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

ID PMID Title PublicationDate abstract
11334506 From reactive arthritis to rheumatoid arthritis. 2001 May Reactive arthritis was initially described as a sterile synovitis, without microbial components present in the joint tissue. It has, however, become evident that bacterial degradation products, and even bacterial DNA, are present in the synovium of patients with this disease. Since intestinal pathogens are important causes of reactive arthritis, and since cellular homing allows transport of bacterial products from the gut to synovium, we have approached the etiology of rheumatoid arthritis from this point of view. A series of observations has led to a hypothesis that patients with rheumatoid arthritis might favour, for genetic reasons, intestinal bacteria which are capable of inducing arthritis. In the long-run, with continuous seeding of bacterial products from the gut, the synovial inflammation is followed by erosion, exposition of cartilage antigens, and autoimmunity.
9888111 Diagnostic investigations in 101 dogs with pyrexia of unknown origin. 1998 Dec Records from 101 dogs presented for investigation of unexplained pyrexia were reviewed. The most common diagnosis was immune-mediated disease (22 per cent of cases), with immune-mediated polyarthritis accounting for 20 per cent of all diagnoses. The frequency of positive results obtained in investigative tests was also assessed. Cytological and radiological examinations provided a high diagnostic success rate, although routine haematology and plasma biochemistry were also useful screening tests. On the basis of these results it is suggested that, in the investigation of unexplained pyrexia, a diagnosis of immune-mediated polyarthritis should be excluded before less common diagnoses are considered.
10749034 Hand performance assessment of ten people with rheumatoid arthritis when using a range of 2000 Feb 15 PURPOSE: The aim of the pilot study was to provide information about the design and use of saucepan handles to enable clinicians and designers to specify and provide products that are more appropriate for use by people with Rheumatoid Arthritis (RA). The objectives were: to evaluate aspects of new handle design for saucepans in terms of their ease of use for people with RA; document hand grip strength and configuration (grip patterns); record relevant anthropometric data to aid the development of new designs and perform an assessment of lifting techniques used in conjunction with perceived optimum handle configuration. METHOD/RESULTS: Observation and video footage show that subjects continued to use familiar, but damaging, ways of lifting the saucepan even after extensive joint protection training by occupational therapists. Grip strengths recorded using a sphygmomanometer were similar to those found by other studies. The anthropometric measurements taken from the sample group were found to be within available anthropometric surveys of able-bodied people. However, hand length within the sample group with RA was longer than the equivalent in surveys of able-bodied subjects. CONCLUSIONS: Subjects preferred the narrower handles with some surface texture to the larger and more rounded tapered handles. Large handled saucepans were found not to be viable due to the constraints of UK cooking hob sizes and existing British Standards relating to saucepan specification.
9106317 Biomechanical analysis of buckling alignment of the cervical spine. Predictive value for s 1997 Apr 1 STUDY DESIGN: A biomechanical analysis of the buckling type of alignment on nonfused cervical segments was carried out in patients with occipitocervical fusion for atlantoaxial dislocation. OBJECTIVES: To examine whether biomechanical analysis is useful for preoperative prediction of subaxial subluxation after occipitocervical fusion. SUMMARY OF BACKGROUND DATA: Rheumatoid arthritis sometimes causes subaxial subluxation after occipitocervical fusion. At present, there are no widely accepted criteria for determining the appropriate extent of fusion to prevent subluxation. METHODS: The subjects were 25 patients with rheumatoid atlantoaxial dislocation and 15 patients with nonrheumatoid atlantoaxial dislocation who underwent occipitocervical fusion. Preoperative and postoperative alignment of the cervical spine were analyzed biomechanically, using a specially developed computer program. RESULTS: Five segments of nonfused cervical spine had subluxation after surgery in the rheumatoid group. For these segments, the preoperative value of buckling averaged 13.5 x 10(-4) and exceeded 10 x 10(-4) in all cases. For the segments that showed no subluxation after surgery, the preoperative value of buckling averaged 4.5 x 10(-4). Subluxation of the nonfused segments did not develop in the nonrheumatoid group. CONCLUSIONS: In patients with rheumatoid arthritis, segments that show abnormal buckling before surgery are likely to develop subluxation after occipitocervical fusion. Preoperative values of buckling over 10 x 10(-4) constitute a risk factor for subaxial subluxation after occipitocervical fusion.
