RABC

Browse

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

PMID	Title	PublicationDate	abstract
1083237	Esophageal varices in Felty's syndrome: A case report and review of the literature.	1976 Mar	A case of upper gastrointestinal tract hemorrhage secondary to esophageal varices in a patient with Felty's syndrome prompted a review of the pathogenesis and treatment of this condition. Six previously reported cases of this association were found. The clinical picture is that of long-standing rheumatoid arthritis with severe articular and extraarticular manifestations including splenomegaly, depression of the blood elements, mild liver function abnormalities, portal hypertension without cirrhosis or portal vein obstruction, an elevated splenic blood flow, and a reduction in portal hypertension by simple splenectomy. The presence of portal hypertension with varices may be another indication of splenectomy in patients with Felty's syndrome.
553067	Patterns of work--rheumatoid arthritis.	1979	Fifty rheumatoid adults successfully competing in full time competitive work were interviewed to determine the factors which distinguish this group and enable their continuing work, which included physical and social barriers and aids to working full time. The data indicate that as a whole they had significant disease, most falling in functional class 2 and 3 (ARA). As a group they were well educated with occupations mirroring their educational attainments. Almost all had inside jobs and most had worked for long times in their occupations. The majority did not change occupations after disease onset and many had been in their jobs for years, often in the same firm. Promotions were few. They had stable marriage patterns. Patients were motivated for work and did what was necessary to get to work despite their disease. These workers had a low level of absenteeism, enjoyed their jobs and felt that personal desire was the most important factor in keeping at work. From consideration of the disease itself, in addition to upper and lower extremity problems, morning stiffness, fatigue and public transport difficulties were highlighted and focus attention on the need to better control these features of the disease and environment.
6402993	HLA DR antigens and gold toxicity.	1983 Feb	One hundred and thirty-two patients with rheumatoid arthritis treated with gold have been studied for possible associations between HLA DR antigens and different adverse reactions occurring during such therapy. Patients possessing HLA DR3 had a significantly greater frequency of side effects than patients lacking this antigen. It was particularly noticed that DR3 positive patients on gold treatment had an 11 times higher risk of getting proteinuria than those without DR3. The lowest frequency of side effects was seen in DR7 positives. No significant differences between the DR antigen groups with respect to skin eruptions, liver reactions, or leucopenia were evident.
6239305	Treatment of intractable rheumatoid arthritis with total lymphoid irradiation (TLI): immun	1983 Aug	Eleven patients with intractable rheumatoid arthritis were treated with total lymphoid irradiation in a feasibility study. The mantle and the inverted Y fields were treated successively to a cumulative dose of 2000 rads. Nine of eleven patients showed at least a 35% improvement in three of four clinical parameters by six months and continued to maintain at least this level of improvement at their last observation points (13-28 months after TLI). There was a marked decrease in the percentage of total T cells and Leu-3 cells (helper), but an increase in the percentage of Leu-2 cells (suppressor/cytotoxic), resulting in a dramatic increase in the Leu-2/Leu-3 ratio. There was also a decrease in response to PHA, Con A and MLR.
950633	The effect of levamisole on adjuvant arthritis in the rat.	1976 Jun	Levamisole (LEV), an immunostimulatory agent, was studied for its effect on adjuvant disease of the rat. The drug was administered continuously according to three schedules: (a) seven days prior to immunization with complete Freund's adjuvant (CFA); (b) simultaneously with CFA; or (c) 14 days after CFA. Control animals received CFA alone, LEV alone, or were sham treated with saline. Three weekly evaluations were made, recording the general condition, weight curves, joint scores, and volume of hind paws. Whole body radiographs were made at the end of six weeks. In all experimental groups, LEV accentuated the severity of the disease as compared to animals receiving CFA alone. Within the experimental groups, an increased severity was observed with earlier administration of LEV, although the day of disease onset was not altered. Spinal involvement was less severe with each consecutive administration of LEV. These findings suggest that LEV is effective not only in restoring an impaired cellular immune response, but also in enhancing an already activated system. It seems however, that for this stimulation the timetable of LEV administration is crucial, and that continuous therapy may result in a loss of efficiency.
