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ID PMID Title PublicationDate abstract
7481480 An immunohistochemical study of immunological phenomena in minor salivary glands in patien 1995 Using different monoclonal antibodies, we performed an immunofluorescent technique on labial salivary glands in order to investigate the immunological phenomena involved in Sjögren's syndrome (SS). An aberrant expression of HLA-DR molecules was detected on cytoplasm of epithelial labial salivary cells in 9 out of 19 (47%) patients, with SS. No such expression was found in 8 patients without SS or in 3 normal controls. HLA-DQ molecules were demonstrated also in two out of ten SS patients without HLA-DR. A lymphocytic infiltration was not correlated with the expression of class II molecules. T cells bearing gamma delta receptors were not detected. The intracellular adhesion molecules (ICAM-1) and lymphocyte function associated antigen-1 (LFA-1) were not found on epithelial glandular salivary cells of patients and controls. In conclusion, these data suggested that the absence of ICAM-1 and LFA-1 in salivary cells and the absence of infiltrating T cells bearing gamma delta receptors exclude their immunopathogenetic role in SS; moreover, these data demonstrated that the aberrant expression of HLA class II molecules on epithelial salivary cells of patients with SS is not a phenomenon correlated with the lymphocytic infiltration.
8275588 Reappraisal of tests for xerostomia. 1993 Sep Our goal was to establish the practical usefulness of combinations of tests (saliva flow rate, SFR; salivary lysozyme, Lys; salivary lactoferrin, Lf; sialography, SG; salivary gland scintigraphy, SGS; and labial salivary gland biopsy, SGB) for the oral component of Sjögren's syndrome (SS). These tests were applied to 40 patients with primary SS (group A, defined by the presence of keratoconjunctivitis sicca, a positive response to two of three selected questions for xerostomia and the presence of two of four autoantibodies), 16 patients with secondary SS (group B), 16 patients with connective tissue disease but no evidence of secondary SS (group C) and 14 normal controls (to establish the threshold of the six tests). SFR was decreased in 68, 56 and 19% of the patients in groups A-C respectively [sensitivity (sens) 68%, specificity (sp) 81%, positive predictive value (PPV) 90% and negative predictive value (NPV) 50% for primary SS]. Lys was elevated in 3, 0 and 0% of the patients in groups A-C (sens 3%, sp 100%, PPV 100% and NPV 66%). Lf was reduced in 58, 69 and 25% of the patients in groups A-C (sens 58%, sp 75%, PPV 82% and NPV 53%). SG was positive in 74, 27 and 13% of the patients (sens 74%, sp 87%, PPV 93% and NPV 41%). SGS was positive in 75, 63 and 25% of the patients (sens 75%, sp 75%, PPV90% and NPV 45%). SGB was abnormal in 95, 94 and 25% (sens 95%, sp 75%, PPV 90%, NPV 14%).(ABSTRACT TRUNCATED AT 250 WORDS)
8242827 [Lymphocyte subsets in labial salivary gland of Sjogren's syndrome]. 1993 Apr Using the immunohistochemical avidin-biotin-peroxidase complex (ABC) method, lymphocyte subsets in the salivary glands of 15 patients with primary Sjogren's syndrome, 7 patients with secondary Sjogren's syndrome and 4 normal controls were identified by monoclonal antibodies. The infiltrating lymphocytes were mainly T lymphocytes, the majority of which were T helper cells (Leu-3a) in SS groups. The Leu-3a/Leu-2a ratio was increased. These changes were related to the degrees of the disease. The lymphocytes of patients expressed the HLA-DR antigen (Ia). Thus genetic predisposition plays an important role in the disease. A proposed mechanism is that the deficiency of suppressor lymphocytes and the overactivity of helper lymphocytes would result in B cells becoming hyperactive. Multiple autoantibodies produced by the B cells would contribute to tissue damage, and the tissue fragments would in turn further stimulate antibody production.