9710891 IL-10 as a therapeutic strategy in the treatment of rheumatoid arthritis. 1998 Aug IL-10 has anti-inflammatory and immunoregulatory properties that suggest a potential therapeutic role in RA. IL-10 inhibits proinflammatory cytokine and chemokine production in addition to blocking T-cell responses to specific antigens. It acts primarily through inhibition of costimulatory properties of macrophages. IL-10 stimulates proliferation and differentiation of antibody-forming B-cells. Preclinical studies in a variety of animal models, including collagen-induced arthritis, have shown that IL-10 is effective in preventing or inhibiting inflammation and autoreactivity. Although in RA, circulating and synovial levels of IL-10 are increased, accumulated evidence suggests that there may be a relative deficit of available IL-10. Moreover, exogenous addition of IL-10 in vitro has been shown to affect the immunopathological processes involved in RA. Preliminary studies of human recombinant IL-10 in patients with RA have demonstrated a trend towards efficacy with a good safety profile. Taken together, the data support a therapeutic role for IL-10 in the treatment of RA.
11108650 Modeling the HLA component in rheumatoid arthritis: sensitivity to DRB1 allele frequencies 2000 Dec Rheumatoid arthritis is an inflammatory disease for which positive associations have been described with some HLA-DRB1 alleles. The associated alleles share a similar amino acid sequence in the third hypervariable region, the shared epitope, but differ at position 71 and 86. It has been suggested that HLA susceptibility to rheumatoid arthritis could be due not only to the shared epitope but could also be influenced by specific amino acids at positions 71 and 86. In this study, we investigated the role of these amino acids in rheumatoid arthritis on 203 unrelated patients. An involvement of amino acid 71 was detected but no conclusion was possible regarding amino acid 86. A study of the sensitivity of the conclusions to marker allele frequencies was performed. We showed that the results obtained for amino acid 71 are not very sensitive to allele frequencies but those obtained at position 86 are highly sensitive. This emphasizes the importance of studying the robustness of results to variations in allele frequencies before conclusions are drawn.
11257158 Pro-inflammatory interleukins in the synovial fluid of rheumatoid arthritis associated wit 2001 Feb BACKGROUND: Joint hypermobility (JH) is frequently seen in rheumatology; in some cases, such as rheumatoid arthritis (RA), it may represent a worsening of disease evolution. The aim of our study was to evaluate the influence of joint hypermobility on RA synovial fluid (SF) inflammation. Patients and methods. One hundred consecutive adult patients with RA and joint effusion of the knee were examined for the presence of JH. In the SF we evaluated volume, the number of white blood cells (WBC) and the levels of interleukin (IL)-1beta, IL-6 and IL-8 and prostaglandin E2 (PGE2). RESULTS: JH was associated with RA (JH-RA) in 18 patients, all of whom were female. Compared with non-JH RA, all the SF indices found in JH-RA were higher, although significant differences were observed only for volume, IL-8 and PGE2. CONCLUSION: In JH-RA, increased joint mobility seems to be associated with a more severe local inflammatory response, which may contribute to the more erosive evolution observed in our patients.
11001373 New insights into the pathogenesis of rheumatoid arthritis. 2000 Jun T lymphocytes play a critical role in the inflammatory process of rheumatoid arthritis (RA). Studies in a new animal model of RA, created by implanting human inflamed synovium into SCID mice, have confirmed that the production of matrix-degrading enzymes and pro-inflammatory cytokines is ultimately under T-cell control. T-cell dysfunction in RA patients also alters T-cell dynamics, resulting in profound abnormalities in T-cell pool composition. The cause and consequences of altered T-cell dynamics in RA are not yet understood, but factors determining T-cell homeostasis include the generation of new T cells, loss of T cells during immune responses and self-renewal of T cells within the system. Understanding the mechanisms that govern the formation of the T-cell pool in RA emphasizes the dynamic and quantitative aspects of lymphocyte behaviour in RA and has profound therapeutic implications when devising strategies to counteract T-cell dysfunction.
