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ID PMID Title PublicationDate abstract
8432515 Association of Sjögren's syndrome with pulmonary hypertension: report of two cases and re 1993 Feb We report two autopsy cases of Sjögren's syndrome associated with pulmonary hypertension. The pulmonary muscular arteries of both cases showed concentric fibrocellular intimal proliferation, medial hypertrophy, and plexiform lesions. To determine the significance and pathogenesis of this rare association, we carried out morphometric and immunofluorescent studies and reviewed the seven similar cases reported in the literature. Depositions of immunoglobulin G, Clq, C3c, C4, and C5 were observed in the pulmonary arterial walls of both of our cases. Morphometric studies revealed increased medial thickness to radius ratios and intimal thickness to radius ratios of the pulmonary muscular arteries in both cases. Previously reported patients were all female, and those cases were frequently associated with Raynaud's phenomenon. This report provides additional and convincing evidence for an association of Sjögren's syndrome and plexogenic pulmonary hypertension based on a detailed study of two cases and a review of the literature. The significance and pathogenesis of this association were examined, but not clarified. However, our studies add to the accumulating data suggesting a link between autoimmune diseases and chronic pulmonary hypertension.
8422560 A preliminary study on the interferon-alpha treatment for xerostomia of Sjögren's syndrom 1993 Jan We studied the therapeutic effect of interferon-alpha on the xerostomia of Sjögren's syndrome by injecting 1 x 10(6) units of interferon-alpha intramuscularly once weekly. Saliva production was quantitated by the Saxon test. Variation of saliva production measured at monthly intervals during the 3-month period prior to administration of interferon-alpha was within +/- 0.30 g/2 min. After administration of interferon-alpha, saliva production increased to greater than 0.30 g/2 min in six patients, and the increase was statistically significant by the paired t-test (P = 0.002). The result suggests a beneficial effect of this agent in increasing the saliva production of patients with primary Sjögren's syndrome.
7846772 [Use of rheumatoid factor IgM analysis. A questionnaire study among the users]. 1995 Jan 16 The aim of this study was to describe who orders the rheumatoid factor analysis (RF-IgM) and the clinical indication compared to the result of the analysis. All analyses over a one month period were registered. The doctor who had ordered the analysis was contacted in order to answer a questionnaire asking about the clinical symptoms, results of other analyses and whether this analysis were the first or more. Four hundred and sixty-seven analyses were registered (population: about 300,000), 21% with a positive ELISA result (cut-off: 6 IU/ml). Thirty-one percent of the patients had clinical symptoms associated with rheumatoid arthritis. Sixty-seven percent of the analyses were ordered by the general practitioner. If we changed the cut-off to 15 or 20 IU/ml only 14 or 12 analyses were registered as having a positive result. We conclude that the analysis is often used for case-finding, perhaps the frequency could be reduced if the analysis were used more specifically and that the doctor who receives the answer has to be aware of the influence of the cut-off used by the local laboratory.
7868378 Susceptible and protective major histocompatibility complex class II alleles in early-onse 1994 Nov Oligonucleotide typing for alleles of the MHC loci DRB1, DQA1, and DQB1 was performed in 160 patients suffering from EOPA, JCA (or JRA = juvenile rheumatoid arthritis). Allele and haplotype frequencies of the patients were compared with the data of an unrelated healthy control group consisting of 200 individuals. Analysis of frequencies shows that HLA alleles are associated not only with susceptibility to EOPA-JCA but also with protection from the disease. The presence of protection connected with certain HLA alleles was assessed using a calculation which takes into account the condition that if one allele is increased, all other alleles of the same locus must be decreased in compensation. Protection can be assumed only in cases where a given allele has an observed frequency which is significantly beyond the expected compensatory decrease. Thus a hierarchy of associations was observed in EOPA-JCA patients. The alleles of the haplotypes DRB1*11 (12)-DQA1*0501-DQB1*0301 as well as DRB1*08-DQA1*0401-DQB1*0402 were found to be associated with susceptibility to disease, whereas the alleles DRB1*07 and DQA1*0201 converge with significant protection from the disease. Whereas the association with disease susceptibility seems to depend on a sequence motif encoded in certain DQA1 alleles, protection is associated either with alleles of DRB1 or DQA1.
8591654 Innovative treatment approaches for rheumatoid arthritis. Non-surgical synovectomy. 1995 Nov Rheumatoid patients with intractable knee effusions may benefit from medical or radio-isotopic synoviorthesis. These offer more convenient, less costly alternatives to surgery with similar long-term outcome. Temporary symptomatic relief may be obtained, but disease progression is unaffected. Potential adverse effects include development of osteoarthrosis with osmic acid and teratogenicity and mutagenicity with alkylating agents and radioisotopes.
