Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 11112671 | Bartonella infection associated with systemic juvenile rheumatoid arthritis. | 2001 Jan | A 4-year-old girl with systemic juvenile rheumatoid arthritis had Bartonella infection diagnosed serologically. This case suggested that Bartonella (most probably Bartonella henselae) infection may in part be responsible for the development of systemic juvenile rheumatoid arthritis. | |
| 18020497 | Vaccination against rheumatoid arthritis: concepts and progress. | 1997 Aug | Recently, interest has grown in the potential benefit of vaccination approaches in humans with rheumatoid arthritis. Approaches evaluated include the use of T cell receptor peptide vaccines, autologous T cells, major histocompatibility complex (MHC) peptides, allogeneic mononuclear cells and oral collagen. The use of T cell receptor peptide vaccination in rheumatoid arthritis has been limited to dose-finding and pharmacokinetic studies with Vbeta14 and Vbeta17 peptides. The results of an ongoing placebo-controlled clinical trial with a combination of Vbeta3, Vbeta14 and Vbeta17 peptides will be of interest. Since the pathogenic T cells in rheumatoid arthritis are not known, the use of mixed T cell populations for attenuated autologous T cell vaccination may be necessary. This approach has been evaluated in a small number of patients. Significant clinical or adverse effects were not observed. The appropriate dose, route of administration and method of attenuation of autologous T cells remains to be more clearly defined. In addition, any immunisation approach that targets T cells that are not pathogenic has the potential of immunising against beneficial T cell clones. Rheumatoid arthritis is associated with certain MHC class II alleles (e.g. HLA-DR1 and DR4). Rheumatoid arthritis frequently remits during pregnancy, although the mechanisms associated with this are not clear. Based on this observation, several therapeutic approaches have been evaluated in rheumatoid arthritis. These include placenta-eluted gamma globulins (which contain antibodies to HLA-DR antigens), DR4/DR1 peptide vaccines and allogeneic mononuclear cell vaccination. In uncontrolled trials, each of these approaches has been shown to have no adverse effects and encouraging clinical benefits have been observed, although double-blind placebo-controlled studies will be needed to assess these approaches. Encouraging clinical results have been reported to date with oral administration of type II collagen as a therapy for rheumatoid arthritis, and large multicentre controlled trials are currently under way. | |
| 10893476 | Effect of methotrexate on the temporomandibular joint and facial morphology in juvenile rh | 2000 Jul | Juvenile rheumatoid arthritis is a disease characterized by chronic inflammation in one or more joints; it affects children and adolescents up to 18 years of age. This disease may cause significant skeletal joint destruction, and the temporomandibular joint, like other joints, may become severely affected resulting in aberrant mandibular growth, abnormal dentofacial development, and/or altered orofacial muscle function. Methotrexate is the most common remittive agent used in juvenile rheumatoid arthritis to modify the course of inflammatory destruction of peripheral joints. The purpose of this study was: (1) to evaluate the effect of methotrexate therapy on the prevalence of temporomandibular joint lesions and aberration in craniofacial development in children afflicted with juvenile rheumatoid arthritis; (2) to further examine the relationship between the temporomandibular joint/cephalometric findings and rheumatologic data (ie, age at onset, duration of disease); and (3) to evaluate further pauciarticular- and polyarticular-onset disease in juvenile rheumatoid arthritis and the prevalence of temporomandibular joint lesions and facial dysmorphology. The following information was obtained from 45 patients with juvenile rheumatoid arthritis: (1) routine rheumatologic clinical examination data; (2) anamnestic temporomandibular joint evaluation data; (3) clinical temporomandibular joint examination data; (4) lateral cephalometric measurement data; (5) posteroanterior cephalometric measurement data; and (6) individually corrected axial tomographic data. The results demonstrated the following: (1) radiographic evidence of condylar degeneration was apparent in 63% of all patients with juvenile rheumatoid arthritis with pauciarticular patients showing less temporomandibular involvement than polyarticular patients; (2) polyarticular juvenile rheumatoid arthritis patients receiving methotrexate showed less severe temporomandibular joint involvement than the polyarticular patients not receiving methotrexate; (3) the craniofacial structure was affected to a greater extent in the polyarticular form of the disease; (4) the craniomandibular index scores were significantly greater in the polyarticular group; (5) vertical height asymmetry and chin deviation were noted in more than 50% of the patients; and (6) there was a correlation between the severity of condylar lesions and cephalometric findings (ie, mandibular retroposition, posterior rotation, smaller ramus and mandibular dimensions) and the onset and duration of the disease. In conclusion, under the conditions of this study, methotrexate therapy was effective in minimizing temporomandibular joint destruction and craniofacial dysmorphology in juvenile rheumatoid arthritis patients with the polyarticular form of the disease. | |
