Browse

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

ID PMID Title PublicationDate abstract
8085138 Is the modality-shift effect specific for schizophrenia patients? 1994 Several studies have found that the reaction time of schizophrenia patients is longer when successive imperative stimuli are of different modality (e.g., light followed by sound) than when they are identical (e.g., sound followed by sound). This effect is called the modality-shift effect. In this study, the reaction times of 175 persons were analyzed: 54 schizophrenia patients, 33 patients with mood disorders, 13 alcoholics, 17 patients with rheumatoid arthritis, 13 patients with internal diseases, and 45 normal controls. The results indicated that a shift from light to sound stimuli lengthened the reaction time for schizophrenia patients considerably more than for alcoholics, patients with rheumatoid arthritis, patients with internal diseases, or normal controls. No difference was found between the reaction times of schizophrenia patients and patients with mood disorders.
1464074 [Pharmacotherapy of rheumatoid arthritis in 1992]. 1992 Oct 9 The author presents an overview of the state of pharmacotherapy of rheumatoid arthritis in 1992. In the area of non-steroidal antirheumatic drugs attention is drawn to some problems associated with their undesirable action on the digestive tract and articular cartilage. The problem of interindividual reactivity to this group of drugs has not been resolved so far. The mechanism of their action, in particular analgetic action, is also still open. It was found that they can exert not only a central but also a peripheral action. Drugs modifying the disease have been extended by sulphasalazine, methotrexate and cyclosporin. Interest in combined treatment with these drugs is increasing as well as attitudes to the strategy of their application. The corticoid group has been extended by the preparation deflazacort which does not have a catabolic effect on osseous tissue. In the posology of corticoids pulsed treatment is gaining support.
1440080 [Clinical characteristics and prognosis of secondary amyloidosis in patients with rheumato 1992 Oct Secondary amyloidosis is an important complication that may have a strong influence on the prognosis of patients with rheumatoid arthritis (RA). We studied 21 RA patients with secondary amyloidosis. The two major initial signs were gastrointestinal symptoms and renal involvement. When 15 of the 21 patients were diagnosed as having secondary amyloidosis, they displayed renal involvement including proteinuria, hematuria and hypercreatininemia. The 15 patients with amyloidosis were either subjected to dialysis or died within 35 months on the average. The causes of death in 13 patients were cardiac failure, gastrointestinal bleeding and infection, which were strongly implicated with renal failure. Dialysis was applied to seven patients. Three of them were maintained with chronic dialysis. We discussed the induction-time and the method of dialysis in patients with amyloidosis secondary to RA.
7826986 [Generalized septic infections in rheumatoid arthritis. Study of autopsy material]. 1994 Nov In the randomized autopsy material of 161 patients with rheumatoid arthritis (RA), a letal, generalized septic infection (GSI) was observed in 22 cases (13.66%). The GSI was accompanied by a pyarthros in 12 (7.45%) and no pyarthros in 10 (6.21%) cases. The clinical parameters of 22 septic RA patients were compared with 139 age and sex matched RA patients without GSI. The average age of septic patients decreased (p < 0.02), with low serum electrophoretic b-globulin level (p < 0.04), and high Waaler-Rose (p < 0.02) and Latex level (p < 0.004). The clinical parameters of 22 septic patients were compared with 76 age and sex matched RA patients without sepsis, vasculitis, or generalized secondary amyloidosis (GSA), and/or miliary epitheloid granulomas of tuberculous type (mT). The differences between the two groups of patients were the same, with a statistically more pronounced age difference (p < 0.005). 29 out of 161 patients (18.01 %) suffered from a clinically manifest diabetes mellitus (in 6 patients accompanied by sepsis), and 11 (6.83 %) from a clinically latent diabetes mellitus (in 2 patients accompanied by sepsis). There was no significant relationship between sepsis and manifest diabetes mellitus. The controlled and treated diabetes mellitus does not influence the frequency of lethal sepsis. Significant correlations were found between sepsis and latent diabetes mellitus (based on the histological detection of amyloid deposition localized to the islets of Langerhans (p < 0.02). 34 out of 161 patients (21.12%) suffered from a generalized secondary amyloidosis (in 3 patients accompanied by sepsis). There was no significant relationship between sepsis and generalized secondary amyloidosis. The thickness of adrenal cortex represents the effect of steroid therapy. Critical random check, using the Mann-Whitney tests, supports significance relationship between the adrenal cortex atrophy and fatal sepsis (p < 0.010). The follicular lymphoid depletion in the spleen represents the effect of immunosuppressive therapy. The size of lympho-follicles decreased significantly in sepsis (p < 0.004). The long term corticosteroid therapy and immunosuppressive represent a potential danger for sepsis.