8071744 Prevalence of circulating immune complexes in patients with cystic fibrosis and arthritis. 1994 Sep We report the clinical and laboratory characteristics of eight patients with cystic fibrosis (CF) and arthropathy. Five patients had frequently relapsing, episodic arthritis; one had chronic arthritis with high titers of rheumatoid factors that could not be distinguished from juvenile chronic arthritis. In two patients the arthropathy did not relapse. Forty-six patients with CF but without arthropathy, seen during the same 1-year period, served as control subjects. Results of lung function tests and sputum cultures were similar in both groups. The sera of six of the eight patients with CF-arthropathy had high levels of circulating immune complexes, measured both by C1q-binding and the indirect granulocyte phagocytosis test, whereas only 1 of 12 control patients tested had positive C1q binding (p < 0.023). Serum complement levels were normal in both groups. Synovial biopsies, performed in three patients, showed only scanty lymphocytic infiltrates; immunofluorescent staining showed deposits of IgM, IgG, and components of complement C1q, C3, and C4. These findings suggest that the arthropathy found in CF is an immune-mediated phenomenon.
8306498 Amelioration of established murine collagen-induced arthritis with anti-IL-1 treatment. 1994 Feb Inflammatory cytokines have been implicated in the pathogenesis of rheumatoid arthritis. To validate a key role for IL-1 in arthritic processes we have studied the protective effect of neutralizing antimurine IL-1 antibodies in the murine collagen-induced arthritis (CIA) model. Combination of anti-IL-1 alpha and anti-IL-1 beta given before onset of arthritis was shown to prevent disease completely. Remarkably, a single treatment was also highly effective in the established phase of arthritis, reducing both inflammation as well as cartilage destruction. Suppression was most pronounced with the combination, but anti-IL-1 beta alone also induced significant relief. Finally, we studied the protective effect of IL-1 neutralization on cartilage metabolism in a unilateral expression model of collagen arthritis. To this end zymosan was injected in one knee joint before onset of disease, resulting in accelerated expression in that particular joint and the draining paw. Anti-IL-1 treatment started after accelerated expression of arthritis was able to fully normalize chondrocyte synthetic function, which was highly suppressed in the control group. It is concluded that IL-1 is an important determinant in both inflammation and cartilage destruction in collagen arthritis, and this may have implications for therapy in human arthritis.
1559765 Antibodies to a 15 kD nuclear antigen in patients with juvenile chronic arthritis and uvei 1992 Apr Young girls with a pauciarticular onset of juvenile chronic arthritis and circulating antinuclear antibodies are at risk for chronic uveitis. The actual nuclear antigen for these antinuclear antibodies has not been defined. Conventional laboratory techniques, such as counter immunoelectrophoresis, have shown that antibodies to well defined "extractable nuclear antigens" (eg, RNP, Sm, SS-A, and SS-B) are not present in patients with juvenile chronic arthritis. Therefore, other, previously unknown nuclear antigens may be involved. Sera of 64 patients with juvenile chronic arthritis, including 22 patients with chronic anterior uveitis, were studied using the immunoblotting technique to characterize the nuclear antigens. Antinuclear antibodies were present in 12 (55%) of the 22 patients with uveitis, and only in six (14%) of the 42 patients without chronic anterior uveitis. With the immunoblotting technique, antibodies to a 15 kD nuclear antigen were found in 10 (45%) of the 22 patients with chronic anterior uveitis, whereas only two (5%) of the 42 patients without chronic anterior uveitis showed these antibodies (P less than 0.001). Only clearly visible and reproducible lines in the immunoblotting patterns were studied. This may provide a diagnostic tool for the early detection of uveitis and means for further pathogenetic studies.
7793099 [Change in phospholipid composition of synovial fluid in children with various types of ar 1995 Mar Phospholipid composition of synovial fluid was studied in patients with reactive, rheumatoid and juvenile chronic forms of arthritis as compared with that of normal synovial fluid. The most pronounced alterations of the synovial fluid phospholipid composition (additional phospholipid fractions, increase in content of lyso-derivatives) were found in the patients with rheumatoid and juvenile chronic arthritis, which appear to occur due to activation of endogenous phospholipases A2, C and lysophospholipase A1.