| 12806438 | Potential of modulatory cytokines in the rheumatoid arthritis process. | 2001 Nov | Rheumatoid arthritis is a chronic systemic disorder of unknown etiology. It is now generally accepted that the proinflammatory cytokines interleukin-1 (IL-1) and tumor necrosis factor-alpha are key mediators in the pathology of rheumatoid arthritis. Controlling the production and the activity of these mediators represents a major therapeutic goal. First data from clinical trials that showed efficacy, however, also revealed that blockade of these cytokines did not fully control the arthritis in all patients. Recent discoveries of novel cytokines in the pathology of arthritis such as IL-17, IL-18 and RANK ligand (RANKL) will help us better understand the pathogenesis of chronic arthritis and may contribute to improvement of current therapies. IL-4 and IL-10 are pleiotropic cytokines and are considered promising modulators in the control of rheumatoid arthritis. | |
| 10795068 | Rheumatoid Arthritis of the Hip. | 1997 Nov | The hip joint may be affected in 15% to 28% of all patients with rheumatoid arthritis. Radiographic evidence of involvement includes periarticular osteopenia, cystic changes, and a variable amount of progressive protrusio acetabuli. Histomorphometric study has shown increased bone turnover in acetabular biopsy specimens from rheumatoid patients undergoing total hip arthroplasty. Due to the relative fragility of bone in these patients, there is an increased risk of fracture of the proximal femur due to minor trauma, and a high rate of loss of fixation has been reported. Total hip arthroplasty has been successful in the treatment of severe rheumatoid arthritis of the hip in patients of all ages. Special attention should be paid to the cervical spine and the patient's medical treatment regimen during the preoperative evaluation. Cemented total hip arthroplasty has been associated with a higher prevalence of late infection and acetabular component loosening in rheumatoid patients than in osteoarthritic patients. Loosening of cemented components is accelerated in patients with juvenile rheumatoid arthritis. Several short-term studies have documented successful early results with noncemented components in patients with rheumatoid arthritis; however, longer-term studies are necessary to determine whether the improvements in function and survival are greater than with cemented components. | |
| 11373918 | Radiologic mimics of juvenile rheumatoid arthritis. | 2001 May | Established criteria for diagnosis of juvenile rheumatoid arthritis require consideration of a number of other joint arthropathies and arthritides. In this pictorial essay, we present an approach to those common and uncommon disorders that should be considered and may be mistaken for juvenile rheumatoid arthritis. | |
| 9798608 | Classification of inflammatory arthritis by enthesitis. | 1998 Oct 3 | Imaging studies of early synovitis suggest that the first abnormality to appear in swollen joints associated with spondyloarthropathy is an enthesitis (inflammation at sites where ligaments, tendons, or joint capsules are attached to bone). We propose that the synovitis of spondyloarthropathy is secondary to liberation of proinflammatory mediators from the enthesis, whereas the synovitis of rheumatoid arthritis is primary. This suggestion allows a classification of arthritis as either primary synovial (rheumatoid-like) or entheseal (spondyloarthropathy-like) and allows differentiation of presentation of a polyarthritis with a good prognosis (spondyloarthropathy-like), from that with a bad prognosis (rheumatoid arthritis). Pathogenesis of spondyloarthropathy, in particular the part played by HLA-B27 and micro-organisms, should be assessed at the enthesis rather than in the synovium. | |
| 15775556 | [Bone changes in osteoporosis associated with rheumatoid arthritis]. | 2001 May | Low bone volume with reduced trabecular thickness and the increased eroded surface are common features in periarticular bone histology in patients with rheumatoid arthritis;however, there is no consensus on the change in bone formation. Main histological changes of iliac bone in rheumatoid arthritis are reduced bone volume, low trabecular thickness, and decreased trabecular connectivity caused by increased bone resorption. Results in parameters for bone formation are conflicting. The experimental model for arthritis demonstrates that bone turnover changes with the severity of arthritis. | |
| 15775566 | [Drug therapy for osteoporosis associated with rheumatoid arthritis (estrogen replacement | 2001 May | Various types of drug therapy are available for the management of osteoporosis associated with rheumatoid arthritis. Hormone replacement therapy plays an especially important part in the management of this condition. Although hormone replacement therapy increases lumbar bone mineral density in patients who have osteoporosis and rheumatoid arthritis, similar to those with primary osteoporosis, its effect on femoral bone mineral density remains controversial. Since hormone replacement therapy is also effective for rheumatoid arthritis, it is an important treatment option in patients who also have osteoporosis. Evidence is awaited from studies with new designs, including assessment of fracture risk. | |
