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ID PMID Title PublicationDate abstract
1594283 Dynamic training and circulating neuropeptides in rheumatoid arthritis: a two-year follow- 1992 Apr Previous research has suggested that a short-term (6 week) high-intensity and a subsequent long-term (1 year) low-intensity dynamic training programme in 8 patients with rheumatoid arthritis (RA) increased circulating levels of beta-endorphin (beta-EP) during the high-intensity training and of corticotropin-releasing factor (CRF) and beta-lipotropin (beta-LPH) levels during the low-intensity training, without an increase of pain experience. The present follow-up study of the patients, using the data obtained after an additional 1-year period of no standardized training as reference values, indicated that CRF levels decreased significantly (P less than 0.01) in relation to those obtained 1 year earlier. For beta-LPH and beta-EP, no corresponding decreases were noted. No significant difference concerning experience of pain over time was found. High-performance liquid chromatography demonstrated a complex elution pattern with low basal concentration of beta-LPH, which increased after 60 min of training.
1525847 Management of early inflammatory arthritis. Intervention with immunomodulatory agents: T c 1992 Jun Current theories of the aetiology of RA point to a central role for the trimolecular complex comprising the MHC class II molecule on the surface of the APC, the antigenic peptide and the TCR on the disease-inducing T cell. Thus the arthritogenic T cell is an important target for new therapy. However, it cannot be directly identified because the causative antigen is unknown, so indirect techniques such as TCV and TCR peptide vaccination are required. In TCV, T cells thought to mediate the disease, in an activated and attenuated form, are injected into the patient, who then develops a specific immune response against these pathogenic T cells. TCV has been shown to be effective in protecting against and treating a variety of animal models of autoimmune disease, including AA, EAE and IDDM in NOD mice. The vaccines initially comprised clones and lines of T cells shown to be capable of transferring the disease, but later unseparated LN cells were also shown to be effective, paralleling more closely the human situation. Interestingly, it has become clear that TCV does not create its own regulatory network but amplifies a natural immunoregulatory network which forms as the disease develops. The major stimulating moiety on the vaccinating T cell is its receptor (anti-idiotypic response), although there is also an anti-ergotypic (anti-activated T cell) response. For this reason the technique of TCR peptide vaccination was developed, which utilizes only a short peptide from the TCR of the disease-causing cells to stimulate an immune response against them. This is effective in the prevention and treatment of EAE, where there is a preferential usage of TCR-V beta 8 by encephalitogenic T cells. The application of both these techniques to human autoimmune disease is in its infancy. Studies of TCV in MS and RA have not shown clear-cut clinical benefit, although immunological changes have been observed; comparison of methodology with the animal work and assessment of results are complex and further studies are in progress. Studies of TCR peptide vaccination in MS and RA are handicapped by the lack of a consensus on TCR usage in these conditions, but a limited study is underway in MS.
7492244 Isolated nail fold vasculitis in rheumatoid arthritis. 1995 Nov OBJECTIVES: To establish the clinical significance of isolated nail fold vasculitis in patients with rheumatoid arthritis (RA). METHODS: Patients attending hospital with established RA were assessed by a single observer using unaided vision. Isolated nail fold vasculitis (NFV) was diagnosed as small nail edge or nail fold lesions without any evidence of other extra-articular or systemic vasculitis. Patients were followed prospectively. RESULTS: Thirty patients with isolated NFV were identified and followed for a median interval of 22 months. Three patients died within three months of diagnosis and six developed complications possibly indicative of extra-articular disease: xerostomia (three), pericarditis (one), pleural effusion and empyaema (one), pulmonary fibrosis (one). No patient developed systemic vasculitis. CONCLUSION: Isolated NFV has a favourable prognosis compared with systemic vasculitis. There is a low risk of developing systemic or extra-articular disease.