19077981 Effects of Second-line Drugs on the Progression or Regression of Rheumatoid Nodules. 1995 Aug Second-line drugs may have different effects on nodules than on synovitis. In this study, we have begun to evaluate the effects of these agents on rheumatoid nodules. The appearance, progression, or regression of rheumatoid nodules were studied in an open series of 119 patients with rheumatoid arthritis (RA) seen at an academic center over the last 20 years. Fifty-six of these patients had nodules during a mean period of observation of 5.4 years. During this time, 1-5 second-line drugs were taken. Our population had a higher prevalence of nodules (47%) than did patients in most previously reported series. New nodule formation and nodule progression were most often associated with methotrexate (n = 21, 68%) but were also noted during use of gold salts (n = 6, 18%) and hydroxychloroquine (n = 3, 8%). Nodule regression and even complete resolution of nodules was most often observed with hydroxycholoroquine (n = 14, 36%) and with sulfasazine (n = 6, 32%) and injectable gold (n = 5, 14%). Changes in nodules occurred without consistent relation to synovitis. Second-line drugs that may modify the articular aspects of RA may exert varying effects on nodules. These very different effects, if confirmed, suggest important differences in drug mechanisms of action on this basic manifestation of RA.
1347987 Sulphasalazine induced hepatitis in juvenile rheumatoid arthritis. 1992 Feb Two 19 year old patients with juvenile chronic arthritis developed liver toxicity during treatment with sulphasalazine. A significant increase in the levels of liver enzymes in serum samples was noticed in relation to the initiation of treatment in one patient and to the increase in dose in the second. The enzymes returned to normal levels 14 days after the drug had been stopped. A rechallenge in one of the patients caused re-exacerbation. This is the first report of liver toxicity induced by sulphasalazine in juvenile chronic arthritis. As spontaneous liver involvement in juvenile chronic arthritis is not rare, the possibility of drug induced hepatitis should be recognised in these patients.
8936893 A social support intervention for parents of children with juvenile rheumatoid arthritis: 1996 Oct Evaluated a 15-month social support intervention for mothers of children with JRA. Five mentors (mothers of young adults who have had JRA since childhood) were linked to mothers of children with JRA ages 2 to 11 for purposes of enhancing specific types of social support and overall mental health. The total number of reported mental health symptoms decreased in the experimental group and remained the same in the control group. The experimental group showed greater improvement on all indices of support relative to the control group. Trends in the data consistently favored the experimental group, but differences between the experimental and control group were statistically significant on few of the outcome measures. Results provide tentative evidence for positive effects of mentoring interventions for this population of parents.
7694452 Efficacy and possible mechanisms of the Chinese herbs suching-huo-hsuei-tang in the treatm 1993 The Chinese herbal formula suching-huo-hsuei-tang (SHT) was studied to evaluate its efficacy and possible mechanism on adjuvant-induced arthritis (AIA) in rats. SHT was extracted with water, butanol and chloroform into 5 different layers. The top 3 layers of SHT showed a significant suppression of AIA and writhing reaction; the top 2 layers suppressed neutrophil chemotaxis and platelet aggregation. The results suggest that SHT is very promising in the treatment of rheumatoid arthritis (RA) by way of its anti-inflammatory and analgesic action. The possible mechanisms for arthritis are multifactorial.
1457492 Do self-reported arthritis symptom (RADAR) and health status (AIMS2) data provide duplicat 1992 Sep This study assessed whether self-report measures of symptoms and functional health status provide unique outcome information, or whether functional status assessments primarily serve as a proxy for self-reported arthritis symptoms. Symptom scores of 138 individuals with rheumatoid arthritis (RA) collected with the Rapid Assessment of Disease Activity in Rheumatology (RADAR) measure were compared with same-day functional health scores collected with the recently revised Arthritis Impact Measurement Scales (AIMS2). Correlational and factor analyses revealed that self-assessed arthritis symptoms, physical function and work impact, psychological status, and social health each made independent contributions to outcome. Satisfaction with health status was shown not to be independent of symptoms, functional capacity, or psychological status. It is important to document that self-reported symptom and health status information, when collected concurrently, provides complementary rather than duplicative information.
1530910 T-cell receptor gamma-delta positive lymphocytes in synovial membrane. 1992 Jan The distribution of T-lymphocytes expressing CD3 and T-cell receptor gamma-delta (T gamma/delta) has been examined by immunocytochemistry in the synovial membrane of eight patients with inflammatory arthritis (six rheumatoid arthritis, two spondyloarthritis) and eight with non-inflammatory arthritis (four osteoarthritis, four post-traumatic arthritis). T gamma/delta cells were present in eight out of eight inflammatory arthritis synovial membranes, but in only one out of eight non-inflammatory membranes (P less than 0.005). The mean T gamma/delta percentage (of total T-cells) in inflammatory arthritis was 14% (range 7-25%). T gamma/delta cells were found mainly in the transitional area of the synovial membrane with a scattered distribution as single cells or couplets. No relation was found between the presence and percentage of T gamma/delta cells and disease duration or steroid treatment.