7612039 Markers of bone metabolism in postmenopausal women with rheumatoid arthritis. Effects of c 1995 Jul OBJECTIVE: To investigate bone metabolism in postmenopausal women with rheumatoid arthritis (RA) treated with or not treated with corticosteroids, and the response to hormone replacement therapy (HRT). METHODS: One hundred six RA patients were divided into those taking low-dose steroids (RA+; n = 35) and those not (RA-; n = 71) and randomly allocated to receive HRT or calcium for 2 years. Bone formation markers included serum osteocalcin (OC) and bone-specific alkaline phosphatase, and resorption markers included urinary deoxypyridinoline (DPyr) and CrossLaps (XL). Bone mineral density (BMD) was measured annually using dual x-ray absorptiometry. RESULTS: OC levels were significantly lower in both the RA+ and RA- groups compared with 112 healthy control subjects (P < 0.01 and P < 0.05, respectively), but were similar in the 2 RA groups. DPyr and XL levels were elevated in the RA+ group compared with the RA- group (P < 0.05) but were similar between the RA- group and controls. OC was negatively correlated with parameters of disease activity (P < 0.05). After HRT, XL excretion decreased significantly in the overall RA group. Three-month changes in XL correlated with 2-year changes in spinal BMD (P < 0.01). CONCLUSION: Bone metabolism may be uncoupled in chronic RA. Bone formation appears to be reduced, partly reflecting disease activity, whereas resorption is increased only in steroid users. HRT reduces resorption in RA irrespective of steroid usage, emphasizing its value in the treatment of postmenopausal women with RA.
8144073 [Initial experience with the Meuli cementless total endoprosthesis of the wrist joint]. 1993 Sep The indications and the technique of implantation will be shown, and the results concerning function, pain reduction, and manual strength three years after surgery presented. Complications arose in cases with poor fixation of the cup prosthesis due to poor bone quality of the carpus. Operative salvage procedures are still possible.
8651984 Expression and functional expansion of fibroblast growth factor receptor T cells in rheuma 1996 Jun OBJECTIVE: Rheumatoid arthritis (RA) is an inflammatory disorder of the diarthroidial joints, characterized by fibroblast proliferation, angiogenesis, and perivascular CD4+ T cell infiltration. The present study examined the interactions between fibroblast growth factor-1 (FGF-1) and T cells. METHODS: Synovial tissues from patients with RA or noninflammatory arthritis were examined for the expression of FGF-1 and its receptor, FGFR-1, by immunohistology and reverse transcriptase-polymerase chain reaction. Functional assays were used to detect enrichment of FGF-1-responsive peripheral CD4+ T cells in RA. RESULTS: FGF-1 is abundantly expressed by rheumatoid synovium. Enhanced expression of its receptor, FGFR-1, was found in perivascular CD4+ T cells. In addition, T cells that are activated by FGF-1 are increased in the peripheral blood of patients with RA, as compared with other inflammatory conditions. CONCLUSION: The increased frequency of peripheral T cells that respond to FGF-1 in RA is consistent with expansion of FGFR-1-expressing T cells in the rheumatoid synovium.
