Browse

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

ID PMID Title PublicationDate abstract
7535361 A pilot study of the effect of oral 8-methoxypsoralen and intraarticular ultraviolet light 1995 Jan OBJECTIVE: To determine the feasibility and safety of combining oral 8-methoxypsoralen (8-MOP) and intraarticular ultraviolet A band light (UVA) to treat rheumatoid synovitis, and to demonstrate a favorable biological effect. METHODS: Six patients with rheumatoid arthritis (RA) and clinically evident knee synovitis were given a single oral dose of 8-MOP (0.6 mg/kg) followed by arthroscopy with a UVA laser equipped small arthroscope. Nine tissue samples treated with UVA doses ranging from 4 to 52 J/cm2 were examined by light microscopy and by immunohistochemistry for vascular cell adhesion molecule 1 (VACM-1), intracellular adhesion molecule 1 (ICAM-1), E-selectin and HLA-DR expression. RESULTS: No reduction in inflammation was evident on light microscopy, nor was there any evidence of tissue injury on gross inspection or light microscopy. At 28 and 52 J/cm2, VCAM-1, ICAM-1 and E-selectin staining were reduced in the posttreatment synovial biopsies. No local or systemic complications were observed by Day 30 in any patient. CONCLUSION: This treatment modality appears to be feasible and safe and may potentially be useful in the treatment of the synovitis associated with RA.
8202664 Monospecific but not polyreactive human hybridoma rheumatoid factors exhibit preferential 1994 Among 38 human hybridoma-derived monoclonal rheumatoid factors (RFs) generated from patients with either rheumatoid arthritis (RA) or systemic lupus erythematosus (SLE), two groups of RFs can be identified. Monospecific RFs were derived primarily from patients with RA and are characterized by a binding specificity for IgG3 and/or IgG4. Polyreactive RFs were derived largely from patients with SLE and show a broader pattern of reactivity to all four isotypes of IgG. Neither population of RFs was exclusive to either disease. The binding specificities identified appear to be different from the RFs isolated from patients with mixed cryoglobulinemia and may reflect a different antigen selection mechanism.
8337193 Group treatment for pain and discomfort. 1993 May Rheumatic patients very often suffer from chronic pain and impairment and show psychological reactions as a consequence of their physical condition. These reactions may vary from psychophysiological symptoms to anger, anxiety, or depression. We developed a cognitive-behavioral treatment programme in a group setting format with components of relaxation, cognitive restructuring, and the promotion of well-being. Subjects included in the study were given diagnoses of low back pain, tension headache, rheumatoid arthritis, and ankylosing spondylitis. Treatment effects in different diagnostic groups were compared to each other, supporting the assumption that pain reduction is greatest in low back pain and least in ankylosing spondylitis. Subjects with inflammatory rheumatic diseases showed some improvement in self-reported physical complaints and in their feelings of well-being.
7895396 Patient's preference regarding the option of performing unselective liver biopsy following 1994 Nov OBJECTIVE: This study was aimed at the evaluation of patient preferences concerning long-term methotrexate (MTX) therapy and whether or not to perform unselective liver biopsy to detect serious liver disease due to MTX therapy in rheumatoid arthritis (RA). METHODS: Seventeen literate patients with RA consecutively selected from a rheumatic disease unit and 17 rheumatologists (asked to consider themselves as RA patients) were assessed by a trained interviewer. The Bedside Decision Board instrument was used to assess the patient preference. Scenarios described the options in terms of follow-up for RA patients treated with MTX. The benefits and risks of liver biopsy, defined according to the published literature, were presented to RA patients and rheumatologists in an unbiased fashion. RESULTS: Twelve patients (71%) preferred not to be subjected to the liver biopsy within 1 month, even though they had already taken MTX for 3 years, and consequently ran the risk of development of cirrhosis in the long term. Conversely, 12 rheumatologists (71%) preferred to undergo an unselective liver biopsy. CONCLUSION: Given patients' preferences, liver biopsy following long term MTX treatment should not be performed unselectively. It can be postulated that rheumatologists did not perceive liver biopsy as an intimidating procedure or were influenced by the until recently recommended guidelines for following up patients treated with MTX.