8764563 IL-8/NAP-1 is the major T-cell chemoattractant in synovial tissues of rheumatoid arthritis 1996 Aug T-cell infiltration into synovium is a crucial process for rheumatoid arthritis (RA). To investigate the mechanism of T-cell infiltration, we studied T-cell attracting activity in synovial tissue extracts of RA or osteoarthritis (OA) whose synovium lacks T-cell accumulation. RA extracts attracted twofold more T cells than OA extracts. By gel filtration column chromatography the activity of RA extracts was separated into two peaks; one was eluted at the 67-kDa region and the other was at the 12-kDa region, while the latter was absent in OA extracts. The activity eluted at the 12-kDa region was absorbed mostly by an antibody against IL-8/NAP-1, a potent T-cell chemotactic factor. IL-8/NAP-1 concentrations in RA extracts were much higher than those in OA extracts and correlated to T-cell attracting activity eluted at the 12-kDa region. The checkerboard analysis revealed that the 67-kDa activity was chemokinetic but not chemotactic. These results suggest that IL-8/NAP-1 is the major T-cell chemoattractant in RA-synovium.
8610215 Comparison of intramuscular gold and sulphasalazine in the treatment of early rheumatoid a 1995 We compared the effects of intramuscular gold and sulphasalazine on early, active rheumatoid arthritis in 128 consecutive patients. Intramuscular gold was started in the first 70 consecutive patients and sulphasalazine in the subsequent 58 patients. The patient groups were comparable with regard to clinical characteristics. In both groups clinical and laboratory parameters improved, but there was no significant difference between the two groups. The clinical improvement was most pronounced during the first three months. However, despite the clinical improvement a clear progression in radiological changes was observed in both groups, 40% of the patients taking gold and 48% of patients taking sulphasalazine discontinued the treatment because of adverse drug reactions or inefficacy during the one year follow-up. Adverse drug reactions were the main reason in both groups. These findings suggest that intramuscular gold and sulphasalazine seem to have an equal, positive effect on symptoms and clinical variables, but that radiological progression does occur in most patients none the less.
8210629 [The enzymatic mechanisms involved in the pathogenesis of rheumatoid arthritis and arthros 1993 Sep Rheumatoid arthritis and osteoarthritis, expression, respectively, of inflammatory and degenerative articular involvement, are the most important diseases affecting joint cartilage. Proteolytic enzymes are the effectors of the articular damage: their increased production by chondrocytes and synoviocytes leads to cartilage breakdown. These enzymes, whose structure and specific activities have been defined in the recent years, carry out their action in the extracellular matrix. They are characterized by the presence of a particular element at the active site, that allows to distinguish four different families. The most studied and the best known among them are metalloproteinases, represented by several enzymes with common features, and serinoproteinases, some members of which, particularly urokinase and tissue-type plasminogen activator, are recently indicated as potential responsible for articular destruction. Activators, and inhibitors of proteinases play a fundamental role: a fine balance, that controls the mechanisms of activation and inhibition, seems to take place at transcriptional level. Any factor able to modify the cellular shape and the cytoskeleton, gives rise to lytic enzyme expression at the genomic level. With the progress of knowledges, serinoproteinases are assuming an increasing relevance, particularly the components of the fibrinolytic pathway.
1474534 Nabumetone compared with naproxen in the treatment of rheumatoid arthritis: a multicenter, 1992 Nov In this double blind, randomized, parallel group study, 298 patients with rheumatoid arthritis received nabumetone (2000 mg/day) or naproxen (1000 mg/day) for 3 months. At the end point, nabumetone treated patients exhibited significant improvement in pain, Ritchie articular index, and duration of morning stiffness when compared to baseline. In contrast, naproxen treated patients showed significant improvement only in Ritchie articular index. Nabumetone was significantly more effective than naproxen for pain relief. More nabumetone treated patients withdrew due to lack of efficacy than naproxen treated patients. However, nabumetone was better tolerated than naproxen because fewer patients withdrew for adverse events or experienced severe adverse events, and significantly fewer patients required treatment for adverse events.