8624581 Immortalized B-lymphocytes from rheumatoid synovial tissue show specificity for bacterial 1996 Feb Several studies indicate a pathogenetic role of T-lymphocytes with specificity for heat shock proteins (HSP) in rheumatoid arthritis (RA). Surprisingly, there are no experimental data for B-lymphocytes with specificity for HSP. To investigate whether B-lymphocytes from rheumatoid synovial tissue show a specificity for HSP 60 we immortalized synovial tissue B-lymphocytes by the electrofusion technique and tested the specificity of the B-cell clones for HSP 60 by ELISA. Tissue samples from four patients with classic, active RA were used in this study. The isolated cells were electrofused in strongly hypo-osmolar medium with cells either of the mouse strain X63-Ag8-653 (Ag8) or the heteromyeloma strain HAB-1. Clones positive for IgG, the IgG fraction of the supernatant of the isolated synovial cells and the IgG of the serum of the patients were tested in an ELISA for reactivity to the recombinant HSP 60 or Yersinia enterocolitica, which shows great homology with mycobacterial HSP 65 and human HSP 60. The expression of this HSP 60 was studied in normal and rheumatoid synovial tissue using a polyclonal rabbit serum against HSP 60 from Y. enterocolitica (Ye HSP 60). In this way we investigate differences in the expression of HSP 60 and compared the pattern of this HSP60 with the pattern of mycobacterial HSP65 and human HSP 60 described by others. In three of four patients 10 IgG secreting B-cell clones showing a specificity for HSP 60 were detected. IgG specific for HSP 60 was also detected in the supernatant of the isolated synovial cells before fusion and in the serum of these patients. HSP 60 was demonstrated immunohistochemically within the rheumatoid synovial tissue and showed stronger expression with a different distribution when compared with the expression in normal synovial tissue. B-cell clones from rheumatoid synovial tissue thus exhibit a specificity for bacterial HSP 60, and a monospecific rabbit serum against this HSP shows strong reactivity within the rheumatoid synovial tissue. It may be postulated that a humoral HSP 60 response, initially directed against an infectious agent, could react with cross-reactive epitopes of rheumatoid synovial tissue or with self-HSP perpetuating the local inflammatory process.
8569605 Treatment of rheumatoid arthritis with radionuclide combination. 1993 Radiation synovectomy (RSIN) with radionuclide combination (N) was performed in 135 patients with rheumatoid arthritis or 417 joints: 155 knee joints (90Y), 230 MCF or PIF joints (169Er), 17 ankle, 7 wrist, 6 elbow and 2 shoulder joints (186Re). Therapeutic effect was followed up during 8 year period. After 3 years positive effect of the treatment was achieved in 70-80% of cases and complete treatment in 50-60% of cases, while 8 years later the same effects were maintained in 55-60%, i.e. 35-40% of the treated joints. The best effect was achieved in the treatment of the knee and the worst in the treatment of the wrist joint. At simultaneous application of one or several different RN, the total dose for one patient did not exceed 259 MBq while the maximum dose was 695 MBq during the long-term treatment.
8444621 Coping with rheumatoid arthritis: is one problem the same as another? 1993 Spring This study examined how individuals with rheumatoid arthritis (RA) cope with illness-related problems in four different areas: daily activities, leisure activities, work, and social relationships. Eighty-five people with RA took part in the study. They participated in an in-depth interview that focused on the types of changes they had experienced in their lives as a result of their arthritis and how they had coped with these changes. Audiotapes of the interviews were transcribed and content analyzed to assess participants' coping behavior. In addition, standardized measures of psychological and physical functioning were administered shortly following the original interview and at a 4-month follow-up. Three major findings emerged. First, people relied less heavily on behavioral coping strategies when dealing with problems involving social relationships than when dealing with problems involving daily activities, leisure activities, or work. Second, there was little consistency in individuals' use of either cognitive or behavioral strategies across different problem areas. Finally, individuals who exhibited limited flexibility in their coping responses experienced poorer psychological functioning compared with more flexible copers. Implications of these findings for health education practice and future research on coping with RA are discussed.
7794045 Long term treatment of rheumatoid arthritis with high doses of intravenous immunoglobulins 1995 May OBJECTIVE: To evaluate the effects of long term treatment of rheumatoid arthritis (RA) with high doses of intravenous immunoglobulins (IVIg). METHODS: Ten patients with active RA and prior unsuccessful treatment with at least one slow acting antirheumatic drug were treated with 400 mg/kg of IVIg for the first three days and then once a month for 12 months. Clinical evaluation and laboratory analysis were performed every month. Serum levels of tumour necrosis factor alpha (TNF alpha), soluble interleukin-2 receptor (sIL-2R), IL-1 alpha, IL-1 beta, IL-6 and interferon gamma (IFN gamma) were measured at baseline and at three monthly intervals for 15 months. RESULTS: Although laboratory parameters were not influenced by the treatment, a late but significant clinical improvement was observed after six months. Serial measurement of cytokines revealed a rapid and persistent decrease in serum TNF alpha and a late and significant reduction in sIL-2R concentrations. CONCLUSION: This study suggests that IVIg can ameliorate the symptoms and improve the functional capability of RA patients. This effect is associated with a partial modulation of serum concentrations of inflammatory cytokines and, more interestingly, with a late decrease in sIL-2R which correlated with the late reduction in disease activity.
