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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
1556685 Arthritis as a manifestation of self-mutilation in childhood. 1992 Jan Traumatic arthritis resulting from self-aggression is rarely encountered in children. Differentiation from child abuse and common causes of childhood arthritis is difficult and rests upon a high level of suspicion. We describe a 10-year-old girl with hand deformities associated with joint pain and swelling managed as juvenile rheumatoid arthritis for 3 years. Reevaluation revealed both physical and radiographic evidence of recurrent trauma. Psychiatric assessment confirmed the diagnosis of autoaggression leading to self-mutilation and psychosocial rehabilitation was essential in successful management.
1491404 Chlamydial associated syndrome of arthritis and eye involvement in young children. 1992 Nov The current classification of juvenile rheumatoid arthritis (JRA) consists of several distinct subsets. We describe 6 children (2 boys, 4 girls, mean age 3.7 years, range 2.0-4.9 years) with arthritis and eye involvement associated with infection with Chlamydia trachomatis. In some of the children, the clinical picture was similar to early onset pauciarticular JRA: onset within the first 4 years of life, predominance of girls, pauciarticular arthritis, subacute uveitis, and presence of antinuclear antibodies. Joint involvement was pauciarticular in 4 patients and polyarticular in 2. Two patients had clinical symptoms of Reiter's disease. Further investigations of this post chlamydial associated syndrome should be performed to establish appropriate diagnostic, therapeutic and prognostic measures.
7855747 [Idiopathic arthritis of the finger joints]. 1995 Jan Degenerative arthritis of the finger joints is a very common disease in middle-aged and elderly patients, in females more frequently than in males. Concerning differential diagnosis rheumatoid arthritis and related conditions, gout, calcinosis, tumors and tumor-like lesions must be considered. Therapy is not necessary in every case. Usually treatment is required if the disease causes pains, joint instability or disabling deformity. Conservative treatment such as diet, physiotherapy, orthotics, local physical and antiphlogistic drug treatment or systemic application of non-steroid antiphlogistics should be preferred. Operative procedures such as removal of osteophytes, arthrodesis or arthroplasty are indicated if conservative treatment fails.
7748213 The arthritis knowledge questionnaire. A test for measuring patient knowledge of arthritis 1995 May OBJECTIVE: To develop a questionnaire for measuring patients' knowledge about arthritis and its self-management. METHODS: An initial item pool of 175 multiple-choice questions was developed, based on the Stanford Arthritis Self-Management Program and on basic medical knowledge about arthritis and its management. A rheumatologist, psychologist, physiotherapist, and several lay individuals assessed the questions for content validity, breadth of coverage, and face validity. Patients assessed the questions for comprehensibility. Four subject groups with varying knowledge levels were recruited to answer the entire set of questions. Item analysis was undertaken to develop parallel forms of subtests so that repeated assessments could be undertaken. RESULTS: The final instrument, the Arthritis Knowledge Questionnaire, consists of 2 tests, each comprising 3 subtests: self-management (15 items), arthritis in general (15 items), and rheumatoid arthritis (11 items). CONCLUSION: We present psychometric evidence that these parallel forms provide highly reliable and valid estimates of knowledge concerning arthritis and arthritis self-management.
8730141 Rheumatoid papules in a patient with acquired immune deficiency syndrome and symmetric pol 1996 Apr We describe a patient with acquired immunodeficiency syndrome (AIDS) and an unusual rheumatoid factor-positive symmetric inflammatory polyarthritis who met all 7 American College of Rheumatology criteria for RA, but who also had many features suggestive of seronegative inflammatory arthritis. Although cutaneous vasculitis has also been described in human immunodeficiency virus infection, this is the first report of cutaneous extravascular necrobiotic granuloma (rheumatoid papule) in AIDS. This case highlights the immunopathogenesis of inflammatory arthritis in AIDS and illustrates the difficulties in making a classic rheumatic diagnosis in the setting of the immune dysregulation caused by AIDS.