8686386 [Successful therapeutic management of risk pregnancy in primary Sjögren syndrome with pla 1996 Mar We describe a 28-year-old woman with primary Sjögren's syndrome who had a miscarriage in the 10th week of gestation in December 1993. In her second pregnancy plasma hyperviscosity and high antibody reactivities to 52/60 kD Ro(SS-A) and La(SS-B) represented elevated risk factors for abortion and fetal congenital heart block. Therefore, we performed plasmapheresis and administered dexamethason. At the end of 37th week of gestation a healthy boy was born by caesarean operation. Interestingly, antibody levels to the anti-Ro(SS-A)/La(SS-B) complex showed an increase during both pregnancies with a decline after the abortion as well as the partus. The combined therapy led to a decrease in both the autoantibody reactivities to 52 kD Ro(SS-A) and La(SS-B) and the plasmaviscosity. Plasmapheresis and dexamethason are safe treatment modalities in identified high risk pregnancies for the birth of a child with CHB.
8055202 Liver involvement in primary Sjögren's syndrome. 1994 Aug Three hundred patients with primary Sjögren's syndrome (pSS) were investigated for liver involvement using clinical, biochemical, immunological and histological data. Seven per cent of patients showed evidence of liver disease either subclinical (2%) or asymptomatic (5%) with elevated liver enzymes. In 6.6% of patients antimitochondrial antibodies (AMA) were detected by immunofluorescence and 27% of pSS patients showed antibodies to pyruvate dehydrogenase (a-PDH) using ELISA. AMA-positive patients were further investigated with transcutaneous liver biopsy. Ninety-two per cent of patients with AMA showed liver involvement with features of chronic cholangitis similar to stage I primary biliary cirrhosis. It is concluded that liver involvement in pSS patients is rare and subclinical with histological features predominantly of stage I primary biliary cirrhosis. AMA is the most sensitive indicator of underlying liver pathology in pSS patients.
1400343 Human autoantibodies as reagents to conserved Golgi components. Characterization of a peri 1992 Oct 5 We have used a serum from a patient with Sjögren's syndrome containing high titer (100,000) anti-Golgi autoantibodies and lower titer (20,000) anti-nuclear autoantibodies to characterize the Golgi complex. The Sjögren's syndrome serum immunoprecipitated a number of components of molecular mass 35-230 kDa from detergent extracts of [35S]methionine-labeled HeLa cells; at high dilution, the serum precipitated one major 230-kDa component. Using the Sjögren's syndrome serum, cDNA clones encoding the Golgi autoantigen were isolated from a lambda gt11 HeLa cell cDNA library. Autoantibodies from the Sjögren's syndrome serum, affinity purified from a recombinant bacterial fusion protein generated from one of the cDNA clones, showed Golgi staining of human, mouse, and chicken cells by immunofluorescence. The purified autoantibodies immunoprecipitated and immunoblotted a 230-kDa component. A rabbit antiserum raised to the recombinant fusion protein specifically stained the Golgi complex by immunofluorescence and reacted with a 230-kDa protein by immunoprecipitation and immunoblotting. The 230-kDa protein was recovered in both the 100,000 x g sedimentable and soluble fractions in cell lysates and in the aqueous phase of Triton X-114 extracts. The 230-kDa autoantigen was dissociated from the Golgi complex by 15-min brefeldin A treatment, dissociation kinetics similar to that of mannosidase II. However, unlike mannosidase II, autoantigen staining was markedly reduced after drug treatment. Removal of brefeldin A resulted in reassociation of the autoantigen with the Golgi complex. The epitopes recognized by the affinity purified human and rabbit antibodies were ultrastructurally localized to the cytosolic face of one side of the Golgi stack, probably the trans-face. Taken together, the 230-kDa protein is a conserved, peripheral membrane component specifically associated with one Golgi compartment. We suggest that this peripheral Golgi protein may have a role in the compartment-specific structural organization of the Golgi or in sorting and transport of proteins.
