Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8864590 | Relationship between osteoporosis and arthritis and effect of corticosteroids and other dr | 1996 Jul | Patients with inflammatory arthritides such as rheumatoid arthritis develop both localized and generalized osteoporosis and have an increased risk of fracture. Bone loss can occur early and is directly related to the inflammatory process as well as to the indirect effects of arthritis on physical activity. Corticosteroid-induced osteoporosis remains a common and important problem in rheumatic disease, but controversy continues about the relative safety of "low-dose" corticosteroid therapy in regard to effects on bone, which should be weighted against the beneficial effects of controlling synovitis and minimizing functional impairment. Further studies are needed to evaluate therapies for glucocorticoid-induced osteoporosis, but prophylaxis or treatment with calcitriol, the active form of vitamin D, or the bisphosphonates shows considerable promise. | |
| 7541148 | Effect of NGF antibodies on mast cell distribution, histamine and substance P levels in th | 1995 | We have previously shown an increase in nerve growth factor (NGF) levels and in mast cell (MC) distribution in the synovium of patients affected by rheumatoid arthritis. We now report that purified NGF antibodies injected into arthritic transgenic mice carrying the human tumour necrosis factor-alpha (TNF-alpha) gene caused reduction in the number of MCs, as well as a decrease in histamine and substance P levels within the synovium. These observations suggest that NGF antibody might be useful in studying the role of these pro-inflammatory markers in joint arthritis. | |
| 7955637 | Aggressive treatment in childhood rheumatic diseases. | 1994 Sep | Much remains to be learned about the optimal therapy for children with rheumatic diseases. Current therapies remain inexact and are aimed at either the inflammatory or the immune responses of patients. There have been a few advances, for example in the treatment of children with dermatomyositis, lupus and, in particular, Kawasaki disease. Progress in the treatment of juvenile rheumatoid arthritis (JRA) and the spondylarthropathies has lagged behind, however, although methotrexate does appear to be promising in the short-term treatment of JRA. Another urgent problem which remains to be resolved is the identification of those children who will have poor outcomes and who warrant early, aggressive treatment. A number of interesting alternative therapies for adults have been proposed, but their applicability to children remains an open question. Further investigation of combined therapies with various drugs also warrants exploration. | |
| 8064722 | Methotrexate in systemic lupus erythematosus. | 1994 May | OBJECTIVE: Methotrexate (MTX) has been used successfully in the treatment of rheumatoid arthritis, psoriatic arthritis, polymyositis, and Reiter's syndrome. Our objective was to determine the effectiveness of MTX in the treatment of systemic lupus erythematosus (SLE). METHODS: We reviewed retrospectively MTX therapy in 5 patients with SLE, 3 with renal disease and 2 with arthritis. RESULTS: MTX therapy was well tolerated and effective in all 5 patients. CONCLUSION: MTX appears to be both effective and well tolerated in patients with SLE. | |
| 8428387 | A high proportion of the V delta 1+ synovial fluid gamma delta T cells in juvenile rheumat | 1993 Feb | We have previously shown that gamma delta T cells in the synovial compartment of patients with juvenile rheumatoid arthritis (JRA) express activation antigens (CD69 and HLA-DR) and that they are predominantly of the V delta 1 subset. In this study we have analysed the expression of activation antigens (CD69 and HLA-DR) and different isoforms of the leucocyte common antigen (CD45RO and CD45RA) on the V delta 1 and the V delta 2 subsets of gamma delta T cells in paired samples of synovial fluid and peripheral blood of nine patients with JRA, and in the peripheral blood of five children with idiopathic scoliosis. In the synovial fluid of children with JRA, there were significantly more V delta 1+CD69+ and V delta 2+CD69+ cells compared with the peripheral blood of the same patients. In contrast, however, in the synovial fluid the V delta 1 and the V delta 2 subsets differed with respect to the expression of the two isoforms of the leucocyte common antigen. The majority of the V delta 1+ cells expressed the high molecular weight isoform (CD45RA+) while most of the V delta 2+ cells carried the low molecular weight variant (CD45RO+) of this molecule. | |
| 8201475 | Vitamin D metabolism and bone mineralization in children with juvenile rheumatoid arthriti | 1994 Jun | OBJECTIVE: To examine bone mineralization and bone mineral content in a cross-sectional population of children with juvenile rheumatoid arthritis (JRA). METHODS: Bone mineral content was measured by single-photon absorptiometry in 44 children with JRA and 37 control children. Serum concentrations of minerals, vitamin D, parathyroid hormone, osteocalcin, bone alkaline phosphatase, and tartrate-resistant acid phosphatase, and urinary concentrations of minerals, were determined. RESULTS: Bone mineral content was decreased in children with JRA. Significantly lower concentrations of osteocalcin (7.4 +/- 3.4 vs 12.5 +/- 2.5 micrograms/L) and bone alkaline phosphatase (78.8 +/- 36.4 vs 123.0 +/- 46.0 IU/L) suggested reduced bone formation; lower levels of tartrate-resistant acid phosphatase (10.3 +/- 4.1 vs 14.4 +/- 5.8 IU/L) and a lower urinary calcium/creatinine ratio (0.07 +/- 0.06 vs 0.12 +/- 0.09) suggested decreased bone resorption. The serum calcium concentration was significantly lower (9.3 +/- 1.0 vs 10.0 +/- 0.4 mg/dl), as was the parathyroid hormone concentration (19.8 +/- 8.6 vs 26.7 +/- 9.3 ng/L); 1,25-dihydroxyvitamin D values (30.1 +/- 10.5 vs 30.4 +/- 9.3 pg/ml) were normal. CONCLUSION: These data suggest that decreased mineralization in JRA is related to low bone turnover; parathyroid hormone and 1,25-dihydroxyvitamin D levels may be inappropriately normal for the decreased serum calcium concentration in children with JRA. | |
