Browse

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

ID PMID Title PublicationDate abstract
8408663 Cognitive coping strategies of children with chronic illness. 1993 Aug Children with chronic illness need to adapt to more stresses than do healthy children. Research highlights the problems of children with chronic illnesses but not how they cope in response to the stress created by these problems. Cognitive appraisal of a stressor and of response options is an important aspect of coping. Our cross-sectional study investigated whether children with chronic illness used cognitive strategies for coping as often as did healthy children. One hundred seventy five children from summer camps with juvenile arthritis, asthma, or diabetes were compared with 145 healthy school children. Spontaneous responses to common painful and stressful events were categorized into coping or catastrophizing ideation. Data on anxiety, disease severity, and other sociodemographic variables were obtained. Coping strategies were reported by 64% of children with chronic illness and 63% of healthy children and varied significantly with age (p < .05) in both groups. Children with different chronic illnesses performed similarly except for a trend among children with severe juvenile rheumatoid arthritis who had higher rates of coping. For the individual stressful events, the rate of coping varied from 46% to 86%. The highest rates of coping responses were found with the child's recent personal stressful event where adolescents with chronic illness were twice as likely to offer more complex coping responses. More children with chronic illness than healthy children offered coping strategies in response to venipuncture (p < .001) but not to dental injection. Children with chronic illness report coping as their predominant strategy for adapting to common painful and stressful events.(ABSTRACT TRUNCATED AT 250 WORDS)
8681020 [Malignancy in autoimmune diseases]. 1996 Feb Association between antecedent autoimmune diseases and malignancy, including lympho-proliferative disorders (LPD), has been reported in generalized autoimmune diseases such as systemic lupus erythematosus (SLE), dermatomyositis (DM) and rheumatoid arthritis (RA), and also in organ-specific autoimmune diseases such as Sjögren's syndrome (SS) and chronic thyroiditis. In this paper, LPD were summarized for DM, SLE, RA and SS, and some etiologic factors were considered. In surveying previous Japanese literature on the topic, it was revealed that LPD occur frequently in DM similar to various types of cancer. The period between the occurrence of cancer and DM is usually within 12 months, suggesting that the etiologic factor may differ between cancer and LPD in DM. Sixty one cases (20.0%) of monoclonal non-malignant LPD were observed among our 306 patients with SS. Fifteen cases (5.0%) of malignant LPD such as malignant lymphomas (13 cases) and Waldenström's macroglobulinemias (2 cases) were also seen among our SS patients. The activation of rheumatoid factor genes such as Humkv 325 and Vg was considered as one of the triggering factors to advance LPD from the benign to malignant state. A high amount of the bcl-2 protein expression was detected in lymphoepithelial lesions of salivary glands in patients with SS, suggesting that the activation of this gene plays an important role in the progression of the lesion from benign to malignant LPD. Accumulation of many genetic abnormalities including bcl-2 and p 53 genes by chronic stimulation of T and B cells at the site of the autoimmune reaction may be important in the high occurrence of LPD in patients with autoimmune diseases.
7699645 Visual prognosis in children with chronic anterior uveitis and arthritis. 1994 Dec OBJECTIVE: To determine the visual and ocular prognosis for children with uveitis and chronic arthritis and in patients with uveitis with juvenile rheumatoid arthritis (JRA) or juvenile psoriatic arthritis (JPsA) and to evaluate risk factors associated with ocular complications. METHODS: We studied 49 children with chronic arthritis having greater than 2 years ophthalmological followup from onset of uveitis. Visual acuity and ocular complications (band keratopathy, synechiae, cataracts, glaucoma, or phthisis bulbi) were documented. For the 45 patients with JRA/JPsA, the antinuclear antibody and HLA status, time and mode of onset, and the course of uveitis, were evaluated as risk factors for developing complications. RESULTS: Mean followup was 9.4 years from diagnosis of uveitis (82 affected eyes). Ocular complications developed in 27 eyes (33%). Visual impairment (corrected acuity 20/50 or worse), occurring only in the presence of complicated uveitis, was present in 12 eyes (15%). Of 45 patients with JRA/JPsA, over 95% developed uveitis within 5 years of onset of arthritis. Those with complicated uveitis (n = 13, mean followup 8.6 years) and uncomplicated uveitis (n = 32, mean followup 10 years) were compared: factors significantly associated with complicated uveitis were (1) a chronic course of uveitis (2) JPsA (3) diagnosis of uveitis prior to, or at the time of arthritis onset (4) symptomatic onset. CONCLUSION: The risk of developing uveitis 5 years after the onset of JRA/JPsA is small. Although ocular complications were common (33%) among patients with uveitis, normal vision was maintained or correctable for over half of them. Those with uveitis and risk factors for developing ocular complications may need close ophthalmological scrutiny.