1563983 Properdin factor B and complement factor C4 allotypes in rheumatoid arthritis: results of 1992 Feb The association between allotypes of properdin factor B (Bf), the fourth component of complement (C4A and C4B), and rheumatoid arthritis (RA), was investigated in a well-characterized cohort of RA patients who were followed from an early phase of the disease for a mean duration of 6 years. The frequencies of probable heterozygous C4AQ0 and of C4A3 were lower in RA patients compared to controls, irrespective of the presence of DR4 [relative risk (RR): 0.52 and 0.49, respectively, 95% confidence intervals (95% CI): 0.34-0.80 and 0.29-0.82]. The frequency of C4A4 was higher in RA patients compared to controls (RR: 1.86, 95% CI: 1.03-3.35), especially in DR4 positive RA patients compared to DR4 positive controls (RR: 2.58, 95% CI: 1.07-6.25), indicating a positive association of this allotype with RA additional to DR4. Bf and C4B allotypes were comparable in RA patients and controls. We did not find significant differences in Bf and C4 allotype frequencies in RA patients subdivided according to severity of the disease into a mild group and a progressive group. Because of inconsistent results in all studies on Bf and C4 allotypes, we conclude that C4 and Bf allotypes do not seem to have an important independent effect on determining disease susceptibility.
8823689 Human parvovirus infection: rheumatic manifestations, angioedema, C1 esterase inhibitor de 1996 Jul OBJECTIVE: To investigate the clinical and serological characteristics of parvovirus infection. CASE SERIES: during 1993-4, 9 adult patients presented with polyarthralgias/polyarthritis. Clinical evaluation and serological studies of antinuclear antibodies, rheumatoid factor (RF), IgM and IgG antibodies to human parvovirus were done in all patients. Other serologies including anti-DNA, serum complement, and C1 esterase inhibitor levels were obtained in some patients. RESULTS: All 9 patients had polyarthralgias/polyarthritis, serological evidence of parvovirus B19 IgM and IgG antibodies, and normal sedimentation rate. All patients were seronegative for RF. Four women had positive ANA titers. In 2 of them the ANA positivity was transient. One developed systemic lupus erythematosus (SLE). Three women had angioedema of the face and tongue; one had transient C1 esterase inhibitor deficiency and another a transient decrease in C4 levels. CONCLUSION: Parvovirus may be implicated in the development of SLE as well as other chronic arthropathies. This is the first reported case of angioedema and decreased C1 esterase inhibitor levels associated with parvovirus infection.
8911084 [A case study of immunohistochemical findings of rheumatic pseudocystic lesions in the fem 1996 Aug Rheumatoid pseudocysts of which pathogenesis are not well known, are commonly observed in the major joints of the body, especially knees in rheumatoid patients. This report investigated the pseudocysts in the knee of a rheumatoid patient radiologically and immunohistochemically. A sixty-three-year-old woman with rheumatoid arthritis who had pseudocysts in the femoral lateral condyle and tibial plateau was hospitalized to have the lesions surgically removed. The MRI findings showed a connection between the pseudocysts and the joint cavity. A window of 1 x 1 cm2 was made at the tibial anterior cortex and the contents of the pseudocyst were resected and hydroxyapatite granules were inserted into the lesion after the removal of the pseudocyst tissue. In the histological findings, the specimen from the tibial pseudocyst revealed fibrous connective tissue with a few inflammatory cells, while the synovial specimen revealed the fibrous tissue with intense inflammatory cells infiltration forming lymphoid follicules. In immunohistochemical findings, both specimens showed positive with anti-HLA class I, anti-HLA DR, anti-CD44 and anti-HSP70 antibodies. The pathological findings of the pseudocystic lesion were similar to those of synovia, and it was considered that the synovia had invaded into the bone and formed the pseudocystic lesion. The MRI findings also support this hypothesis. The pseudocystic lesion was surrounded by bone and it was isolated from cytokain-rich joint effusion. This isolation from rheumatic joint effusion may explain the weaker inflammation of the pseudocystic lesion than that of synovia.