| 8510892 | Cataract development and cataract surgery in patients with juvenile rheumatoid arthritis-a | 1993 Jun | PURPOSE: The authors used an aggressive stepladder, steroid-sparing, therapeutic algorithm in the care of patients with iridocyclitis associated with juvenile rheumatoid arthritis (JRA) to preserve vision, limit cataract formation, and improve probability of successful visual rehabilitation when cataract surgery became necessary. METHODS: The authors treated 60 patients with JRA-associated iridocyclitis with topical and regional corticosteroids, systemic nonsteroidal anti-inflammatory drugs, systemic steroids, and systemic immunosuppressive chemotherapy to achieve total quiescence of intraocular inflammation. Cataract surgery (phacoemulsification extracapsular cataract extraction) combined with pars plana vitrectomy was performed on those eyes with cataract sufficient to limit visual acuity to 20/200 or less, after maintenance of complete freedom from inflammation for at least 3 months. The incidence of cataract development and the visual outcome of cataract surgery were analyzed in those patients for whom a minimum follow-up of 1 year was available. RESULTS: Eventually, 10 of the 60 patients required systemic immunosuppressive chemotherapy in the stepladder therapeutic approach to achieve complete abolition of all active inflammation. Of 72 phakic eyes without cataract, significant cataract developed in 13 (18%) while under our care. The average postoperative stable visual acuity in this group was 20/40. Sixteen eyes of 12 additional patients had visually significant cataract at the time of our first evaluation of them. The average postoperative stable visual acuity in this group of patients after cataract surgery was 20/40. CONCLUSIONS: Iridocyclitis associated with JRA is an insidiously blinding disease, with 12% of individuals affected by this problem eventually blinded by the inflammatory consequences to the eye. A therapeutic philosophy of complete intolerance for active inflammation and limited tolerance for chronic steroid use may offer the most realistic hope for the next step in progress to prevent blindness in this patient population. The results of this study suggest that such a therapeutic attitude results in diminished cataract prevalence and decreased prevalence of vision-limiting retinal pathology, with resultant improved visual outcome of the cataract surgery which is eventually needed in a small proportion of the patients. | |
| 7993709 | Chronic arthritis in children. | 1994 Sep | Chronic inflammatory arthritides in children include a wide range of various diseases. One of the main concerns of physicians who treat these disorders is the risk of permanent physical disability resulting from joint damage. Actual classification relies mainly on clinical features, particularly the number of joints affected at onset, although the general feeling is that chronic childhood arthritis exists in many different entities gathered together under the common names juvenile chronic arthritis or juvenile rheumatoid arthritis. The past 2 years were rather fertile in debates for proposing a progression for more objectivity in nomenclature, which was the theme of the Pediatric Rheumatology Study Group session at the American College of Rheumatology annual meeting held in Atlanta in 1992. The viewpoints from North America and Europe addressed at this meeting were published in a supplement of the Journal of Rheumatology in 1993. A debate on this topic was also organized at the International League Against Rheumatism Congress held in Barcelona in 1993. At present, the main criteria rely on clinical experience and natural history of the diseases and on biology and immunogenetics. Another important concern among pediatric rheumatologists is efficacy of treatment. Questions include, "Are we doing enough?" and "How safe are the therapeutic strategies?" In this review some of the recent studies that may be important for classification and nomenclature and therapy and management are discussed. | |
| 29275743 | Nontraumatic Hip Pain in Active Children. | 1996 Jan | In brief A case report of an 8-year-old baseball player who was diagnosed with Legg-Calvè-Perthes (LCP) disease gives an opportunity to consider the many nontraumatic causes of hip pain. Possibilities include slipped capital femoral epiphysis, septic arthritis, transient synovitis, juvenile rheumatoid arthritis, and bone tumor. Radiographs and bone scans are used to document and stage LCP, and to evaluate the effectiveness of treatment. Though the aggressiveness of treatment depends on the disease stage, the treatment of choice is generally nonsurgical containment of the femoral epiphysis with a cast or orthosis. | |
