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ID PMID Title PublicationDate abstract
8674793 Plasmapheresis for a schizophrenic patient with drug-induced lupus anti-coagulant. 1996 Jan A 59-year-old patient with schizophrenia developed Sjögren's syndrome. She also presented with the lupus anticoagulant attributed to long-term medication with chlorpromazine. Serial plasmapheresis treatments were performed to decrease the anti-coagulant activity. As a result, the activated partial thromboplastin time was temporarily improved, but the lupus anti-coagulant activity did not change. Because of her unstable emotional state, she continued to require chlorpromazine, but took a low dose of aspirin (87 mg/day) and never manifested any signs of thrombotic events. In view of the potential anti-thrombotic effects of chlorpromazine, it may not be necessary to use plasmapheresis in an attempt to reduce anti-coagulant activity among patients with chlorpromazine-induced lupus anti-coagulant.
8077681 A new animal model for primary Sjögren's syndrome in NFS/sld mutant mice. 1994 Sep 15 In this study, we report an established and characterized animal model for primary Sjögren's syndrome in NFS/sld mutant mice bearing an autosomal recessive gene with sublingual gland differentiation arrest. Significant inflammatory changes develop spontaneously in both the salivary and lacrimal glands of NFS/sld mutant mice thymectomized 3 days after birth without any immunization, whereas no significant inflammatory lesions were found in other organs or in nonthymectomized mice. This pathology resembles primary Sjögren's syndrome in humans, which involves the parotid, submandibular salivary, and lacrimal glands. A significantly higher incidence of autoimmune lesions was found in female mice, and the anti-salivary duct autoantibodies were detected in sera from mice with autoimmune lesions but not in control mice. The inflammatory infiltration into the salivary and lacrimal glands consisted mainly of CD3+ and CD4+ T cells, and a lesser proportion of CD8+ T cells and B220+ B cells during the course of disease. When the repertoire of TCR V beta genes transcribed and expressed within the inflammatory infiltrates was analyzed in mice with autoimmune lesions, a considerable preferential use of TCR V beta gene (V beta 8 predominant) was detected in these lesions from the onset of disease. Thus, we can propose a newly established animal model for primary Sjögren's syndrome developing in this mutant strain of mice. Moreover, the predominant patterns of TCR transcript expression in an animal model may be somewhat restricted, suggesting that TCR-based immunotherapy of Sjögren's syndrome is possible.
1581471 Histopathological changes in exocrine glands of murine transplantation chimeras. I: The de 1992 Sjögren's syndrome (SS) is a connective tissue disease characterized by general affection of exocrine glands. The three main components of SS are: dry eyes, dry mouth, and other connective tissue disease. When only two of these, dry eyes and dry mouth, are present, the disease is designated primary SS. In the presence of the third component, most commonly SLE or RA, with one or both of the two first components the disease is designated secondary SS. In murine transplantation chimeras, we have demonstrated the development of both primary and secondary SS depending upon the mouse strains used. We transferred large numbers of viable leucocytes from homozygotic donors to heterozygotic recipients. When DBA/2 mice were used as donors, a full-developed SLE-syndrome, with autoantibodies against native DNA, nuclear antigens, and red blood cells was observed. We found immune deposits in skin ("lupus band") and kidneys, immune complex glomerulonephritis (ICGN), proteinuria, ascites, and hepatosplenomegaly. In later stages, we found a generalized dacryoadenitis. In the kidneys we found interstitial nephritis, and occasionally "half-moon" nephritis. In skin, immune deposits were demonstrated in intercellular spaces. These findings are similar to those found in patients with Sjögren's syndrome secondary to SLE. The murine transplantation chimera is therefore an experimental model for spontaneous autoimmune diseases.
1536673 Nerve growth factor in the synovial fluid of patients with chronic arthritis. 1992 Mar Cytokines regulate nerve growth factor (NGF) synthesis during inflammatory processes. Since cytokines are also involved in the inflammatory processes of autoimmune rheumatic diseases, we examined levels of NGF in patients with rheumatoid or other types of chronic arthritis. NGF was present in the synovial fluid and synovium of patients with chronic arthritis, but was undetectable in control fluids. We conclude that NGF might be involved in the pathogenesis of arthritis.