10627433 Reduced incidence of alcohol related deaths in subjects with rheumatoid arthritis. 2000 Jan OBJECTIVES: It has previously been shown that people with ankylosing spondylitis have an increased incidence of alcohol related deaths from accidents and violence. This study investigated alcohol related deaths in subjects with rheumatoid arthritis (RA). METHODS: The study covered the subjects, 1666 in number, who had died in 1989 and had been entitled under the nationwide sickness insurance scheme to receive specially reimbursed medication for RA. RESULTS: There were eight alcohol related deaths among the 480 men and three deaths among the 1186 women with RA. The standardised mortality ratios and their 95% confidence intervals (CI) were 0.40 (95% CI 0.20, 0.80) and 0.40 (95% CI 0.13, 1.26), respectively. CONCLUSION: Alcohol either protects from RA or, subjects with RA curtail their drinking after the manifestation of RA.
9775673 A potential moderating role of stress in the association of disease activity and psycholog 1998 Aug This study investigated the role of perceived daily stress as a potential moderator in the relation between a set of predictors (disease activity, education, pain) and psychological status (anxiety, depression) of 31 patients with rheumatoid arthritis. Psychological measures served as dependent variables in hierarchical regression analyses testing for potential interaction effects of daily stress upon relationships between predictors and dependent measures. No predictors predicted directly scores on depression and anxiety; however, daily stress directly predicted scores on depression and anxiety, even after having separately controlled for each of the predictors. Increased disease activity had significantly stronger associations with increased psychological morbidity only among patients reporting high scores on daily stress, suggesting a potential moderating role for stress.
9021501 5- to 18-year follow-up study of cemented total knee arthroplasty for patients 55 years ol 1997 Jan Seventy-two cemented total knee arthroplasties were performed on 52 patients who were 55 years old or younger. Results on 68 knees in 50 patients with an average follow-up period of 9.92 years are reported. The average age of the patients was 50.7 years (range, 30-55) at the time of surgery. The diagnosis was osteoarthritis in 37 knees, rheumatoid arthritis in 29 knees, and ankylosing spondylitis in 2 knees. The average preoperative Knee Society knee score was 23 and the average follow-up knee score was 97. All knees were rated as good or excellent for knee score. The average latest function score was 75 (preoperative, 36). Both knees in one patient required revision for loose components. This review demonstrates that cemented total knee arthroplasty in younger patients with osteoarthritis and rheumatoid arthritis can attain results comparable to the excellent results obtained in the older age groups.
10068780 Quantitative histochemical study of hyaluronic acid binding protein and the activity of ur 1999 Feb OBJECTIVE: To examine hyaluronic acid (HA) dynamics in synovia with rheumatoid arthritis (RA), relying on a new quantitative technique introduced into histochemistry. STUDY DESIGN: Synovial lesions from 28 patients were classified into four histologic stages of RA according to the degree of inflammation. The distribution of HA was histochemically investigated with a hyaluronic acid binding protein (HABP) and that of HA-producing cells enzyme histochemically with the expression of uridine diphosphoglucose dehydrogenase (UDPGD) activity in the synovium of RA patients. The results were quantified using an image processor for analytical pathology. The positive area of HABP reaction, the number of UDPGD-positive cells and the color density of the enzyme-histochemistry of UDPGD activity were measured with the IPAP system. RESULTS: HA was shown to be diffusely distributed in the synovia, particularly densely in the superficial layer, and the distribution overlapped with that of UDPGD activation. HA distribution and UDPGD activity varied with the severity of synovial inflammation, and the positive area was the most extensive in the early stage, while it completely disappeared in the fibrotic stage. CONCLUSION: We assume that for HA, not only does the production decrease, but the range of distribution contracts with time.
9375985 HLA markers in a community-based rheumatoid arthritis series. 1997 Aug We wanted to investigate whether rheumatoid arthritis (RA) patients, defined by the American College of Rheumatology (ACR) 1987 criteria and selected from one community by the help of the official Finnish data registers, share the common HLA susceptibility genes. The HLA frequencies of 88 RA patients representing 85% of the prevalent cases of RA in the community were compared with those of 188 healthy controls. Fifty-four per cent of the index cases with RA had DR4 compared with 30% of the healthy controls (P <0.001). The 'RA susceptibility sequence' was found in 75% of the DRB1 genes in the index cases, but it did not correlate with the severity of the disease. The frequency of DR3 was not increased in RA patients but it was associated with features of severe disease, that is, with a high erythrocyte sedimentation rate (P<0.05), extra-articular disease (P<0.01) and prostheses in large joints (P<0.05). According to our results community-based RA patients satisfying the new ACR criteria show the common DR4 association. DR3 was the only HLA allele which showed some disease-modifying effect correlating with the severity of RA.