7936371 [Physiology and pathology of the immune system of reproduction]. 1994 May The Authors describe in detail the complex immunological mechanisms thanks to which the maternal organism does not reject the embryo, constituting an allogenic transplant. They examine the modifications, referring to both natural and adoptive immunity, occurring in the pregnant without ignoring the important contribution the foetus itself and adnexa make to the gestation positive termination. In the second part of the paper all the pregnancy pathologies, originating from an imbalance proper to the immunity system, are considered. The following pathologies are particularly described: a) the spontaneous recurrent abortion, both primary and secondary; b) the gestosis; c) the maternal-foetal isoimmunization towards transferable antigens present on red corpuscles, white corpuscles and blood platelets. At last Authors describe all the autoimmune illnesses in pregnancy and their influence on the foetus. Such illnesses may be: a) organ-specifics (immunological thrombocytopenic purpura, thyrotoxicosis, myxedema, serious myasthenia); b) systemics (rheumatoid arthritis, lupus erythematous). The course of each pathology, its influence on the embryo and, the present therapeutic protocols are examined.
7858569 [Cytokines and anti-cytokines in inflammatory rheumatism]. 1994 Dec 15 Studies done over the last few years have demonstrated that interleukin-1 and tumor necrosis factor alpha, which are produced mainly by monocyte-macrophages, are the key mediators of inflammation and tissue destruction in rheumatoid arthritis. The synergistic effects of these factors lead to the production of large amounts of metalloproteases by the synovial cells, chondrocytes, and bone-derived cells. Direct membrane-to-membrane contact between activated lymphocytes and monocyte-macrophages is one of the main factors activating the production of interleukin-1 and tumor necrosis factor alpha. This activation involves several glycoproteins expressed at the surface of activated lymphocytes (CD11, CD69). Antibodies can partially block this lymphocyte-monocyte interaction. Recent studies have identified two mechanisms capable of inhibiting macrophage and synovial cell activation. One calls into play the antiinflammatory cytokines, such as interleukin-4 and interleukin-10, which are potent inhibitors of the production of interleukin-1, tumor necrosis factor alpha, and the metalloproteases. Interleukin-10 also activates the tissue inhibitor of metalloproteases. The second mechanism, which is more specific, involves antagonists such as the interleukin-1 receptor antagonist and inhibitory soluble fragments derived from the extramembranous portion of the two receptors for tumor necrosis factor alpha (TNF-sR55 and TNF-sR75). These molecules, which we first studied in their naturally-occurring form, have been cloned and are being tested in several conditions including rheumatoid arthritis. Similar soluble fragments of the receptors for interleukin-1 alpha and beta can inhibit interleukin-1.(ABSTRACT TRUNCATED AT 250 WORDS)
8525899 Effect of corticosteroid on lymphocyte adhesion. 1995 Pulse steroid therapy is utilised in the treatment of vasculitis and active rheumatoid arthritis. Decreased entry of lymphocytes to sites of cell-mediated immune reactions is well recognised, though the mechanism is not fully understood. It may involve adhesion to endothelium. We have therefore measured the effect of methylprednisolone on lymphocyte adhesion to porcine lamina propria endothelium. A marked decrease in adhesion was found after incubating cells at 4 degrees C or at room temperature, with a clear dose response effect, from 0.46mM to 6.3mM. We have previously demonstrated binding of rheumatoid synovial fluid mononuclear cells to lamina propria endothelium. It is suggested that the ameliorating effect of steroid pulsing may be mediated by down-regulating adhesin expression of a gut-seeking population of cells.