| 7481895 | Juvenile spondyloarthropathies: clinical manifestations and medical imaging. | 1995 Aug | The spondyloarthropathies comprise four distinct entities--ankylosing spondylitis, psoriatic arthritis, the arthritis associated with inflammatory bowel disease, and Reiter's syndrome and other related forms of reactive arthritis. Although these are distinct diseases, they have a number of clinical, radiologic, and genetic characteristics in common which permit them to be classified under the unifying term "spondyloarthropathy". They are diseases of young adults, and when they present in patients under 16 years of age we refer to them as the "juvenile" spondyloarthropathies. They must be distinguished from juvenile rheumatoid arthritis, which is a totally separate entity; however the distinction may not always be obvious. Involvement of peripheral and sacroiliac joints commonly occurs in the juvenile spondyloarthropathies. The peripheral arthritis may be erosive and associated with bone apposition at the joint margins. Axial involvement is usually a late finding. Dactylitis and tenosynovitis are frequently present early on. Enthesitis, a highly specific feature, occurs much more often in the juvenile spondyloarthropathies than in the adult forms and it may be the only presenting feature. The plain radiograph is the primary and most important imaging modality for the assessment of these diseases. However, an expanding role of magnetic resonance imaging is evident. | |
| 7597890 | [Synovial cyst of the hip. Apropos of a case manifested by venous compression]. | 1995 | Femoral vein compression by a synovial cyst of the hip is described, and the differential diagnosis is discussed. Such a lesion may be associated with rheumatoid arthritis, idiopathic necrosis of the femoral head or acute arthritis. The various clinical patterns are reviewed. | |
| 8076398 | Psoriatic arthritis. Plain radiology and other imaging techniques. | 1994 May | The incidence of radiological change in psoriatic arthritis (PsA) is uncertain. The general pattern of the disease has been classified into five groups. This classification is still widely used, but recently a change of emphasis has been stressed in the classification and prevalence, particularly relating to the polyarthritic forms and the variability of symmetry and asymmetry. The plain film findings in the axial and appendicular skeleton are described. In the former, bulky paramarginal ossification in the thoracolumbar spine is a prominent feature; destructive as well as ankylosing disease is seen in the cervical spine. In the latter, the key features are marginal erosions associated with proliferative new bone, acro-osteolysis, preservation of bone density, periostitis and bony ankylosis. Progress of the disease is variable and, while the course is usually less severe than that in rheumatoid arthritis, progressive joint deformity occurs. Isotope scintigraphy is a useful technique for showing a general overview of joint involvement, but has limitations which impair its use in individual joints. CT is useful for looking at detailed bone anatomy and early demonstration of sacroiliitis. MRI may also be used to look at early sacroiliitis and has the potential for directly imaging the inflammatory process and the articular cartilage. Radiological differentiation of PsA from other arthritides may be difficult, particularly in the early stages, and in oligoarticular disease. The differential diagnosis is discussed. | |
| 8023588 | Immunohistochemical demonstration of calcium-dependent cysteine proteinase (calpain) in co | 1994 Mar | The mechanisms whereby destructive changes in joints develop in rheumatoid arthritis (RA) are not fully understood, but cartilage degradation is considered one of the most important factors. Calpain, a calcium-dependent cysteine proteinase that degrades a variety of substrate proteins in various tissues, may be among the proteolytic enzymes that mediate cartilage degradation associated with RA and other inflammatory arthritides. The object of this study is to ascertain immunohistochemically whether calpain is present in the inflamed joints of mice with collagen-induced arthritis (CIA), as an experimental animal model of inflammatory arthritis such as RA. Murine hindpaws with CIA were decalcified, frozen-sectioned, and stained by immunoperoxidase method (PAP) using a polyclonal antibody against calpain II. Calpain was present in the articular tissues affected by CIA: positive staining was observed in 1) proliferating synovia, and 2) surface, matrix, and chondrocyte lacunae of articular cartilage. It was postulated that calpain functions as one of the enzymes responsible for the cartilage degradation associated with CIA. | |
| 8869512 | What happens to patients awaiting arthritis surgery? | 1996 Feb | The length of orthopaedic waiting lists attracts much interest, but the needs of patients awaiting surgery gain little attention. We studied 97 patients awaiting lower-limb surgery (49 osteoarthritis, 41 rheumatoid arthritis, seven other diagnoses). Ninety had pain; 44 significant night pain. Psychological and social problems were common (44 and 45 cases respectively). Only 11 were employed full-time. Sixty-eight required help with daily activities, usually from relatives and neighbours. Forty-three patients walked less than 120 metres in 12 minutes. After review we recommended further aids in 32, medication changes in 27, and additional professional support in six cases. Clinical changes whilst on the waiting list caused alterations in the priority for surgery in 32 cases; the planned procedure was no longer appropriate in 12 of these. We suggest that patients awaiting surgery require clinical review to maintain quality of life; and that waiting lists require administrative review so that patients in need of surgery receive it as soon as possible. | |
