Browse

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

ID PMID Title PublicationDate abstract
10414251 [Gougerot-Sjögren syndrome. Neurologic complications]. 1999 Jun 19 PERIPHERAL NERVE INVOLVEMENT: Peripheral nerve involvement is better known than central nervous system involvement. The dominant features are sensoromotor polyneuropathies or pure sensorial polyneuropathies. CENTRAL NERVOUS SYSTEM: The manifestations are polymorphous, generally presenting as encephalitis and/or focal or multifocal involvement of the spinal cord. OTHER LOCALIZATIONS: Diffuse encephalic involvement is less common: acute aseptic meningitis, intellectual deterioration. Psychiatric manifestations are also frequently observed. THERAPEUTIC OPTIONS: Response to corticosteroid therapy or immunosuppressor therapy can be spectacular but is unpredictable.
9564776 [Interstitial cystitis in case of primary Sjögren's syndrome]. 1998 Feb A 53-year-old woman who had xerostomia for ten years was admitted to our hospital because of refractory lower abdominal pain and pollakisuria of five years duration. Although she had undergone surgical treatments including cholecystectomy, ovarian cystectomy and groin hemiorrhaphy, she still suffered from abdominal symptoms. A diagnosis of interstitial cystitis was confirmed by hydraulic distention during a cystoscopic examination and by histopathological examination of the bladder. Her symptoms disappeared soon after the cystoscopic procedure, which also had a therapeutic effect of interstitial cystitis. Laboratory findings revealed hypergammaglobulinemia, a high titer of rheumatoid factor, positive anti-nuclear antibody, and positive anti-SS-A/Ro antibody. She was diagnosed as having primary Sjögren's syndrome based on the results of a gum test (8.5 ml/ 10 min), sialography (Stage II), and a positive minor salivary gland biopsy. Starting one month after the hydraulic distention, her abdominal symptoms gradually reappeared along with elevation of her serum IgG level. These features were markedly improved with 30 mg/day of oral prednisolone, which was then successfully tapered. These results suggested that interstitial cystitis in this case was caused by immunological abnormalities associated with Sjögren's syndrome.
10982691 Aminobisphosphonate (YM175) inhibits bone destruction in rat adjuvant arthritis. 2000 This study was designed to examine the effects of an aminobisphosphonate (YM175, which is also called incadronate) on bone destruction in rat adjuvant arthritis (AA). Thirty-five female Lewis rats were given an intradermal injection of heat-killed Mycobacterium butyricum and randomly allocated to five groups (seven rats/group). In the three YM175-treated (0.01, 0.1 and 1 mg/kg per day) groups, YM175 was injected subcutaneously every day from day 0 to day 42. The effects of YM175 in AA rats were evaluated according to an arthritis score, hind paw volume, and radiological and histological examinations. The results showed that YM175 suppressed the radiological and histopathological changes, as well as the joint swelling, in rat AA in a dose-dependent manner. The number of tartrate-resistant acid phosphatase (TRAP)-positive cells (osteoclasts and preosteoclasts or osteoclast precursors) in bone mar-row spaces and granulation tissue in the YM175-treated groups was also reduced in a dose-dependent manner. This study provides the first evidence that YM175, among aminobisphosphonates, not only inhibits bone destruction in rat AA, probably by reducing osteoclast numbers, but that it also suppresses joint inflammation. These results suggest that YM175 may be a useful drug for the prophylactic treatment of both bone destruction and joint inflammation in patients with rheumatoid arthritis.
11094414 Epidemiology of organic solvents and connective tissue disease. 2000 Case reports suggest that solvents are associated with various connective tissue diseases (systemic sclerosis, scleroderma, undifferentiated connective tissue disease, systemic lupus erythematosis, and rheumatoid arthritis), particularly systemic sclerosis. A small number of epidemiological studies have shown statistically significant but weak associations between solvent exposure, systemic sclerosis, and undifferentiated connective tissue disease. However, the interpretation of these positive findings is tempered by a lack of replication, an inability to specify which solvents convey risk, and an absence of increasing risk with increasing exposure. Existing studies, on aggregate, do not show conclusively that solvents (either as a group of chemicals or individual chemicals) are causally associated with any connective tissue disease. Further investigations should be carried out to replicate the positive existing findings and to specify the solvents and circumstances of exposure that carry risk.
