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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
7656923 Detectable levels of pyridinoline are present in synovial fluid from various patients with 1995 Jun There is a major interest for using biochemical markers of bone metabolism as a non-invasive tool for diagnostic purposes in the field of bone and joint diseases. Based upon the fact that the pyridinium cross-links of collagen are markers of bone and cartilage degradation, this study was designed to assess the presence of pyridinoline in synovial fluid samples originating from various arthritic and non-arthritic knee joints. Using a sample pooling method, significant levels of pyridinoline could be measured in synovial fluid by high performance liquid chromatography. Pyridinoline levels ranged from 19.3 +/- 5.8 pmol mL-1 (mean +/- SD) in osteoarthritic knee joints up to 32.4 +/- 14.6 pmol mL-1 in rheumatoid arthritis joints. Pyridinoline levels in synovial fluid were not significantly correlated to disease duration and synovial fluid cell count, but were correlated to erythrocyte sedimentation rate in osteoarthritic patients (r = 0.99, P = 0.002). This study demonstrates that synovial fluid originating from knee effusion contains significant levels of pyridinoline which can be quantified by high performance liquid chromatography and could, therefore, be a tool to investigate the metabolism of a single joint.
1613696 Polyamine levels in synovial tissues and synovial fluids of patients with rheumatoid arthr 1992 May We determined the polyamine contents of the synovial tissues from 11 patients with rheumatoid arthritis (RA), and the free putrescine levels in the synovial fluids (SF) from 10 patients with RA, 7 with osteoarthritis (OA), 5 with posttraumatic arthritis, and 3 with infectious arthritis. Putrescine levels in the synovial tissues correlated with serum C reactive protein concentration in patients with RA. Free putrescine levels in SF were significantly elevated in patients with infectious arthritis, compared with those found in RA, OA, and posttraumatic arthritis. Free putrescine levels in SF from patients with RA were significantly higher than in those with OA. Our findings suggest that polyamines may play an important role in RA.
1433018 Massive intrahepatic hemorrhage following routine liver biopsy in a patient with rheumatoi 1992 Sep Massive intrahepatic hemorrhage occurred in a patient with rheumatoid arthritis (RA) after a routine liver biopsy done to assess possible methotrexate (MTX) hepatotoxicity. Major complications of liver biopsy occur about once in every 600 biopsies, and mortality from liver biopsy has been reported. Life threatening hepatic toxicity occurs rarely during low dose MTX administration, and it is unclear whether routine liver biopsies identify patients at high risk for these complications. Until the relative risks of liver biopsy and serious MTX liver toxicity are better defined, the use of routine liver biopsies should be recommended only after careful consideration of potential procedural complications in patients with RA treated with MTX.
1319084 Histological distribution of the interleukin-4 receptor (IL4R) within the normal and patho 1992 Mar The authors sought the synovial distribution of the interleukin-4 receptor in the synovium of 3 normal subjects, 5 cases of osteoarthritis (OA) and 10 cases of rheumatoid arthritis (RA) and various other inflammatory arthritic conditions. The specific receptor for interleukin-4 was mainly found on cells around subintimal blood vessels and within lymphocytic aggregates where dendritic-like cells were strongly stained. Conversely, synovial lining cells did not express the interleukin-4 receptor. In conclusion, it is believed that the expression of interleukin-4 receptor is restricted to the early activation stage of the mononuclear cells in the pathological joint.
8354047 [Efficacy and tolerability of ketoprofene administered through iontophoresis in rheumatoid 1993 Jun Three-hundred and twelve patients with osteoarthritic diseases were admitted to a multicenter clinical trial. The patients were given 100 mg Ketoprofen twice-a-day by iontophoresis for 10 consecutive days. Pain relief was almost complete in 94.6% of the patients, improvement of active motility in 83.6%, disappearance of swelling in more than half of the patients and functional improvement in about all the cases. Two allergic skin reactions of a mild degree (0.6%) were registered. Therefore, Ketoprofen administered by iontophoresis showed to be efficacious and safe in the treatment of acute osteoarthritic diseases also in high risk patients.
7881318 Diet and disease. 1994 Sep Dietary factors are influential in the most important public health problems of Western society. Together, diseases such as coronary heart disease and stroke, cancers, and the effects of osteoporosis constitute the most common causes of disability and death. All of these diseases are multifactorial in their aetiology, but there remains some potential for disease prevention by dietary manipulation. For coronary heart disease and stroke, dietary factors play important roles in modulating blood lipids and their propensity for oxidation. In addition the propensity for thrombosis can be influenced by dietary factors, particularly by the inclusion of fish oils. For cancers, the influence of the diet is less certain, but fats, fibre and antioxidant vitamins and minerals have been most closely scrutinised. In osteoporosis the most important dietary factor is the availability of calcium. This is important both in building peak bone mass and in minimising bone loss later on. There is also some evidence that dietary factors can be helpful in minimising the symptoms of disease. Most notably, the inflammatory process in rheumatoid arthritis can be modified by fish and evening primrose oils, although these effects are relatively mild compared with standard pharmaceutical treatments.