7564001 [A case of interstitial pneumonia in polymyositis difficult to distinguish from gold pneum 1995 Jul Rheumatoid arthritis was diagnosed in a 48-year-old woman. She received a gold compound, and 4 weeks after the start of that therapy, interstitial pneumonia appeared. Findings from a muscle biopsy, and high serum CPK and LDH levels indicated that she suffered from polymyositis rather than rheumatoid arthritis. The result of a drug lymphocyte stimulation test (DLST) for the gold compound was more than 200%. Because the usefulness of the DLST for the gold compound in the diagnosis of gold pneumonitis is not thoroughly established, the DLST was also done in patients with rheumatoid arthritis who were receiving the gold compound without side effects, and in normal subjects. Many of the rheumatoid arthritis patients and some of the normal subjects had a positive response to the gold compound. Therefore a positive response on the DLST for the gold compound does not always support the diagnosis of gold pneumonitis.
1342200 Cytomorphological, ultrastructural and immunological particularities of the synovial fluid 1992 Jul Our studies on the cytomorphological and ultrastructural analysis of 15 Synovial Fluid (SF) samples from patients diagnosed with seronegative Rheumatoid Arthritis (RA) and 10 SF from patients with Hydroarthrosis considered as controls were carried out. By cytomorphological studies we determined the cellularity, ragocytosis and synoviocytogram. SF in seronegative RA is characterized by leucocytosis (7,656/mm3) with polynucleosis (65.38%) and ragocytosis (59.27%) versus hydroarthrosis SF defined morphologically by lymphocytosis (47%). Degenerative forms of ragocyte-like polymorphonuclears (PMN) cells, individualized by an ultrastructural alteration less evident than recorded in seropositive Rheumatoid Arthritis (RA), associated with a remarkable capacity of endocytosis. The ultrastructural alterations, immune complexes (CIC), the immunoglobulins (MG) and the anticollagen II antibodies, suggest the early implication of these immune parameters in etiopathogenesis. The corroboration of the cytomorphological, ultrastructural and immunological data allows the profound study of the etiopathogenic mechanism and may represent a paraclinical criterion for differentiated seronegative RA field.
8633114 Magnetic resonance imaging of rheumatoid arthritis. 1996 Mar MR imaging is able to demonstrate both the structural changes that occur in rheumatoid arthritis and the inflammatory changes, including synovial proliferation and joint effusion. MR imaging can demonstrate erosion before it is visible on radiographs. Although MR imaging appears to be very helpful in assessing the severity of rheumatoid arthritis and its response to therapy, the optimal technique for this assessment and the ultimate clinical value of MR imaging have yet to be determined.
8448640 Efficacy of cyclosporin A in rheumatoid arthritis: worldwide experience. 1993 Mar The effects of cyclosporin A (CyA) on the activity of RA have mainly been investigated in patients with active, refractory, long-term disease. The data obtained in these trials suggest that CyA is not only a symptomatic treatment for RA but can also be considered a DMARD. The potential benefits of CyA on one hand and its potential toxicity on the other indicate that a careful assessment should be made of its use in patients with early active RA.
7858110 Expression of rheumatoid factor idiotypes 17.109, 6B6.6 and 4C9 in the sera of Pima Indian 1994 This study was undertaken to determine whether the expression of 17.109, 6B6.6 and 4C9 rheumatoid factor (RF) idiotypes is predictive of the development of rheumatoid arthritis (RA) and whether the RF response is idiotypically restricted in an inbred population of Pima Indians who have a genetic predisposition for the disease. Serial sera were obtained from 25 subjects who developed RA and 25 RF-positive subjects who did not develop RA over the course of a longitudinal community health survey. RF titers and titers of the RF-associated idiotypes 17.109, 6B6.6 and 4C9 were determined by ELISA, and the relationship between 6B6.6 and 4C9 was analyzed by cross-absorption studies. Expression of the three RF-associated idiotypes was found in both the subjects who developed RA and those who did not. The amount of idiotype expressed was variable, but a few subjects in both groups had high levels indicative of an oligoclonal RF response. Reactivity with 6B6.6 and 4C9 antiidiotypes overlapped, with 4C9 appearing to mark a broader spectrum of RF than 6B6.6. Thus, even in an inbred and genetically predisposed population, the RF-associated antiidiotypes studied here did not identify a dominant idiotypic response and were no better markers for the development of RA than was RF itself.