11469839 Wrist arthrodesis with the AO titanium wrist fusion plate: a consecutive series of 42 case 2001 Aug In a 4 year period (1996-1999), 42 total wrist fusions in 25 men and 17 women were performed using the AO/ASIF Titanium wrist fusion plate. The median age of the patients at the time of surgery was 41 (range, 19-72) years. The indication for fusion was post-traumatic arthritis in 29 wrists, Kienböck's disease in eight, rheumatoid arthritis in three, mono-arthritis in one and Volkmann's contracture in one. All patients were reviewed at a median follow-up of 23 (range, 6-50) months. The Buck-Gramcko and Lohmann score for functional evaluation was excellent in 35, good in 5 and satisfactory in 2 patients. We conclude that wrist arthrodesis with the AO/ASIF Titanium wrist fusion plate is an excellent option for treatment of various painful disorders of the wrist.
9448995 Rheumatic manifestations of hematologic disorders. 1998 Jan A review of the literature during the past year on rheumatic manifestations in hematologic diseases supports the idea that 80% of the hemorrhage in hemophilia occurs within the joints, with knees, elbows, and ankles being the most affected joints in adults. In contrast, the ankle is the target joint in children. Septic arthritis in hemophilic patients is becoming more important due to the advent of HIV infection. Radioactive synoviorthesis in hemarthrosis has the same rate of success as surgical synovectomy, but with far lower costs. A new study documents the association of arthritis and vasculitis in patients with myelodysplasic syndromes and lymphoproliferative disorders. An increased incidence of scoliosis in patients with beta-thalassemia has been noted. Finally, the effects of bone marrow transplantation in patients with previous autoimmune diseases is reviewed. Progression of rheumatoid arthritis after bone marrow transplantation is documented in a patient with 13 years of follow-up. Hematologic disorders in rheumatic diseases are not the topic of this review.
11821939 Collagen II-pulsed antigen-presenting cells genetically modified to secrete IL-4 down-regu 2001 Dec We explored the possibility that pulsed antigen-presenting cells (APC) provide a model vector system for site-specific delivery of immunosuppressive proteins during collagen-induced arthritis (CIA), an animal model for rheumatoid arthritis. Thus, mice were treated with either B cells or macrophages engineered to secrete IL-4 and loaded (or not) with type II collagen (CII). Systemic injection of an IL-4-producing B cell hybridoma resulted in a reduction of arthritis severity which was further improved when APC were incubated with CII before their transfer. Unmanipulated B cells loaded with CII also exerted a potent suppressive effect. Likely, clinical amelioration was observed in mice given at priming syngeneic bone marrow-derived macrophages producing IL-4 and pulsed with CII in comparison to the other groups. When the same dose of cells was transferred at disease onset, a moderate beneficial effect was observed. Whatever the APC inoculated, the beneficial effect did not rely upon an IL-4-driven shift towards Th2 phenotype. Systemic administration of fluorescent dye labeled macrophages to arthritic mice has shown that some of these cells rapidly migrate to joints. Moreover, IL-4 transfected macrophages retained their potent capacity to present CII peptides to T cells. These findings validate the use of CII peptide-loaded engineered APC as therapeutic vector cells in CIA and allow consideration of this strategy for the administration of various anti-inflammatory proteins.
11508428 Juvenile arthritis and autoimmunity to type II collagen. 2001 Aug OBJECTIVE: Joint inflammation in juvenile rheumatoid arthritis (JRA) is sometimes associated with an autoimmune response to type II collagen (CII), a cartilage-specific protein. To test the hypothesis that down-regulation of autoimmunity to CII can be accomplished in JRA by oral administration of CII, an open-label study of CII was performed in 9 patients with JRA. METHODS: Seven rheumatoid factor-negative JRA patients with polyarticular disease and 2 JRA patients with pauciarticular disease (1 with early onset and 1 with late onset) were treated for 3 months with oral bovine CII. Patients were examined for disease activity and underwent routine laboratory testing at monthly intervals. Two of the patients had flares of disease when treatment was discontinued, and these patients were re-treated for an additional 3 months. To test the hypothesis that oral tolerance induces an immune deviation of T cells, peripheral blood mononuclear cells from patients were collected before and after treatment and cultured with CII. Supernatants and RNA were collected and analyzed for the presence of various cytokines. RESULTS: Eight patient trials met the criteria for clinical improvement outlined by Giannini and coworkers in 1997. None of the patients had any side effects from the treatment. In 6 of the 8 patients who improved, interferon-gamma production decreased after oral CII therapy, correlating with clinical improvement, while 6 patients had increases in levels of transforming growth factor beta3. CONCLUSION: These results are encouraging. The possible beneficial effect of oral CII in JRA merits further investigation.
