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ID PMID Title PublicationDate abstract
11122255 Expression of cyclooxygenase-1 (COX-1) in labial salivary glands of Sjögren's syndrome. 2000 Dec COX plays an important role in inflammatory diseases such as rheumatoid arthritis. To determine the role of COX in Sjögren's syndrome (SS), we examined COX expression in the salivary glands of SS patients. We examined 15 patients with SS and two normal subjects. Labial salivary gland tissue samples were analysed immunohistochemically using anti-COX-1 and COX-2 antibodies. All biopsy samples from 15 patients with SS were stained for COX-1. In contrast, COX-1 immunostaining was not detected in normal salivary gland tissues. Co-expression of COX-1 and CD68 was confirmed by mirror section technique and double antibody immunostaining. This finding indicated that COX-1-expressing cells in SS salivary glands were infiltrating macrophages. In contrast to COX-1 staining, only a little COX-2 immunostaining was observed in salivary gland tissues from SS patients. These data suggest that COX-1 expression on infiltrating macrophages may contribute to the inflammatory process of salivary glands in SS.
25851395 Vasculitis unlimited in rheumatoid arthritis an illustrated review. 1998 Jul Rheumatoid arthritis has a multitude of extra-articular manifestations, of which systemic vasculitis is a clinically significant co-morbidity and co-mortality determinant in the prognosis of the disease. Rheumatoid vasculitis may occur in the early stage of the disease but, more commonly, in patients who have had seropositive rheumatoid arthritis for 10 years or longer. Rheumatoid vasculitis has a wide variety of histopathologic expressions and it may affect blood vessels of all sizes (from vasa nervorum or vasa vasorum to the aorta; and occasionally veins and venules). The diagnosis ideally requires biopsy or autopsy tissue confirmation, which is discussed and illustrated in this review.
10405952 Remission of juvenile rheumatoid arthritis with varicella infection. 1999 Jul This report describes 2 children with juvenile rheumatoid arthritis (JRA) poorly responsive to therapy. Both patients experienced dramatic improvement in their arthritis coincident with acute, uncomplicated varicella infection. Although remission of JRA has been associated with other viral infections, this phenomenon has not been previously reported with varicella infection.
15332741 Cartilage proteoglycan aggrecan as a predictor of joint damage in juvenile rheumatoid arth 2001 Nov Aggrecan was measured in the sera of 31 children with juvenile rheumatoid arthritis and in the synovial fluid of 10 of them. Patients were evaluated at baseline and 3 months later. Radiographs were repeated also after 1 year. As comparison, 15 apparently healthy children with no disease and 10 children with arthritis due to other collagen vascular diseases were studied. Baseline serum aggrecan was significantly higher in juvenile rheumatoid arthritis patients compared to controls and other patients. On re-evaluation, a significant drop in serum aggrecan from baseline values coincided with a significant drop in clinical and laboratory indices of active inflammation. Serum aggrecan can help to assess the extent of cartilage destruction and is useful as a prognostic tool to predict joint damage in patients with juvenile rheumatoid arthritis.
10224175 Psychological symptoms in chronic fatigue and juvenile rheumatoid arthritis. 1999 May OBJECTIVE: To determine if psychological morbidity in youth with chronic fatigue is caused by the stress of coping with a chronic illness. STUDY DESIGN: Case-control study comparing pediatric patients with debilitating chronic fatigue and matched subjects with juvenile rheumatoid arthritis, a chronic medical illness with similar functional sequelae. SETTING: Pediatric Infectious Diseases Clinic and Juvenile Rheumatoid Arthritis Clinic of Kosair Children's Hospital. PARTICIPANTS: Nineteen children and adolescents with debilitating chronic fatigue and 19 age- and sex-matched peers with juvenile rheumatoid arthritis. Outcome. Structured Interview, Kaufman Brief Intelligence Test, Child Behavior Checklist, and Youth Self-Report. RESULTS: Intellectual functioning on the Kaufman Brief Intelligence Test Composite was average (103, standard score) for both groups. Pediatric patients with chronic fatigue had higher levels of internalizing psychological distress than patients suffering from juvenile rheumatoid arthritis, despite the fact that both groups had a similar pattern of decline in social and physical activities. Duration of illness did not explain the difference in psychological symptoms. CONCLUSIONS: Psychological factors may play a more active role in debilitating chronic fatigue in pediatric patients than can be explained by the stress of coping with a similar chronic, non-life-threatening illness.
