Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8624628 | Infertility may sometimes be associated with NSAID consumption. | 1996 Jan | Non-steroidal anti-inflammatory drugs are widely used in the treatment of inflammatory joint diseases. Many patients suffering from these disorders are young women during their childbearing years. We report three cases of infertility where the cause may have been NSAID-induced 'luteinized unruptured follicle' syndrome. This phenomenon is well recognized in obstetric circles, and we would like to bring it to the attention of rheumatologists since it is not documented in the rheumatological literature. | |
| 8863346 | Influence of the rheumatoid arthritis-associated shared epitope on T-cell receptor reperto | 1996 Jul | Rheumatoid arthritis is associated with several human leukocyte antigen DRB1 types that express a common five-amino acid sequence called the shared epitope. Here we show that the human leukocyte antigen DRB1 shared epitope expands naive T lymphocytes that express the same T-cell-receptor variable region-joining region combinations that are prevalent in the synovia of rheumatoid arthritis patients. Thus, the shared epitope could affect rheumatoid arthritis disease susceptibility by selecting in the premorbid state specific T-cell subsets that contribute to synovial inflammation. | |
| 1416685 | Measuring outcome of total knee replacement using quality of life indices. | 1992 Jul | A series of 26 patients was studied before and after total knee replacement to determine the change in their quality of life, expressed as a gain in Quality Adjusted Life Years (QALYs). Global health status was assessed using the Nottingham Health Profile, disability by the Harris scale, pain by the McGill Pain Questionnaire, and anxiety and depression by the Hospital Anxiety and Depression Scale. Substantial reductions were found in pain, anxiety and depression, and a significant improvement was found in mobility. These data were used to generate a 'QALY' (Quality Adjusted Life Year) comparable to the measure used by Williams (1) in his comparative evaluation of medical and surgical treatments. A gain of only 0.42 QALY was found for knee replacement, which is about one-tenth the figure given by Williams for hip replacement. The difference appears to be attributable not to differences in the success of the operations, but rather to the scope that QALY calculations give for allocating comparable patients to different quality of life states. Tighter criteria are needed if QALYs are to be used to guide resource allocation. | |
| 8771484 | Complete palmar dislocation of the lunate in rheumatoid arthritis. Avascularity without av | 1996 Jun | We report a case of complete palmar dislocation of the lunate in a rheumatoid patient. X-rays showed a normal bone structure of the lunate without sclerosis or collapse and on MRI an almost normal signal intensity was found. The lunate was removed. Histological examination showed complete necrosis of both marrow and bone cells, and tetracycline labelling showed no fluorescence. This case illustrates that neither X-ray nor magnetic resonance imaging (MRI) can detect complete bone necrosis. When X-ray or MRI changes do occur, these are indications of cellular events following some degree of spontaneous revascularization. | |
| 8836354 | Instrumentation of the patellar osteotomy in total knee arthroplasty. The relationship of | 1996 Summer | This study investigates the influence of patellar thickness in total knee arthroplasty (TKA) with routine patellar resurfacing on the rate of lateral retinacular release. A study group comprised of 121 TKAs using surgical instrumentation allowing a measured resection of the patella was compared with a control group comprised of 100 TKAs using an "eye-ball" technique for patellar resurfacing without particular attention to patellar thickness. A composite without patellar thickness equal to or slightly less than the original patella was attempted in the study group. The average thickness difference of the patella in the study group was -1.58 mm. Lateral retinacular release for patellar maltracking was performed in 12.4% of knees in the study group compared with 55% of knees in the control group. The variation in patellar thickness in this series often led to a residual bone thickness < 15 mm. No clinical problems have been observed to date. | |