| 10936982 | Pulmonary hemosiderosis with juvenile rheumatoid arthritis: a case report. | 2000 Apr | Pulmonary hemosiderosis may rarely be associated with juvenile rheumatoid arthritis or can develop during the course of the disease. We present a three-year-old boy with severe iron deficiency anemia (without any pulmonary symptoms) and arthralgia at the time of diagnosis. Two years after the initial diagnosis he developed pulmonary hemosiderosis and pauciarticular type of juvenile rheumatoid arthritis which progressed to seronegative polyarticular juvenile rheumatoid arthritis. He responded very well to prednisolone and was maintained well on low-dose alternate-day prednisolone and naproxen sodium treatment. This is the only case of association of these two diseases in our experience in both the Pediatric Rheumatology and Pediatric Respiratory Diseases Departments. | |
| 10503657 | Juvenile rheumatoid arthritis. | 1999 Sep | The heterogeneous nature of juvenile rheumatoid arthritis is further defined in publications from the past year. Decreased IL-10 production, an anti-inflammatory cytokine, and soluble IL-6 receptor are associated with systemic juvenile rheumatoid arthritis (JRA). IL-4 may have an anti-inflammatory role in the pathogenesis of pauciarticular JRA and may protect, along with IL-10, against the development of joint erosions. Active JRA is associated with lower levels of platelet activating factor acetylhydrolase, which may contribute to the loss of anti-inflammatory activity and increased risk of atherogenesis. The phase 3 clinical trial of etanercept confirmed its efficacy and safety in JRA. Intra-articular steroids are safe and effective in the treatment of JRA. Methotrexate does have disease-modifying effects. The risk of hepatotoxicity with methotrexate use increases with serial transaminase abnormalities and with obesity. Osteoclasts are responsible for joint erosions. Cyclosporine A, mycophenolate mofetil, and methotrexate are effective in the treatment of refractory uveitis. During the past year a number of scientific publications have contributed significantly to our understanding and treatment of juvenile rheumatoid arthritis. | |
| 10937386 | Role of IgM & IgA rheumatoid factors in complement activation in patients with juvenile rh | 2000 Mar | We studied the relationship between the degree of complement activation in juvenile rheumatoid arthritis (JRA) with the levels of circulating IgM and IgA rheumatoid factors (RF). Forty children with JRA and 25 matched controls were included in the study. Levels of C3d (a degradation product of complement component C3), circulating immune complexes (CICs), IgM RF and IgA RF were measured by ELISA. Levels of C3d, CICs, IgM RF and IgA RF were elevated in patients with JRA as compared to controls. Levels of C3d had a linear relationship with levels of CICs (P < 0.05) but not with levels of circulating IgM RF and IgA RF. Thus, complement activation occurs in children with JRA and is associated with raised levels of CICs but not with levels of circulating IgM and IgA RF. Circulating IgM and IgA RF have little, if any, role in complement activation observed in patients with JRA. | |
| 10875316 | Interleukin-16 in synovial fluids from cases of various types of arthritis. | 2000 | OBJECTIVES: To examine the characteristic relationship between interleukin-16 (IL-16) and clinical data in various types of arthritis. METHODS: We measured IL-16 levels of the synovial fluids (SF) of patients with various types of arthritis, which included rheumatoid arthritis, traumatic arthritis, pseudogouty arthritis, gouty arthritis, and osteoarthritis, by an enzyme immunosorbent assay, and examined their correlations with clinical parameters. RESULTS AND CONCLUSIONS: Higher levels of IL-16 in synovial fluid from patients with rheumatoid arthritis, traumatic arthritis, and pseudogouty arthritis, compared to those with osteoarthritis, and gouty arthritis were indicated. Also, synovial IL-16 levels in patients with rheumatoid arthritis correlated significantly, especially with synovial matrix metalloproteinase-3 levels. But the IL-16 levels of both synovial fluid and peripheral blood did not correlate with conventional inflammatory parameters such as C-reactive protein, erythrocyte sedimentation rate, or rheumatoid factor. Although the function of IL-16 in inflammatory arthritis has not yet been defined, these data indicated some essential features of IL-16. | |
| 9365737 | [Still disease]. | 1997 | Adult onset Still's disease is a systemic disorder of unknown etiology. The diagnosis is difficult and based upon Yamaguchi's criteria after exclusion of infectious diseases, hematologic process or autoimmune diseases. Clinical manifestations are various. Functional prognosis depends essentially on articular involvement. Vital prognosis depends on either hepatic failure or hematological or infectious complications, or amyloidosis. Ferritinemia is an important biological parameter which is not included in current criteria. Treatment is not well codified but steroids represent the most efficient therapy to control fever and systemic manifestations. Search for new treatments and specific markers of adult onset Still's disease are needed. | |
