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

PMID	Title	PublicationDate	abstract
8976077	[Interstitial pneumonia treated with intermittent cyclophosphamide pulse therapy].	1996 Nov	A 52-year-old woman was admitted to the hospital because of polyarthralgia and dry coughing. A chest X-ray film showed bilateral diffuse reticulo-nodular shadows. A specimen obtained by transbronchial lung biopsy revealed alveolar septal thickening and infiltration by mononuclear cells. Interstitial pneumonia associated with rheumatoid arthritis was diagnosed. Interstitial pneumonia relapsed soon after the first pulse of corticosteroid therapy. Cyclophosphamide pulse therapy was given in addition to a second pulse of corticosteroid therapy; 700 mg of cyclophosphamide (500 mg/m2) was administered intravenously every month and the dose of steroids was gradually reduced. Cyclophosphamide pulse therapy was repeated three times and the dose of oral corticosteroids was reduced from 60 mg to 35 mg. There was no bone marrow suppression or hemorrhagic cystitis after the cyclophosphamide pulses. Eventually, corticosteroid therapy was stopped with no clinical deterioration. This case suggests that intermittent cyclophosphamide pulse therapy can be effective for treatment of interstitial pneumonia unresponsive to corticosteroids.
8126041	Upper-airway obstruction and perioperative management of the airway in patients managed wi	1994 Mar	We reviewed the records of 128 patients who had a total of 128 consecutive posterior operations on the cervical spine for problems related to rheumatoid arthritis. Our purpose was to examine perioperative complications related to the airway. The patients were divided into two groups for analysis on the basis of the technique of intubation that had been used. An upper-airway obstruction developed after extubation in eight (14 per cent) of the fifty-eight patients who had been intubated without fiberoptic assistance compared with one (1 per cent) of the seventy patients who had been intubated fiberoptically (p = 0.02). The two groups had similar characteristics with regard to age, sex, severity of the myelopathy, American Rheumatology Association classification, American Society of Anesthesiologists physical status classification, cigarette use, duration of the arthritis, use of preoperative traction, use of steroids (both preoperatively and intraoperatively), size of the endotracheal tube, duration of the operation, total duration of the anesthesia, intraoperative fluid balance, and type of immediate immobilization of the neck. The only significant difference between the groups was the time to extubation, which averaged 17.9 hours in the fiberoptic group and 10.6 hours in the non-fiberoptic group (p = 0.02). Logistic regression analysis showed that non-fiberoptic intubation was the significant risk factor, even when allowance was made for the difference in the lengths of time to extubation. We concluded that this life-threatening complication can be minimized with fiberoptic management of the airway.
8016733	[The activity of superoxide dismutase and its isoenzymes in the immunocompetent cells of t	1994	General activity of superoxide dismutase (SOD) and its isoenzymic spectrum in lymphocytes and neutrophils were studied in the peripheral blood from 63 SLP and 85 RA patients. A significant decline in SOD activity and qualitative shifts in SOD isoenzymic spectrum were found in both cell groups. The differences were specific for lymphocytes and neutrophils. SOD isoenzymic aberrations proved significant in minimal activity of SLP and RA and go in the same direction in both the diseases. General SOD activity and its isoenzymic composition can serve sensitive indications of immunocompetent cell function both in SLP and RA and of the need in antioxidants inclusion into combined treatment of both the diseases.
7730819	Femoral head autograft in simultaneous primary and revision total hip arthroplasty.	1995 Feb	Bilateral total hip arthroplasty during one anesthetic procedure can be beneficial in properly selected patients. For patients who have a failed hip arthroplasty requiring revision and a contralateral arthritic hip requiring primary arthroplasty, bilateral surgery permits the resected femoral head from the primary procedure to be used as a fresh autogenous bone-graft during the revision procedure. Four patients underwent combined primary hip arthroplasty and contralateral revision hip arthroplasty during one anesthetic procedure. The femoral head obtained during the primary procedure was used as a structural acetabular bone-graft in three patients, and bone slurry was used to fill cavitary acetabular defects in one patient. A femoral neck autograft was used to reconstruct a calcar defect in one of the patients. After an average follow-up period of 27 months, all hips were functioning well with healed bone-grafts and stable prosthetic components.
