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PMID	Title	PublicationDate	abstract
6788211	Evidence for defect of complement-mediated phagocytosis by monocytes from patients with rh	1981 Jun 27	In-vitro measurements of the rate of monocyte phagocytosis of heat-killed yeast preopsonised in human AB serum from 14 patients with rheumatoid arthritis and 14 normal controls showed a significant reduction in five patients with active vasculitis but no change in nine with active arthritis alone. Further studies of complement- and Fc-mediated monocyte phagocytosis in which the rate constants (Kc and KFc respectively) were determined using complement-coated Saccharomyces cerevisiae and Candida albicans opsonised with IgG in monocytes from nine patients with rheumatoid vasculitis and 12 controls showed a significant reduction in Kc (p less than 0.01) but normal KFc. Kc was normal in three patients with inactive vasculitis. Low Kc was correlated with low serum C3 concentrations but not with Clq binding or anticomplementary activity, and no evidence of intracytoplasmic or membrane-bound immune complexes was detected in monocytes from patients with active vasculitis. These results show that cutaneous vasculitis in rheumatoid arthritis is associated with selective impairment of complement-mediated monocyte phagocytosis, which does not appear to result from receptor blockade by immune complexes.
3968518	Spontaneous production of fibroblast-activating factor(s) by synovial inflammatory cells.	1985 Jan 1	A characteristic feature of rheumatoid arthritis is hyperplasia of the synovial lining cells and fibroblasts, the source of tissue-degrading mediators, in association with the appearance and persistence of lymphocytes in affected joints. Diseased synovial tissue obtained at arthroscopy from 10 of 12 rheumatoid arthritis patients was found to release a factor(s) that could stimulate quiescent fibroblasts to proliferate in vitro. Mononuclear cells isolated from this synovial tissue and from the synovial fluid spontaneously produced fibroblast-activating factor(s) (FAF). In contrast, synovial tissue from patients with noninflammatory joint disease did not release FAF. By gel filtration, FAF was detected in two peaks (40,000 and 15,000 mol wt) that were consistent with the previously described peripheral blood T lymphocyte- and monocyte-derived factors with identical activity. The mononuclear cells were predominantly OKT3+/Leu-1+ T lymphocytes and OKM1+ cells of monocyte/macrophage lineage that expressed HLA-DR antigens, suggesting prior activation of these cells. Mononuclear cells isolated from the peripheral blood of these patients did not spontaneously secrete FAF. Lymphocytes and monocytes from the site of synovial inflammation appear to be activated in situ to produce factors that may contribute to the hyperplasia and overgrowth of the synovial membrane in rheumatoid arthritis.
373942	Pirprofen and aspirin in the treatment of rheumatoid arthritis.	1979 May	Pirprofen (800 mg/day) or aspirin (3,600 mg/day) was administered in double-blind fashion for up to one year to 40 adult outpatients with rheumatoid arthritis, after a short, single-blind placebo period. There were no statistically significant differences in efficacy between pirprofen and aspirin, as evidenced by patient opinion, observer opinion, grip strength, walking time, number of tender joints, number of swollen joints, or erythrocyte sedimentation rate. Clinically significant pain of gastrointestinal origin occurred in an equal number of patients from each group. Audiologic evaluation revealed 3 pirprofen-treated patients and 5 aspirin-treated patients in whom sensorineural hearing loss progressed during therapy and required either discontinuation or reduction of drug dosage. Ophthalmologic evaluation disclosed a high prevalence of lesions, the most common being decreased visual acuity and cataracts not explained by previous antiarthritic therapy. The high prevalence of audiologic and ophthalmologic pathology reported in the literature in patients with rheumatoid arthritis makes it difficult to establish in our study whether pirprofen or aspirin affected these organ systems.
6813473	Single dose pharmacokinetics of auranofin in rheumatoid arthritis.	1982 Jul	Six rheumatoid arthritis (RA) patients were given 2 6 mg doses of auranofin (AF) containing Au195, 6 months apart. The radioactivity in the whole body and in plasma, urine, and stool samples was measured for 6 months after each dose. Absorption was rapid with peak plasma concentrations occurring 1.2-2 h post administration. 195Au plasma half-lives (t1/2) ranged from 11.0-31.3 days, with 195Au detectable in plasma for about 80 days. Total body t1/2 averaged 69.2+/-29.7 days. Urinary excretion accounted for 15% of the dose. Cumulative stool excretion was 89%, although 72% was excreted in 10 days. Continued stool excretion over 6 months suggested a "central-enteric" component to the excretory route.