9632535 Cytokines in juvenile rheumatoid arthritis (JRA). 1998 Jun Juvenile rheumatoid arthritis (JRA), unlike rheumatoid arthritis of adulthood (RA), is a heterogenous disease comprising at least five subtypes that differ in clinical course and prognosis, and require different therapeutical approaches. As compared to RA, the production of local and systemic cytokines in JRA have not yet been as extensively investigated. In this article we review the available literature on cytokine expression in serum and synovial fluid in all five different subtypes of JRA. Even though the data are still fragmentary, the evidence so far suggests that the determination of serum cytokines yields relevant information as to clinical subtype and inflammatory activity of the disease. Furthermore, the cytokine data suggest that the pathogenesis of JRA may even by more heterogenous than defined by the clinical subtypes. Finally, future directions of research in this area are proposed, and-based on the latest results-arguments for (anti)cytokine therapies in JRA are critically discussed.
11254240 Hypothalamus-hypophysis-thyroid axis, triiodothyronine and antithyroid antibodies in patie 2001 It has been well established that, anti-thyroglobulin antibodies (ATG) and anti-microsomal antibodies (AMC) may be present in various thyroid disorders and other systemic autoimmune diseases, including Sjögren's syndrome (SS). However, presence of circulating autoantibodies to thyroid hormones, i.e. both to triiodothyronine (T3) and tetraiodothyronine (T4), has not been studied extensively in SS. Autoantibodies to T3 and T4 are very important, because serum T3 and T4 levels may be detected spuriously higher or lower, due to the presence of these autoantibodies. Their presence should be suspected when measured serum thyroid hormone levels are not consistent with clinical status of the patient. SS is a slowly progressive, inflammatory autoimmune disease, affecting primarily the exocrine glands. Thyroid gland, being a target in some autoimmune diseases, is well known to be affected in SS as well. Keeping this possibility in mind, we investigated T3 autoantibody levels and thyroid gland involvement in patients with SS. Twenty-six SS patients (F/M:22/4) with a mean age of 46.6 years, were recruited in this study. Twelve of them were accepted as primary SS (pSS), while others had secondary SS (sSS) (7 with rheumatoid arthritis (RA), 3 with systemic lupus erythematosus (SLE), 3 with progressive systemic sclerosis (PSS) and 1 with sarcoidosis). Thyroid function tests, including T3, T4, fT3, fT4, TSH, ATG, AMC, T3 antibody measurements, thyroid scintigraphy, thyroid ultrasonography and TRH stimulation tests were performed in all patients. We compared our results with those of the twenty healthy normal controls. Serum ATG and/or AMC were detected in three patients with pSS (25%) and no patients with sSS. No significant difference could be shown in the other parameters, including T3 autoantibodies and thyroid function tests. TRH stimulation test was also normal, showing that the hypothalamus-hypophysis-thyroid axis was not affected in patients both with pSS and sSS. In conclusion, we found that T3 autoantibody levels in pSS, were not significantly higher than sSS and normal controls.
19078174 Unusual digital sparing in rheumatoid arthritis a case of neuropsychoimmunologic involveme 1997 Jun An unusual pattern of hand involvement in a patient with rheumatoid arthritis (RA) is presented. There is complete sparing of a single digit, despite a severe, destructive polyarthritis involving all the other fingers. Of note, the patient began wearing a treasured family heirloom ring on the nonaffected finger approximately 1 year before the onset of her arthritis. The potential role for psychoimmunologic regulation of rheumatoid arthritis is discussed.