910045	Calcaneal abnormalities in articular disorders. Rheumatoid arthritis, ankylosing spondylit	1977 Nov	The calcaneus of normal control patients, and those with rheumatoid arthritis, ankylosing spondylitis, psoriasis, and Reiter syndrome was studied. Pathological abnormalities of the plantar aponeurosis, Achilles tendon, and retrocalcaneal bursa account for the radiographic alterations. In normal individuals, lateral radiographs show the thickness of the Achilles tendon to be not greater than 8 mm; the retrocalcaneal bursa creates a radiolucency which extends at least 2 mm below the superior surface of the calcaneus. In patients with any of these 4 articular disorders, Achilles tendinitis produces thickening of the tendon, and retrocalcaneal bursitis obliterates the normal radiolucency.
6342961	'Osmosin' in rheumatoid arthritis: interim results.	1983	The interim results of an on-going trial in patients with active rheumatoid arthritis are reported. The findings from 17 patients so far treated and followed-up for 4 to 6 weeks suggest that 'Osmosin' (105 mg sodium indomethacin trihydrate), given once daily for the first 2 weeks and twice daily thereafter, is effective in reducing the inflammatory activity of joint disease, as assessed by visual analogue and 5-point semantic severity scales. Analysis showed that there was a strong association between the assessments on the two scales and this was stronger if patients were not conditioned by being allowed to see their previous visual analogue scale assessment.
312056	Middle ear function in rheumatoid arthritis.	1978 Dec	Using an otoadmittance meter the function of the middle ear was compared in 38 patients with rheumatoid arthritis (RA) and 30 matched controls with non-articular rheumatism. Patients with pre-existing ear disease were excluded from the study. No subjects in either group showed hearing loss on pure tone audiometry, but otoadmittance abnormalities were recorded in 16 of the RA (42%) and in 2 of the control groups (7%). The pattern of abnormality was similar in each case and indicated an increased laxity of the conducting system. The reason for this unexpected finding is unknown. There were no significant differences between the RA patients with normal or abnormal recordings as regards clinical or laboratory features or treatment.
6084477	Decreased plasma fibrinolysis in patients with rheumatoid arthritis.	1984 Dec	We have investigated the fibrinolytic status of 56 patients with rheumatoid arthritis (RA). Plasma fibrinogen and plasminogen were significantly elevated. Levels of these two substrates, along with alpha 2 macroglobulin and antithrombin III correlated with disease activity. Plasminogen activator (PA) activity was decreased in patients with severe disease. Twelve patients were given stanozolol, a fibrinolytic enhancing agent, for two months as a test for endothelial production of plasminogen activator. This caused a significant increase in blood plasminogen and PA activity. Five patients received a two-week course of stanozolol with joint aspiration before and after. Joint plasminogen levels were increased. We suggest that inadequate fibrinolysis occurs in RA, and that this may contribute to some of the pathological features of the disease. It is possible to stimulate both blood and joint fibrinolysis by stanozolol. A more prolonged increase in plasminogen activator activity might decrease joint fibrin deposition, and stanozolol should be investigated as a therapeutic agent in RA.
1065285	Salicylate therapy and drug interaction in rheumatoid arthritis.	1975 Dec	Salicylates form the basis of drug treatment in rheumatoid arthritis. Despite their use for many decades, there is considerable confusion about what constitutes a regime which will ensure anti-inflammatory properties. We have found that blood vessels in the proposed therapeutic range can be maintained overnight on a four times daily dose regime, using either soluble aspirin (in the form of "Disprin") or aloxiprin ("Palaprin Forte"), and on a 12 hourly regine using an aspirin-sustained release aspirin combination ("BiPrin"). Because of variation in the levels reached using a fixed dosage schedule, treatment should be individualised. No correlation was found between dosage levels and either disease activity or serum albumin levels. No significant alteration in free or total salicylate levels was found following the addition of indomethacin to therapy.
7101073	Septic polyarthritis due to Bacteroides fragilis in a patient with rheumatoid arthritis. A	1982 Aug 7	Gram-negative septic arthritis is an uncommon but serious complication of rheumatoid arthritis and is usually mono-articular. The present case is unusual in that a septic polyarthritis due to Bacteroides fragilis developed in nine joints. The organism was grown only in anaerobic synovial fluid and blood cultures. The patient recovered after treatment which included repeated needle aspirations of the joints under anaesthesia and oral metronidazole (Flagyl; Maybaker). Any patient with rheumatoid arthritis who develops an acute flare-up of disease in one or more joints should have these aspirated to exclude the possibility of septic arthritis. Both anaerobic and aerobic cultures of synovial fluid and blood should be done. Prompt antibiotic treatment and joint drainage are the cornerstones of treatment.