7131457	Reliability of xerographic reproduction measurements of ulnar deviation.	1982 Jul	The lack of a practical validated measure of ulnar deviation in rheumatoid arthritis (RA) has precluded serious consideration of conservative treatments to correct ulnar deviation. The xerographic photocopier provides an available, inexpensive, safe instrument for recording hand positions. Randomized xerographs detected differences in individual finger angles in both RA and normals (p less than .01) when using a standardized method for angle measurements. This method is simple, safe (no radiation), and offers a practical approach to assessing the treatment of ulnar deviation in RA.
769705	Laboratory diagnosis of rheumatoid arthritis. Prospective study of 85 patients.	1975 Oct	Because early diagnosis of rheumatoid arthritis is difficult increasingly important, we have assessed the value of laboratory investigation in 85 patients with knee effusions studied from presentation and followed for sufficiently long periods to allow a definite diagnosis. Histopathology on needle biopsy specimens narrowed the differential diagnosis to rheumatoid arthritis and closely related conditions even at an early stage of disease and also allowed recognition of other conditions which would not otherwise have been detected. Immunofluorescence on similar specimens further narrowed differential diagnosis since the presence of IgM was found to be very suggestive of rheumatoid arthritis. Other tests were of less value. It is concluded that laboratory investigation can improve diagnostic sensitivity and specificity in relatively early rheumatoid arthritis.
999482	Functional evaluation of normal and pathologic knees during gait.	1976 Dec	The functional performance of the knee joints of 29 normal volunteers, 65 patients with degenerative joint disease and 30 patients with rheumatoid arthritis was studied according to clinical (historical, physical and roentgenographic) and biomechanical gait parameters. Temporal and distance gait factors (velocity, cadence and stride length) were significantly reduced in patients with diseased knees. Sagittal plane knee motion was markedly reduced, as was stance phase flexion, indicating poor tolerance of loading the flexed knee in the patient groups. There was no correlation between passive motion of the diseased knee and the amount of motion used during gait. Patients with rheumatoid arthritis generally showed more compromise of knee joint function than did patients with degenerative joint disease. Statistically, significant correlations between various clinical and biomechanical gait parameters suggest that the techniques used are an objective measurement of knee joint function and may be employed as a means of evaluating various treatment modalities for the diseased knee.
547966	Instability and wear of total hip prostheses determined with roentgen stereophotogrammetry	1979	A roentgen stereophotogrammetric analysis of hip prostheses was made in four patients with rheumatoid arthritis during a postoperative period of 2 years. Implanted tantalum balls, prosthetic femoral head, and ends of the wire in the acetabular socket were used as measurement points. The migration of the prosthetic head and the acetabular socket in relation to the pelvic bone was determined. The difference between the cranial migration of the head and the socket is a measure of the postoperative instability of the hip joint and deformation of the prosthetic components. This deformation occurs in the plastic acetabular socket and is mainly due to wear. The roentgen stereophotogrammetric method can be applied to standard hip orostheses with a metal femoral head and a plastic or metal acetabular socket to study migration or loosening of the prosthesis in relation to the supporting bone, prosthesis instability, and deformation of the prosthetic components.
1169813	Immunoglobulin clases IgG, IgM, IgA and complement component C3 in dental periapical lesio	1975	To identify the immunoglobulin classes present in dental periapical lesions and to determine how, if at all, the distribution of immunoglobulin classes IgG. IgM and IgA differ in the dental periapical lesions of rheumatoid and control patients, paraffin-embedded and frozen tissues from the dental periapical lesions of 36 rheumatoid and 22 control patients were examined by the direct immunofluorescence technique. In addition, both rheumatoid and control tissues were examined for the presence of complement component C3, albumin and fibrinogen. Neither the greater frequency and abundancy with which IgG and to a lesser degree, IgA occurred in the dental periapical lesions of rheumatoid patients than in the corresponding lesions of control patients, nor the more frequent occurrence of complement component C3 in these same lesions, was statistically significant. No difference in the distribution of the various immunoglobulin classed could be discerned between the rheumatoid and control group. Albumin was distributed almost equally between the two patient groups. The greater abundance of fibrinogen among control patients was, however, statistically significant. These results do not provide evidence that an immunologic reaction takes place in the dental periapical lesions of patients with rheumatoid disease similar to that which characterizes rheumatoid inflammation. However, the presence of such a reaction cannot be excluded without more extensive investigation.