7799392 DC-ART classification: review of relevant clinical studies. 1994 Sep The proposed disease controlling antirheumatic therapy (DC-ART) definition requires that the therapy change the course of rheumatoid arthritis (RA) for at least 1 year, evidenced by (1) sustained improvement in physical function, (2) decreased inflammatory synovitis, and (3) slowing or prevention of structural joint damage. Selected studies are reviewed. All studies were at least 1 year in duration, but most did not include all 3 of the DC-ART requirements. In these studies, patients treated with placebo generally had no improvement in inflammatory synovitis and progressive structural joint damage, judged by serial joint radiographs. A minority of studies significantly favored one or another of the available agents (gold injections, D-penicillamine, auranofin, antimalarials, azathioprine, sulfasalazine, methotrexate), but the evidence for any one agent is not convincing. For future DC-ART clinical trials patients with early RA should be studied. A hybrid study design may be useful, combining an initial double blind randomized controlled clinical trial with continuing longterm observation of all withdrawals using specified clinical, radiographic, and self report assessments at regular intervals, and an intent-to-treat analysis comparing longterm response rates of the original control and experimental therapy groups. Responsive subgroups should be sought, their characteristics identified, and their responsiveness confirmed in additional trials limited to the identified subgroup.
8218599 Clinical and preclinical studies presented at the Keystone Symposium on Arthritis, Related 1993 Aug Topics include treatment of multiple sclerosis (MS) with T cell receptor (TCR) peptides, rheumatoid arthritis (RA) with IL-1ra, IL-2 toxin conjugate, or antibodies to TNF, to CD4, or to ICAM-1, sepsis and five other diseases with IL-1ra, and treatment of experimental animal diseases with soluble receptors, IL-12, TGF-beta2, or small molecule antagonists of cytokines.
1584581 Penetrating keratoplasty in patients with rheumatoid arthritis. 1992 Apr The authors reviewed in a retrospective manner 47 penetrating keratoplasties performed on 23 eyes of 21 patients with rheumatoid arthritis. The indications for the first penetrating keratoplasty were corneal melt in 19 eyes (83%), infectious keratitis in 2 eyes (9%), and corneal scarring after ulceration in 2 eyes (9%). Twelve of the 23 eyes required 24 repeat penetrating keratoplasties. Seventeen of the 23 eyes (74%) had clear grafts at the last follow-up visit, a median of 13.7 months after the last penetrating keratoplasty. The final best corrected visual acuity was greater than or equal to 20/60 in 4 eyes (17%), 20/70 to 20/100 in 1 eye (4%), 20/200 to 20/400 in 7 eyes (30%), counting fingers in 4 eyes (17%), hand motions in 2 eyes (9%), and light perception in 4 eyes (17%). One eye (4%) was enucleated. Anatomic success (absence of phthisis bulbi, enucleation, or conjunctival flap) was achieved in 20 eyes (87%). The survival probability for the 21 patients was only 48% 5 years after the first penetrating keratoplasty. The authors conclude that penetrating keratoplasty is often anatomically successful in patients with rheumatoid arthritis; however, the prognosis is poor for both vision and survival of the patient.
1543667 Nonneoplastic hematologic disease. 1992 Feb Recent literature on nonneoplastic hematologic disease in the rheumatic disorders has been reviewed, and current concepts on the anemia of rheumatoid arthritis and its treatment have been expanded. The anemia of chronic renal failure and of acquired immunodeficiency syndrome has responded to treatment with recombinant human erythropoietin. Recent studies document that the anemia of rheumatoid disease can also be alleviated with intermittent intravenous or subcutaneous administration of erythropoietin without apparent adverse reaction. However, no improvement is evident in the underlying rheumatoid disease or functional abilities of these patients. Further data are needed to determine the utility of erythropoietin therapy in rheumatoid arthritis and in other rheumatic diseases. Other mechanisms of anemia of rheumatoid disease have been studied, and as the underlying defects become known, other therapies may become available to patients with rheumatoid arthritis and other rheumatic diseases.