8335735	Bullous pemphigoid and autoimmunity.	1993 Aug	BACKGROUND: There are many case reports of bullous pemphigoid (BP) in association with a variety of autoimmune disorders, but no large case controlled studies have been performed. OBJECTIVE: Our purpose was to determine whether there is an increased incidence of autoimmune disorders in patients with BP and whether there is a particular haplotype associated with this. METHODS: A total of 108 patients with BP were studied and compared with a group of 108 age- and sex-matched controls. HLA typing at the A, B, C, and DR loci was performed on 55 of the 108 patients with BP. RESULTS: The difference in incidence of autoimmune disorders between patients and controls was not significant. The haplotypes of patients with BP were similar to those of a locally drawn population. CONCLUSION: There is no increase in the incidence of autoimmune disorders in BP, and no particular haplotype appears to be associated with a predisposition to this condition.
7933576	[HLA-linked susceptibility to intractable vasculitis syndrome].	1994 Aug	Sixty-four patients with Takayasu arteritis, 204 patients with rheumatoid arthritis (RA), 53 patients with systemic lupus erythematosus (SLE) and 64 patients with mixed connective tissue disease (MCTD) in the Japanese population were typed for HLA class II genes at DNA level. The results suggest that susceptibility to Takayasu arteritis is controlled by HLA-B52-DRB11502-DRB50102-DQA10103-DQB1 0601-DPA102-DPB10401 haplotype, because the frequency of that HLA haplotype was increased with statistical significance in the patients as compared with that in the healthy controls. On the other hand, the HLA-DRB10405-DQA10301-DQB10401 haplotype was associated with the susceptibility to RA. Susceptibility to SLE and MCTD are controlled by the HLA-DRB1 1501-DRB50101-DQA10102-DQB10602 haplotype and the HLA-DRB10401-DRB40101- DQA10301-DQB1*0301, haplotype respectively. These observations clearly indicate the presence of HLA-linked disease susceptibility genes to Takayasu arteritis, RA, SLE and MCTD, and the difference in HLA-linked genetic background between these four diseases.
7685623	Chromosome aberrations in tenosynovial giant cell tumors and nontumorous synovial tissue.	1993 Apr	Five tenosynovial giant cell tumors--4 pigmented villonodular synovitis (PVNS) and 1 nodular tenosynovitis (NTS)--were investigated cytogenetically. Clonal chromosome aberrations were detected in 3 of them. One PVNS had t(7;16)(q22;q24) as the sole anomaly, whereas 1 PVNS and the NTS displayed aberrations suggesting clonal evolution: t(1;19)(p11;p12)/t(1;19), +12 and ins(5;1)(q31p34)/ins(5;1),t(2;4)(p23;q21), respectively. Including our 3 cases, a total of 6 tenosynovial giant cell tumors with karyotypic changes have been reported. Apart from 2 PVNS with trisomies 5 and 7, and 2 NTS with rearrangement of chromosome band 1p13, no recurrent chromosome change has been detected. Although the detection of clonal, acquired chromosome abnormalities has formerly generally been accepted as sufficient to conclude that a lesion is neoplastic, the interpretation of the pathogenetic significance of the karyotypic aberrations in synovial tumors is obscured by the fact that we have also detected comparable aberrations in obviously nonneoplastic synovial tissue. One of 2 lesions from patients with hemorrhagic synovitis carried a clonal del(13)(q12q21), and 2 of 4 synovectomy samples from patients with rheumatoid arthritis displayed -Y and -Y together with +7. The available cytogenetic data therefore cannot be used to resolve the controversy as to whether tenosynovial giant cell tumors are truly neoplastic or only reactive, inflammatory proliferations.
7880350	Posterior portals for arthroscopic surgery of the knee.	1994 Dec	Posterolateral and posteromedial portals are necessary for certain arthroscopic procedures of the knee. Many surgeons hesitate to use portals. A cadaveric study was performed to identify the structures at risk in establishing these portals. These include the saphenous vein and nerve, popliteal vessels, lateral superior and inferior genicular arteries, and peroneal nerve. Two basic techniques can be used to visualize the posterior compartments--from the same side or diagonally across the intracondylar notch. A clinical review of 179 patients in which posterior portals were used showed no serious complications. In three cases there was residual numbness in the distribution of the saphenous nerve and in two cases the saphenous vein was punctured. In three cases, the posterior compartments could not be safely visualized. In 87 cases the posterior compartment was visualized from the ipsilateral side; in the remaining 92 cases we used the contralateral technique placing the arthroscope diagonally across the intracondylar notch.
8597246	Abnormalities in the glycosylation of IgG and its clinical utility.	1995	It is approximately ten years since the first detailed analysis of the variation in oligosaccharide structures attached to human serum IgG was published [1]. This study also showed that the percentage incidence of agalactosyl structures on the bi-antennary oligosaccharide complex linked to the Fc region, was increased in patients with rheumatoid arthritis. An earlier study [2], published in abstract from only, had also suggested that this was the case but was never followed up. In this review the considerable amount of work that has explored the clinical relevance of abnormalities in the glycosylation of IgG is analysed critically.