1536665 The radiographic criterion in the 1987 revised criteria for rheumatoid arthritis. Reassess 1992 Mar OBJECTIVE: To assess the radiographic criterion in the 1987 revised criteria for the classification of rheumatoid arthritis (RA), in patients with early RA. METHODS: The diagnostic value of radiologic changes in the hands was compared with that of radiologic changes in the feet, in a prospective study of 78 patients with early definite or classic RA (symptoms for less than or equal to 12 months) according to the 1958 criteria. RESULTS: At entry, 23% of the patients had erosions only in metatarsophalangeal (MTP) joints, 6% only in hands, and 5% both in hands and in feet. After 2 years of followup, 29% of the patients had only MTP joint erosions and 3% had only hand erosions. At study entry, the level of clinical activity in patients with erosions in the feet only was lower than that in other patients, and 44% of these patients would not have been diagnosed as having RA by the 1987 criteria. CONCLUSION: In early RA, radiographic changes in the feet seem to be a more sensitive criterion than radiographic changes in the hands. Therefore, addition of radiographic evaluation of the feet to the revised criteria may improve the classification of recent-onset RA.
8234382 The multiple benefits of accurate assessment. Effective management of leg ulcers. 1993 Nov 1. To be effective, the treatment of leg ulcers should be directed at the underlying cause. 2. If the underlying cause is chronic venous insufficiency, the most effective treatment is compression therapy. 3. There are a number of effective bandaging systems in use; the choice of any particular regimen is of less importance than the skill of the practitioner in applying it. 4. The prevention of recurrence should form a significant part of the care plan.
1502502 Nucleotide sequence analysis of rheumatoid factors and polyreactive antibodies derived fro 1992 Aug The heavy and light chain nucleotide sequences of 17 monoreactive and polyreactive rheumatoid factors largely derived from the inflamed synovial tissue of two patients with rheumatoid arthritis are described. Some of these sequences have been the subject of a previous report from our laboratories. Additionally, a few rheumatoid factors from the peripheral blood of patients with systemic lupus erythematosus and Sjogren's syndrome as well as a normal individual are included. A review of our previous results as well as the new data provided within this paper lead to the following major conclusions: (1) Rheumatoid factors and polyreactive antibodies derive from a diverse array of VH and VL gene segments; (2) While many rheumatoid factors and polyreactive antibodies are direct or nearly direct copies of germline genes, some show clear evidence of somatic mutation; (3) The CDR3 of all of these antibodies is extraordinarily diverse in length and composition. Certain 'restrictions' do appear in this very large sample: (a) the polyreactive antibodies are exclusively lambda, and (b) there seems to be a preponderance of a particular subset of VH3 genes beyond that one would expect based on random utilization.
7482064 [IgG rheumatoid factor in rheumatoid arthritis with interstitial lung disease]. 1995 Aug Case of rheumatoid arthritis (RA) with interstitial lung disease (ILD) have been reported to show increased titers of rheumatoid factor (RF) in serum; however the pathogenic role of this substance in the lung is still obscure. The aims of this study were to estimate IgGRF in the bronchoalveolar lavage fluid (BALF) in RA and to investigate its possible roles in the ILD of RA. Two step bronchoalveolar lavage in 20 RA patients (9 males, 11 females) was performed in conjunction with high resolution chest CT. IgGRF was measured by enzyme-linked immunosorbent assay and its molecular size in BALF was evaluated by high performance liquid chromatography. IgGRF bound to BALF cells was eluted by sonication of the cells. RA patients with ILD had significantly elevated levels of IgGRF in serum as well as in BALF. The IgGRF in BALF was monomeric in 2 of 3 RA patients with ILD. The activity of IgGRF bound to BALF cells was significantly higher in RA with ILD than in control patients. These findings suggest that monomeric IgGRF in the lungs of RA patients could bind to the cells with Fc receptors.
8820338 Levels of serum IgG against Porphyromonas gingivalis in patients with rapidly progressive 1995 Dec Levels of serum IgG against Porphyromonas gingivalis cell sonicate were determined in patients with rheumatoid arthritis (RA) (n = 25), rapidly progressive periodontitis (RPP)(n = 25) and adult periodontitis (AP)(n = 15) and controls (HP)(n = 10) utilizing the ELISA technique. Comparison between groups showed no significant differences between the HP and RA groups and also between the RPP and AP groups. The increased levels of IgG in the RPP and AP groups were comparable. Significant differences in IgG levels were noted between HP and RPP (p<0.05) and between HP and AP (p<0.01). The differences between RA and RPP and between RA and AP were highly significant (p<0.0001). Thus it was revealed that the serum levels of IgG against P. gingivalis in RPP and AP patients were elevated, whereas the levels in RA patients were comparable to those in controls.