| 1387122 | [Lichenoid eruptions after gold therapy. Report of two cases]. | 1992 Aug | Lichenoid eruptions appearing in two women receiving chrysotherapy (Solganal B oleosum R) a described. The morphological diagnosis, distribution of skin eruptions, histological and immunological features and monoclonal antibodies (Leu 4, Leu 2A and Leu 3A) against several cell surface markers were studied. Individual lesions were not distinguishable from idiopathic lichen planus, with some features typical for gold lichenoid eruptions: hyperpigmentation, psoriasiform eruptions, and hair loss. Histopathological and immunological examination of biopsy specimens with monoclonal antibodies generally confirms clinical impressions. The authors suggest similar pathogenetic mechanisms in the development of idiopathic lichen planus and of lichenoid eruptions after gold therapy. | |
| 7504903 | Neural mechanisms of joint pain. | 1993 Jul | Joint pain is a common symptom in various forms of arthritis. Unfortunately, the mechanisms involved in the pathogenesis of joint pain are not well understood, but probably include peripheral and central neural mechanisms. The sympathetic system appears to interact with sensory afferents under pathological conditions, and this may be mediated directly via receptors on sensory neurons, or indirectly via inflammatory mediators. Classical inflammatory mediators such as serotonin and bradykinin appear to activate some nociceptive afferents and serotonin may sensitise these afferents to non-noxious stimuli in an inflamed joint. A purely sensory function has traditionally been ascribed to sensory afferents, but unmyelinated C fibres have in addition a neurosecretory role and release peptides such as substance P which may contribute to inflammation. Lastly, central sensitisation in the spinal cord may play an important role in the pathogenesis of joint pain. Activation of N-Methyl-D-Aspartate (NMDA) receptors and the wind-up phenomenon may be involved in central sensitisation. | |
| 8779792 | [Pancytopenia and Pneumocystis carinii pneumonia associated with low dose methotrexate pul | 1996 Jun | Low-dose weekly pulse MTX therapy is effective for rheumatoid arthritis (RA) and is used for patients with RA who are unresponsive to conventional disease-modifying antirheumatic drugs (DMARDs). We used MTX to a 62-year-old man with RA who had received DMARDs for 5 years. MTX was effective for RA but after 12 weeks MTX therapy started, he complicated pancytopenia and developed Pneumocystis carinii pneumonia. We reviewed all RA patients reported in Japan and in the world from 1965, complicated with Pancytopenia (37 cases) and Pneumocystis carinii pneumonia (13 cases) after MTX therapy. Results were as following; (1) MTX should not be used with TMP-SMX. and risk factors for pancytopenia were (2) age over 60 years old (3) renal hypofunction (4) use of NSAID. | |
| 1611717 | Pathways of coagulation activation in situ in rheumatoid synovial tissue. | 1992 May | Immunohistochemical techniques were applied to rheumatoid synovium in order to detect components of coagulation and fibrinolysis pathways within these tissues. These techniques revealed an intact coagulation pathway and plasminogen activator inhibitor-2 associated with macrophage-like cells that were present throughout these tissues, especially in subsurface areas. Cell-associated thrombin generation appeared to account for conversion of abundant fibrinogen to fibrin. Occasional macrophage-like cells also stained for urokinase but tissue-type plasminogen activator and plasminogen activator inhibitor-1 were restricted to vascular endothelium. Intense synovial fibrin deposition (with the limited evidence for associated fibrinolysis) may contribute to local inflammation and explain certain clinical features of rheumatoid arthritis. These findings suggest novel treatment hypotheses for this disease. | |
| 7668905 | Persistence of parvovirus B19 in synovial fluid and bone marrow. | 1995 Jul | OBJECTIVES: To determine whether parvovirus B19 (B19) persists in rheumatoid arthritis (RA). METHODS: Polymerase chain reaction (PCR) was used to detect parvovirus B19 genome in the synovial fluid cells or peripheral blood mononuclear cells from 61 patients with early RA; bone marrow from one patient was also studied. The synovium or synovial fluid cells from 28 patients with advanced RA, and synovial fluid cell samples from 18 patients with reactive arthritis (as controls) were studied. Two separate sets of primers and probe were used. RESULTS: Parvovirus B19 specific gene sequences were detected in two patients with early arthritis fulfilling the criteria for RA. CONCLUSION: Parvovirus B19 does not play a significant role in the aetiopathogenesis of RA. However, a few cases of a disease indistinguishable from RA may be triggered by parvovirus B19 infection. | |
