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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
8165442 A Swedish version of the short-form McGill Pain Questionnaire. 1994 A short-form of the McGill Pain Questionnaire (SF-MPQ) has been translated into Swedish. One hundred women with either fibromyalgia (FS) or rheumatoid arthritis (RA) filled out the SF-MPQ three times--the RA patients monthly while receiving their routine care, and the FS patients over 6 months while participating in an experimental treatment. Results indicated that the MPQ 15-item descriptor section was internally consistent (Cronbach's alphas .73 to .89), but lacked content validity in the RA sample. Test-retest reliabilities ranged from .45 to .73. Convergent construct validity was demonstrated by significant correlations between the SF-MPQ and other pain measurements. A principal components analysis showed that the 15-item descriptor section has three distinct factors: acute sensory, chronic sensory, and affective. We conclude that the SF-MPQ is reliable and valid for use with FS patients.
7805163 [IL-1 and TNF-alpha bioassay and PGE2 immunoassay of supernatant of cultured synovia in pa 1994 Jun Using arthroscopy technique, synovia were adopted and cultured, and the supernatant was harvested on 1, 4, 7, 14 and 28 days. The bioactivity of supernatant IL-1 were measured in 33 cases (RA 11 cases), TNF-alpha in 30 cases (RA 9 cases); the content of supernatant PGE2 were measured in 44 cases (RA 11 cases). The results showed that IL-1 Growth Index (GI) and TNF-alpha Killing Rate (KR) in RA group are higher than in non-synovitis group (negative control) with statistically significant difference and that the cultured time of the IL-1 highest value is consistent with TNF-alpha. In RA group, the cases treated with disease-modifying anti-rheumatic drugs (DMARDs), especially using the combined therapy, the activity of IL-1 and TNF-alpha decreased. The contents of PGE2 in RA+ synovitis group were higher than osteoarthritis (OA) + nonsynovitis group with statistically significant difference. In conclusion, cytokines such as IL-1 and TNF-alpha have very important status in the pathogenesis of RA. This work provides some clues for new approaches and strategies in the treatment of RA.
9147581 Restricted heterogeneity and changing spectrotypes in autoantibodies to La/SS-B. 1996 Isoelectric focusing (IEF) spectrotype of specific immunoglobulins has been studied as a marker for B-cell clonality. In the present study, the spectrotype of anti-La antibodies in human autoimmune sera were analyzed by newly developed IEF sandwich assay in which focused total immunoglobulin on filter papers are incubated with crude antigen followed by horse-radish peroxidase-labeled anti-La antibodies. The anti-La spectrotypes contained oligoclonal bands, the positions and patterns of which are different in each patient, suggesting the preferential expansion of limited numbers of anti-La producing B-cell clones unique to individual patients. Furthermore, the bands on anti-La spectrotype in sequentially obtained sera changed continuously, suggesting alteration in the expanding anti-La producing clones. These may reflect affinity maturation and/or diversification of the B-cell epitopes involving somatic mutation.
8358978 Rheumatoid arthritis as a cause of cardiac compression. Favourable long-term outcome of pe 1993 Jun In order to clarify the significance of rheumatoid arthritis (RA) as a cause of cardiac compression, we scrutinized pericardiectomy files of 47 patients over a ten-year period at two university hospitals in Finland. Five patients with RA were found. All the patients with RA were men with seropositive disease and subcutaneous rheumatoid nodules. Two of the patients had pulmonary fibrosis, one had cutaneous vasculitis and three had had rheumatoid pleurisy. There was a mean delay of 10 months from the first cardiac symptom to the diagnosis of cardiac compression, the most common misdiagnosis being primarily a liver disease. On the basis of clinical and operative data, four out of the five patients had constrictive pericarditis and one had an effusive-constrictive form of the disease. The histopathological findings in all cases were consistent with chronic fibrosing pericarditis. A follow-up of seven to seventeen years of four patients has not revealed any signs of recurrent pericardial disease. Our results demonstrate that RA is an important aetiological factor for cardiac compression. The long-term outcome of this manifestation seems to be good after pericardiectomy.
8975276 [Roentgen diagnosis and computerized tomography in inflammatory rheumatic diseases. Method 1996 Aug Plain-film radiography is an important and basic element in the assessment of inflammatory rheumatic diseases. Its various uses include assessment of inflammatory osseous destruction and the activity of inflammatory changes. Furthermore, the inflammatory collateral phenomena can indicate an acute clinical phase, and the articular soft tissue swelling and tenosynovitis are shown directly and indirectly very clearly. On the other hand, high-resolution computed tomography is very capable of showing cortical structures of bone complementary to MR. In some special clinical questions and anatomical regions, especially the axial skeleton, it delivers information of high specifity, partly for definitive diagnosis and partly for planning surgical procedures. The assessment of changes in the sacroiliac joints, sternoclavicular joints and craniocervical junction are domains of computed tomography.