7656471 Fucose concentrations in sera from patients with rheumatoid arthritis. 1995 Mar The clinical significance of L-fucose was investigated in serum of a well characterized cohort of 135 RA patients and 60 healthy controls. In RA patients, serum L-fucose was significantly decreased to a mean of 5.57 +/- 0.97 mg%, (range 2.2-7.5 mg%), compared with 7.5 +/- 1.04 mg% (range 5.7-9.8 mg%) (p < 0.001) in normal controls. In early RA serum L-fucose was significantly depressed to a mean of 6.08 mg%, a value which was significantly higher than the mean concentration of L-fucose in patients with advanced RA. Serum L-fucose was significantly correlated with the rheumatoid disease activity, duration, number of involved joints, and bone erosions. No statistically significant difference was found between seropositive and seronegative RA patients. However, a significant difference (p < 0.001) between female (5.57 mg%) and male (6.59 mg%) patients with advanced RA, and between male (6.08 mg%) and female (5.99 mg%) patients with early RA was found. These findings suggest that serum L-fucose is depressed in patients with rheumatoid arthritis, a promising observation since L-fucose is a safe and simple natural sugar. It may be used as an additional parameter and as an indicator for the disease activity in the follow up of patients with rheumatoid arthritis.
1432016 Risk of kidney cancer in analgesics users. 1992 Sep The risk of kidney cancer was examined in a cohort of people discharged from Danish hospitals from 1977-1987 with a diagnosis of rheumatoid arthritis, osteoarthrosis or backpain. These individuals are presumably more or less regular users of mild analgesics. A total of 155,554 people were identified. The risk of cancer of the urinary tract was slightly increased [relative risk (RR) = 1.31], almost exclusively because of an increased risk of renal cell carcinoma (RR = 1.40). The relative risk was higher in individuals with rheumatoid arthritis than among individuals with osteoarthrosis or backpain, and higher among women than men. Although this study lacks information on the actual analgesics consumption of the individual, and various biases may be present, these findings offer little support to the concern that increased analgesics use raises the risk of kidney cancer.
8154636 Increased interleukin-4 production in response to mast cell mediators and human type I col 1994 Apr Mast cell synovial hyperplasia can occur in patients with rheumatoid arthritis. Histamine can accelerate synovitis and heparin can inhibit lymphocyte function. Since interleukin-4 (IL-4) can stimulate murine mast cell and IgE synthesis, we determined whether mast cell mediators and anti-IL-4 might effect lymphocyte proliferation from patients with rheumatoid arthritis. Twenty-four patients with rheumatoid arthritis and nine normal controls were evaluated by history, physical examination, physician and patient-assessed joint and allergic symptoms, and diary scores. An IL-2-driven-T cell (3H) Tdr proliferation assay with monoclonal anti-IL-4 and a sensitive ELISA were performed with isolated peripheral blood mononuclear cells (PBMC) with 10 micrograms/mL of either concanavalin A (Con A), type I human collagen, or heparin and 10(-6) M histamine. Increased lymphocyte proliferation indices with Con A (mean 21.69 +/- 4.9; 6.54 +/- 3.2 normal controls), type I human collagen (mean 2.17 +/- 0.52; 1.1 +/- .17, normal controls), histamine (mean 1.66 +/- .36; 0.62 +/- 0.08, normal controls), heparin (mean 1.61 +/- .38; 0.69 +/- .11, normal controls) occurred in peripheral blood mononuclear cells from all patients with rheumatoid arthritis compared with normal controls (P < .0236 to .0015) which was inhibited in 32% of peripheral blood mononuclear cells by anti-IL-4. Increased IL-4 ELISA levels in cultured supernatants were noted with heparin (P < .25) and collagen (P < .05).(ABSTRACT TRUNCATED AT 250 WORDS)
8484092 Reduction of tumor necrosis factor alpha and interleukin-1 beta levels in human synovial t 1993 The effects of recombinant human interleukin-4 (IL-4) and the glucocorticoid, dexamethasone, on tumor necrosis factor alpha (TNF alpha) and interleukin-1 beta (IL-1 beta) levels in cultures of rheumatoid and osteoarthritic synovial tissue were studied. Low concentrations of IL-4 and dexamethasone suppressed the levels of both cytokines in the supernatants of both types of tissue after stimulation with lipopolysaccharide (LPS); the IL-1 beta and TNF alpha levels were measured by ELISA. It is suggested that it is the monocyte/macrophage in the synovial tissues that is responsive to the inhibitors. It is proposed that glucocorticoids may act on synovial tissue in this manner in vivo and IL-4 may do so if administered intraarticularly.