7836029 Intra-articular injection of somatostatin in knee osteoarthritis: clinical results and IGF 1994 Recently somatostatin (SST) intra-articular administration has been used in the treatment of some rheumatoid diseases such as rheumatoid arthritis, psoriatic arthritis and osteoarthritis with encouraging results. The aim of this study was to evaluate the efficacy and tolerability of SST intra-articularly injected, involving 20 patients with knee osteoarthritis. Treatment consisted of 4 injections, administered weekly, each of 750 mcg SST. Additionally, in six of them we evaluated the circulating levels of the insulin-like growth factor (IGF)-1 at the base-line time and then every 7 days (immediately before each dose of SST). The results revealed an improvement in pain and in joint function after intra-articular SST, confirmed by statistical analysis. The circulating levels of IGF-1 did not show significant variations following intra-articular administration of SST. The excellent tolerability and the absence of unwanted side-effects with SST allow us to foresee that intra-articular SST could be used in cases of painful knee osteoarthritis, especially in those patients in which other drugs are not appropriate. Moreover, in the absence of modifications of serum levels of IGF-1, SST could be used in athletes.
9264901 [Exfoliative conjunctival cytology in Sjögren's syndrome]. 1996 Oct The study has been performed in order to give a contribution to the knowledge of the conjunctival cytology in Sjögren's syndrome. Exfoliated cells were obtained by a tampon from the inferior conjunctival sac of 11 patients affected by primary or secondary Sjögren's syndrome; the material was placed onto a microscope slide and it was stained with May-Grumwald-Giemsa, after the ferning test had been performed. Tear production had been previously assessed in all patients by Schirmer's I test and basic secretion test that showed an evident tear fluid hyposecretion. Cytoanalysis of tear fluid showed, in all patients, a marked lymphocytosis, presence of epithelial cells (sometimes cell-adhesion) and a number of "snake-cells", with a nucleus-cytoplasm ratio in favour of cytoplasm. Some of those cells have a thicker cytoplasmic membrane and/or a spindle-shaped peripheral nucleus, characteristic finding of keratoconjunctivitis sicca. In all cases we found mucus and fibrin (sometimes with included cells), organic debris and big crystals, some of which aggregated.
8730149 Fulminant hepatic failure in adult onset Still's disease. 1996 Apr Adult onset Still's disease (AOSD) is a well characterized rheumatoid disorder with frequent liver involvement. This is usually asymptomatic but severe hepatic failure has occasionally been reported. We describe a 44-year-old woman who developed acute liver failure 2 months after presenting symptoms of AOSD. Full etiologic evaluation was done and all other causes of liver failure were excluded. She underwent emergency orthotopic liver transplantation but developed disseminated intravascular coagulation with acute renal failure, seizures, and coma, and died after 48 hours.
8531354 [Analysis of Fas and bcl-2 expression on peripheral blood lymphocytes from primary Sjögre 1995 Oct The Fas antigen is the major trigger for apoptosis. In MRL/lpr mice, defects in Fas expression lead to autoimmunity and lymphoid accumulation, same as in the Sjögren's syndrome (SS). Bcl-2 protein is able to repress a number of apoptotic death. Therefore, we examined both Fas antigen and bcl-2 expression in peripheral blood lymphocyte (PBL) from SS patients. The rate of Fas+CD4+ PBL was significantly elevated (p < 0.01) in SS patients (n = 11) compared to normal controls (n = 15). Both Fas+CD3+ and Fas+CD8+ cells from SS patients showed a tendency to increase, whereas Fas+B cell was not different between each group. The percentages of bcl-2+ lymphocytes in SS patients were no different compared to the normal control. This study suggests that the increased expression of Fas may result in enhanced susceptibility to apoptosis.
7732483 [Ataxic sensory and autonomic neuropathies associated with primary Sjögren's syndrome: a 1995 Feb A 49-year-old woman had xerostomia and foreign body sensation of eye since 27 years old. Since the age of 30 she developed occasional fever attack released by cooling body without medication. Three years later she began to complain difficulty to maintain standing position with closed eyes. Upon admission axillary lymph node swelling, anisocoria and Adie's pupils were evident. She had reddish and atrophic dry tongue. Peripheral reflexes of upper extremities were decreased. Patellar and achilles tendon reflexes were diminished. Perception of pain and temperature were reduced on the right peripheral upper and lateral lower extremities. Deep sensation of four extremities were also decreased. Romberg's sign was positive. She had ataxic gait, orthostatic hypotension, Valsarlva abnormalities and hypohidrosis. Laboratory findings revealed elevated erythrocyte sedimentation rate, high IgG and rheumatoid factor levels, leukopenia, positive anti SS-A/Ro antibody and positive minor salivary gland biopsy. Axillary skin biopsy, CT scan cerebrospinal fluid were normal. Sensory nerve conduction velocity and amplitude were decreased, but motor nerve conduction velocity was normal. Sural nerve biopsy was characterized by loss of large and small myelinated fibers. All findings found in our patient were consistent with those of thirteen patients reported by Griffin et al in 1990 who postulated that T-cell inflammation of the dorsal root ganglion was an extraglandular site of autoimmune attack in Sjögren's syndrome.