7614737 Increased synovial expression of transforming growth factor (TGF)-beta receptor endoglin a 1995 Aug The ingress of inflammatory cells into the rheumatoid (RA) synovial tissue (ST) plays a role in the pathogenesis of this disease. Transforming growth factor beta (TGF-beta) may play a role in this process. We have investigated the distribution of endoglin, a newly described receptor for TGF-beta 1 and -beta 3, in RA compared to osteoarthritis (OA) or normal ST. Immunohistochemical analysis was carried out using an anti-TGF-beta 1 monoclonal antibody (mAb) as well as 10 mAbs raised against various epitopes of endoglin. This study was performed on ST from 10 patients with RA, 10 with OA, and 4 normal individuals. TGF-beta 1 expression was significantly up-regulated on RA compared to OA and normal ST lining cells, interstitial macrophages, and endothelial cells (P < 0.05). All anti-endoglin mAbs uniformly reacted with endothelial cells in RA, OA, and normal STs. However, 3 out of 10 anti-endoglin mAbs reacted with significantly more RA versus normal ST lining cells (P < 0.05), as well as RA compared to OA and normal macrophages (P < 0.05). There was a positive correlation between TGF-beta 1 and endoglin reactivity on the synovial lining layer and subsynovial macrophages (P < 0.05). These results indicate that TGF-beta 1 and certain epitopes of endoglin, a TGF-beta 1 and -beta 3 receptor, are up-regulated on myeloid elements in RA compared to normal ST. Endoglin is also present on ST endothelia, and its expression may also be increased on OA compared to normal ST lining cells. These findings implicate endoglin in the pathogenesis of RA.
8109834 Effects of nonsteroidal antiinflammatory drugs on bone loss in chronic inflammatory diseas 1993 Nov 30 Several controlled clinical trials have indicated that nonsteroidal antiinflammatory drugs may slow alveolar bone loss in periodontitis. Demonstration of this efficacy is dependent on the development of accurate, sensitive, and specific quantitative methods for the assessment of bony change, such as digital subtraction radiography. Further studies of such methodologies are required to more fully investigate the effect of nonsteroidal antiinflammatory drugs in rheumatoid arthritis.
8991979 The assessment of functional status in rheumatoid arthritis: a cross cultural, longitudina 1995 Oct OBJECTIVE: To compare a disease specific measure of functional status, the Health Assessment Questionnaire (HAQ) with a generic measure of functional status, the Groningen Activity Restriction Scale (GARS) in a cross cultural and longitudinal setting. Besides the comparison of psychometric properties, sex differences were also studied. METHODS: In a sample of 634 patients with rheumatoid arthritis (RA) (290 from The Netherlands, 116 from France, 228 from Norway), the psychometric properties (Cronbach's alpha and rho) of the GARS and the HAQ were compared among countries. The sensitivity for change between T1 and T2 was tested by means of the standardized response mean for a one year followup; furthermore, the relative efficiency of both instruments was computed. A t test was used to trace sex differences. RESULTS: The psychometric properties of both the HAQ and the GARS were very good. Both form unidimensional scales of hierarchically ordered items; alpha and rho are > 0.91 for both instruments. For patients who improved between T1 and T2, measured by the Ritchie Articular Index, the standardized response mean of the HAQ and the GARS were moderate, whereas for patients who worsened, the standardized response means were small. The results based on the relative efficiency were ambiguous. Furthermore, the mean score for women on the HAQ was 0.25 higher in contrast to scores for men. The GARS did not yield different scores for women and men. CONCLUSION: The internal consistency of the GARS and the HAQ are comparable. The HAQ has yielded different results for women and men. Therefore, when the HAQ is used, sex differences should be taken into account. With respect to sensitivity to change, the GARS and the HAQ obtained much better results for patients who improved in contrast to patients who worsened. The GARS was found to be more sensitive to change for patients who improved.
8610227 Listeria monocytogenes arthritis of several joints. 1995 A patient with rheumatoid arthritis (RA) developed an infection caused by Listeria monocytogenes in her left knee and both shoulder joints. The clinical presentation of the disease was rather indolent with relatively moderate joint symptoms. Moreover, the synovial fluid sample was only slightly turbid with a white blood cell count of 23.5 x 10(9)/1. As compared to the earlier reported cases of L. monocytogenes septic arthritis, our patient is unique because she had infection in several joints. The polyarticular joint involvement combined with the clinical symptoms resembling the activation of RA posed us diagnostic difficulties.