6673269	Cryogel studies for the optimization of cryofiltration (CF) therapy.	1983	This study has shown that cryofilter plugging correlates with pretreatment pathologic macromolecule concentrations (e.g. rheumatoid factor and immune complexes) in the treatment of patients with rheumatoid arthritis. Pathologic macromolecules are concentrated relative to albumin in the cryogel. Molecular aggregation in the cryogel depends upon heparin concentration, exhibiting maximum aggregation in a specific range of heparin concentrations. Molecular aggregation in cryogel increases with decreasing temperature. In the use of cryofiltration in over 50 rheumatoid arthritis patients, clinical improvement has accompanied the removal of cryogel and the pathologic macromolecules it contains. Filter plugging or cryogel formation may be indicators of disease activity. Formation of cryogel is variable depending upon type of disease, severity of disease, temperature, heparin concentration, and membrane structure. These factors are important parameters to consider to optimize conditions for removal of cryogel and for continuing improvement of plasma therapeutic techniques for the treatment of rheumatoid arthritis.
132817	[Influence of antiphlogistics, antireheumatics, and acid mucopolysaccharides on in-vitro c	1975 May	41 compounds, anti-inflammatory agents, acid mucopolysaccharides, and other substances were investigated in vitro for their ability to influence the formation of collagen fibrils. The acid anti-inflammatory agents accelerated the formation of collagen fibrils partially, acid mucopolysaccharides inhibited it. The results are discussed regarding the effects exhibited by anti-inflammatory agents and mucopolysaccharides in rheumatoid arthritis and osteo-arthrosis.
1153250	Benign rheumatoid nodules.	1975 Jul	Fifteen asymptomatic children with benign rheumatoid nodules, followed up to 12 years, are described. Nodules are characterized by subcutaneous location with predilection for pretibial regions and scalp, occasional large size, spontaneous regression, and frequent recurrence. Granuloma annulare was present in two patients. All 15 children were healthy and free from rheumatoid arthritis, rheumatic fever, or any other recognizable systemic disease at followup and none had positive tests for antinuclear antibodies or rheumatoid factors. Histologically the nodules closely resembled those seen in adult-onset rheumatoid arthritis. Though biopsy may be useful for confirmation of the clinical diagnosis of benign rheumatoid nodules, wide surgical excision, skin grafting, and treatment with medication are unnecessary in this self-limited syndrome.
7084280	Rater reliability in reading PA films of hands for bone and cartilage changes in rheumatoi	1982	Three experiments were conducted to evaluate the rater reliability for scoring osseous defects (articular erosions) and joint space narrowing (cartilage destruction) in patients with rheumatoid arthritis. The experiments show that two raters, using different techniques, obtain similar scores; the scores differing primarily by a multiplicative factor. A single rater achieves reproducible results under similar conditions. But with a change in reading technique, such as using a magnifying lens and intense light, the same rater obtains a change in scores. The problems of measurement must be carefully examined for any proposed measurement technique. The superficial objectivity and precision of a measurement scale are less important than its objectively and precision of a measurement scale are less important than its objectively evaluated reliability. Comparing alternative procedures is a statistical problem, and can be subjected to suitable statistical analysis to evaluate alternatives.
929124	Acid glycosaminoglycans in plasma. II. Findings in rheumatoid arthritis.	1977	The glycosaminoglycans (GAG) directly adsorbable from undiluted plasma on DE-52 anion-exchange cellulose (free GAG) and the GAG adsorbable on AG 1 X 2 anion exchange resin after papain proteolysis (bound GAG) were determined in 35 patients suffering from active erosive rheumatoid arthritis (RA) and in 50 control subjects. Free GAG levels were significantly elevated in both female (p less than 0.001) and male (p less than 0.05) RA patients. Bound GAG levels were significantly depressed in female (p less than 0.02) but not in male RA patients. Total GAG concentrations in RA patients and in controls were fairly similar. No consistent differences in the electrophoretic patterns of the plasma GAG from RA patients and controls were discernible. The free GAG concentrations in RA plasma samples did not correlate with seropositivity or ESR.
7434845	[Clinico-pharmacological investigation of an oral form of a depot preparation on silicone	1980 May 1	Indomethacin depot tablets on the basis of silicon resin were investigated in a clinical pharmacological study including pharmacokinetic data on 20 patients with rheumatoid arthritis. Effects and side-effects of the depot tablet are equal to those of the standard Metindol-capsules. After depot tablets serum indomethacin level is in the therapeutic range for 8--12 hours so that drug administration is reduced to twice daily.