7869307 Depressive symptoms in patients with systemic lupus erythematosus: association with centra 1994 Nov OBJECTIVE: To determine if patients with systemic lupus erythematosus (SLE) with depressive symptoms differ in regard to organ involvement and serological activity from other patients with SLE. METHODS: Disease manifestations were compared between 71 patients with SLE with a history of depressive symptoms and 278 patients without a history of depressive symptoms by univariate analysis and multiple logistic regression. RESULTS: Both univariate and logistic regression analysis revealed an association of depressive symptoms with neuropsychiatric lupus and secondary Sjögren's syndrome (SS). Patients with neuropsychiatric lupus had an adjusted odds ratio of 3.43 (95% CI 2.55, 4.63; p = 0.00005), and patients with secondary SS had an adjusted odds ratio of 2.97 (95% CI 2.08, 4.25; p = 0.0006) for depressive symptoms. No other organ involvement or serological abnormality was associated with depressed mood. CONCLUSION: These discrete associations of depressive symptoms with neuropsychiatric lupus and secondary SS suggest that depression does not occur purely as a response to social stresses, and may be a manifestation of autoimmune disease in some patients.
1554600 Psoriasis, psoriatic arthritis and the possible association with Sjögren's syndrome. 1992 Mar Thirty patients with psoriatic arthropathy (PA) were age- and sex-matched with patients with plaque psoriasis alone to investigate a possible link between Sjögren's syndrome (SS) and PA. The results of clinical examination, Schirmer's test, maximal stimulated salivary flow rate, haematological and serological investigations were compared in the two groups. Median maximal stimulated salivary flow rate was significantly reduced in patients with PA suggesting that salivary glands are affected in this condition. One patient with PA had SS.
8782824 A genome scan localizes five non-MHC loci controlling collagen-induced arthritis in rats. 1996 Sep Identification of specific genetic loci that contribute to susceptibility to rheumatoid arthritis (RA) in humans has been hampered by several factors, including: i) multiple interacting genetic loci contributing to susceptibility; ii) complex interactions of environmental and genetic factors; iii) genetic heterogeneity; and iv) low penetrance. We have, therefore, mapped quantitative trait loci (QTLs) that control inflammatory arthritis susceptibility and/or severity in progeny of two inbred rat strains with significantly different susceptibilities to collagen-induced arthritis (CIA), an animal model for RA. Not surprisingly, we identified a major susceptibility factor, Cia1, on chromosome 20 in the vicinity of the rat major histocompatibility complex (MHC). However, by limiting the analysis to animals with arthritis-susceptible MHC genotypes and using genome-wide QTL analytic techniques, we also found four non-MHC QTLs-Cia2, 3, 4 and 5-on chromosomes 1, 4, 7 and 10, that contributed to disease severity. In addition, a QTL on chromosome 8 was suggestive for linkage. Characterization of the genes underlying these QTLs will facilitate the identification of key biochemical pathways regulating experimental autoimmune arthritis in rats and may provide insights into RA and other human autoimmune diseases. These genes may also represent novel targets for therapy.
8882415 T-cell receptor BV6S1 null alleles and HLA-DR1 haplotypes in polyarticular outcome juvenil 1996 Feb JRA is a complex of disease subtypes which are normally identified by clinical features such as age of onset and extent of joint involvement both at onset and during the course of the disease. We previously identified an association between TCR BV6S1 null allele and one subgroup of early-onset pauciarticular patients positive for HLA-DQA1*0101, an HLA haplotype predisposing to a polyarticular course of the disease. In this report we extend this observation by identifying an increased prevalence of this nonfunctional or null allele in the patients with a polyarticular disease course regardless of the mode of onset. This increase was most prominent in clinical subsets that have early onset of the disease and a polyarticular outcome. In one clinical group, stratification of patients by the HLA allele DQA1*0101 strengthened the association considerably. This implies that there is an increased genetic load defined by specific alleles of both MHC and TCR genes.