7986867 Smoking, obesity, alcohol consumption, and the risk of rheumatoid arthritis. 1994 Sep There is some evidence that sex hormones may influence the incidence of rheumatoid arthritis. Obesity has been found to increase endogenous estrogens, particularly among postmenopausal women. Although the association of endogenous hormones with smoking and alcohol use is less clear, we examined the relation of these three factors with rheumatoid arthritis in women. We conducted a population-based case-control study of rheumatoid arthritis in King County, WA, and Group Health Cooperative of Puget Sound. We compared 349 incident cases of rheumatoid arthritis with 1,457 controls selected by random digit dialing or by random selection from the enrollment files of Group Health Cooperative. We conducted personal interviews to collect data on weight, smoking, alcohol history, reproductive variables, and other demographic variables. Women with 20 or more pack-years of smoking had a relative risk of 1.5 [95% confidence interval (CI) = 1.0-2.0] compared with never-smokers. Post-menopausal women who averaged more than 14 alcoholic drinks per week had a reduced risk of rheumatoid arthritis (relative risk = 0.5; 95% CI = 0.2-1.7). Women in the highest quartile of body mass index had a risk of 1.4 (95% CI = 1.0-2.0) relative to women with lowest body mass index.
8091145 Synovial volume--a marker of disease severity in rheumatoid arthritis? Quantification by M 1994 Volumes of synovial membrane and joint effusion were determined by magnetic resonance imaging (MRI) in patients with inflammatory gonarthritis. Volumes were calculated by adding the outlined areas of synovium/effusion from a continuous series of gadolinium-DTPA-enhanced 5 mm transversal T1-weighted MR-images. Ten knees with clinically active gonarthritis (CAG), 8 knees with clinically inactive gonarthritis (CIG) and 5 healthy controls (HC) were examined. The synovial volume of CAG-, CIG- and HC-knees were significantly different. The median volumes were 79 ml, 21 ml and 3 ml, respectively. Synovial and effusion volumes were highly correlated. A selected sagittal one-slice volume showed a high correlation to the total volumes. The reliable quantification of synovial and effusion volumes could be useful in the assessment of disease severity and as an outcome measure to treatment.
7791185 Listeria monocytogenes infection in a patient treated with methotrexate for rheumatoid art 1995 Apr We describe a patient with rheumatoid arthritis who developed bacteremia from Listeria monocytogenes after treatment with low dose oral pulse methotrexate. We discuss possible immunologic mechanisms for susceptibility to Listeria infections. As the elderly population increases with more frequent use of immunosuppressive medications, clinical suspicion must be maintained to correctly diagnose and treat infections such as Listeria.
7684449 Substance P levels in the synovium and synovial fluid from patients with rheumatoid arthri 1993 Apr Experimental results suggest that substance P (SP) may play an important role in pain and inflammation in rheumatic diseases. Measurements of SP-like immunoreactivity (SPLI) were performed in synovial fluid (SF) and synovial tissue from 40 patients with rheumatoid arthritis (RA) or osteoarthritis (OA). High levels of SPLI were found in the SF of patients with RA compared with OA. Conversely, SPLI content in synovial tissue was higher in OA than in RA, suggesting that there is an active secretory process of SPLI into the SF in RA, thus depleting SPLI stores in the synovium. Our data support the involvement of SP in the perpetuation and exacerbation of inflammation in RA, and may also explain some clinical features of this disease.
8714798 Safety aspects of cyclosporin in rheumatoid arthritis. 1995 While cyclosporin has an established role in the management of patients with rheumatoid arthritis, its use can be accompanied by various adverse events. In daily practice, the potential for cyclosporin to induce nephropathy is of most concern and has, to some extent, limited the use of this drug. However, these effects on renal function are dose dependent. Two international meetings have resulted in the publication of guidelines aimed at limiting the risk of adverse events when cyclosporin is used in patients with rheumatoid arthritis. The 1994 International Consensus guidelines with respect to renal safety recommend the principal dosage regimen of 'go low, go slow', which requires starting patients on a daily dose of between 2.5 and 3.5 mg/kg with the maximum daily dose not exceeding 5 mg/kg. The cyclosporin dosage chosen should be titrated against the highest acceptable increase in serum creatinine, i.e. a 30% increase over the baseline value. Renal biopsy data support these guidelines, and when the latter are followed by physicians, it is very unlikely that histological damage will occur. The new oral microemulsion-based formulation of cyclosporin (Neoral) has a more predictable absorption and a 20% greater bioavailability than the conventional formulation (Sandimmun). Therefore, the microemulsion formulation may enable more patients to receive effective treatment at lower doses. This could have interesting safety and pharmacoeconomic implications.