1644327 Small bowel enteroscopy in undiagnosed gastrointestinal blood loss. 1992 Jul Sixty five of 70 consecutive patients with undiagnosed gastrointestinal blood loss were examined using the new technique of small bowel enteroscopy. Using a balloon driven sonde enteroscope (SIF-SW) extended views of the small bowel were obtained as far as the distal ileum. Medium length of small bowel examined was 140 cm (range (30-200 cm). All patients studied had a normal upper gastrointestinal endoscopy. Nineteen (41%) of 46 anaemic rheumatoid arthritis patients taking non-steroidal antiinflammatory drugs (NSAID) and three (27%) of 11 patients with unexplained iron deficiency, were found to have small bowel lesions to account for their anaemia. Small bowel lesions were found in a further three of eight (37%) patients with acute gastrointestinal bleeding. The procedure failed or was terminated in five patients. Small bowel enteroscopy has considerable potential in the investigation of undiagnosed gastrointestinal blood loss and deserves more widespread application.
1295090 Dyslipoproteinemia in the course of active rheumatoid arthritis. 1992 Dec Concentrations of serum lipids and serum very low-density lipoproteins and low-density lipoproteins (VLDL+LDL, originally called beta lipoproteins) were measured and agarose gel electrophoresis of serum lipoproteins was performed in 69 patients with active rheumatoid arthritis (RA), 40 patients with psoriatic arthritis (PA), 21 patients with osteoarthritis (OA), and 65 healthy blood donors. These lipid parameters were also compared in 21 RA and 40 PA patients during periods of severe disease activity (SA) versus minimal disease activity (MA). RA patients had significantly decreased concentrations of total serum lipids, total serum cholesterol, cholesterol in LDL, and cholesterol in high-density lipoproteins (HDL) compared with healthy blood donors. RA patients with SA had significantly decreased cholesterol in LDL and HDL compared with patients with MA. As the disease activity decreased, RA patients had normalization of almost all serum lipid concentrations. Electrophoresis of serum lipoproteins showed heterogeneous patterns in RA patients. Patients with PA also had some evidence of dyslipoproteinemia. Serum lipids changed with disease activity in PA patients in a manner similar to that in RA patients. These data show that patients with RA and PA have a dyslipoproteinemia that is related to disease activity.
8549696 The preventive effect of oral administration of type I interferon on collagen-induced arth 1995 Apr We investigated the effect of oral administration of type I interferon (IFN) on an autoimmune disease collagen-induced arthritis (CIA) in rats that was induced by immunization with type II collagen (CII). The results showed that the oral administration of IFN before immunization with CII significantly suppressed the development of CIA. Delayed type hypersensitivity, in vitro proliferative responses of lymph node cells to CII, and IL-2 production were also inhibited by the fed cytokine. The serum from IFN-fed animals downregulated the development of CIA and proliferative responses to CII. In contrast, IFN given orally after the onset of CIA failed to affect the proliferation of T cells to CII as well as the progression of the disease. There was a decrease in the production of anti-CII antibody in rats fed IFN before, but not after, immunization with CII. Thus, orally administered IFN may have preventive, but not therapeutic, effects on autoimmune inflammatory joint diseases.
8005184 Sodium naproxen: concentration and effect on inflammatory response mediators in human rheu 1994 Twelve patients suffering from rheumatoid arthritis and having swollen knees were treated with 1.1 g/day of sodium naproxen administered in one dose, daily for 5 days. The 72-h wash-out period was verified by the absence of any nonsteroidal anti-inflammatory drug using a HPLC screening. Blood and synovial fluid samples were drawn just before treatment and 24 h after the last dose. Eicosanoids (PGE2, 6-keto-PGF1 alpha, TXB2, LTB4, LTC4) in synovial fluid were determined by immunoenzymatic assays. In plasma and synovial fluid, hyaluronic acid was assayed by radiometric assay and sodium naproxen by HPLC. Free drug was determined by equilibrium dialysis. Statistical analysis used nonparametric tests. Pain relief (evaluated on a visual scale), morning stiffness, and scores on the Lee and Ritchie indices all decreased significantly, as did PGE2 and LTB4 concentrations. The decrease in 6-keto-PGF1 alpha and TXB2 was not significant. No significant change was found for LTC4 and hyaluronic acid. Total concentrations of sodium naproxen were equivalent in plasma (16.1 micrograms.ml-1) and synovial fluid (18.9 micrograms.ml-1). Free fractions were significantly higher in synovial fluid (0.14%) than in plasma (0.11%), as shown by binding of the drug to human serum albumin, at various protein concentrations. Interestingly, the clinical efficacy, as shown by decreases in morning stiffness and in the Lee index score, correlated with the free concentration of naproxen in synovial fluid.
