheumatoid synovial tissue cells, whereas CD86 was expressed by perivascular HLA-DR+HLA-DQ+CD80+CMRF-44+ DC, and by some CD14+ monocytes. Anti-CD86 mAb and CTLA4 Ig, but not anti-CD80 mAb, inhibited the MLR stimulated by SF DC. Both CMRF-44+ and CMRF-44- SF DC were efficient stimulators of the allogeneic MLR, which was in each case blocked by CTLA4 Ig. The data indicate that rheumatoid synovial DC can undergo full functional differentiation, associated with CD86 expression, in vitro and in situ. Synovial DC expressing high levels of MHC molecules and CD86 are strategically located to present arthritogenic Ag to T cells after transendothelial migration.
8578890 [Virus-associated arthritis]. 1995 Nov From the about 400 virus species known to cause illness in man, only a small but growing list of representatives are able to induce arthritis. Although virus-associated arthritides are mostly of acute and short-living type, some patients develop long-lasting or even chronic joint inflammation. The viral or host factors which contribute to chronicity or severity of viral joint disease are not known. However, the study of patients with long-lasting viral arthritis and of patients with idiopathic chronic arthritides may allow unique insights into the potential role of viruses in the pathogenesis of inflammatory joint disease.
1738751 Rethinking the therapeutic pyramid for rheumatoid arthritis. When are NSAIDs alone not eno 1992 Feb 1 A large number of agents that compare quite favorably to nonsteroidal anti-inflammatory drugs in terms of toxicity and efficacy are available to physicians for the treatment of rheumatoid arthritis. Primary care physicians need to familiarize themselves with the use of these drugs and consider prescribing them early in the course of the disease, when they may be of greatest benefit.
7612046 Increased levels of stromelysin-1 and tissue inhibitor of metalloproteinases-1 in sera fro 1995 Jul OBJECTIVE: To evaluate the efficacy of stromelysin-1 (matrix metalloproteinase-3 [MMP-3]) and tissue inhibitor of metalloproteinases-1 (TIMP-1) in serum as markers for joint inflammation in rheumatoid arthritis (RA). METHODS: Levels of both macromolecules in sera from 97 healthy controls, 109 patients with RA, and 47 patients with osteoarthritis (OA) were measured by respective 1-step sandwich enzyme immunoassays. In the patients with RA, serum levels of MMP-3 and TIMP-1 were investigated in relation to laboratory and clinical measures of disease activity. In addition, the relationships between serum and synovial fluid (SF) levels in paired samples from individual patients were examined. RESULTS: Serum levels of both MMP-3 and TIMP-1 in RA patients were significantly higher than those in OA patients and in healthy controls (P < 0.001), and were shown to correlate with traditional systemic markers of inflammation including the erythrocyte sedimentation rate and C-reactive protein level, and with the Lansbury articular index. In addition, it was noted that serum levels of MMP-3 correlated with the corresponding values in paired SF samples obtained concurrently from patients with RA (rs = 0.588, P < 0.001), while such correlations were not found for TIMP-1 levels. CONCLUSION: Our results support the notion that levels of both MMP-3 and TIMP-1 in RA patient sera are increased in association with inflammation. Furthermore, the level of MMP-3 in serum provides a particularly useful marker of inflammatory activity in the joints of patients with RA.
7964169 Effects of fatty acids on proliferation and activation of human synovial compartment lymph 1994 Nov The object of this study was to determine the effects of eicosanoid precursor fatty acids on activation and proliferation of T lymphocytes from synovial fluid and synovial tissue of rheumatoid arthritis patients. Proliferation was determined by direct cell counts; phenotypic characterization of surfaces molecules was by cytofluorometric analysis. Dihomogammalinolenic acid, arachidonic acid, and eicosapentaenoic acid suppressed proliferation of interleukin-2-dependent lymphocytes by as much as 80%; cell viability was not altered by fatty acids. Administration of particular fatty acids may prove to be a useful therapeutic intervention in rheumatoid arthritis patients because of their ability to suppress activation and proliferation of synovial compartment T lymphocytes.