8068514 Viral infection including HIV and AIDS. 1994 Jul Viruses have long been considered candidates for infectious etiologic agents or cofactors in the development of rheumatic diseases. The current epidemic of HIV infection and the recognition of "emerging viruses" has focused interest on the possible role of viruses in pathogenesis of diseases without defined etiology. Over the past year, the role of parvovirus B19 in chronic arthropathy was further defined. Additional data added to our understanding of the mechanisms by which rubella virus may cause chronic arthritis. We were reminded of the potential the togaviruses have to cause epidemics of febrile arthritis. The developing story of hepatitis C virus in essential mixed cryoglobulinemia encourages us to explore strategies for specific antiviral therapies. The members of the herpesvirus family came under scrutiny for their role in Sjögren's syndrome. The retroviruses continue to attract attention because of rheumatic disease syndromes in AIDS patients and the suggestion that still undefined retroviruses may play an etiologic role in rheumatoid arthritis. This review highlights efforts made in the past year to elucidate the role of viral infection in rheumatologic disease.
8016124 Agalactosyl glycoforms of IgG autoantibodies are pathogenic. 1994 Jun 21 The glycosylation of IgG results in many different glycoforms. A large body of correlative data (including remission of arthritis during pregnancy) has suggested that IgG molecules lacking galactose were associated with rheumatoid arthritis. We now demonstrate that agalactosyl IgG glycoforms are directly associated with pathogenicity in murine collagen-induced arthritis. We show that passive transfer of an acute synovitis in T-cell-primed mice can be enhanced by using IgG containing autoantibodies to type II collagen when the antibodies are present as the agalactosyl glycoform. Thus, nonpathogenic doses of autoantibodies can be made pathogenic by altering their glycosylation state.
7523746 [Interferon and diseases]. 1994 Aug Interferon (IFN) is part of the body's natural defense system. IFN production is a cellular response to the foreign constituents of microbes, tumors and antigens. The three types (alpha, beta and gamma) of IFN proteins differ both structurally and antigenically and have molecular weights ranging from 16,000-25,000 daltons. The IFN proteins induce antiviral, antimicrobial, antitumor, and immunomodulatory actions. We reviewed the recent studies on the relation between IFN and diseases concerning; 1) the IFN-alpha and -gamma producing capacity in patients with cancers, liver cirrhosis, diabetes mellitus and rheumatoid arthritis, 2) endogenous IFN in sera and exudates or extracts of local lesions obtained from patients with immunological diseases such as SLE, sarcoidosis, rheumatoid arthritis, Behçet's disease, and psoriasis, 3) deletion of IFN-alpha and -beta genes in human lymphoblastoid cells lines and leukemia, and 4) the expression of IFN and other cytokine (interleukins and TNF) mRNA in normal organs under physiological conditions. Although IFNs may play an important role in cancers and immunological diseases, it is necessary to consider the interactions between IFNs and other cytokines as IFN is one of the factors involved in the cytokine network in vivo.
1403582 Phospholipase A2 in rat gingival tissue. 1992 Sep Phospholipase A2 (PLA2) is a proinflammatory enzyme in the synovial fluids of all--and sera of some--patients with rheumatoid arthritis. Due to the similarities in pathogenesis between rheumatoid arthritis and periodontitis, we sought to study the enzymatic properties of PLA2 in periodontal tissue. In this study, we demonstrated PLA2 activity in rat gingival tissue, about 80% of which was present in the cytosolic fraction. We characterized the cytosolic PLA2 enzyme with respect to substrate specificity, sensitivity to detergent, Ca2+ ion dependency and optimum pH. We found that phosphatidylethanolamine, rather than phosphatidylcholine, was the preferred substrate, the Ca2+ ion was essential for the expression of PLA2 activity, the enzyme was active over a broad pH range, with the optimum at pH 9.0, and sodium-deoxycholate inhibited the enzyme activity strongly in a concentration-dependent manner. These results are consistent with those which have been obtained with synovial fluid PLA2 and suggest that gingival PLA2 may be involved in the pathogenic processes of gingivitis and periodontitis.
8796975 Disease-modifying antirheumatic drugs, including methotrexate, gold, sulfasalazine, antima 1996 May The class of agents known as disease-modifying antirheumatic drugs remains the predominant treatment for rheumatoid arthritis. Methotrexate has again demonstrated efficacy in long-term studies, and more reports on its pharmacokinetics and possible mechanism of action have been published. Renal impairment has been highlighted again as a major risk factor for methotrexate toxicity, and studies have supported the American College of Rheumatology guidelines concerning elevated transaminases as a warning sign for liver toxicity. Although questions about the long-term efficacy of gold have again been raised, some interesting reports have focused on its mechanism of action. The sulfasalazine literature includes reports on possible immunomodulatory roles for the drug in the gastrointestinal tract. The usefulness of hydroxychloroquine has been confirmed in a large study of early rheumatoid arthritis. The minimal effective dose of D-penicillamine has been questioned in a clinical study. Combination therapy using existing disease-modifying antirheumatic drugs has not demonstrated major benefits over single-drug therapy.