6514289	Mortality rate in rheumatoid arthritis patients developing necrotizing scleritis or periph	1984 Oct	We performed a nonrandomized clinical trial comparing the ocular and systemic efficacy of cytotoxic immunosuppression with steroidal and nonsteroidal anti-inflammatory therapy in the care of 34 patients with rheumatoid arthritis who developed peripheral ulcerative keratitis and/or necrotizing scleritis. Nine of the 17 patients managed with conventional therapy died of a vascular-related event during the ten-year period of the study. In 13 of the 17 patients, the ocular inflammatory process progressed, and in 5 patients extraocular, although nonlethal, vasculitic lesions developed. One of 17 patients treated with long-term immunosuppressive therapy died during the ten-year follow-up period, and this death occurred after cytotoxic therapy was withdrawn. None of the patients on immunosuppressive regimens developed extraocular vasculitis while taking the drug, and none had progression of the ocular destructive lesion. The results of this study emphasize that the eye is a sensitive indicator for potentially lethal occult systemic vasculitis in patients with rheumatoid arthritis who develop peripheral ulcerative keratitis or necrotizing scleritis. Our mortality data strongly suggest that the use of cytotoxic drugs may alter favorably the general as well as the ocular prognosis in these patients.
384933	Effects of carrageenin on human synovial cells in vitro: morphology, hyaluronic acid produ	1979 Jun	Some in-vitro effects of the arthritogenic polysaccharide carrageenin were studied on cells from human synovium. Synovial cells were isolated from intact human knee joints, and cell lines were developed by passaging with trypsin. Carrageenin was ingested by the cells but did not significantly affect cell growth, numbers of lysosomes, intracellular lysosomal enzyme activity (N-acetyl-beta-D-glucosaminidase), or release of lysosomal enzyme from cells. Carrageenin produced a reduction in net hyaluronic acid synthesis. It also induced a striking morphological change in a high proportion of synovial cells, characterised by increased spreading over the culture surface and apparent condensation of the cytoplasm into a pattern of ridges. Nonrheumatoid and rheumatoid synovial cells behaved similarly to one another.
6327772	Abnormally elevated frequency of Epstein-Barr virus-infected B cells in the blood of patie	1984 Jun	Patients with rheumatoid arthritis (RA) are known to have in vitro regulatory T cell abnormalities relating to Epstein-Barr virus (EBV). In this report, we asked whether patients with RA have more circulating EBV-infected B cells than normals. To address this question, we determined the frequency of spontaneously transforming B cells in the peripheral blood of 18 normals, 15 patients with RA, and 8 patients with systemic lupus erythematosus (SLE). The mean frequency of spontaneously transforming B cells in RA patients was 10.1/10(6) B cells, which was significantly greater than that of the normal controls, 2.8/10(6) B cells (P less than 0.005). The group of patients with SLE did not differ from the normals (P greater than 0.4). In further studies undertaken to investigate as to whether RA B cells are more easily transformed by EBV than normal B cells, we determined that the frequencies of transforming B cells in the presence of exogenous EBV were similar in RA patients and normals. Lymphocytes obtained from patients with RA demonstrate a profound T cell defect in their EBV-specific suppression, as measured in vitro; there was no direct correlation, however, between this in vitro T cell abnormality and the number of circulating EBV-infected B cells. Thus, patients with RA, as a group, have abnormally elevated numbers of circulating EBV-infected B cells, and this abnormality most likely derives from a complex dysregulation of the defense mechanisms for infection with EBV.
6481719	Controlled trial of clinical utility of serum salicylate monitoring in rheumatoid arthriti	1984 Aug	A crossover double-blind controlled trial was performed on 36 patients with rheumatoid arthritis to assess the necessity for serum salicylate monitoring in determining optimal dosage. There was no clinically or statistically significant increase in the clinical improvement of patients associated with serum monitoring but potentially toxic serum levels occurred without tinnitus when serum monitoring was not used.
6681146	The prediction of radiological destruction during the early stage of rheumatoid arthritis.	1983 Oct	A total of 107 patients with definite rheumatoid arthritis of no longer than six months' duration were observed for three years. The radiological destruction of the hand and foot joints after the follow-up time was compared with 65 anamnestic, clinical, laboratory and radiological variables at the onset of the disease. Of the individual variables, early radiological changes in the joints showed the best correlation with the progress of joint destruction. Grip strength, ESR, serum iron, serum C1 esterase inhibitor, rheumatoid factor and old age also had prognostic value. In multiple regression analysis 15 variables explained about 50% of the variance in the progress of joint destruction.