1386602 Characterization of autoantibodies that recognize U4/U6 small ribonucleoprotein particles 1992 Aug 15 We identified autoantibodies that recognize the U4/U6 snRNPs in a serum from a 63-year-old Japanese patient (TT) with primary Sjögren's syndrome. This patient's serum immunoprecipitated U4 and U6 sn-RNAs exclusively from 32P-labeled HeLa cell extracts and a newly identified 120-kDa protein along with the Sm core proteins (B'/B, D, E, F, and G) from [35S] methionine-labeled HeLa cell extracts. Immunoblotting demonstrated that only the 120-kDa protein was recognized by this unique serum. In glycerol density gradient centrifugation, the 120-kDa protein reactive with TT serum cosedimented with U4 and U6 snRNAs, suggesting that the 120-kDa protein is a unique component of the U4/U6 snRNP particle. In the same study, the U4/U6 snRNP precipitated by TT serum sedimented only in the lower density, whereas anti-Sm antibodies precipitated U4/U6 snRNAs in a broad range of the gradient. This result suggests the presence of at least two molecular forms of the U4/U6 snRNP particles; larger particles, probably the U4/U5/U6 snRNP complex, and free particles. Thus, the U4/U6 snRNP recognized by TT serum includes the U4 and U6 snRNAs, with Sm core proteins, and the novel 120-kDa protein, and appears to be a free particle not associated with larger complexes.
8706179 [Proliferation of PBMC in patients with Sjögren's syndrome via CD2 pathway]. 1995 Oct Primary Sjögren's syndrome is an autoimmune disease whose etiology is unknown. Recent studies show that there is T cell abnormalities in addition to B cell hyperreactivity. In order to better understand the immunoregulatory abnormalities of primary Sjögren's syndrome, cellular immunology has become the main focus of recent studies. As such, the function of CD2 and CD3 pathways constitutes an integral part of these studies. The proliferation of PBMC, non-adhesive cells (mainly T cells) and adhesive cells (mainly B cells) has been investigated in patients with primary Sjögren's syndrome and normal controls; the results show that the proliferation of PMBC and non-adhesive cells in patients is much lower than that in normal controls (P < 0.05), whereas there is no difference in that of adhesive cells between these two groups (P > 0.05). It is also found that the non-adhesive cells' abnormality can not be adjusted by adding adhesive cells of normal controls. In addition, it seems that there is a relationship between the proliferation of PBMC via CD2 pathway in patients and the positivity of anti-SSA and anti-SSB antibodies. However, the underlying mechanism behind the pathogenesis of primary Sjögren's syndrome has yet to be fully understood. This study warrants further research into gaining a better concept of the CD2 pathway at molecular levels.
7917254 A comparison of clinical, pathological and radiological findings with magnetic resonance i 1994 In the past few years a variety of papers on magnetic resonance imaging (MRI) of the salivary glands have been published, mainly focusing on the evaluation of salivary gland tumors. More recently, non-tumorous lesions have also been examined with this imaging technique. In Sjögren's syndrome (SS) a characteristic inhomogeneous pattern with a "honeycomb-like" appearance of the parotid gland tissue has been shown in the T2-weighted sequence. This study shows MRI findings in four cases of intraglandular lymphoma occurring in patients with SS. Four patients with suspected lymphomas were examined with MRI, following which all lesions were either biopsied or removed. This enabled us to correlate clinical, radiological and pathological findings. Results indicate that MRI is a useful imaging tool in the detection of intraglandular lymphatic infiltrates, although it is not possible to distinguish morphologically between a localized lymphatic infiltrate and an early stage malignant lymphoma. Nevertheless, MRI is considered to be a valuable non-invasive method for deciding whether or not to perform a biopsy. Due to the excellent soft tissue differentiation obtained, it is also helpful for the surgeon to plan and perform a successful biopsy with minimal risk to the facial nerve.