14635281 The disease process and utilization of health services in rheumatoid arthritis: the relati 2000 Apr OBJECTIVE: To examine the predictive ability of a wide array of measures of disease severity in explaining Dutch and German patterns of health services utilization during a 2-year period. METHODS: Slightly over 200 rheumatoid arthritis (RA) patients, 136 from a Dutch and 98 from a German outpatient clinic, supplied information on symptom and functional status, global health, and emotional and social functioning at baseline. The patients' rheumatologists provided clinical assessments of functional grade and disease activity. A questionnaire mailed twice at 12-month intervals was the source of retrospective information on physician consultations, hospitalization, and referrals for surgery and physical therapy during the previous period. Major determinants of use were studied with multivariate analyses. RESULTS: German patients reported more frequent physician contacts than Dutch patients, but the volume of surgery, hospital admissions, and referrals for physical therapy did not differ between the two countries. In a hierarchical regression, the consultation rate was directly associated with pain quality and global health. Markers of RA progression were related to surgery, and the latter to volume of in-hospital care. Fatigue severity and physical disability predicted referrals for physical therapy. Patient self-management activities were only weakly associated with disease severity variables. CONCLUSION: The activity and damage components of RA were related to the separate components of total health service utilization. Disease activity was the prime determinant of physician services used, and RA progression the determinant of surgical interventions and hospitalization.
9485088 Age, depressive symptoms, and rheumatoid arthritis. 1998 Feb OBJECTIVE: To examine the relationship between age and depression in persons with rheumatoid arthritis (RA). METHODS: Two separate outpatient cohorts of persons with RA were studied. In both studies, the Center for Epidemiological Studies Depression Scale was administered to all subjects, and the prevalence of depressive symptoms was determined by age group. In the second study, data on additional measures of disease activity, pain, life stress, and coping were collected for use in multiple linear regression analyses. RESULTS: In both samples, a significant correlation between age and depression was found; younger persons (age < or = 45 years) with RA were significantly more depressed, even after controlling for potentially confounding variables such as sex, marital status, antidepressant medication, arthritis medication, functional class, and disease duration. CONCLUSION: The findings show that younger persons with RA are at higher risk for depressive symptoms than their older counterparts.
10097305 [Efficacy of D-penicillamine and methotrexate in the treatment of rheumatoid arthritis in 1999 AIM: To optimize treatment for rheumatoid arthritis (RA) and to define indications for D-penicillamine and methotrexate therapies on an individual basis by taking into account the levels of rheumatoid factor (RF) isotopes circulating in blood. MATERIALS AND METHODS: A total of 105 patients (mean age 46.39 +/- 1.35 years) with varying RA were observed. Indirect solid-phase enzyme immunoassay was used to analyze RF isotopes; the pattern of the disease and the efficiency of therapy for RA were compared with the patients' immunity. RESULTS: With elevated RF IgG levels, the cardiovascular system, thyroid, mucous membranes were found to be more frequently impaired and vasculitis was diagnosed. CONCLUSION: The use of cuprenil and methotrexate in RA substantially improves patients' immunity.
11128666 Detection and quantitation of stem cell factor (kit ligand) in the synovial fluid of patie 2000 Dec OBJECTIVE: To identify and quantitate stem cell factor (SCF; kit ligand) in the serum and synovial fluid (SF) of patients with rheumatoid arthritis (RA) and to compare these values with those measured in normal serum, RA serum, SF of patients with other rheumatic diseases, and conditioned medium from cultured synoviocytes. METHODS: SCF was measured in serum, SF, and conditioned synovial cell culture medium by a sensitive ELISA. Results were correlated with hematologic variables including white blood cell count, hemoglobin, platelet count, erythrocyte sedimentation rate, and rheumatoid factor. RESULTS: SCF levels in RA SF exceeded those measured in RA serum, osteoarthritis SF, and SF from patients with other inflammatory arthropathies. SCF was detectable in conditioned medium from cultured synoviocytes. CONCLUSION: High levels of SCF are present in RA serum and SF. Local production of SF may influence expansion of myeloid progenitor cells and mast cell function in RA.