1617893 Serum levels of interleukin-1b, tumour necrosis factor-a and interleukin-2 in rheumatoid a 1992 Jun Cytokines are potent immunoregulatory factors and may be directly involved in the disordered immunoregulation found in chronic rheumatic diseases. Interleukin-1b (IL-1b), Interleukin-2 (IL-2) and Tumour Necrosis Factor-a (TNF-a) have been implicated in the pathogenesis of rheumatoid arthritis (RA) as mediators of chronic inflammation. Serum levels of IL-1b and TNF-a measured by radioimmunoassay were significantly higher in patients with RA than in healthy controls of similar sex and age while serum levels of IL-2 were significantly lower in the same patients. Further IL-1b and TNF-a were significantly elevated in RA patients with active disease and IL-2 was significantly reduced when compared with patients with low active disease. Serum IL-1b and TNF-a appear to correlate with systemic inflammation, and systemic features of RA may result from dissemination of cytokines produced in the synovium. The role of IL-2 in RA remains controversial. Reduced levels of IL-2 may be an expression of a deficiency of T-cells to produce IL-2 in the active phases of RA or may be due to a possible absorption of IL-2 by lymphocyte receptors.
8599812 [Cyclosporin A in the treatment of refractory rheumatoid arthritis]. 1995 Nov 15 BACKGROUND: In the treatment of rheumatoid arthritis an irreplaceable position is held by so-called disease modifying drugs. Recently among the latter cyclosporin A was included. The objective of the present study was to assess its therapeutic effect in patients with rheumatoid arthritis refractory to treatment. METHODS AND RESULTS: To a group of 20 patients with the refractory form of rheumatoid arthritis cyclosporin A (Consupren-Galena) was administered for 6 months in a mean daily dose of 3.5 mg. Clinical and laboratory examinations were made after one-month intervals. Cyclosporin administration influenced the clinical indicators of disease activity but did not lead to changes of red cell sedimentation values or the titre of the latex fixation test. Three patients did not complete the study because of serious undesirable effects. CONCLUSIONS: The results of the investigation indicate the clinical effectiveness of cyclosporin in patients with rheumatoid arthritis who do not react to other forms of disease modifying drugs. It is not clear whether cyclosporin affects the progression of rheumatoid tissue changes or whether is its effect is close to symptomatic treatment.
8019790 Decrease in detectable complement receptor type 1 levels on erythrocytes from patients wit 1994 Jul The complement receptor type 1 (CR1) levels on erythrocyte membranes from 23 patients with PsA was determined by using ELISA. Six patients had an axial form, the rest had peripheral arthritis (10 polyarthritis and seven oligoarthritis). A significant decrease in levels of this receptor was found in patients with polyarthritis compared with healthy controls. Non-significant differences were found when comparing the other two groups of patients with the controls, although the mean values of CR1 were lower in the patients' group. We also found an inverse correlation between CR1 levels and articular index, but not with ESR, CRP or disease duration. No differences in the CR1 density were obtained for HLA-B27 positive and HLA-B27 negative patients.
7940335 [Heart defects in rheumatoid arthritis patients (the results of a multiyear prospective cl 1994 The analysis of life-time diagnosis of valvular heart disease in rheumatoid arthritis (RA) patients has been made basing on a long-term clinico-echocardiographic investigation. Within 18-year follow-up valvular disease was revealed in 17 out of 214 RA patients (7.9%). Only 3 patients developed the disease in childhood prior to RA diagnosis. In 8 patients the diagnosis of valvular disease was established in the presence of RA, in 6 RA patients the disease was determined during the follow-up period. Mitral stenosis, aortal stenosis, combined mitral valve incompetence, combined aortal defect, mitral defect and tricuspid incompetence, combined mitral defect and pulmonary artery valvular incompetence were detected in 2, 2, 3, 1, 1, and 1 patients, respectively. Valvular disease occurs more frequently in progredient seropositive RA uncontrollable by on-going therapy. The authors emphasize the value of a prospective clinical echocardiographic examination of RA patients in early diagnosis of valvular disease in them. Frequent valvular lesions in RA patients dictate the need of persistent antirheumatic therapy to inhibit the activity and prevent progression of the disease.