| 27922364 | A non-vasculitic rheumatoid ulcer. | 1994 Oct 2 | An account of the care of a patient with rheumatoid arthritis whose recurring leg ulcer was found not to be caused by vasculitis. | |
| 8575144 | HLA frequencies in HLA-B27 negative patients with reactive arthritis. | 1995 Sep | The purpose of the present work was to find out whether there is an HLA type common to the patients who, in spite of being B27 negative, have developed reactive arthritis (ReA). We compared the HLA-antigens of 25 HLA-B27 negative ReA patients to those of healthy control persons. No statistically significant differences were observed in the HLA-A, B, C, DR and DQ antigen frequencies between the patients and the control group. The frequency of DR4 was slightly lower in the patients than in the controls, although this difference was not statistically significant. On the other hand, 18/25 (72%) of the B27-negative ReA patients experienced a chronic or prolonged course of the disease. These findings indicate that DR4 does not contribute to the chronicity of ReA in the same way that it is known to do in rheumatoid arthritis (RA) or Lyme arthritis. They do not support the hypothesis that some other HLA-antigen, in addition to HLA-B27, could have a predisposing or protective effect in ReA. | |
| 7617753 | A review of autoimmune disorders anecdotally linked to mammary implants. | 1995 Summer | Autoimmune disorders lead to a sequence of tissue reactions and damage that may produce diffuse, systemic signs and symptoms. Litigants in many breast implants trials have claimed their autoimmune disorders (rheumatoid arthritis, scleroderma, and SLE) were from a causal relationship with mammary implants. Science suggests environmental factors, such as vinyl chloride, and hereditary factors may account for some of the prevalence of these disorders, however the exact cause remains a mystery and brings into question the claims being brought by litigants regarding implants. | |
| 7671322 | Suppressive effect of a neutrophil elastase inhibitor on the development of collagen-induc | 1995 Oct 1 | A novel neutrophil elastase inhibitor, ONO-5046, was administered to BB/DR rats and DBA/1 mice immunized with type II collagen to study its effect on the development of collagen-induced arthritis (CA), an experimental model of human rheumatoid arthritis. ONO-5046 reduced the incidence as well as the severity of CA in both rats and mice. This suppressive effect on severity was correlated with improvement of the histological findings, particularly with reduced destruction of the articular cartilage. These results indicate that neutrophil elastase may play an important role in the pathogenesis of CA. | |
| 8429430 | Human parvovirus B19-associated arthritis in children. | 1993 Feb | Human parvovirus B19 (HPV B19) infection has been associated with chronic joint complaints in adult patients. We now report 22 children with joint complaints associated with recent HPV B19 infection. These children had either erythema infectiosum or serologic evidence of recent infection. Twenty children had arthritis; two had arthralgias. Eleven children had associated constitutional symptoms. Laboratory findings were generally normal. The duration of joint symptoms was less than 4 months in 14 children; however, six children have had persistent arthritis for 2 to 13 months, which would fulfill criteria for the diagnosis of juvenile rheumatoid arthritis. Although HPV B19 is usually associated with acute arthritis of brief duration, in some children infection with HPV B19 may be associated with the development of chronic arthritis. | |
| 1411577 | Sarcoidosis in autoimmune disease. | 1992 Aug | Sarcoidosis is a multisystem granulomatous disease of unknown etiology. Sarcoidosis coexisting with connective tissue diseases, once considered rare, complicates various such disorders, including rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis, Sjögren's syndrome, and the spondyloarthropathies. Symptoms common to sarcoidosis and autoimmune disease include keratoconjunctivitis sicca, weight loss, fever, lymphadenopathy, pulmonary complaints, and cutaneous lesions. Consequently, the diagnosis of sarcoidosis in association with connective tissue disease is often difficult and may require biopsy of the lung, liver, skin, lymph node, muscle, or bone marrow for pathological confirmation. Abnormalities of immune function as well as autoantibody production, including rheumatoid factor and antinuclear antibodies, are seen in sarcoidosis and in connective tissue diseases, suggesting a common immunopathogenic mechanism. The severity and course of sarcoidosis associated with autoimmune disease is variable. The incidence of sarcoidosis in association with rheumatic disease may be underestimated if new symptoms of sarcoidosis are attributed to the primary rheumatic disease and a secondary diagnosis is not pursued. |