19078221 Two faces of "rheumatoid arthritis": type a versus type B disease. 1997 Dec Is rheumatoid arthritis one disease or a "catch-all" term for inflammatory arthritis that tends to spare axial joints? We have subdivided "rheumatoid arthritis," utilizing the criteria of periarticular osteopenia and marginally (distributed), symmetrical polyarticular erosions, in absence of axial (odontoid disease excepted) involvement as type A and presence of peripheral joint fusion and subchondral erosions as type B.Biomechanical analysis of axial joint sparing inflammatory arthritis also revealed the two distinct patterns. The low vibration/power cluster (type A) had symmetrical polyarticular marginal erosions, but no peripheral joint fusion. The high vibration/power cluster (type B) had both subchondral and marginal erosions, and/or peripheral joint fusion, indistinguishable from spondyloarthropathy (S).Erosive arthritis also was noted in two distinct patterns in pre-Columbian North American cemeteries. The type B pattern was never observed in populations with the type A pattern. The type B pattern was only observed in populations with spondyloarthropathy. Demographic analysis in a modern skeletal population revealed that spondyloarthropathy and type B were quite similar to each other, but easily distinguished from type A. Evaluation of over 500 skeletons of animals with erosive arthritis revealed only type B.As type B is indistinguishable from spondyloarthropathy, it is suggested that type B be recategorized with spondyloarthropathv and that only type A be classified as rheumatoid arthritis.
9027967 HLA class II genes in Latvian patients with juvenile rheumatoid arthritis. 1997 Jan PCR-based HLA genotyping was used to analyze the association of HLA-DR and -DQ genes in 127 juvenile rheumatoid arthritis patients and 111 population-based controls from Latvia. The results show DQA1*03 to be positively associated in overall patients and DRB1*01-DQA1*0101-DQB1*0501 to be negatively associated with JRA in overall patients and in polyarthritis patients compared to controls. These data indicate the immunogenetic heterogeneity in the JRA patients, in the disease subgroups and in different ethnic groups. Rheumatoid factor (RF) was assayed in patients (n = 119) and controls (n = 98). RF was present in patients (7/119, 6%) compared to controls (5/98, 5%). None of the DQA1, DQB1 alleles, DQ and DR-DQ haplotypes was associated in seropositive patients compared to seropositive controls. DR1-DQ5 (DQA1*0101-B*0501) was decreased in seronegative patients (11/111, 10%) compared to seronegative controls (24/105, 23%), but the difference was not significant after correction of the p value.
9444431 Delayed diagnosis of juvenile rheumatoid arthritis in a girl with Turner's syndrome. 1997 Nov Although increased risk for autoimmune diseases has been documented in Turner's syndrome (TS), the involvement of juvenile rheumatoid arthritis (JRA) has rarely been reported. A detailed case description of JRA associated with Turner's syndrome is presented as the second such case report in the literature. The arthritis was diagnosed 8 years after its onset due to the confounding of its symptoms with those of TS.
9776122 Progressive pseudorheumatoid chondrodysplasia: a hereditary disorder simulating rheumatoid 1998 Progressive pseudorheumatoid chondrodysplasia is a rare hereditary disorder. This autosomal recessive condition is characterised by progressive arthropathy and platyspondyly. The symptoms are similar to those of rheumatoid arthritis but synovitis is absent. In this study a patient with inherited progressive pseudorheumatoid chondrodysplasia is presented.