| 11439149 | Chemokines and cell trafficking in Sjögren's syndrome. | 2001 Jul | Sjögren's syndrome is a chronic inflammatory condition affecting exocrine glands, manifested clinically as dry eyes and dry mouth. It arises secondary to systemic immune-mediated diseases such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), scleroderma or 'primary' Sjögren's syndrome. Histologically it is characterized by peri-ductal aggregates of CD4 T lymphocytes, the frequent occurrence of ectopic germinal centres and, in some patients, B-cell infiltration of ductal epithelium (myoepithelial sialadenitis). This latter lesion is the precursor for the development of low grade (MALT) B-cell lymphoma. The identification over recent years of chemokines and their receptors enables us to address the specific processes involved in the migration of inflammatory cells into exocrine glands, the development of their secondary structures and patterns of retention within the glands and potentially the subsequent transformation of B cells into mucosa associated lymphoid tissue (MALT) lymphoma. | |
| 28246977 | Treatment of the ankle joint in rheumatoid arthritis with surgical and radiation synovecto | 1999 Sep | Results of surgical synovectomy and radiation synovectomy (radiosynoviorthesis) of the tibiotalar joint in rheumatoid patients are reported. The staged concept for management of the rheumatoid ankle joint is presented which is based on the radiographic appearance of disease progression. Results of 16 rheumatoid patients with disease to the ankle joint suggest that pain and walking capability is positively influenced by synovectomy and radiosynoviorthesis. Follow-up of 30 months revealed no deterioration of postoperative clinical improvement. In the absence of contraindications to radiosynoviorthesis it is suggested to combine arthroscopic synovectomy with radiosynoviorthesis for the treatment of early stages of rheumatoid disease of the ankle joint. Open synovectomy is prefered to arthroscopic synovectomy, if tenosynovectomy is simultaneously required. | |
| 9602213 | Methotrexate-induced hypersensitivity pneumonitis in a child with juvenile rheumatoid arth | 1998 May | Low-dose methotrexate, widely used for juvenile rheumatoid arthritis, has been reported to cause pneumonitis in adults. We report on methotrexate-induced hypersensitivity pneumonitis in a child with juvenile rheumatoid arthritis. Physicians should be aware of this rare complication. | |
| 17650036 | Study of brucellosis in a pastoral community and evaluation of the usefulness of clinical | 2000 Jul | A study of differentials causing flu-like symptoms (malaria, typhoid, streptococcal infections and rheumatoid arthritis) in 488 patients from a pastoralist area is presented. The potential usefulness of clinical signs, symptoms and diagnostic tests in ruling-in or ruling-out these diseases was investigated in the District hospital and three outlying health dispensaries. For each patient a detailed clinical history plus diagnostic test for brucellosis, typhoid, streptococcal infections and rheumatoid arthritis, and for some patients malaria were conducted. Incidence levels of these diseases were estimated using laboratory test results; brucellosis, 13%, typhoid, 40%: streptococcal infections, 6% malaria, 9%: and rheumatoid arthritis, 10%. Brucellosis could not be differentiated clinically from the other flu-like diseases but rheumatoid arthritis could. | |
| 28246815 | Rheumatoid arthritis: current trends in conservative treatment. | 1998 Mar | During the past few years the treatment of rheumatoid arthritis, the most frequent of the rheumatic inflammatory systemic diseases has improved a great deal. The treatment strategy is based on the one hand on the so-called prognostic factors and on the other hand on the extent of the inflammatory activities, especially during the first phase. Numerous controlled studies and meta-analyses have enabled optimal application of the basic disease-modifying drugs, with regard to efficacy and side effects. During the first stage of these disease, the immunobiological substances against pro-inflammatory cells are employed. Improved knowledge of physiotherapeutic treatment, correct diet and careful observation of the patient's progress with the aid of questionnaires enable optimal care with regard to life quality. | |
| 17984874 | Problems associated with the treatment of instability of the spine and the occipito-verteb | 2000 Dec 30 | This article discusses the clinical problems caused by the changes in the cervical spine accompanying rheumatoid arthritis. The most commonly encountered pathology of the spine in the course of rheumatoid arthritis is C1-C2 instability, which can only be treated surgically. The development of new surgical techniques and operation methods has made it possible to obtain good outcomes. The clinical material described here includes 16 patients operated using new methods. The observation of these patients allows for the following conclusions: - Fixation should involve only the C1-C3 segment, and is best accomplished by frame stabilization; - The fixation method of choice is to achieve stability by using implants; - The disease process of rheumatoid arthritis is progressive, which is changes in the cervical spine may serve as indicators of the further progress of changes, both at the point of surgery and in other parts of the cervical spine. |