1462872 Determination of tissue kallikrein and alpha 1-antitrypsin-tissue kallikrein complexes in 1992 An enzyme-linked immunosorbant assay was developed to determine tissue kallikrein and alpha 1-antitrypsin-tissue kallikrein complexes in pooled synovial fluid of patients with rheumatoid, osteo and psoriatic arthritis. Even though basal values could be determined, the addition of synovial fluid shifted the standard curves for both tissue kallikrein and alpha 1-antitrypsin-tissue kallikrein complex to the right, because of the presence of a novel inhibitor.
7993000 Minocycline in rheumatoid arthritis. A 48-week, double-blind, placebo-controlled trial. MI 1995 Jan 15 OBJECTIVE: To assess the safety and efficacy of minocycline in the treatment of rheumatoid arthritis. DESIGN: A double-blind, randomized, multicenter, 48-week trial of oral minocycline (200 mg/d) or placebo. SETTING: 6 clinical centers in the United States. PATIENTS: 219 adults with active rheumatoid arthritis who had previous limited treatment with disease-modifying drugs. MEASUREMENTS: As the primary outcomes, 60 diarthrodial joints were examined for tenderness, and 58 joints were examined for swelling (hips excluded). Grip strength, evaluator's global assessment, morning stiffness, Modified Health Assessment Questionnaire, patient's global assessment, hematocrit, erythrocyte sedimentation rate, platelet count, and IgM rheumatoid factor levels were also assessed; radiographs of both hands and wrists were taken. RESULTS: 109 and 110 patients were randomly assigned to receive minocycline and placebo, respectively. At entry, demographic, clinical, and laboratory measurements were similar in both groups. Most patients had mild to moderate disease activity and some evidence of destructive disease. At the week 48 visit, 79% of the minocycline group and 78% of the placebo group continued to receive the study medication. At 48 weeks, more patients in the minocycline group than in the placebo group showed improvement in joint swelling (54% and 39%) and joint tenderness (56% and 41%) (P < 0.023 for both comparisons). The minocycline group also showed greater improvement in hematocrit, erythrocyte sedimentation rate, platelet count, and IgM rheumatoid factor levels (all P values < 0.001), and more patients receiving minocycline had laboratory values within normal ranges at 48 weeks. For the remaining outcomes, P values ranged from 0.04 to 0.76, all greater than the critical value of 0.005 (Bonferroni adjustment for multiple comparisons). The frequency of reported side effects was similar in both groups, and no serious toxicity occurred. CONCLUSIONS: Minocycline was safe and effective for patients with mild to moderate rheumatoid arthritis. Its mechanisms of action remain to be determined.
7532320 Cytokines and acute phase proteins in rheumatoid arthritis. 1994 Cytokines are extracellular signalling glycoproteins that play an important pathological role in rheumatoid arthritis (RA) where they mediate acute inflammation, chronic inflammation and connective tissue destruction. In RA the macrophage-derived cytokines such as interleukin-1 (IL-1), interleukin-6 (IL-6), interleukin-8 (IL-8), tumour necrosis factor (TNF), colony stimulating factors (CSFs) and growth factors play a key role in amplifying and perpetuating inflammation. IL-1 and TNF activate cartilage and bone degrading enzymes, while IL-8 recruits inflammatory cells into the joint. IL-1 and TNF play an important role in the acute phase response in that they potently induce IL-6, itself the major mediator and regulator of hepatic synthesis of acute phase proteins (APPs). The acute phase response is signalled by the rapid elevation of APPs such as C-reactive protein (CRP) and serum amyloid A (SAA) in the blood, and these can be used as good surrogate markers of disease activity. In health, the activity of cytokines such as IL-1 or TNF is checked by inhibitory molecules such as receptor antagonist molecules or soluble receptor molecules. In disease, cytokine activity appears to be relatively unopposed, leading to the recent development of cytokine inhibitory molecules as potential anti-RA therapies. However, while cytokines are mediators of disease, they probably do not provide the initial stimulus for RA to develop, although polymorphisms in TNF, IL-1 and IL-1 receptor antagonist genes which have been recently found may represent important genetic modifying factors of disease severity in RA.
8289756 [Microprolactinoma and rheumatoid arthritis. A case of rheumatoid-like polyarthritis]. 1993 Jun A case of the rheumatoid-like polyarthritis-associated microprolactinoma is described. Its main clinical features are underlined, and its possible pathogenic mechanisms are reported.