1626237 Total wrist arthroplasty. Experience with Swanson flexible silicone implants, 1982-1988. 1992 In a study of the results of silicone rubber arthroplasty of the wrist 18 patients (19 operated wrists) were re-examined after a mean follow up of five years. Experience with the ulnar head implant was discouraging, and it was not used in the last eight wrists. This did not affect the outcome, patients having good supination and pronation without pain. The range of motion with the radiocarpal prostheses was 0-70 degrees, mean 39 degrees. Radiological results showed severe subsidence in all patients followed up for more than two years, and prosthetic fracture in five (26%), which was disappointing. Nevertheless the patients had a useful range of motion and all but two were relieved of pain. By the patients' own assessments 16 wrists were considered good, one fair, and two poor. Predictors of failure (prosthetic fracture) were poor alignment before operation, postoperative range of motion of more than 50 degrees, and rupture of the carpal extensor tendon. With these reservations we recommend the silicone spacer as the best solution for most patients with severe problems of the wrist as a result of rheumatoid arthritis.
1588738 [Glucocorticoids]. 1992 Mar Recent years have witnessed the reassessment of cotherapy with steroid preparations and antirheumatic agents for the treatment of rheumatoid arthritis. However, in addition to desirable anti-inflammatory and immunosuppressive properties, the pharmacological spectrum of glucocorticoids includes diverse activities which may result in numerous adverse reactions. Antirheumatic therapy therefore requires strict adherence to the prescribed indications and careful selection of the specific drug type and dosage regimen. Based on the patient's response, dose reduction or withdrawal of any steroid preparations should be attempted. Although antirheumatic and non-steroidal anti-inflammatory agents are the mainstay treatment for rheumatoid arthritis, steroid therapy is usually employed when these drugs are not sufficiently effective.
1285885 Remission of rheumatoid arthritis during pregnancy and maternal-fetal class II alloantigen 1992 Oct Rheumatoid arthritis (RA) is an autoimmune disorder known to be associated with specific class II genes. Although it has been known since 1938 that the majority of women with RA experience disease improvement or remission during pregnancy, the reasons remain unknown. Pregnancy represents an immunologic challenge and maternal immune recognition of the semi-allogeneic fetus occurs as part of normal pregnancy. We hypothesized that maternal immune response to fetal HLA antigens might be associated with the effect of pregnancy on arthritis activity. To test this hypothesis, we studied HLA antigens in mother-child pairs comparing maternal-fetal HLA antigen sharing for pregnancies where arthritis improved with those where disease was active. No significant difference was observed in the two groups for class I HLA antigens. Fetal-maternal disparity for HLA-DR and HLA-DQ antigens was observed significantly more frequently in pregnancies with remission or improvement compared with those in which disease was active. These observations suggest that maternal immune response to fetal paternally-inherited class II HLA antigens may be important in RA remission observed during pregnancy.
7895398 Des-Lys58-beta 2m and native beta 2m in rheumatoid arthritis serum and synovial fluid. 1994 Nov OBJECTIVE: Levels of beta 2-microglobulin and modified beta 2-microglobulin (Des-Lys58-beta 2m) were measured in serum and synovial fluids from patients with rheumatoid arthritis (RA) and other inflammatory joint disorders using rabbit antisera prepared against the beta 2m peptide VEHSDLSFS encompassing residues 49-57 and absorbed with the C-terminal beta 2m peptide (87-97) LSQPKIVKWDR: These antisera which did not react with native beta 2m were employed to quantitate Des-Lys58-beta 2m in serum and SF. Native beta 2m was measured using a direct ELISA method. RESULTS: Removal of serum rheumatoid factor by adsorption to monomeric IgG columns did not change serum levels of beta 2m or Des-Lys58-beta 2m. Native beta 2m was found in all of 20 RA sera, but only rarely in SLE sera. No serum beta 2m was found in 20 patients with ankylosing spondylitis or 25 normal controls. Significant elevations of Des-Lys58-beta 2m were found in 80% of 21 SF from RA patients and in 43% of 41 SF from other subjects with various forms of inflammatory arthritis. In RA and other disorders such as gout or pseudogout, levels of Des-Lys58-beta 2m were higher in synovial fluid than in serum during an acute episode of synovitis. Both native beta 2m and Des-Lys58-beta 2m showed minimal neutrophil and T cell chemotactic activity. CONCLUSION: Des-Lys58-beta 2m present in many inflammatory SF may contribute to the inflammatory reaction in many forms of connective tissue disease by its known amplification of T cell cytotoxicity.