1523692	Cell surface antigens expressed on polymorphonuclear cells in the peripheral blood from pa	1992 May	Cell surface antigens, such as CR3, Fc gamma RIII, cALLa and Leu 8 antigen, expressed on polymorphonuclear cells (PMN) in the peripheral blood (PB) are associated with certain functions of PMN. Functional alterations of PMN have been reported in some rheumatic diseases. In this study, therefore, the cell surface antigens were examined by 2-color flow-cytometry using monoclonal antibodies to clarify whether expressions of the antigens on PMN are abnormal in patients with rheumatic diseases including BehÃ§et's disease (BD), rheumatoid arthritis (RA) and SjÃ¶gren's syndrome (SS). We found that expressions of CR3 and cALLa were increased on PB-PMN from patients with BD or RA, but not from those with SS. In BD, we further determined the phagocytic activity of PMN by a flow-cytometric method using fluorescent particles. The phagocytic activity was significantly higher in BD patients than in healthy controls, and correlated slightly with the expression of CR3 on PMN in the patients. In addition, prednisolone or colchicine seemed to decrease the expression of CR3 and/or cALLa in patients. The above results indicated that PB-PMN in BD and RA, but not SS, are phenotypically activated in vivo, and the activation probably reflects several cytokines and/or other stimuli to PMN produced in the inflammatory process.
8151589	Current practices for monitoring ocular toxicity related to hydroxychloroquine (Plaquenil)	1994 Jan	OBJECTIVE: Growing interest in aggressive early management of rheumatoid arthritis (RA) with hydroxychloroquine (alone or in combination with other immunomodulating drugs) is reason to review current practices for monitoring ocular toxicity in patients who take antimalarial therapy. METHODS: We surveyed by mail all ophthalmologists and rheumatologists in the State of Indiana about their practices in this regard. RESULTS: Twenty-nine of 31 rheumatologists (94%) responded. All but one recommended ophthalmologic examinations every 6 months and 41% would leave the choice of testing procedures to the ophthalmologist. Fifty percent had discontinued hydroxychloroquine because of a patient's failure to make and/or keep an appointment with the ophthalmologist. Of 213 ophthalmologists surveyed, 150 (70%) responded. Seventy-nine percent recommended semiannual examinations. Funduscopy, visual acuity, and color vision tests were reported to be performed routinely. Eleven of 13 retina specialists (85%), but only 25% of 127 general ophthalmologists, would obtain macular photographs (p < 0.001). Forty-two percent of general ophthalmologists, compared with 8% of retina specialists, would perform computerized perimetry (p < 0.001). Recognition of retinal hyperpigmentation as a classic sign was surprisingly low in both groups. Concurrent review of the medical records of 24 patients with RA or systemic lupus erythematosus showed extremely variable followup intervals for ophthalmologic examination; 7 of the 24 patients had no record of an ophthalmologic evaluation. CONCLUSION: As interest in the early, aggressive management of RA continues to grow, significant education needs to be devoted to the monitoring and diagnosis of ocular toxicity of hydroxychloroquine by both rheumatologists and ophthalmologists.
8967706	Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-do	1996 Dec 15	BACKGROUND: Therapy with low-dose corticosteroids is commonly used to treat allergic and autoimmune diseases. Long-term use of corticosteroids can lead to loss of bone mineral density and higher risk for vertebral fractures. Calcium and vitamin D3 supplementation is rational therapy for minimizing bone loss, but little evidence for its effectiveness exists. OBJECTIVE: To assess 1) the effects of supplemental calcium and vitamin D3 on bone mineral density of patients with rheumatoid arthritis and 2) the relation between the effects of this supplementation and corticosteroid use. DESIGN: 2-year randomized, double-blind, placebo-controlled trial. SETTING: University outpatient-care facility. PATIENTS: 96 patients with rheumatoid arthritis, 65 of whom were receiving treatment with corticosteroids (mean dosage, 5.6 mg/d). INTERVENTION: Calcium carbonate (1000 mg/d) and vitamin D3 (500 IU/d) or placebo. MEASUREMENTS: Bone mineral densities of the lumbar spine and femur were determined annually. RESULTS: Patients receiving prednisone therapy who were given placebo lost bone mineral density in the lumbar spine and trochanter at a rate of 2.0% and 0.9% per year, respectively. Patients receiving prednisone therapy who were given calcium and vitamin D3 gained bone mineral density in the lumbar spine and trochanter at a rate of 0.72% (P = 0.005) and 0.85% (P = 0.024) per year, respectively. In patients receiving prednisone therapy, bone mineral densities of the femoral neck and the Ward triangle did not increase significantly with calcium and vitamin D3. Calcium and vitamin D3 did not improve bone mineral density at any site in patients who were not receiving corticosteroids. CONCLUSION: Calcium and vitamin D3 prevented loss of bone mineral density in the lumbar spine and trochanter in patients with rheumatoid arthritis who were treated with low-dose corticosteroids.