307165	[Effect and tolerance of Biarison (proquazone) in rheumatoid arthritis (author's transl)].	1978 Jun 30	Biarison was tested in 24 patients mainly with classical rheumatoid arthritis for its efficacy and tolerance. There was a distinct improvement in the course of the 4 weeks' therapy with a mean dosage of 900 mg/day (it was in the meantime raised to a maximum of 1500 mg/day in isolated cases) especially in the pain, stiffness and functional capacity. Biarison caused few gastrointestinal side effects: the tolerance may be said to be good on the whole.
6723122	Pharmacokinetics of the major metabolites of D-penicillamine in patients with rheumatoid a	1984	The pharmacokinetic disposition of D-penicillamine and its major metabolites, penicillamine cysteine disulfide ( PSSC ) and penicillamine disulfide ( PSSP ) has been studied in eight patients with rheumatoid arthritis. Plasma concentrations of D-penicillamine, PSSP and PSSC displayed similar characteristics in terms of times to maximum concentrations and biphasic elimination from plasma. Initial t1/2 (alpha) phase ranged from 0.86 to 4.41 h for parent drug and 0.81 to 4.41 h for metabolites. Final t1/2 (beta phase) ranged from 3.4 to 9.45 h for D-penicillamine and 5.62 to 21.7 h for the metabolites. Total drug and metabolites detected in urine accounted for 12.0 to 48.7% of oral drug.
488792	Interpositional arthroplasty of the wrist in rheumatoid arthritis.	1979 Jun	The procedure of interpositional arthroplasty of the wrist joint in rheumatoid arthritis, using silicone sheeting, is described. The results and complications of sixty arthroplasties are presented.
6455314	Penicillamine-induced lupus-like reaction in rheumatoid arthritis and vasculitis.	1981	A 44-year-old woman with rheumatoid arthritis and vasculitis of the skin developed a lupus erythematosus-like reaction after 5 weeks of D-penicillamine therapy. The diagnosis was established on the clinical and histological picture, immunofluorescence studies and serological investigations. The reaction faded upon cessation of the drug.
7191311	[Treatment of chronic polyarthritis with acemetacin and indomethacin].	1980	In a controlled double blind study the therapeutic efficacy and tolerability of equimolar doses of [1-(p-chlorobenzoyl)-5-methoxy-2-methylindol-3-acetoxy] acetic acid (acemetacin, TV 1322, Rantudil) and indometacin (acemetacin: 180 mg/day, indometacin: 150 mg/day) were studied in 40 patients suffering from rheumatoid arthritis. The period of treatment lasted 42 days. With the exception of the parameter "state of the joint" a statistically confirmed improvement was detectable in the acemetacin group. The parameter "pain" was significantly improved after acemetacin as well after indometacin. With regard to the test criteria "functional disturbances" and "inflammation" only acemetacin was able to achieve a significant improvement. Neither of the antirheumatic agents had a significantly positive influence on the "state of the joint". The therapeutic effect on the course of the disease was better in the group treated with acemetacin than in the group treated with indometacin. However, the difference was not statistically significant. The number of undesired effects which occurred in the acemetacin group was smaller and less pronounced than in the indometacin group. In one instance, the therapy in the acemetacin group was discontinued because of a glossitis and stomatitis. one patient in the control group was excluded from the study owing to heamatemesis.
786666	Disparity between clinical and immune responses in a controlled trial of azathioprine in r	1976 Mar 22	Drugs that interfere with the immune response in vitro, such as azathioprine (AZ), have been used extensively since 1964 in clinical therapeutic trials of autoimmune diseases. However, few adequately controlled studies are available concerning the concurrent effect of AZ on the immune and clinical responses to treatment of rheumatoid arthritis (RA). Thirty patients suffering from classical seropositive RA received AZ (1.5 - 2.0 mg/kg/day) and placebo in a controlled clinical cross-over study for two 12-week periods. Other treatments were kept constant throughout the entire 6 months. In terms of the clinical responses of joint count and grip strength patients receiving AZ improved markedly, in contrast to the placebo group. After 2 months, joint scanning revealed no progress of the disease in patients undergoing AZ treatment. Corresponding with the remarkably beneficial clinical effect of AZ, a significant drop in immunoglobulins was observed. However, since AZ failed to suppress in vivo specific antibody synthesis in RA, the question remains as to whether this drug actually does interfere with the autoimmunogenesis of the disease.