7916176 Transmission of molecular information through electro-magnetic waves with different freque 1994 Jan Our previous study indicates the principle that information on the molecular structure and its quantity will be transmitted bi-directionally through a red-spectrum soft laser beam when specific molecules are placed in the close vicinity of the laser beam. The method was immediately applied for diagnosing diseases or localizing specific substances, using the Bi-Digital O-Ring Test, in moving or stationary animals or human subjects at clearly visible distances, without directly contacting the subject. This principle was also applied for the microscopic Bi-Digital O-Ring Test to examine cellular structures and substances within the cell at the magnified focused projected plane. The method was further expanded to an electron-microscopic Bi-Digital O-Ring Test, where, instead of a light beam as a source of electromagnetic wave carrier, an electron beam was used. Thus, it was possible to study the ultra-fine structure of cells. During the past several years, the author has been experimenting with the question of whether, instead of using visible light in the microscopic Bi-Digital O-Ring Test, if much shorter wavelengths, such as X-ray with strong penetrating force through living tissue, are used as the carriers of molecular information, and if X-ray pictures of the body are evaluated by a similar method as in the microscopic Bi-Digital O-Ring Test, molecular information existing in the pathways of the X-ray through the body might be detectable or not. Our studies indicate that, using X-ray film with good picture quality taken of specific parts of the body, one can detect not only specific microbial infections, such as bacterial, viral, or spirochete (e.g., Lyme), and changes in local chemistry including blood chemistry such as glucose, total cholesterol, uric acid, in major arteries or the heart, but also potentially effective medication. Using the Bi-Digital O-Ring Test resonance phenomenon between a reference control substance and an identical substance or its electromagnetic field imprint, anatomical structures of the soft tissue, such as blood vessels, nerves, and muscles can be identified even when they are not visible on the X-ray film because of the masking effect of other tissues with high density or large volume of tissue. Similar findings were also found in the CAT Scan and MRI pictures of normal and abnormal organs of the body. In this paper, two examples of such analyses, i.e. X-ray films of one patient with adenocarcinoma of the colon and another patient with rheumatoid arthritis of the knee joint are shown.
8339139 The association of HLA DR beta alleles with self-limiting and persistent forms of early sy 1993 Jul RA is associated with a group of class II DR beta alleles, which share a conserved sequence in the third allelic hypervariable region (3AHVR). These include the DR4 subtypes Dw4, Dw14 and Dw15, and also DR1. In contrast Dw10 and Dw13 which are also DR4 subtypes show no association with RA and have a quite distinct 3AHVR. We have assessed the frequency of these alleles in 55 patients who initially presented with symmetrical peripheral polyarthritis suggestive of RA. After 4 years 27 had progressed to definite or classical RA, while 28 had never fulfilled the criteria for this disease. Dw4 was markedly elevated in the rheumatoid group (17/23) compared with either the non-rheumatoids (5/28) or healthy controls (12/100). Dw14 and non-DR4 associated DR1 were not elevated in either group of patients. This study suggests that the DR beta association with RA is likely to facilitate persistence or severity of disease rather than the initial induction of symmetrical peripheral arthritis.
21413289 Bone, Joint, and Necrotizing Soft Tissue Infections. 1996 Necrotizing infections of the soft tissues are characterized by extensive tissue necrosis and production of tissue gas. These infections may extend through tissue planes and are not well contained by the usual inflammatory mechanisms. They may develop and progress with dramatic speed, and extensive surgery and systemic antibiotic therapy are required to eradicate them. Arthritis or inflammation of a joint space may be caused by a wide variety of infectious or noninfectious processes. Non-infectious arthritis is the more common type of arthritis and is usually secondary to degenerative, rheumatoid, or posttraumatic changes within the joint. Infectious arthritis, although less common, is often accompanied by a striking polymorphonuclear inflammatory response and can cause severe destruction of the articular cartilage if not properly diagnosed and treated. Bone infections are called osteomyelitis (from osteo [bone], plus myelitis [inflammation of the marrow]). Hematogenous osteomyelitis and contiguous-focus osteomyelitis are the two major types of bone infections. Both types can progress to a chronic bone infection characterized by large areas of dead bone. Bone, joint, and soft tissues, with the exception of the skin, are normally sterile areas. Bacteria may reach these sites by either hematogenous spread or spread from an exogenous or endogenous contiguous focus of infection (Fig. 100-1). Host defenses are important in containing necrotizing soft tissue infections. A systemically or locally compromised host (Table 100-1) is more likely to develop these types of infections and to be unable to contain them.