7778308 Emotions, coping, and psychological well-being in elderly people with arthritis. 1995 Jun Rheumatoid arthritis, the most destructive and crippling of all forms of arthritis, poses a number of stressful demands on individuals. In a sample of elderly women (N = 59) and men (N = 19) with rheumatoid arthritis, the relationship between social economic status, severity of impairment, sex, stress emotions, type of coping strategy, and psychological well-being was explored. Path analysis results indicated that higher social economic status was directly related to greater use of confrontive types of coping strategies. Severity of impairment had a direct, negative influence on psychological well-being, but sex was not an important factor. Optimistic coping strategies were used most often and emotive coping strategies the least.
7923907 Collagen-induced arthritis as a model of rheumatoid arthritis. 1994 Oct Collagen-induced arthritis (CIA) is an animal model for the human autoimmune disease rheumatoid arthritis (RA). CIA can be induced in several species including primates by immunization with heterologous type-II collagen (CII). Polyclonal antibodies are formed upon immunization with CII that exhibit a broad range of epitope specificities (some that cross-react with hose CII); however, only antibodies directed against certain specific epitopes on CII are arthritogenic. Recently, the importance of cognate interactions between T-cells and B-cells to the induction of CIA was demonstrated by administration of monoclonal antibodies against a T-cell surface protein, gp39. Blocking the interaction of T-cell gp39, with its receptor/ligand on the surface of B-cells (CD40), completely blocked induction of CIA in mice. A concomitant reduction in the level of anti-CII IgG produced in anti-gp39-treated animals was observed, demonstrating the crucial importance of T-cell:B-cell interactions via gp39:CD-40 binding to the primary immune response to CII in vivo and therefore to the induction of CIA. Other features of CIA are important in elucidating the condition and this article will deal with some important issues.
8945114 The effect of person-centered counseling on the psychological status of persons with syste 1996 Feb OBJECTIVE: We tested the effectiveness of a 6-month person-centered (PC), nondirective, telephone-based counseling intervention for improving the psychological status of persons with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). METHODS: The design was a parallel-group, randomized, controlled study comparing a PC counseling intervention (8 SLE, 28 RA patients) with usual care (7 SLE, 30 RA patients). The Arthritis Impact Measurement Scales was used to measure psychological dysfunction, physical dysfunction, and pain at baseline and at followup. RESULTS: The main finding was that the PC counseling intervention significantly improved the psychological status of the SLE patients (P < 0.05, effect size = 1.13, responsiveness = 0.77) in comparison to usual care. There was no evidence of a benefit for persons with RA or of improvements in physical function or pain for persons with either disease. CONCLUSIONS: PC counseling may be an effective intervention for improving the psychological status of persons with SLE, but may not be for those with RA.
7484113 Late results of the Souter-Strathclyde total elbow prosthesis in rheumatoid arthritis. 6/1 1995 Oct We performed total elbow replacement, using the Souter-Strathclyde prosthesis in 19 elbows of 18 patients with rheumatoid arthritis and followed the patients for 5 (1-11) years. Pain relief was achieved initially in all patients. The average range of flexion-extension was increased by 12 degrees and pronation-supination by 40 degrees. There were no infections. 1 patient sustained an intraoperative fracture of the medial epicondyle, 3 patients developed neuropathies and 1 patient had an immediate postoperative dislocation of the joint. At follow-up, 6 prostheses had radiographic loosening, with sagittal titling and migration of 4 humeral components. 2 patients had clinical symptoms of loosening.
8731891 [Simultaneous bilateral total knee replacement for the patients with serious rheumatoid di 1995 Oct This retrospective study reviews 57 patients with serious rheumatoid disease who had bilateral total knee arthroplasties simultanneously between 1987 and 1994. The short follow-up results revealed that there was no increase in complications in the patients with simultaneous bilateral procedures, and nearly identical postoperative results to those observed among patients with single joint replacement. Advantage of simultaneous bilateral total arthroplasty include reduction in hospital cost, the need for less invasive surgical event and the ability to rehabilitate the patient symmetrically.