7924633	Altered circadian rhythms of natural killer (NK) cell activity in patients with autoimmune	1994 Jan	Natural Killer (NK) cells are a lymphocyte subset actively involved in cytotoxicity against tumor-transformed and virus-infected cells; they are a reliable model for the study of neuroendocrine-immune interactions. In previous works we demonstrated that in healthy subjects NK activity of peripheral blood mononuclear cells (PBMC) and susceptibility to endogenous modifiers display statistically validated circadian rhythms. In rheumatoid arthritis (RA) and in other autoimmune rheumatic diseases abnormalities of the circadian rhythm of serum cortisol and altered levels of NK cell activity have been reported. We evaluated the circadian pattern of NK cell activity in 7 hospitalized patients with autoimmune rheumatic diseases (4 RA, 1 scleroderma, 2 mixed connective tissue disease). Temporal variations of in vitro responses to either positive recombinant (immune interferon, r IFN-gamma IFN-gamma: 650 IU/ml; recombinant interleukin-2, r IL-2 IL-2: 100 IU/ml) or negative (cortisol: 10(-6) M) modifiers were also studied. Blood was drawn at 4h intervals for 24 h, starting at 0800. PBMC preparations were immediately separated and incubated for 20h in the presence or absence of modifiers. NK activity was assessed with a direct non-radiometric 4h cytolytic assay, using K 562 cells as targets. Significant circadian variations of spontaneous NK activity were documented only in women with RA, with a peak in the evening hours and a minimum in the night or in the early morning (p < 0.05, PR 51.5%, phi 1829). Population-mean cosinor analysis did not yield detection of significant circadian variations of in vitro responsiveness to modifiers.(ABSTRACT TRUNCATED AT 250 WORDS)
7923963	Combined treatment with cyclophosphamide and prednisolone can induce remission of nephroti	1994 Jul	A 67-year-old woman, who had been diagnosed with classical rheumatoid arthritis (RA), was admitted to our hospital because of massive proteinuria. Biopsy of the kidney revealed deposition of amyloid fibrils in the subepithelial and subendothelial spaces of the glomerular capillary walls. Though the treatment with prednisolone and dipyridamole against nephrotic syndrome and amyloidosis due to RA was not effective, cyclophosphamide, which was added after tapering of prednisolone, was able to induce remission of nephrotic syndrome after two years. The levels of CRP and serum amyloid A protein (SAA) returned to within the normal limits. As the impairment of renal function is thought to be due to deposition of amyloid supplied from the precursors of amyloid fibrils filtered from the general circulation in RA patients, remission of nephrotic syndrome might result from the suppression of production of SAA or removal of amyloid fibrils. Cyclophosphamide, which has the potential both to suppress disease activity in RA and to produce degradation of amyloid fibrils in glomeruli, may be useful against renal or systemic amyloidosis complicated by RA.
8076393	Natural history of psoriatic arthritis.	1994 May	Psoriatic arthritis is a distinct form of inflammatory arthritis associated with psoriasis, which exists in a number of clinical presentations. Although a large number of patients have a mild form of arthritis, there is a population who present with a very aggressive, deforming and disabling arthritis. The prognostic factors for the development of this type of arthritis are unclear as yet. Therefore, PsA may not be as benign a condition as previously thought, and the approach to its management should be similar to that for rheumatoid arthritis. Current investigations are in progress to identify the prognostic factors associated with severe disease in PsA. Until the results of these studies are available, all patients should probably be treated more aggressively, and earlier.
7905458	Gold in the dermis following chrysotherapy: histopathology and microanalysis.	1993 Oct	Paraffin-embedded sections of skin from patients with rheumatoid arthritis treated with gold who had developed skin rashes were examined by light microscopy and scanning electronmicroscopy with microanalysis. Sparse, small, brown or black granules in plump, often elongated cells in the dermis were shown to contain gold by energy dispersive X-ray microanalysis. These cells expressed some macrophage markers. The amount of gold present showed some correlation with the total gold dose. Gold was not confined to lesional skin. In one case where uninvolved skin was examined, more gold was found there than in lesional skin.