| 8644507 | Autoregulation of Tcr V region epitopes in autoimmune disease. | 1995 | Normal individuals possess low levels of autoantibodies specific for certain peptide defined regions of T-cell receptor (Tcr) variable regions, particularly CDR1 and Fr3. These regions are predicted to be exposed on the surface of the native molecule and, by analogy and comparison with immunoglobulins, correspond to public idiotype determinants. The anti-Tcr idiotype antibodies appear to be ubiquitous and we propose that they play a role in the regulation of T-cell function. To delineate the parameters of expression of these antibodies, we characterized anti-Tcr antibody activity in normal individuals, in those suffering from the autoimmune diseases rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), and in patients with non-autoimmune arthritis (osteoarthritis) as a disease control. There were significant increases in autoantibody levels in the autoimmune patients. There was also variation in isotype and the particular variable regions recognized. IgM autoantibodies directed against a few peptide defined determinants were elevated in RA, whereas SLE patient sera showed high levels of IgG binding to a broad spectrum of Tcr peptides. | |
| 1440081 | [Clinical usefulness of the measurement of type-II procollagen carboxypeptide (C-II propep | 1992 Oct | Type-II procollagen-C-peptide (pColl-II-C) in synovial fluids was studied in 319 patients with osteoarthritis (OA; 151), rheumatoid arthritis (RA; 141), traumatic arthritis (TA; 27) and 15 healthy volunteers using the newly developed ELISA kit. The mean levels of pColl-II-C in synovial fluids of healthy controls, OA, TA, and RA were 0.3 +/- 0.1 ng/ml, 5.9 +/- 0.3 ng/ml, 6.8 +/- 1.4 ng/ml and 1.1 +/- 0.1 ng/ml, respectively. pColl-II-C levels in synovial fluids of OA and TA were significantly higher compared to those of healthy controls and RA. It was also demonstrated that pColl-II-C levels could reflect the quantitative and qualitative change of cartilage metabolism. Therefore, the quantification of this molecule in synovial fluid could be beneficial to know the synthetic activity of type II collagen of chondrocytes, since pColl-II-C is a part of the precursor molecule of type II collagen. | |
| 7987500 | Gas chromatographic-mass spectrometric determination of ibuprofen enantiomers in human pla | 1994 Jun 17 | A relatively rapid, inexpensive, sensitive and stereospecific gas chromatographic-mass spectrometric method was developed for the quantification of S(+) and R(-)-ibuprofen in human plasma. This method uses a commercially available internal standard and has no interference from endogenous substances nor metabolites. The method involves derivatization of ibuprofen enantiomers with optically active R(-)-2,2,2-trifluoro-1-(9-anthryl)ethanol using oxalyl chloride as the coupling reagent. The subsequently formed diastereoisomers are separated by gas chromatography and analysed by mass spectrometry using selected-ion monitoring. The assay is successfully applied to a pharmacokinetic study. The simplicity, sensitivity and precision of the method make it convenient for the quantification of ibuprofen enantiomers in biological samples. | |
| 7616734 | The relation between cubital tunnel syndrome and the elbow alignment. | 1994 Dec | The authors reviewed forty-three surgically managed cases of cubital tunnel syndrome treated during the past twelve years. Surgery had been performed on thirty-one men and twelve women. Their average age was 46.8 years old. The etiology of cubital tunnel syndrome had been determined as follows: There were twenty-three cases of osteoarthritis of the elbow joint. There were four cases of isolated cubitus valgus deformity. There were three cases of isolated cubitus varus deformity. There were three cases of rheumatoid arthritis. One patient had sustained trauma to the cubital tunnel. In nine other patients there were various causes but no joint malalignment. The selection of the