8636188 Extensile posterior approach to the ankle. 1996 May Surgical exposure of the ankle is usually obtained by an anterior approach, especially for replacement arthroplasty. The transfibular approach has been popular for arthrodesis. We describe a new posterior approach to the ankle and posterior subtalar joint based on an extra-articular vertical calcaneal osteotomy behind the subtalar joint. The posterior flap so formed is hinged medially and offers wide exposure of the back of the ankle and posterior subtalar joint. This hinge allows safe and stable reduction of the osteotomised calcaneum, and the plane of dissection follows an 'internervous plane' behind the fibula. We have had good results after using this incision in 12 patients with osteoarthritis or rheumatoid arthritis and there have been no difficulties with wound healing.
8858430 Illness careers: the chronic illness experience. 1996 Aug The provision of skillful psychosocial care to patients suffering from chronic illnesses starts with an appreciation of what it is like to live with a chronic condition. Definitions of self-esteem may be realigned when patients encounter a prolonged problem, and reliance upon professional help. Getting inside the experience of such illness may be key to understanding patient motivation, noncompliance with therapy and altered patterns of social engagement. Individuals' personal constructs may usefully then be used to explore the extent to which chronic illness sufferers share common problems and needs.
8506432 [Synovial biopsy: expectations, results and assessment]. 1993 Apr 6 In arthropathies without clear diagnostic clinical, radiological and laboratory findings, a synovial biopsy should be performed. The histologic examination yields a diagnosis in 5 to 29% or is complementary to clinical, radiological and laboratory findings leading to the diagnosis in another 23 to 40%; the diagnosis of "chronic synovitis" results at best for the remaining cases. The histological features of the main types of arthritis and arthropathy are briefly discussed.
7498110 Arthritis and perceptions of quality of life: an examination of positive and negative affe 1995 Sep The utility of measuring both positive and negative affective states for assessing rheumatoid arthritis (RA) patients was examined in 3 independent samples of male and female RA patients (Sample A: 179 women, 48 men; Sample B: 177 women, 24 men; Sample C: 134 women, 38 men). Confirmatory factor analyses of each sample indicated that positive and negative affect constituted separate, negatively correlated factors. The relations among disease variables, coping, and affects were consistent with a model in which coping mediates the relationship between disease variables and positive and negative affect. Patients with higher pain and limitation from RA had higher levels of maladaptive coping, and maladaptive coping was associated with lower positive affect and higher negative affect. Those RAs with higher activity limitation also reported less adaptive coping, which was associated with less positive affect.
7809908 Role of endothelium in chronic inflammatory synovitis. 1994 May The rheumatoid synovial membrane is infiltrated by chronic inflammatory cells. The major fraction of the infiltrating lymphocytes is composed of CD4+ cells. A large number of studies of the composition of the T cell receptors of these lymphocytes have failed to demonstrate evidence of a dominant clonal population of T cells which is characteristic of rheumatoid synovitis. Most of the T cells are polyclonal in nature. This report discusses the basis for this polyclonality. Current evidence is reviewed which supports the conclusion that T cells emigrate from postcapillary venules because they are in an activated state. The activated T cell is characterized by elevated expression and avidity of adhesion receptors capable of reacting with counterreceptors on the endothelial cells of postcapillary venules, leading to binding and emigration from the blood. The T cells are retained in the perivascular connective tissue because their adhesion receptors interact with counterreceptors on other mononuclear cells and on matrix proteins. The increased expression of adhesion receptors on the T cells may be a result of prior contact with antigen; increased expression of counter-receptors on the endothelial cells results from stimulation by cytokines released by local inflammatory cells. The interaction between T cell adhesion molecules and counterreceptors is independent of the immunological specificity of the T cell. Hence, the T cells of the rheumatoid synovium are largely polyclonal memory cells.
8156304 The prevalence of serum IgG antibodies to type II collagen in American patients with rheum 1994 Apr Serum IgG antibody levels to native and denatured bovine type II collagen were elevated in 31.5 and 21.5% sera respectively from 200 American patients with RA. The prevalence of serum antibodies to native type II collagen is significantly higher than previously found in large studies of the prevalence of this autoantibody in Britain and Japan when using the same methodology.