10902771 Inhibitory effects of muscarinic receptor autoantibodies on parasympathetic neurotransmiss 2000 Jul OBJECTIVE: Sjögren's syndrome (SS) is an autoimmune disorder characterized by dry eyes and mouth (sicca syndrome) and lymphocytic infiltration of the lacrimal and salivary glands. Abnormalities of parasympathetic neurotransmission may contribute to the glandular dysfunction. In this study, we used a functional assay to investigate autoantibody-mediated effects on parasympathetic neurotransmission and smooth muscle contraction. METHODS: Serum and purified IgG were obtained from patients with primary and secondary SS and from control subjects. Contraction of isolated bladder strips in response to stimulation of M3-muscarinic receptors by a muscarinic receptor agonist, carbachol, or by endogenous acetylcholine released from postganglionic parasympathetic nerves was measured before and after the addition of patient serum or IgG. RESULTS: Sera from 5 of 9 patients with primary SS and from 6 of 6 patients with secondary SS inhibited carbachol-evoked bladder contraction by approximately 50%. Sera from these patients also inhibited the action of neuronally released acetylcholine at M3-muscarinic receptors. Sera from 7 of 8 healthy individuals, from patients with rheumatoid arthritis without sicca symptoms, and from patients with systemic lupus erythematosus had no effect. The anti-muscarinic receptor activity was localized in the IgG fraction, since purified IgG from patients with SS also inhibited agonist- and nerve-evoked contractions. In this preliminary study, the autoantibodies seemed to be associated with the presence of bladder symptoms and other autonomic features. CONCLUSION: Autoantibodies that act as antagonists at M3-muscarinic receptors on smooth muscle occur in a subset of patients with primary and secondary SS. Their presence in secondary SS was unexpected and provides new evidence for a common pathogenetic link between primary and secondary SS. These autoantibodies appear to contribute to sicca symptoms and may explain associated features of autonomic dysfunction in some patients.
10370653 Gastroduodenal lesions in children with juvenile rheumatoid arthritis. 1999 Mar BACKGROUND/AIMS: There are few studies about gastrointestinal abnormalities in patients with juvenile rheumatoid arthritis-probably due to the fact that this association is not frequently recognized. The aim of our study was to observe the prevalence of endoscopic gastroduodenal lesions in these patients. METHODOLOGY: Fourteen patients with juvenile rheumatoid arthritis, all of them using non-steroidal anti-inflammatory drugs associated or not with methotrexate, were assessed clinically and by endoscopy. Gastric antrum biopsy and Helicobacter pylori search were also performed. RESULTS: The mean age of the patients was 10.6 years (7 boys). Abdominal pain was observed in 27% of them. Macroscopic endoscopic lesions were found in 43% and infection by Helicobacter pylori in 57%. The correlation between anemia and endoscopic abnormalities was statistically significant (p < 0.05). CONCLUSIONS: Our data show that patients with juvenile rheumatoid arthritis have considerable susceptibility to gastroduodenal lesions, especially if they are using any drug association and present anemia.
9338669 Molteno implantation for secondary glaucoma in juvenile rheumatoid arthritis. 1997 Oct OBJECTIVE: To evaluate the outcome of Molteno implantation in secondary glaucoma associated with juvenile rheumatoid arthritis. METHODS: Between January 1, 1986, and December 1, 1996, 27 eyes of 19 consecutive patients with secondary glaucoma due to juvenile rheumatoid arthritis received a Molteno implant. The diagnosis of juvenile rheumatoid arthritis was made according to the American Rheumatism Association criteria. RESULTS: At the end of the follow-up (mean, 40 months; range, 6-116 months), the mean (+/-SD) postoperative intraocular pressure (IOP) (14.4+/-4.3 mm Hg) was statistically significantly lower than the preoperative IOP (38.3+/-5.6 mm Hg) (P<.001). The Snellen visual acuity remained within 1 line of the preoperative level or improved in 23 (85%) of 27 eyes. A successful outcome (defined as a final IOP of > or =6 mm Hg and < or =22 mm Hg, with fewer than or an equal number of antiglaucoma medications as preoperatively) was achieved in 24 (89%) of 27 eyes. Life-table analysis success rates were 95% after 27 months and 90% after 52 months of follow-up. Postoperative complications included flat anterior chamber (3 eyes), tube block by iris or vitreous (3 eyes), cataract (3 eyes), cornea-tube touch (2 eyes), choroidal detachment (1 eye), corneal edema (1 eye), and corneal abrasion (1 eye). CONCLUSION: The Molteno implant is useful and well tolerated in controlling IOP in patients with glaucoma secondary to juvenile rheumatoid arthritis.