8019399 Immunomodulation by interleukin-2 receptor targeted therapy. 1994 Mar The interleukin-2 receptor (IL-2R) is expressed on proliferating T-lymphocytes following antigen stimulation. Activated IL-2R bearing lymphocytes accumulate as cellular infiltrates in autoimmune thyroiditis, insulin-dependent diabetes mellitus, rheumatoid arthritis and graft rejection. Affected cells in Hodgkin's disease, hairy cell leukaemia, non-Hodgkin's lymphoma, cutaneous T-cell lymphoma and lymphoid blast crises of chronic myeloid leukaemia also express IL-2R. Anti-IL-2R monoclonal antibodies or chimeric IL-2R toxins provide a way of selective elimination of such cells. These have been used in experimental models of autoimmunity and transplantation with beneficial results, providing a novel way of selective immunosuppression. In open uncontrolled trials, chimeric IL-2R toxin was found to be safe and effective in patients with refractory rheumatoid arthritis, insulin-dependent diabetes mellitus and IL-2R bearing leukaemias and lymphomas.
18475455 Mechanism of action of 5-arninosalicylic acid. 1992 5-Aminosalicylic Acid (5-ASA) has been used for over 50 years in the treatment of inflammatory bowel disease in the pro-drug form sulphasalazine (SASP). SASP is also used to treat rheumatoid arthritis. However whether the therapeutic properties of SASP are due to the intact molecule, the 5-ASA or sulphapyridine components is unknown. Several mechanisms of action have been proposed for 5-ASA and SASP including interference in the metabolism of arachidonic acid to prostaglandins and leukotrienes, scavenging,of reactive oxygen species, effects on leucocyte function and production of cytokines. However, it is unlikely that the anti-inflammatory properties of SASP and 5-ASA are due to several different properties but more likely that a single property of 5-ASA explains the theraapeutic effects of 5-ASA and SASP. Reactive oxygen species (ROS) are involved in the metabolism of prostaglandins and leukotrienes and can act as second messengers, and so the scavenging of ROS may be the single mechanism of action of 5-ASA that gives rise to its antiinflammatory effects in both inflammatory bowel disease and rheumatoid arthritis.
8102807 Class I associations and frequencies of class II HLA-DRB alleles by RFLP analysis in child 1993 A total of 94 patients with juvenile chronic arthritis (JCA) was tested for HLA class I by serology and for class II by RFLP typing. Early onset JCA (EOPA) is associated with HLA-A2, DR5 and DR8 in both males and females. The combination (joint occurrence) of these JCA associated alleles (A2, DR5, DR8) is frequently seen in patients with chronic iridocyclitis. Late onset pauciarticular disease has an increased frequency of HLA-B27, especially in males. Our data confirm that polyarticular JCA with early childhood onset (< or = 4 years) is associated with DR5 and DR8 and has a different immunogenetic background from polyarticular JCA with later childhood (> 4 years) onset (associated with DR4).
8597241 Lectin-carbohydrate interactions in disease. T-cell recognition of IgA and IgD; mannose bi 1995 Two disease associated lectin-carbohydrate interactions have been studied. (1) A T-cell surface lectin which binds IgA1 and IgD is expressed on CD4+ and CD8+ T-lymphocytes in a number of diseases including systemic lupus erythematosus, rheumatoid arthritis (RA), Behcet's disease and IgA nephropathy. We have demonstrated that calcium independent binding to this receptor is mediated by the O-linked disaccharide Gal beta 3GalNAc which is associated with the hinge regions of both IgA1 and IgD. (2) In rheumatoid arthritis the proportion of IgG0 glycoform populations lacking terminal galactose increases. We have shown that terminal GlcNAc residues on oligosaccharides in the Fc region of IgG0 can bind to the C-type lectin, serum mannose binding protein, and thus activate the classical complement pathway. This provides a mechanism of activation of the complement system not available to the other classes of IgG glycoforms.