8617988 Rheumatoid factor idiotypic and antigenic specificity is strongly influenced by the light 1996 May 1 The aim of this study was to define the structural basis for rheumatoid factor (RF) specificity and for the expression of the RF light chain-associated Ids, 4C9 and 6B6.6, by determining the reactivity of recombined heavy and light chains of Ig derived from monoclonal B cell lines of patients with rheumatoid arthritis and of light chains with site-directed mutations. We found that expression of the 4C9 and 6B6.6 Ids resulted from use of the VkIIIa genes Humkv 328 and Vg, but only in the presence of a permissive VJ junction. Expression of the Ids was independent of heavy chain use for the Humkv328-encoded light chains, but was highly dependent on the associated heavy chain for the Vg-encoded light chains. The RF specificity of the Abs was primarily heavy chain dependent, but the light chain VJ junction was critical in determining the relative avidity of the Abs for Fc. Our study points to the critical contribution of the somatically generated VJ junction to RF autoantibody specificity and to the expression of the two RF-associated Ids studied.
7797401 Effects of cytogenin, a novel anti-arthritic agent, on type II collagen-induced arthritis 1994 The anti-arthritic effects of cytogenin (8-hydroxy-3-hydroxymethyl-6- methoxyisocoumarin) on type II collagen-induced arthritis in DBA/1J mice and adjuvant arthritis in Lewis rats were examined. Prophylactic treatment with cytogenin (30, 100 mg/kg) had a potent inhibitory effect on type II collagen-induced arthritis. Prophylactic or therapeutic treatment with cytogenin (10, 30 and 100 mg/kg) also had a potent inhibitory effect on adjuvant arthritis. In contrast to nonsteroidal anti-inflammatory drugs (NSAIDs), cytogenin (10, 30 and 100 mg/kg) had neither an anti-inflammatory effect on carrageenan-induced paw oedema in rats nor an analgesic effect on acetic acid-induced writhing in mice. These results suggest that the mode of the anti-arthritic action of cytogenin is different from that of NSAIDs and that cytogenin may become a useful drug for the treatment of rheumatoid arthritis.
7555441 Adult celiac disease is frequently associated with sacroiliitis. 1995 Sep No data are available on the presence and frequency of peripheral or central joint disease, routinely determined by bone scintigraphy with 740 MBq of [99mTc]MDP, in adult celiac disease. Bone scintigraphy was carried out to detect early acute inflammatory lesions in 22 adult celiac patients (15 females and seven males; mean age 36.72 years, range 17-63). Bone scintigraphy was positive for sacroiliitis in 14 cases (63.6%). Except in the case of one patient suffering from rheumatoid arthritis, laboratory data were normal. Our data suggest that as in other chronic intestinal diseases, celiac disease in adults, is frequently associated with central joint disease. This high incidence of sacroiliitis, the joint disease most frequently found in our patients, has not been previously reported in other series. We believe, therefore, this difference could be explained by the different methodology used for the screening of joint disease.
8165440 Group II phospholipase A2 in synovial fluid and serum in acute arthritis. 1994 Increased catalytic activity of synovial-type (group II) phospholipase A2 (syn-PLA2), has been associated with cartilage erosions in rheumatoid arthritis and osteoarthritis. The catalytic activity of phospholipase A2 and the concentration of syn-PLA2 were measured in a prospective study in synovial fluid (SF) samples from 66 patients with acute knee joint effusion. The median (range) of the concentration of syn-PLA2 in SF was 210 micrograms/l (80-1480 micrograms/l) in culture-positive septic arthritis, 460 micrograms/l (270-1040 micrograms/l) in reactive arthritis, 780 micrograms/l (120-2710 micrograms/l) in osteoarthritis and 230 micrograms/l (80-1400 micrograms/l) in traumatic joint effusions. High concentrations of syn-PLA2 are found also in SF of patients with arthritides not expected to lead to permanent destruction of cartilage.
8761799 [Use of methotrexate in spondylarthropathies. Review of the literature]. 1996 Methotrexate (MTX) is one of the most effective treatments of rheumatoid arthritis. It has also been used in other conditions such as spondylarthropathies (SPA). The literature concerning MTX in SPA was reviewed. Thus, MTX has been mainly prescribed in psoriatic arthritis and Reiter's syndrome with success for dermatological manifestations of these diseases. However, only a few controlled trials have been conducted in psoriatic arthritis and only one placebo controlled study did not demonstrate a real beneficial effect. Furthermore, it seems that MTX has no influence on the radiological outcome of psoriatic arthritis. There has been no controlled study upon the efficacy of MTX in Reiter's syndrome, ankylosing spondylitis or arthropathy associated with inflammatory bowel diseases. Such studies in SPA are required to evaluate the responding conditions, the efficacy, the side-effects, and the effective dose of MTX.