1512763 The differing patterns of interstitial lung involvement in connective tissue diseases. 1992 Jul Connective tissue disorders (CTD) have a relatively high incidence of pulmonary complications but their delineation has been hampered by difficulties inherent in the diagnostic techniques. One fresh approach to this problem is based on a clustering method that uses data from 8 separate investigations to cluster the patients into 4 distinctly separate categories representing normal nonsmoker, normal smokers, those with active interstitial lung disease and those with bronchiolitis. Using this method, a large group of patients with CTD have been examined to assess the nature and extent of their pulmonary complications. Subjects in the first cluster had a normal test profile across all variables, and included no current active smokers. The normal smoking cluster contained only smokers who had a high total lavage cell number with a relative increase in macrophages and a decrease in lymphocytes. In this group, all respiratory variables were normal with the exception of a mildly depressed DLCO, also known to be associated with smoking. The general characteristics of the active interstitial lung disease cluster was a markedly depressed DLCO indicating impaired gas exchange, and elevated gallium index, bronchoalveolar lavage (BAL) cell number and neutrophil and lymphocyte percentages, all indicating an active inflammatory process. However more careful analysis of this group suggested the presence of 2 subgroups, one with a lymphocytic alveolitis, and another with a neutrophilic alveolitis. The bronchiolitis cluster characteristics were a markedly depressed maximal mid expiratory flow rate and raised BAL lymphocyte percentage and gallium index. The distribution of patients within the cluster groupings suggested that Sjögren's syndrome, often an accompaniment of other CTD, is most frequently associated with pulmonary disease.(ABSTRACT TRUNCATED AT 250 WORDS)
1581772 Association of DR3 with susceptibility to and severity of primary Sjögren's syndrome in a 1992 May A study of HLA and primary Sjögren's syndrome (1 degree SS) was performed in 40 index cases and 180 relatives all of whom were Caucasian. The association of DR3 and 1 degree SS was confirmed. In probands, DR3 associated with extraglandular manifestations of 1 degree SS and homozygosity for DR3 associated with younger onset of disease. Familial clustering of 1 degree SS was evident. Definite or probable 1 degree SS (Fox criteria) occurred with a prevalence of 4.4% in the relatives, exclusively in older female first degree relatives and was associated with DR3. The relative risk was greatest in those who expressed anti-nuclear factor, rheumatoid factor or Ro and DR3. We identified a group of young females expressing some criteria for 1 degree SS and the same immunogenetic markers. They may be at risk of full expression of 1 degree SS as they become older. Milder forms of 1 degree SS were common in older relatives but not DR3 associated. 1 degree SS in males was rare and mild irrespective of immunogenetic status. Symptoms of 1 degree SS in relatives were mild or absent. Such individuals will only be identified through a family study or a community survey.
1315384 Sequential quantitative scintigraphy of parotid glands with chronic inflammatory diseases. 1992 May A practical, time-saving procedure for sequential quantitative scintigraphy is introduced and 4 parameters chosen from 12 parameters by discriminant analysis are used to evaluate the function of the parotid gland. The examination was performed in 120 cases, including 16 cases with recurrent parotitis in childhood, 33 with chronic obstructive parotitis (COP), 37 with Sjögren's syndrome (SS), 4 with sialadenosis, and 30 normal controls. The scintigraphic findings were analyzed and compared with the histologic findings. The diagnostic value of this method was investigated and scaling for differential diagnosis of COP and SS was established. Scintigraphy is considered to be a useful method for evaluation of parotid function and as a diagnostic aid for SS and COP, especially in patients in whom sialography cannot be performed.
8635281 Investigation of activation markers demonstrates significant overexpression of the secreto 1996 Jun Labial salivary glands biopsies (LSG) performed to support clinical anomalies suggestive of Sjögren's syndrome (SS) sometimes fail to confirm the diagnosis. Here we investigated whether epithelial activation markers could provide further information. Frozen cut sections of LSG from 40 patients, including 23 confirmed SS, were examined in immunofluorescence for the expression of HLA class II molecules, the protector of apoptosis bcl-2, the intercellular adhesion molecule 1 (ICAM-1) and secretory component (SC). Class II molecules were highly expressed on epithelial cells in SS patients (DR > DP > DQ). Bcl2 was expressed in infiltrating cells which were more numerous in the group of SS patients. ICAM-1 was present on endothelial and infiltrating cells of a few patients in both groups. Epithelial cells produced SC in 83% of SS patients samples vs four cases of non-SS patients (P = 0.0002). Investigation of the expression of SC on glandular epithelial cells could therefore be proposed as a marker of SS.