7665938 Serum levels of tumour necrosis factor- alpha in schistosomiasis mansoni and their analogo 1995 Aug Serum levels of TNF-alpha was quantitatively estimated by the use of solid enzyme amplified sensitivity immunoassay (EASIA) in different stages of schistosomiasis mansoni, rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and schistosomal arthropathy. Statistically, significant higher levels were detected in the different groups compared to the normal control group. The level was found highest in hepatosplenic schistosomiasis with ascites (group 1c). The difference was significantly higher compared to cases of early S. mansoni infection (group Ia) and insignificant compared to hepatosplenic schistosomiasis without ascites (group 1b). No significant difference was detected comparing groups 1a and 1b, or groups 2a (RA) and 2b (SLE). Cases of schistosomal arthropathy (group 3) showed significantly higher level compared to groups 1a and 1b, although the level in group 1c was still significantly higher compared to group 3, the level was also significantly higher in group 3 compared to cases of RA but not to cases of SLE.
8670599 Prediction of permanent work disability in a follow-up study of early rheumatoid arthritis 1996 Jul The objectives of this study are: (a) to determine the occurrence of permanent work disability (PWD) in early rheumatoid arthritis (RA); (b) to identify prognostic groups of patients; (c) to assess the employment rates for these groups over time. Seventy-three gainfully employed consecutive out-patients with early RA (> or = 5 ARA 1958 criteria, disease duration < or = 12 months) at time one (T1) were re-examined at time two (T2) after a mean follow-up of 6 yr (S.D. +/- 2 yr). Potential risk factors, identified at T1, for PWD at T2 were entered in a tree structured survival analysis using RECPAM (RECursive Partition and AMalgamation). Cumulative 3 yr employment rates (3-yrER +/- S.E.M.) were computed from the resulting Kaplan-Meier curves. At T2, PWD occurred in 27 of the 73 patients (37%). The fastest decline in the employment rate was found within the first 3 yr of the disease onset, with a 3-yrER reduced to 73 +/- 5%. The group with the poorest prognosis (n = 14; 3-yrER 14 +/- 9%) was defined by age > or = 50 yr with either ESR > or = 60 mm/h or the combination of modified functional class (1-7) > or = 4 with a disease duration > or = 7 months. An intermediate group (n = 38; 3-yrER 79 +/- 6%) was defined by (a) age > or = 50 yr and low or moderate disease activity, (b) age < 50 yr and more strenuous job-related physical requirements, (c) age < 50 yr and less strenuous work, but joint count > or = 15. No case of PWD occurred in 21 individuals aged < 50 yr with a joint count < 15 and less physically demanding jobs. PWD occurs early in a substantial number of patients with RA. RECPAM defines risk profiles that can readily be applied in actual clinical situations and allow an estimation of the risk of PWD at different time points using the resulting Kaplan-Meier curves.
8996472 The impact of early rheumatoid arthritis on psychological distress. A comparison between 2 1996 The objective of our study was to estimate the impact of early rheumatoid arthritis (RA) on psychological distress by comparing patients with RA and matched controls. A sample of 238 patients (age 20-70 years, mean age 52 yrs) with RA of 0 to 4 years duration (mean 2.2 yrs), was compared to 116 control persons matched to the patients with respect to sex, age, and geographic area. Data were collected through self-report questionnaires. Patients with RA rated their mental health significantly lower than the controls. Symptoms of anxiety and depression were significantly higher among arthritic patients. Twenty% of the patients had scores indicating possible psychiatric caseness compared to 6% of the controls. However, controlling for pain, disability, and fatigue, there was no significant difference in psychological distress between the patients and the controls. RA appears to have a strong impact on mental distress even early in the disease. The present study demonstrates that pain, disability, and fatigue are strongly related to the increased levels of psychological distress in RA.