1295425 Polyneuropathy following intra-muscular sodium aurothiomalate for rheumatoid arthritis--a 1992 Nov A patient with rheumatoid arthritis developed rapid onset of peripheral neuropathy whilst on treatment with intra-muscular (IM) gold (Sodium Aurothiomalate). At the time of admission, the arthritis was relatively quiescent. Electromyogram showed evidence of sensorimotor polyneuropathy. Investigations excluded other causes of polyneuropathy. Sural nerve biopsy did not reveal inflammation or vasculitis. The patient's condition improved after cessation of gold therapy. Gold induced neuropathy should be considered in a patient with rheumatoid arthritis who presents with polyneuropathy while on gold therapy.
7881836 Association of HLA-DR4, protease inhibitor phenotypes and keratoconjunctivitis sicca with 1995 Jan One-hundred rheumatoid arthritis (RA) patients were assessed for the association of HLA-DR4, protease inhibitor (Pi) phenotype and keratoconjunctivitis sicca (KCS) with a variety of clinical features, airflow obstruction and bronchial reactivity. Spirometry, lung volume and gas transfer factor measurements were performed to detect airflow obstruction. Bronchial reactivity to inhaled methacholine was assessed by measuring the provocative dose of methacholine causing a 20% fall in FEV1 from the baseline (PD20). Sixty-two patients were HLA-DR4 positive, 87 had Pi MM and 13 MS phenotypes and 37 had positive Schirmer's tear tests. Patients with KCS had a significantly increased history of wheeze (11/37 vs 7/63, P = 0.03, relative risk (RR) 1.8 [95% CI 1.04, 3.1]), those with HLA-DR4 had a significantly decreased atopy on skin-prick testing [3/62 vs 7/38, were significantly higher in the Pi MS group compared to Pi MM group. There was no significant association of HLA-DR4, Pi phenotype and KCS with bronchial reactivity. We conclude that there is no overall significant association of HLA-DR4, Pi phenotype and KCS with airflow obstruction and bronchial reactivity in RA.
1481578 [Rheumatic diseases in advanced age--psychological aspects]. 1992 Nov This paper discusses the importance of cognitive representation and individual patterns of behavior for coping with chronic disease. Chronically ill patients differ very much in their psychic situation. Biographical and situational factors and the future perspective contribute to these interindividual differences. Diagnostic and therapeutical tools are discussed from a psychological perspective.
8356406 Occurrence of autoimmune diseases and relationship of autoantibody expression with HLA phe 1993 Presence of autoimmune diseases and relationship of autoantibody expression with HLA association has been studied in 44 multicase rheumatoid arthritis (RA) families of Asian Indian origin. An increased prevalence of systemic lupus erythematosus (SLE) was observed in relatives (2.3%). Although HLA-DR4 segregated preferentially with seropositivity in general, no difference was observed among seropositive versus seronegative RA. On the other hand, no HLA association was observed with ANF positivity in these families. An increased frequency of DR7 in the ANF negative and RF negative group of RA patients compared to positive groups suggests that it may act as protective element for the development of autoantibodies in RA. An increased occurrence of DR4 in relatives affected with SLE was observed. While RA segregated mostly with HLA-DR4 in these families, autoimmune thyroid disease and insulin dependent diabetes mellitus (IDDM) segregated with HLA-DR3 suggesting the involvement of at least two sets of HLA-linked autoimmunity favouring susceptibility genes in the Indian population.
8326316 Rupture of the quadriceps tendon after total knee arthroplasty. A case report. 1993 Jun Reported herein is the case of a 45-year-old woman with knee involvement due to rheumatoid arthritis. She had a total knee arthroplasty with a rupture of the quadriceps tendon 1 month later. Surgical repair of the rupture was performed following the Scuderi technique plus reinforcement with Dacron (Lig Aid, Levallois, Cedex, France) tape cerclage. An above-knee walking-plaster cast was applied with the knee in full extension for 6 weeks. The functional result was good 1 year after surgery.
7799655 Experimental study on effect of traditional bone-knitting drugs on traumatic gu bi (bone-r 1994 Sep Traditional bone-knitting drugs (TBKD) are used frequently in the treatment of bone fractures. An animal model of Gu Bi (bone-related rheumatoid lesions) with defects of articular cartilage as the main lesion was developed by surgical trauma under the stereomicroscope in Wistar rats and treated with TBKD. The results showed that TBKD could promote proliferation of cartilage cells around the traumatic site and improve the osteogenetic function in the traumatic state, suggesting that TBKD can be used in combination with other Chinese drugs to treat Gu Bi, including bony lesions of the late-stage rheumatoid arthritis and bony arthritis. But the experimental results also suggested that TBKD might have an effect of promoting development of inflammation, and therefore, should be used with care in the acute phase of inflammation.