9751089 Radiographic outcome of recent-onset rheumatoid arthritis: a 19-year study of radiographic 1998 Sep OBJECTIVE: To describe the longitudinal radiographic course of rheumatoid arthritis (RA), and to identify and quantitate predictors of radiographic progression. METHODS: This prospective, longitudinal study of radiographic progression and clinical predictors of RA involved 256 patients with RA who were seen within the first 2 years of disease (mean 0.77 years) and were followed up for up to 19 years. Participants underwent a total of 6,278 clinical assessments (mean 24.5) and 934 paired radiographs (mean 3.1, range 2-6). Clinical assessments at every visit included determination of the erythrocyte sedimentation rate (ESR), grip strength, pain scores, tender joint counts, and anxiety and depression measurements. Regression analyses utilized time-integrated predictors. RESULTS: Overall, radiographic progression rates, as measured by the summary Sharp scores, appeared constant over the course of RA. The strongest correlate of progression was the time-integrated ESR (rho=0.53). This association grew stronger with time. At 0-5 years, 5-10 years, 10-15 years, and 15-20 years, correlations were 0.40, 0.50, 0.65, and 0.74, respectively, and for the period 10-20 years, the correlation was 0.67. In multivariate models, the mean ESR, mean grip strength, rheumatoid factor positivity, and tender joint count were independent predictors of radiographic progression. CONCLUSION: Radiographic damage occurs at a constant rate in RA, and is not greater early in RA or reduced later in the course of the illness. Acute-phase reactants are, by far, the strongest determinants of progression.
9536392 Enterobacterial antibodies in Chinese patients with rheumatoid arthritis and ankylosing sp 1998 Mar OBJECTIVE: To study the role of microbial infection in rheumatic diseases. METHODS: Sera from 39 Chinese patients with rheumatoid arthritis (RA), 52 patients with ankylosing spondylitis (AS) and 51 healthy subjects (HS) were examined for IgG, IgA, and IgM class antibodies against Proteus mirabilis, Escherichia coli, Campylobacter jejuni, Salmonella typhimurium and enteritidis, Yersinia enterocolitica, and Klebsiella pneumoniae (capsular serotypes 31 and 43), using an enzyme-linked immunosorbent assay. RESULTS: In patients with RA, IgA class antibodies against all bacterial strains used as the antigen were increased when compared to healthy controls. In patients with AS, significantly elevated IgA levels were observed against Campylobacter and Klebsiella K43. IgM class antibodies were less frequently elevated in RA and in AS than IgA class antibodies. In RA patients, IgG antibodies against Klebsiella K43 and Proteus were significantly increased. No differences were observed in IgG class antibodies between AS patients and healthy controls. CONCLUSION: Increases in serum bacterial antibodies in RA and AS suggest that in both diseases stimulation of the intestinal immune system by enterobacteria may have a role. However, the question whether this phenomenon is due to increased intestinal permeability and/or represents cross reactions between different enterobacteria remains open.
11257146 Mortality associated with cervical spine disorders: a population-based study of 1666 patie 2001 Feb OBJECTIVE: To evaluate the mortality associated with cervical spine deformities in rheumatoid arthritis (RA) based on national data. METHODS: The role of rheumatoid disorders of the cervical spine as a cause of death was studied in 1666 subjects who died in Finland in 1989 and had been entitled under the national sickness insurance scheme to receive reimbursed medication for RA. Death certificates and certificates for drug reimbursement of these 1666 patients and the clinical files of 853 patients were examined for the mention of cervical spine disorders. Thereafter, the cervical spine radiographs and detailed clinical histories of patients with diagnosed cervical spine disorder were evaluated separately. RESULTS: According to the official death certificates, cervical spine disorder was not an underlying, contributory or immediate cause of death in any of these patients. Cervical spine abnormalities had been diagnosed only in 38/853 (4.5%) patients. Cervical spine radiographs from 33 patients were available for examination, and in 17 patients cervical spine deformities were found to be severe enough to be a potential cause of fatal complications. Among these 17 cases, four sudden and four postoperative deaths were recorded (one after cervical spine operation) and three patients were suffering from quadriparesis or paraparesis at the time of death. Among the other 16 patients with cervical spine radiographs, the cervical deformities were less severe and their death histories differed from those of the group with more severe deformities. CONCLUSIONS: Cervical spine disorders in RA should be diagnosed early and treated actively to prevent severe and potentially fatal complications. Deaths caused by these disorders are rare, but they should be remembered when the death certificates are written.