8969553	[Adverse effects of low-dose methotrexate therapy in rheumatoid arthritis].	1996 Oct	To analyze the possible adverse effects of low dose methotrexate (MTX) therapy, 276 patients with rheumatoid arthritis (RA) were examined retrospectively. One hundred and seven patients (39%) experienced 113 adverse events : 57 showed liver dysfunction, 24 gastrointestinal complaints, 13 cutaneous symptoms, 6 respiratory symptoms, and 6 malignancies. Interestingly, 3 patients developed a dry cough without infiltration nor interstitial shadow on chest X-ray. The cough was rapidly resolved by discontinuation of MTX, but it recurred in 1 patient when MTX was re-administered. This finding might suggest a close association between MTX administration and the occurrence of dry cough. Of the 6 patients with malignancies diagnosed during MTX therapy, 2 showed malignant lymphoma, 2 lung cancer, 1 breast cancer and 1 colon cancer. MTX might have an oncogenic potential in RA because the coincidence rate, especially with respect to lymphoma, was significantly higher than estimated in a normal population.
8350335	Gamma delta + T cells from patients with psoriatic and rheumatoid arthritis respond to str	1993 Jun	OBJECTIVE: To investigate cellular immune responses to streptococcal antigens in patients with psoriatic arthritis (PsA). To specifically examine responses of the gamma delta + T cell subset. METHODS: Proliferation of PsA synovial fluid lymphocytes (SFL) and peripheral blood lymphocytes (PBL) cultured with streptococcal antigen was measured using a 3H thymidine (3HTdr) uptake assay system. gamma delta + T cells from PsA PBL and SFL were phenotyped by flow cytometry. Following culture with streptococcal antigen, gamma delta + enriched SFL were sorted by automated flow cytometry and 3HTdr uptake measured. RESULTS: Patients with PsA and the control group did not differ significantly in their PBL responses to 2 strains of streptococci, one of which was isolated from a patient with guttate psoriasis (Strep 1) and the other from a patient with rheumatic fever (Strep 2). There was also no difference in their responses to a cell wall preparation derived from the former strain. SFL from 8 of 9 patients with PsA responded to both streptococcal strains as did SFL from 3 patients with rheumatoid arthritis (RA). gamma delta + SFL from 7 patients with PsA 3 patients with RA responded only to the psoriasis associated strain. CONCLUSIONS: PsA PBL and SFL responded to stimulation by streptococcal antigen but this reactivity was not disease specific. We have demonstrated that gamma delta + T cells from PsA SF proliferated when cultured with a psoriasis associated strain of streptococcus (Strep 1). However, RA gamma delta + SFL responded similarly suggesting that gamma delta + T cell reactivity to streptococcal antigen may be a feature of inflammatory arthritis.
1361734	The development of monoclonal antibodies to the human mitochondrial 60-kd heat-shock prote	1992 Dec	OBJECTIVE: To assess the claim that the human 60-kd heat-shock protein (HSP) is highly expressed in the joints of patients with rheumatoid arthritis (RA), but is not readily detected in normal tissues. METHODS: Monoclonal antibodies were raised against the human 60-kd mitochondrial heat-shock protein (P1 protein; hsp60), and their specificity was established. They were then applied to synovial tissue. RESULTS: HSP was expressed similarly in normal, osteoarthritic, and RA synovium. Low levels of hsp60 were detected in synovial fluid by immunoprecipitation. CONCLUSION: Minor differences in the distribution of hsp60 in synovium from RA joints were attributable to increased cellularity and to the disorganization of the tissue architecture.
7612410	Biologic agents in the treatment of inflammatory rheumatic diseases.	1995 May	Due to our increasing knowledge of mechanisms underlying pathogenic events in autoimmune rheumatic diseases, biologic agents have been further explored and tested in open and controlled clinical trials. Based on the results of placebo-controlled trials, monoclonal antibodies to CD4+ T cells have been found ineffective in treating rheumatoid arthritis. However, this type of monoclonal antibody might be useful for combination therapy with monoclonal antibody, against tumor necrosis factor-alpha. The most promising data have been collected from a placebo-controlled four-center study of monoclonal anti-tumor necrosis factor-alpha antibodies in rheumatoid arthritis patients. This type of treatment was demonstrated for the first time to effectively interfere with ongoing inflammatory processes. Undoubtedly, the progress in the development of biologic agents for the therapy of inflammatory rheumatic diseases is steadily improving. Thus, for the future, even better treatment principles for this group of diseases can be expected.