surgical technique for the correction of cubital tunnel syndrome was a function of the etiology of the condition. Cubital tunnel syndrome from osteoarthritis was surgically managed with a modified King technique. Ulnar neuropathy with a cubitus valgus deformity was managed with an ulnar nerve anterior transposition. Ulnar neuropathy with a cubitus varus deformity was managed with a neurolysis. The surgical outcome for cubital tunnel syndrome in patients with an angular deformity at the elbow frequently was not optimum. However, although some patients remained symptomatic, the majority of postoperative patients did obtain improved motor strength and conduction velocities. This confirmed the efficacy of surgical management regardless of the cubital tunnel syndrome etiology. | |
| 8838509 | Longterm low dose cyclosporine in patients with rheumatoid arthritis: renal function loss | 1996 Jan | OBJECTIVE: To investigate whether administration of low dose cyclosporine for 2 years induces structural changes in the kidneys of patients with rheumatoid arthritis (RA). METHODS: Renal biopsies were performed in 11 patients with RA who had been treated with cyclosporine [mean dose 3.3 mg/kg/day; mean maximum dose 4.4 (3.5-5.1) mg/kg/day; mean cumulative dose 2.8 (1.6-3.9) g/kg] [mean (range)] for a mean period of 26 (15-30) months. The renal biopsy specimens and specimens of autopsy material of 22 control patients with RA matched for age, disease duration, sex, and previous use of gold and/or D-penicillamine were scored by 2 renal pathologists according to a semiquantitative scoring system (absence of lesions to severe lesions). RESULTS: In the patients taking cyclosporine, creatinine clearance decreased from 111 ml/min before cyclosporine to 82 ml/min (-26%) after 24 months. Seven percent of the glomeruli in the renal biopsy specimens compared to 13% of glomeruli in the autopsy specimens showed obsolescence. Minimal arteriolopathy (one hyaline deposition in one arteriole) was detected in 3 biopsy specimens and in one autopsy specimen. Moderate and severe lesions were not seen. Tubular atrophy was common but mild in both the biopsy specimens (10/11 patients) and the autopsy specimens (16/22 patients). Five of 11 renal biopsy specimens and 13 of 22 autopsy specimens showed minimal to slight interstitial fibrosis. All biopsy specimens were classified as Group I (minimal lesions) according to the advisory board of nephropathologists. CONCLUSION: Longterm continuous treatment of RA with low dose cyclosporine does not result in more structural nephropathy than the disease process itself, in spite of substantial and persistent deterioration of the renal function. | |
| 1458286 | Localization of interleukin-1 alpha, type 1 interleukin-1 receptor and interleukin-1 recep | 1992 Dec | Using monoclonal antibodies and immunohistochemical techniques we have investigated the presence and distribution of interleukin-1 alpha (IL-1 alpha), type 1 IL-1 receptor (IL-1R1) and of interleukin-1 receptor antagonist (IL-1ra) in synovial tissue from 18 rheumatoid arthritis (RA) and eight osteoarthritis (OA) patients and in eight normal synovial tissue samples. IL-1 alpha and IL-1R1 were found in all of the samples examined. In RA, there were a large number of synovial cells expressing IL-1 alpha and IL-1R1, with 85 and 90% positive cells in the lining layer, 45 and 80% in the interaggregate area, and 90% of the vascular endothelial cells. In the lymphoid aggregates, 20% of the cells contained IL-1 alpha and 70% expressed IL-1R1. IL-1 alpha and IL-1R1 expressing cells showed a similar distribution in OA synovial membrane, but there was a smaller number of positive cells in the deeper area; and the staining intensity was lower. In contrast to IL-1 alpha and IL-1R1, IL-1ra was found only in 10/18 RA, 5/8 OA and 2/8 normal tissue samples. IL-1ra was detected in 35% of RA and 45% OA lining layer cells; 25% RA and 35% OA vascular endothelium; 10% RA and 15% OA interstitial cells and 30% cells in RA lymphoid aggregate. The staining intensity in both RA and OA tissues was comparably low. The presence of IL-1ra in RA and OA tissues was confirmed by Northern blot analysis for IL-1ra mRNA.