1166279	Response of synovial immunocytes to intra-articular agents in experimental arthritis.	1975	In rabbits with immune arthritis the numbers of lymphoid aggregates and pyroninophilic and non-pyroninophilic cells per unit area of synovium were calculated from sections taken at various intervals after intra-articular drug injections. A model of immune arthritis based on the results is presented. In the active phase of the arthritis, plasma cells, plasmablasts and lymphoid aggregates proliferate, while the number of lymphocytes decreases. In the inactive phase after treatment, the cell pattern is the reverse. The ratio of pyroninophilic to non-pyroninophilic cells proved to be a good measure of the activity of the arthritis. A favourable therapeutic effect was achieved with triamcinolone hexacetonide and combined steroid-osmic acid, but not with osmic acid alone.
899297	[Decrease of mitogen stimulation of lymphocytes in rheumatoid arthritis].	1977 May	Peripheral blood lymphocytes of 51 patients with rheumatoid arthritis and of 14 healthy blood donors were cultivated in autologous and homologous normal pool-serum and stimulated with phytohemagglutinin (PHA-P), concanavalin A (Con A) and pokeweed mitogen (PMW) in different doses. In autologous as well as in homologous pool-serum the 3H-thymidine uptake of stimulated lymphocytes from patients with rheumatoid arthritis was significantly depressed independent of the mitogen concentration used. Serum from patients with rheumatoid arthritis depressed the activation of blood donor lymphocytes by Con A and PWM. The depression of lymphocyte activation was not related to the presence of rheumatoid factors in the serum, the severity of the disease and the anti-rheumatic therapy.
944196	Circulating and intra-articular immune complexes in patients with rheumatoid arthritis. Co	1976 May	The correlation between the incidence and level of immune complexes in serum and synovial fluid and the various clinical and biological manifestations of rheumatoid arthritis has been studied. Immune complexes were quantitated using a sensitive radioimmunoassay, the 125I-Clq binding test, in unheated native sera and synovial fluids from 50 patients with seropositive (RA +) and 45 with seronegative (RA -) rheumatoid arthritis, 17 with other inflammatory arthritis, and 37 with degenerative and post-traumatic joint disease. The following observations were made: (a) when compared to the results from patients with degenerative and post-traumatic joint diseases, the 125I-Clq binding activity (Clq-BA) in synovial fluid was found to be increased (by more than 2 SD) in most of the patients with RA + (80%) and RA - (71%) and in 29% of patients with other inflammatory arthritis; the serum Clq-BA was also frequently increased in both RA + (76%) and RA - (49%) patients, but only exceptionally in patients with other inflammatory arthritis (6%); (b) a significant negative correlation existed between the Clq-BA and the immunochemical C4 level in synovial fluids from patients with RA + and RA -; (c) neither the serum nor the synovial fluid Clq-BA in rheumatoid arthritis significantly correlated with the erythrocyte sedimentation rate, the clinical stage of the disease, or the IgM rheumatoid factor titer; and (d) the serum Clq-BA in patients with rheumatoid arthritis and extra-articular disease manifestations (40 +/- 34% in those with RA +,32 +/- 29% in those with RA -) was significantly increased as compared to the serum Clq-BA in patients with joint disease alone (24 +/- 30% in those with RA +, 10 +/- 13% in those with RA -). Experimental studies were carried out in order to characterize the Clq binding material in rheumatoid arthritis. This material had properties similar to immune complexes: it sedimented in a high molecular weight range on sucrose density gradients (10-30S) and lost the ability to bind Clq after reduction and alkylation, or after acid dissociation at pH 3.8, or after passage through an anti-IgG immunoabsorbant. DNase did not affect the Clq BA. These results support the hypothesis that circulating as well as intra-articular immune complexes may play an important role in some pathogenetic aspects of rheumatoid arthritis. The 125I-Clq binding test may also be of some practical clinical value in detecting patients who have a higher risk of developing vasculitis.