8508556 Prednisone and piroxicam for treatment of primary Sjögren's syndrome. 1993 Mar Primary Sjögren's syndrome is a systemic autoimmune exocrinopathy characterized by a lymphoplasmacytic infiltrate and destruction of salivary and lacrimal glandular tissues. There is no widely accepted or effective systemic therapy for this disorder. The purpose of this 6-month randomized, double-blinded, placebo-controlled study was to examine the effects of prednisone (30 mg, alternate days), piroxicam (20 mg, daily), or placebo on the salivary, lacrimal and immunologic alterations of primary Sjögren's syndrome. Eight patients were enrolled in each group. Salivary and lacrimal function were assessed at entry and at the completion of treatment. Labial minor salivary gland tissue was obtained at these times and examined for intensity of infiltration (focus scores) and for the relative proportion of glandular elements. Serologic and subjective evaluations were done as well, and patients were monitored for therapy-related side effects. Neither active treatment led to significant improvement in salivary or lacrimal function, although prednisone improved salivary flow in selected patients and was associated with positive subjective responses. Prednisone also significantly decreased the serum total protein, IgG, IgA, and sedimentation rate and increased the white cell count. There were no significant alterations in either focus scores or the percentage of glandular component tissues of minor glands with either active treatment. This study demonstrated that 6 months of prednisone or piroxicam at the doses utilized failed to improve the histological or functional parameters of salivary and lacrimal glands in primary Sjögren's syndrome.
8473753 Superantigen can reactivate bacterial cell wall-induced arthritis. 1993 May 1 Intravenous injection of toxic shock syndrome toxin-1 (TSST-1) produced by Staphylococcus aureus, can reactivate arthritis in a rat ankle joint that has been previously inflamed by injection of peptidoglycanpolysaccharide polymers isolated from the cell walls of group A streptococci. The severity and chronicity of this renewed arthritis is dose dependent and at higher doses (125 micrograms/kg) a prolonged joint inflammation with pannus formation and marginal erosion of cartilage and bone is induced after a single injection of TSST-1. Only modest synovial hyperplasia is induced in control ankle joints by systemic injection of TSST-1. Another superantigen, streptococcal pyrogenic exotoxin induces a much weaker, acute reactivation of arthritis that resolves by 2 days. Repeated injections of TSST-1 at 7-day intervals give the same undiminished pattern of joint response, but the joint swelling persists at a higher level with each succeeding injection. Cyclosporin A suppresses all phases of the recurrent arthritis, indicating that TSST-1 could be functioning through its property of a superantigen activating T lymphocytes. II-1 receptor antagonist and anti-TNF-alpha neutralizing antibody, which reduce reactivation of arthritis by peptidoglycan-polysaccharide polymers, have no effect on reactivation by TSST-1. This experimental model provides a means to examine in vivo the possible role of superantigens in rheumatoid arthritis and related diseases, and to analyze the cellular and molecular pathways induced by this family of microbial products.
7638850 [Blocking of carbohydrate adhesion. A new principle for therapy of many conditions?]. 1995 Jun 20 Cell adhesion is of fundamental biological importance. In this article we describe the therapeutic potential of blocking carbohydrate dependent adhesion. The animal studies are promising, and there is a realistic hope that "anti-adhesion" therapy for acute conditions like reperfusion injury and severe infections will be of clinical value. Treatment of more chronic diseases like rheumatoid arthritis and cancer by blocking carbohydrate mediated cell adhesion is theoretically possible, but probably more difficult.
8372722 Possible mechanisms of action of antimalarials in rheumatic disease. 1993 Understanding of the mechanism of action of the antimalarials in rheumatoid arthritis remains limited in spite of knowledge of a wide range of potentially relevant effects at the cellular level. Among the difficulties with proposed mechanisms of action are a lack of specificity, doubt about demonstrable effects at appropriate concentrations and a failure to explain the slow onset of action. It is possible that pharmacokinetic factors, or the slow change in the underlying disease pathology, might account for the slow onset.