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 8215627 | Renal effects of aspirin and low dose methotrexate in rheumatoid arthritis. | 1993 Aug | OBJECTIVES: The aim of this investigation was to study the glomerular and tubular effects of low doses (15 mg) of methotrexate in patients with rheumatoid arthritis with and without combined treatment with aspirin (2 g single dose). METHODS: Renal function was measured by the plasma clearance of EDTA labelled with chromium-51 (51Cr-EDTA) and mercaptoacetyltriglycine labelled with technetium-99m (99mTc-MAG-3). RESULTS: Clearance of 51Cr-EDTA was reduced from 98 (6) to 87 (5) ml/min (mean (SEM)) for patients receiving methotrexate only and further reduced to 76 (5) ml/min for patients receiving methotrexate and aspirin. This effect was reversible as 51Cr-EDTA increased to 85 (6) ml/min during continued treatment with methotrexate alone. Clearance of 99mTc-MAG-3 also decreased from 366 (18) to 315 (17) ml/min in patients receiving methotrexate alone and further to 295 (17) ml/min during treatment with aspirin and methotrexate. Continued treatment with methotrexate alone resulted in a further decrease in the 99mTc-MAG-3 clearance to 253 (17) ml/min. CONCLUSIONS: The study shows that treatment with low doses of methotrexate particularly when combined with aspirin affects glomerular and tubular function. These effects may be of clinical importance and renal function should therefore be monitored with more sensitive methods than serum creatinine as this may not reflect these changes. | |
| 1421723 | Wegener's granulomatosis in a patient with a rheumatoid arthritis. | 1992 Sep | A 38-year-old woman with rheumatoid arthritis who developed Wegener's granulomatosis is described. Wegener's granulomatosis appeared with saddle nose, perforation in her nasal septum, and granuloma in the nasal cavity. Laboratory evaluation showed a positive rheumatoid factor and circulating immune complex. Radiographic examination revealed ankylotic changes in both wrist and elbow joints. Bilateral anosmia and other disease manifestations completely responded to treatment with oral cyclophosphamide and prednisolone. | |
| 1350524 | Clonal heterogeneity of synovial fluid T lymphocytes in inflammatory synovitis. | 1992 Apr | Several studies have examined patients with rheumatoid arthritis for the presence of oligoclonal populations of synovial T lymphocytes. The results of these studies have been conflicting. In this study one patient with rheumatoid arthritis and two with other forms of inflammatory synovitis were examined by Southern blot analysis of T cell clones generated from synovial fluid by primary limiting dilution. Evidence of oligoclonality was documented only in a patient with psoriatic arthritis. The distinguishing characteristics of this patient, in addition to the diagnosis, included the fact that only one joint was involved, the synovitis in the affected joint was of recent onset, and the synovial fluid lymphocytes from which the T cells were cloned responded strongly to soluble antigens. Because of the association with the strong response to soluble antigens, synovial fluid T lymphocytes from another patient with rheumatoid arthritis were cloned in response to a crude mycobacterial antigenic mixture. Three of the seven clones examined were identical by Southern blot analysis. These observations suggest that the presence of oligoclonality is limited in patients with inflammatory arthritis. The relationship of a specific antigen-driven response within the joint to the detection of oligoclonal T cells within that joint remains to be determined. | |
| 9230950 | Restoration of metacarpophalangeal extension of the thumb in inflammatory arthritis. | 1996 Oct | Nine patients (11 cases) with inflammatory arthritis who had an early boutonnière deformity of the thumb treated by rerouting of the extensor pollicis longus tendon were reviewed. Preoperatively, all patients complained of pain, disability in activities of daily living and extensor lag of the MP joint ranging from 10 to 60 degrees. At a mean follow-up of 38 months, nine thumbs had equal active and passive MP joint extension. Two thumbs had a moderate extensor lag. Functional strength assessment demonstrated no deleterious effect of the procedure in the operated compared to the non-operated thumb. Subjectively, all patients but one were satisfied. This procedure appeared to correct or to limit the progression of the deformity. A deficit of interphalangeal extension in five patients may require a modification of the procedure to tighten the extensor pollicis longus distal to the MP joint. |