18031079 Progress towards optimal trial end-points in rheumatoid arthritis. 1997 Jan Trials in rheumatoid arthritis have been difficult to perform and interpret due to disagreement over what to measure. This paper reviews the most frequently used measures and their validity against the background of the Outcome Measures in Rheumatology (OMERACT) consensus conferences. These conferences have resulted in the adoption of a core set of end-points to be used as a minimum in all clinical trials in rheumatoid arthritis. These are known as the World Health Organization/International League of Associations for Rheumatology (WHO/ILAR) core set. This set of measures comprises: pain;patient global assessmentphysical disability;swollen joints;tender joints;acute phase reactants;physician (assessor) global assessment; and, in studies of 1 or more years duration,radiographs of joints. Other developments include a renewed interest in aggregate end-points (indices) such as response criteria, and in the measurement of adverse effects and economic costs. In sum, measurement methodology in rheumatoid arthritis has been improved in time to take advantage of expected important advances in treatment.
19078194 Prodromal urticaria with seronegative rheumatoid arthritis. 1997 Aug This case report describes an association of chronic diurnal urticaria with the onset of seronegative arthritis in a 38-year-old woman after her first pregnancy. Remission of the urticaria and rheumatoid arthritis occurred with methotrexate therapy. The variety of urticarial lesions that can be seen with arthritis are noted.
20470593 [Our approach to metacarpophalangeal joints of the long fingers in patients with rheumatoi 1997 In the submitted paper the author describes the surgical indication scheme in deformities of the metacarpophalangeal joint of the long fingers caused by rheumatoid arthritis, as used at the Orthopeadic Clinic, Faculty Hospital, Hradec Králové. The author evaluated a group of patients treated in 1984-1996 where a total of 43 joints were operated. The mean time interval after surgery was 3.5 years. As compared with the world literature, comparable results were achieved, the only complication was a dislocation of the endoprosthesis Rubena II in one patient during the postoperative period. It was found that the final effect of surgery of deformities affecting the metacarpophalangeal joints of the long fingers in patients with rheumatoid arthritis is complete or partial functional painlessness, marked improvement of the cosmetic appearance, partial increase of the range of functional movements and the muscular strength of the grip and "pinch". Key words: rheumatoid arthritis, ulnar drift of the metacarpophalangeal joints, implantation arthroplasty.
18031086 [Not Available]. 1997 Feb A novel therapeutic approach for systemic inflammatory diseases such as rheumatoid arthritis is directed towards adhesion receptors. Interactions mediated by adhesion receptors govern the recruitment of inflammatory cells into inflammatory sites, such as the rheumatoid synovium, and the activation of immunocompetent cells. Therefore, adhesion receptors may be valuable therapeutic targets for immunologically driven, systemic inflammatory diseases such as rheumatoid arthritis. For example, antiadhesion therapy might hinder the ability of arthritogenic T cells to access the synovium and perpetuate the inflammatory response. Alternatively, inhibition of adhesion receptors might modulate the function of immunocompetent cells already present in the inflamed synovium, thereby attenuating the progression of disease. The potential utility of antiadhesion therapy in inflammatory arthritis has been confirmed in various animal models. Moreover, an antibody directed against the adhesion receptor intercellular adhesion molecule-1 (ICAM-1) has been successfully utilised in several open trials in patients with rheumatoid arthritis. Recent progress in this exciting discipline is reviewed, and relevant future directions are considered.
9055198 Low-dose pulse methotrexate inhibits articular destruction of adjuvant arthritis in rats. 1997 Feb The purpose of this study was to determine whether low-dose methotrexate pulse therapy, which had recently become important in the treatment of rheumatoid arthritis, was effective for controlling the progression of articular destruction in rats with adjuvant arthritis. Intraperitoneal methotrexate at a dose of 0.05 or 0.1 mg kg-1 twice weekly inhibited inflammation in rats with adjuvant arthritis, as shown by reduction of the hind-paw volume. Methotrexate also inhibited articular destruction, as shown by X-ray findings. Although the mechanisms by which low-dose pulse methotrexate acts on rat adjuvant arthritis are still unclear, our results imply that it might effectively slow the progression of articular destruction in rheumatoid arthritis in man. In addition, assessment of articular destruction in this animal model might be useful when evaluating new treatments for rheumatoid arthritis.