8668965 Idiopathic eosinophilic synovitis. Case report and review of the literature. 1996 Eosinophilia of synovial fluid is an uncommon condition. The majority of the reported cases are associated to diseases such as rheumatoid arthritis, parasitic disease, hypereosinophilic syndrome, Lyme disease, and allergic processes as well as hemarthrosis and arthrography. Presently there are only four cases of eosinophilic synovitis with unknown cause. We are reporting a patient with oligoarthritis of the knees, massive eosinophilia, and Charcot-Leyden crystals in synovial fluid without associated cause. We review the clinical and biological features of eosinophilic synovitis and discuss its pathogenesis.
7853158 Acrometastases. Initial presentation as diffuse ankle pain. 1994 Dec Acrometastases are rare and often misdiagnosed or overlooked. When it involves the feet, it generally attacks the larger bones containing the higher amounts of red marrow. The patient may or may not have a known history of cancer, which makes diagnosis much more difficult. The symptomatology is generally vague and can mimic other conditions, such as osteomyelitis, gouty rheumatoid arthritis, Reiter's syndrome, Paget's disease, osteochondral lesions, and ligamentous sprains. Therefore, the physician must consider metastatic disease in the differential diagnosis. Once the diagnosis is made, the prognosis is poor and treatment is limited to pain relief and maintaining function.
7996699 [Alzheimer's disease and the immune system response]. 1994 Nov Elements that belong to the natural immune system have been identified immunohistochemically in brain of patients with Alzheimer's disease (AD). Senile plaques and ghost tangles appear to be the site of chronic inflammatory response where reactive microglia, the brain resident macrophages, play a major role. Activation of the complement, coagulation and fibrinolysis systems also occur in such lesions. Nevertheless, the accumulation of plaques and tangles in postmortem brain tissue indicates the failure of microglia to phagocytose and degrade these pathological debris. "Frustrated" microglia might elicit the persistent immune responses and cause the neuronal deterioration in AD. The low incidence of AD in rheumatoid arthritis patients, who have received the long-term anti-inflammatory medication, supports this notion.
1404142 Prosthetic knee infection due to Achromobacter xylosoxidans. 1992 Jun Achromobacter xylosoxidans is an aerobic gram negative organism that has been infrequently implicated in clinical infections in a variety of anatomical sites. We describe a case of a prosthetic knee infection due to Achromobacter xylosoxidans in a patient with rheumatoid arthritis receiving high dose prednisone.
1730110 Total knee arthroplasty infection due to Gemella haemolysans. 1992 Jan Gemella haemolysans, a relatively unknown commensal of the upper respiratory tract, rarely causes clinically important infections. This report deals with an infection of a total knee arthroplasty due to Gemella haemolysans in a patient with rheumatoid arthritis. The microbiology of this bacterium is discussed and the clinical features of previously reported cases of Gemella infections are briefly reviewed.
1411234 [Biopsy of the salivary glands. The importance and technic of biopsy of the sublingual gla 1992 A new method of taking a sublingual gland sample is suggested by the authors in the fore pole. They emphasize on this straightforward operating act and on the amount of tissue removed. The aim of the removal could be etiologic within the framework of the Gougerot-Sjögren's syndrome, diagnostic in the sarcoidosis and rheumatoid arthritis, prognostic in the graft versus host disease.
8535642 Sulphasalazine, sulphapyridine or 5-aminosalicylic acid--which is the active moiety in rhe 1995 Nov Sulphasalazine is cleaved into 5-aminosalicylic acid and sulphapyridine by colonic bacteria. The bulk of evidence favours sulphapyridine rather than 5-aminosalicylic acid as the active moiety (as well as the main producer of side-effects) though a therapeutic action from the 30% of sulphasalazine that is absorbed unaltered also cannot be excluded.
7799386 Other special considerations in assessing DC-ART: potential application of newer technolog 1994 Sep Developments in technology will change and improve methods of assessment of rheumatoid arthritis (RA) progress and outcome. Three areas are discussed: quantitative microfocal radiography; assessment of cartilage volume using magnetic resonance imaging and 3D computer reconstruction; polymerase chain reaction on tissue sections to allow simultaneous identification of multiple mRNA for cytokines, leukotrienes, and other participants in RA synovitis in serial blood samples or office-based arthroscopic synovial biopsy sections.