8099805 Disease-modifying antirheumatic drugs, including methotrexate, sulfasalazine, gold, antima 1993 May Rheumatoid arthritis is a progressive inflammatory disease with evidence of early cartilage damage. Consequently, there is a trend toward earlier use of disease-modifying antirheumatic drugs. This review focuses on recent data on methotrexate, sulfasalazine, gold, hydroxychloroquine, D-penicillamine, and combination therapy. Methotrexate is focused on most, reflecting the increasing popularity of this agent; studies continue to show its good clinical efficacy. Combination therapy studies have been disappointing and are still marred by short duration and low power. Sulfasalazine has a fairly rapid onset of clinical effects and modulates immune function. Gold is still the subject of new studies, with evidence that clinical experience leads to improved patient efficacy. The beneficial effect of hydroxychloroquine in mild rheumatoid arthritis has been confirmed, and information on D-penicillamine suggests an effect on oxygen radical scavenging. Clinical studies are still required to ascertain the relative efficacy of these drugs, and potential long-term adverse effects remain a source of concern.
24227287 Optimism and coping as determinants of psychosocial adjustment to rheumatoid arthritis. 1994 Jun Psychosocial adjustment in 66 patients with chronic rheumatoid arthritis, with a mean duration of 12 years with the disease, were evaluated in a prospective design, with 62% of the sample followed up 16 months later. It was predicted that dispositional optimism would predict adjustment over time and that perceived support and perceived control would be related to psychosocial adjustment at the time of concurrent measurement. At Time 1, psychosocial adjustment was associated with greater optimism and perceived support and less disability. Optimism at Time 1 was the only significant predictor of changes in adjustment at Time 2 controlling for Time 1 adjustment and Time 2 disability. It was found that optimism temporally precedes increases in psychosocial adjustment. In terms of coping strategies, wishful thinking was related to poorer social adjustment, whereas problem-focused coping was marginally related to positive adjustment. Neither coping strategy predicted adjustment across time. Optimism at Time 1 did predict problem-focused coping at Time 2. Perceived social support regarding a specific circumstance at a given point in time enables one to persist in solving a task. Interventions to enhance the quality of life of individuals coping with progressive deteriorative disease must look at the influence of their behavior and attitude on those who provide care for them.
8443258 Gender, depression, and ankylosing spondylitis. 1993 Mar Depression has been established as a common reaction to rheumatoid arthritis but has rarely been investigated among people with other forms of arthritis. The present study examined the prevalence and determinants of depressive symptoms in people with ankylosing spondylitis, focusing on gender differences and set in the context of widely held medical views concerning the psychosocial nature of ankylosing spondylitis patients. Results showed that approximately one third of the ankylosing spondylitis patients reported a high level of depressive symptoms and that women reported more depression than men. No evidence was found to support the stereotype of the "typical" ankylosing spondylitis patient as being less depressed than people with other forms of arthritis. Pain was found to be a major determinant of depression for women, but was of lesser importance for men. The implications of these findings are discussed.
8431834 Joint diseases associated with aging. 1993 Jan A realistic assessment of the nature, severity, and prognosis of arthritic disorders, appropriate patient education, allaying unrealistic patient fears and minimizing realistic ones, and maintaining the patient's functional independence should be prime considerations in the management of the older patient. Appropriate management of arthritic disorders will alleviate pain, increase functional capacities, and prolong independence. This article considers the diagnosis, presentation, and treatment of specific joint disorders found in the older population, including osteoarthritis, rheumatoid arthritis, gout, and other frequently seen rheumatic disorders.
8826678 Current status of metacarpophalangeal arthroplasty and basilar joint arthroplasty of the t 1996 Jul MP joint arthroplasty finds its widest application in the patient with rheumatoid arthritis. With only minor design modification over the years, the Silastic MP joint space is a predictable, durable device with reasonable longevity. In contrast, reconstruction of the CMC joint of the thumb relies primarily on soft tissue reconstruction with arthroplasty techniques having limited applications.
7747116 The joint, a redox sensitive microenvironment?--an hypothesis. 1995 Antioxidant depletion in a normal adult increases the risk of developing rheumatoid arthritis (1). We discuss how redox processes "control" the inflammatory reaction and suggest that the synovium is a peculiarly "redox-sensitive" microenvironment. This discussion will be illustrated by a zonal model of tissue injury to represent the diseased synovium.