7910148 Orange-red birefringence of gold particles in paraffin wax embedded sections: an aid to th 1994 Feb Chrysiasis, the systemic deposition of gold pigment in patients on long term chrysotherapy, is identified histologically as small black granules within macrophages. Histological sections from 12 confirmed cases of chrysiasis were examined under crossed polarized light. This revealed a striking orange-red birefringence of the pigment not detected in other histologically similar deposits. This technique provides a valuable adjunct to the histological identification of gold without the need to resort to ultrastructural and analytical procedures.
8975277 [MRI and ultrasound in rheumatology]. 1996 Aug Technical innovations and software improvements in magnetic resonance imaging (MRI) and high-resolution sonography (US) have definitely influenced the diagnostic imaging of rheumatic diseases. For MRI, improvements in surface coils, dedicated low-field systems (0.2 T), and software improvements (shorter acquisition times and refinements of fat suppressing techniques) must be mentioned. For sonography, the main innovations concern the development of higher transducer frequencies (7-15 Mhz) and power Doppler imaging. Clinical evaluations have shown that MRI and US are most useful in cases of suspected rheumatic disease with negative plain film radiographs and for documenting the course of the disease, diagnosing of early rheumatoid arthritis, making a differential diagnosis in clinically unclear rheumatic diseases, investigating vascularization, and quantifying pannus formation. In order to improve diagnostic efficacy the role of MRI and US in the management of patients with rheumatic disease should be reconsidered.
8344675 [Impaired function of polymorphonuclear neutrophilic granulocytes in rheumatoid arthritis] 1993 Apr The aim of this study was to investigate the PMN functions ingestion (I), bacterial killing (BK) as well as the chemiluminescence response to phorbol esters (PMACL) as a measure of PMN respiratory burst activity in RA compared to osteoarthritis and controls. Our findings demonstrated a significant reduction of I and BK in RA compared to OA and controls (p < 0.01 resp.) but an enhanced PMACL (p < 0.01). There was no significant difference of I, BK and PMACL in OA and control subjects. These data clearly demonstrated impaired PMN ingestion and bacterial killing yet enhanced PMACL in RA, thus contributing at least in part to altered host defense in these patients.
8219713 Histopathological observation of joint lesions of extremities in mice transferred genome. 1993 Aug Pathological examination of arthritic lesions in transgenic mice produced by the pX region of the human T-cell leukemia virus type-1 (HTLV-1) was carried out. Clinically, erythema, swelling and/or ataxia of the limb joints were observed in many transgenic mice about 1 month-old. Histopathologically, proliferation of synovial lining cells, infiltration of inflammatory cells with lymphoid structures and formation of pannus with cartilage and/or subchondral bone destructions were observed in various joints of transgenic mice. The frequency of abnormalities in the joints was higher in females than in males. These histopathological findings were very similar to those of human rheumatoid arthritis (RA). Present results indicate that the pX genome of the HTLV-1 is an etiological agent for the incidence of arthritic lesions in the transgenic mice.
8016424 Methotrexate: adverse reactions and major toxicities. 1994 May The long-term efficacy of methotrexate has been proved in prospective trials. With the chronic administration of methotrexate, however, concern has been raised about its safety. While side effects are common, they are seldom life threatening and rarely necessitate withdrawal of the drug. Serious side effects of methotrexate include hepatic, hematologic, and pulmonary toxicity. These toxicities are much less common, but usually result in the withdrawal of the drug. With careful monitoring of patients symptoms and laboratory test, however, these toxicities can be minimized or even prevented.
8108669 Pneumocystis carinii pneumonia associated with low dose methotrexate treatment for rheumat 1994 Since 1983 there have been several reports on Pneumocystis carinii pneumonia (PCP), complicating low dose methotrexate (MTX) therapy for rheumatoid arthritis (RA). Two additional cases of this opportunistic infection are reported and a review of the literature on the complication is presented. It is concluded that PCP is a serious complication of low dose MTX therapy for RA and should always be ruled out when a patient presents with pulmonary symptoms. Several factors may play a role in the occurrence of this opportunistic infection, but the exact mechanism has not yet been elucidated.