1444837 [Role of opioid peptide in rheumatoid arthritis--detection of beta-endorphin in synovial t 1992 Sep The presence of beta-endorphin (beta-end) was immunohistologically identified in synovial tissue samples biopsied from patients with rheumatoid arthritis (RA) and osteoarthritis (OA). The amount of beta-end in culture supernatants of synovial tissue explants was also determined by RIA. beta-end was strongly detected in mainly superficial synovial cells, vascular endothelial cells and a few synovial interstitial cells in RA patients, but not in OA patients. In RA patients the beta-end concentration was significantly higher in the supernatants of tissue explants (26.4 +/- 8.3 pg/ml) than in the plasma of the same patients (15.3 +/- 2.5 pg/ml) (p < 0.01). Using isolated synovial cells, the beta-end concentration in the culture supernatants of non-adherent cells (19.4 pg/ml) was higher than that of adherent cells (4.0 pg/ml). It is suggested that beta-end is produced by non-adherent cells such as lymphocytes and neutrophils in addition to synovial lining cells and endothelial cells and may play some role in the pathology of RA synovial inflammation.
8304691 Hydroxychloroquine toxicity despite normal dose therapy. 1993 Oct The risk of retinopathy associated with the use of hydroxychloroquine is said to be nullified if the dosage recommendations are followed strictly. In this case report, we describe an elderly patient with rheumatoid arthritis who had bilateral maculopathy, presumably secondary to hydroxychloroquine therapy, despite a dosing regimen within therapeutic guidelines. We believe special attention should be given to elderly patients who are being treated with hydroxychloroquine because their retinal pigment epithelium may be more susceptible to the toxic effects of this drug.
7493112 [Primary orbital lymphoma within the context of Sjögren's syndrome secondary to rheumatoi 1994 We are describing the case of a seventy-four year old woman presenting a voluminous hard and painless tumor of the right lids, which has appeared half a year ago. Past medical history consists in a Sjögren's syndrome secondary to rheumatoid arthritis. The right eye is not visible and the left eye presents an important xerophthalmia and an opaque and vascularized cornea. CT Scan and biopsy allow to diagnose a diffuse monocytoid B cell non hodgkin-lymphoma, starting from the lacrymal gland with an extension to the lids and the anterior orbit. The appearance of a non hodgkin lymphoma in the course of the evolution of a rheumatoid arthritis and/or Sjögren's syndrome has been described well. The monocytoid feature of this lymphoma with the Sjögren's syndrome has recently been reported. However, the orbital localisation of this lymphoma is rare.
7785573 Renal osteodystrophy: imaging findings that mimic those of other diseases. 1995 Jul Musculoskeletal complications in patients with chronic renal failure are common and may be related to the disease itself or to treatment. The altered metabolism in patients with chronic renal failure leads to renal osteodystrophy, which consists of osteomalacia and secondary hyperparathyroidism [1]. Erosive changes attributable to secondary hyperparathyroidism may be easily confused with rheumatoid arthritis, seronegative spondyloarthropathies, infection, or even malignancy. Brown tumors and amyloid deposition can easily be mistaken for a neoplastic process. The purpose of this article is to illustrate radiographic findings that are caused by renal failure and that often mimic other diseases by use of plain radiographs, CT scans, and MR images. Particular emphasis is placed on periarticular findings.
1478475 Peculiar properties of mycoplasmas: the smallest self-replicating prokaryotes. 1992 Dec 15 Mycoplasmas are the smallest and simplest prokaryotes capable of self-replication, with information provided by a genome which may be as small as 600 kb, estimated to carry less than 500 genes. Keeping the number of structural elements, metabolic pathways and components of the protein synthesizing machinery to an essential minimum places mycoplasmas closest to the concept of 'minimum cells'. Mycoplasmas are, therefore, most adequate candidates for the complete deciphering of the machinery of a self-replicating organism, and studies towards this goal are already underway. Living as 'minimum cells' was made possible by adopting a parasitic mode of life, securing from the host the many nutrients which cannot be synthesized by the mycoplasmas themselves. When pathogenic, infections by mycoplasmas usually follow a chronic course, with host immune reactions playing an important role in symptom production. Recent studies on the possible association of mycoplasmas with rheumatoid arthritis and AIDS are reviewed.