8867539 Rheumatic manifestations of malignancy. 1996 Jan Rheumatic manifestations of malignancy include a wide spectrum of osteoarticular, muscular, glandular, endocrinologic, and systemic features, posing a therapeutic challenge. The clinician should be aware that Sjögren's syndrome, polymyositisdermatomyositis, rheumatoid and rheumatoid-like arthritis, polymyalgia rheumatica and temporal arteritis, and diverse osteomuscular conditions may be the immunopathogenic features of a neoplasm, the direct consequence of osteomuscular tumors, the effect of tumor-associated hormones, or the consequence of cancer therapy. The principal articles that have appeared in the past year on these associations are discussed. We also review the association of x-ray irradiation and cancer in patients with ankylosing spondylitis.
7556293 Rhenium-188 sulphur colloid as a radiation synovectomy agent. 1995 Jun Radiation synovectomy has been shown to be an effective treatment for the rheumatoid arthritic knee. In this study, we evaluated the suitability of rhenium-188 as a radiation synovectomy agent. In addition, we were successful in labelling sulphur colloid with 188Re. In vitro stability tests revealed that more than 95% of the 188Re remained in colloid form over a 3-day period. Intra-articular injection of 188Re sulphur colloid into arthritic rabbit joints was followed by gamma camera imaging to quantify the leakage. The mean retention percentages of 188Re colloid in arthritic knees were 93.7% (+/- 1.4%), 90.8% (+/- 1.7%) and 87.2% (+/- 0.6%) at 1 h, 1 day and 2 days, respectively. A biodistribution study of the arthritic rabbits revealed that the highest activity outside the knees was in the liver and the kidneys. Our preliminary results indicate that 188Re sulphur colloid may be an effective radiopharmaceutical for radiation synovectomy.
19077969 The 'rule out lupus' rheumatology consultation: clinical outcomes and perspectives. 1995 Jun Forty-four female patients who met the following criteria were studied. All were referred for rheumatology consultation because of symptoms and a positive antinuclear antibody (ANA) to rule out lupus. None fulfilled the American College of Rheumatology (ACR) criteria for systemic lupus erythematosus (SLE) at the time of the initial visit. All had a normal or noncontributory complete blood count, urinalysis, and blood panel. They lacked antideoxyribonucleic acid, anti-Smith (anti-Sm), antiribonucleoprotein (anti-RNP), anti-Ro, anti-La, and antiscleroderma 70 (anti-Scl-70) antibodies, and none had rheumatoid factor, elevated creatine phosphokinase levels, or decreased C3 complement or C4 complement values. We performed additional tests or procedures in an effort to improve diagnostic accuracy. Nine of 44 (20%) had a negative ANA on retesting. All patients were tested for antiribosomal P, antineuronal, antihistone-(H2A-H2B)/deoxyribonucleic acid complex antibody, anti-smooth muscle antibody and antithyroid antibodies, as well as Westergren sedimentation rate. Anticardiolipin antibody, serum protein electrophoresis, bone scanning, or skin biopsies with or without lupus band testing were obtained as clinically indicated. At the 6-month follow-up, 19 patients (43%) fulfilled the ACR criteria for SLE, 14 (32%) fulfilled the ACR criteria for fibromyalgia only, 4 (9%) had seronegative rheumatoid arthritis, 1 (2%) had myasthenia gravis, and 6 (14%) remained undiagnosed; 18/19 diagnosed with SLE had an additional antibody or positive diagnostic test listed above versus 3/25 without SLE (p<0.0001). Additional laboratory and diagnostic testing beyond the routine ANA profile correlated with the evolving diagnosis in 86% of the patients at 6 months.
9345435 Failure to detect measles virus RNA, by reverse transcription-polymerase chain reaction, i 1996 Feb We have examined peripheral blood leucocytes (PBLs) from 17 multiple sclerosis patients, two patients with rheumatoid arthritis, one case of acute childhood measles and one case of subacute sclerosing panencephalitis, as well as 19 healthy adult controls for measles virus (MV) RNA, by the technique of reverse transcription-polymerase chain reaction. MV nucleocapsid gene specific primers were used to amplify all PBL-derived cDNA samples. These proved to be negative with the exception of the sample derived from the acute measles case. Selected cases were examined further, using fusion gene and matrix gene specific primers. MV RNA could not be detected.