1519073 [Arthroscopy of the elbow joint. Long-term results, complications and indications]. 1992 Aug Based on the results of a retrospective study of 67 patients who had diagnostic and surgical arthroscopy of the elbow from 1977 until 1990, we present the technique, results, complications, and indications for elbow arthroscopy. The average age of the patients was 26 years (range: 11-59). At follow-up, the patients were examined both clinically and radiologically. The results were scored according to Figgie's score, which contains the criteria of pain, function, power, and range of motion. The overall score increased significantly from 61.6 preoperatively to 85.3 postoperatively. The age of the patient did not influence the results. However, patients who were laborers had a poorer outcome than the others. Patients with a preoperative pain of 4 months to 2 years had better results than patients with a preoperative course of more than 2 years. With respect to the criteria (pain, function, power, range of motion), the pain improved significantly, whereas the other parameters showed no significant improvement. Breaking the diagnosis down into three categories (specific diagnosis, degeneration, unclear diagnosis), only patients with a specific and clear preoperative diagnosis showed significant improvement. The high number of neurological complications was especially striking. CLINICAL RELEVANCE: According to our results, patients with loose bodies, early rheumatoid arthritis, and joint infection seem to be good candidates for elbow arthroscopy. However, patients with severe degeneration or patients with unclear preoperative diagnosis will rarely benefit from this procedure. In general, the patients' pain can be treated effectively, but range of motion or power will not increase after elbow arthroscopy.(ABSTRACT TRUNCATED AT 250 WORDS)
8532398 Pancreatic pseudotumor arising in association with Sjögren's syndrome. 1995 Jul A case is presented of an elderly female who was found by imaging to have an enlarged pancreas with narrowed distal common bile duct, thought to be neoplastic. Resection revealed an inflammatory and fibrosing process of the pancreas, suggestive of autoimmune disease. Subsequently she developed dry mouth, enlarged salivary glands, and an enlarged lacrimal gland with typical histology of Sjögren's syndrome. Pathological review of the contralateral lacrimal gland excised 20 years earlier showed similar histology. This case is a rare, but not unique, example of pancreatic pseudotumor associated with Sjögren's syndrome. The increasing use of sophisticated abdominal imaging may result in an increased detection of such pseudotumors. Failure to recognize their real nature can lead to inappropriate surgery.
8015801 Sjögren's syndrome in the adolescent. Report of four cases. 1994 Apr We report three cases of Sjögren's syndrome and a case with a probable diagnosis of Sjögren's syndrome at the ages of 16 (2 cases), 17, and 18 years. Two patients were affected by systemic lupus erythematosus. All four patients showed periductal lymphocytic infiltration in the labial glands. Two of the three patients underwent parotid sialography that revealed punctate or globular sialectasis. A decrease in stimulated parotid flow rate was noted in three of the cases compared with age-matched healthy females, whereas only one patient was diagnosed as having keratoconjunctivitis sicca.
1496164 Cutaneous manifestations of Sjögren's syndrome. 1992 Aug The major mucous membrane and cutaneous manifestation of Sjögren's syndrome (SS) is xerosis. Severe dryness of the eyes, mouth, nasal passage, and vagina produce many annoying symptoms, including photophobia, burning and itching of the eyes, alterations in taste and smell, recurring nonallergic bacterial sinusitis rhinitis, and dysparunia. SS patients frequently complain of dryness of lips and soreness and a burning sensation of the tongue and oral mucosa. SS patients also complain of dryness of their hair and note a decrease in luster, and severe dryness of the skin is frequently accompanied by pruritus.
7653937 Cytokines in Sjögren's syndrome. 1995 This review discusses the respective role in Sjögren's syndrome of pro-inflammatory cytokines, such as interleukin (IL)-1 beta and tumour-necrosis factor-alpha, and anti-inflammatory cytokines, such as transforming growth factor-beta, interferon-alpha and IL-10. The former products are secreted by lymphocytes as well as epithelial cells. Th 1 cell cytokines predominate within the focal infiltrates. Increased levels of circulating IL2 receptors correlate to the progression of the ongoing disease.