7593375 Advances and issues in the pharmacotherapy of rheumatoid arthritis. 1995 Jun Rheumatoid arthritis (RA) is an unremitting and progressive disease despite the use of second-line drugs in the majority of patients. In addition, a shortened life-span directly attributable to RA is now recognized. The additions of methotrexate and sulfasalazine to the therapeutic armamentarium represent important treatment advances during the past decade. To improve the effectiveness of second-line drug therapy, earlier intervention and use of these newer drugs in combination with older second-line drugs is being advocated. Several proposed strategies for intervening earlier, combining second-line drugs, and/or improving patient selection for second-line drug therapy are reviewed. Systematic evaluation of these strategies is needed. Controlled studies to date have not demonstrated combining second-line drugs is superior to using individual second-line agents. Future advances in optimizing patient outcomes with these drugs will require systematic screening for potentially superior treatment strategies followed by supportive proof of effectiveness in the form of large-scale studies.
8195678 Analysis of elevated serum interleukin-6 levels in rheumatoid arthritis: correlation with 1994 May The purpose of this study was to determine whether selected antirheumatic drugs would suppress elevated circulating interleukin-6 (IL-6) levels in patients with rheumatoid arthritis (RA). The 267 patients who enrolled in a double-blind randomized protocol received placebo, naproxen (1500 mg/day), or prinomide (1500 mg/day) for up to 16 weeks. Serum samples from 143 of the patients completing the trial and from 135 normal donors were analyzed by quantitative sandwich enzyme-linked immunosorbent assay for IL-6 concentrations. A mean normal IL-6 value was determined to be 3 pg/ml (95th percentile value = 10 pg/ml). IL-6 levels at baseline for the patients with RA were significantly higher than those for control subjects (p < 0.0001). Elevated IL-6 levels (> 10 pg/ml) at baseline were found in 80% of subjects with RA (median = 36 pg/ml, range 12 to 403). For patients with elevated levels of either IL-6, C-reactive protein (CRP), or erythrocyte sedimentation rate (ESR) at baseline, initial median values of IL-6, CRP, and ESR were compared with those from the final visit for each treatment group. There was no significant decrease in IL-6 levels with treatment. Median CRP levels decreased significantly, from 1.9 to 0.8 mg/dl (p = 0.002), as did median ESR (37 to 34 mm/hr, p = 0.013), only in the prinomide-treated group.
7839070 R-h-erythropoietin counteracts the inhibition of in vitro erythropoiesis by tumour necrosi 1994 Anaemia of chronic disease (ACD) is a common extra-articular manifestation of rheumatoid arthritis (RA). Tumour necrosis factor alpha (TNF alpha) plays an important role in the development of ACD. The objective of the present study was to assess inhibition of in vitro colony-forming unit erythrocyte (CFUe) and blast-forming unit erythrocyte (BFUe) growth by TNF alpha and to examine whether this suppression could be counteracted by adding increasing concentrations of recombinant human erythropoietin (EPO) (r-h-EPO) to bone marrow cultures of RA patients with ACD and without anaemia (controls). Bone marrow cells of RA patients with ACD and control patients were cultured. The cultures were incubated with increasing concentrations of r-h-EPO (0.25; 0.5; 1; 2 U/ml), each in combination with increasing quantities of TFN alpha (0; 50; 100; 200; 400 U/ml). CFUe and BFUe were assessed after 7 and 14 days, respectively. Dose-dependent inhibition of BFUe and CFUe by increasing concentrations of TNF alpha was observed in ACD and controls. Regarding CFUe (ACD patients) incubated with 0.25 U/ml EPO, 50 U/ml TNF alpha caused 28% suppression compared to cultures without TNF alpha. Increasing the concentration of r-h-EPO from 0.25 U/ml to 2 U/ml completely restored the number of CFUe. A similar pattern was observed in BFUe growth in both groups. These data demonstrated the suppressive effects of TNF alpha on erythropoiesis in vitro and that the suppressed erythropoiesis could be partly corrected by the addition of excess r-h-EPO to the cultures. No significant differences were observed between ACD and control RA patients.(ABSTRACT TRUNCATED AT 250 WORDS)