8773281 Relationship between atlanto-odontoid osteoarthritis and idiopathic suboccipital neck pain 1996 Jan We discuss the relationship of atlanto-odontoid (AO) (anterior C1-C2 joint) osteoarthritis to suboccipital pain. A questionnaire regarding suboccipital neck pain was presented to 210 consecutive patients undergoing computed tomography (CT) of the brain or sinuses for a variety of indications. In all patients the AO joint and the lateral scout image of the cervical spine were studied. In 104 (49%) degenerative changes were seen at the AO joint. There were 89 patients (42%) who reported pain in the suboccipital region, although this was not the reason for CT in any patient. Statistical analysis of the prevalence of suboccipital neck pain in all patients showed the presence of AO osteoarthritis seen on CT to be associated with occurrence of these symptoms. This association remained significant in the same study population after excluding patients with a history of rheumatoid arthritis, migraine, stress and neck trauma and patients with signs of degenerative changes of C2-C7 on the computed lateral scout image.
7576228 Cytokine regulation of matrix metalloproteinase activity and its regulatory dysfunction in 1995 Jun Matrix metalloproteinases (MMPs) represent a family of structurally and functionally related enzymes responsible for the proteolytic degradation of extracellular matrix (ECM) components such as basement membrane or interstitial stroma. MMPs are important participants of normal tissue remodeling. Due to their potential hazardous effects MMPs are highly regulated at different levels. At the transcriptional level, MMP expression is precisely controlled by various cytokines acting through positive or negative regulatory elements of its genes. Moreover, MMP activity is post-transcriptionally regulated by proteolytic activation of the latent proenzymes and by interaction with specific tissue inhibitors of metalloproteinases (TIMPs). Expression and secretion of both MMP activating enzymes and TIMPs are also influenced by cytokines. Dysregulation of MMP production and activation may cause altered extracellular proteolysis that is associated with a number of diseases such as rheumatoid arthritis and tumor metastasis. Thus, the molecular analysis of the regulatory mechanisms of gene expression and activity of MMPs and their inhibitors is essential for understanding the complex scenario of tissue remodeling and ECM degradation under both normal and pathological conditions.
8068494 Disposition and absorption of hydroxychloroquine enantiomers following a single dose of th 1994 The disposition of hydroxychloroquine enantiomers has been investigated in nine patients with rheumatoid arthritis following administration of a single dose of the racemate. Blood concentrations of (-)-(R)-hydroxychloroquine exceed those of (+)-(S)-hydroxychloroquine following both an oral and intravenous dose of the racemate. Maximum blood concentrations of (-)-(R)-hydroxychloroquine were higher than (+)-(S)-hydroxychloroquine after oral dosing (121 +/- 56 and 99 +/- 42 ng/ml, respectively, P = 0.009). The time to maximum concentration and the absorption half-life, calculated using deconvolution techniques, were similar for both enantiomers. The fractions of the dose of each enantiomer absorbed were similar, 0.74 and 0.77 for (-)-(R)- and (+)-(S)-hydroxychloroquine, respectively (P = 0.77). The data suggest that absorption of hydroxychloroquine is not enantioselective. The stereoselective disposition of hydroxychloroquine appears to be due to enantioselective metabolism and renal clearance, rather than stereoselectivity in absorption and distribution.
7528023 Topical capsaicin-pharmacology and potential role in the treatment of temporomandibular pa 1994 Capsaicin is an over-the-counter topical analgesic marketed at 0.025% and 0.075% concentrations. It is currently approved by the United States Food and Drug Administration for the topical relief of pain due to rheumatoid arthritis, osteoarthritis and various neuralgias. This paper will review the basic and clinical pharmacology of capsaicin, and discuss its potential role in the management of pain in the temporomandibular joint region.