21374337 Immunity to T-cell receptor : suppressive vaccination with DNA encoding a variable region 2000 A common theme found in studies with mouse models of autoimmune diseases is that pathogenic T cells are primarily responsible for the pathology. Such models include diabetes in non-obese diabetic (NOD) mice, experimental autoimmune encephalomyelitis (EAE)-a model of multiple sclerosis (MS), collagen II (CII)-induced arthritis (CIA)-a model of rheumatoid arthritis (RA). Pathogenic T cells in EAE utilize a restricted repertoire of genes encoding the T-cell receptor (TCR) (1). For example, upon immunization of H-2(u) mice with either myelin basic protein, or its immunodominant fragment, peptide Ac1-20, the Vβ8.2 TCR gene product is expressed in the majority of pathogenic T cells (2-4). The restricted usage of the Vβ8.2 TCR gene product has also been found in rats in which EAE was induced by a peptide of myelin basic protein (5). Similarly, a restriction in the TCR usage was found also in CII-induced arthritis in mice (6,7), and in the TCR alpha chain usage in non-obese diabetic (NOD) mice (8).
9420626 Immunization with alum-collagen II complex suppresses the development of collagen-induced 1997 Dec Collagen-induced arthritis (CIA) is an experimental rat model sharing a number of features with human rheumatoid arthritis (RA). The model is associated with a proinflammatory (TH1) type of immune response and treatments with cytokines associated with TH2 immune responses are beneficial. Since agents with TH1-inducing properties, such as Freund's incomplete adjuvant (FIA), are necessary for disease induction, it is of interest to investigate whether an adjuvant with TH2-inducing properties affects CIA in a different way than does FIA. The authors studied arthritis development in DA rats after immunization with the TH2 stimulatory adjuvant alum adsorbed to rat collagen type II (CII) or collagen II fragments. Such treatments suppressed disease development both prophylactically and therapeutically. This beneficial effect of alum-CII immunization was associated with an increase in the IgG1 anti-CII antibody response as compared to untreated rats or rats pretreated with alum alone. Treatment with alum without the addition of collagen did not have any clinical effect. In addition, alum-CII treated rats had a significantly higher expression of IL-4 mRNA than untreated rats in the lymph nodes, 7 days after CIA induction. The authors suggest that alum-CII induces a TH2 immune response against rat CII which counteracts the development of CIA.
12973438 Arthritis gene therapy. 1999 Apr Because of the limitations of current therapies for rheumatoid arthritis (RA), novel approaches need to be developed for the treatment of this disease. Although certain antiinflammatory proteins such as soluble tumor necrosis factor-alpha receptor or interleukin-1 receptor antagonist protein are able to reduce certain pathologies associated with RA, there have been difficulties with targeting the proteins to sites of disease such as the joints. One novel approach for targeting proteins to sites of disease is to deliver the gene(s) encoding the therapeutic agent to specific cell types such as synovial cells or T-cells. Significant progress has been made towards developing gene therapy strategies for treating RA and the first clinical trial for the treatment of RA by gene therapy has been initiated recently. This review will summarize the approaches and progress made towards developing gene transfer methods for treating RA.
11499780 Bony ankylosis following thermal and electrical injury. 2001 Jul OBJECTIVE: Bony ankylosis has been described following trauma, paralysis, psoriasis, Reiter's syndrome, ankylosing spondylitis, juvenile chronic arthritis and rheumatoid arthritis. Reports of bony ankylosis following thermal and electrical injury are limited. DESIGN AND PATIENTS: Thirteen cases of burn-related joint ankylosis in four patients are presented. CONCLUSION: Patients with burns from thermal or electrical injury may develop bony ankylosis among other radiographic manifestations. This bony ankylosis may result either from bridging extra-articular heterotopic ossification with preservation of the underlying joint or from intra-articular fusion due to joint destruction.
11102777 Novel, non-antigen-specific therapeutic approaches to autoimmune/inflammatory diseases. 2000 Dec Anti-TNF therapy has made a major impact on the treatment of inflammatory arthritides and Crohn's disease. It leads to prompt and prolonged clinical response, even in patients refractory to conventional therapy. Moreover, the progression of joint damage noted in patients with rheumatoid arthritis treated with methotrexate was prevented by an anti-TNF-alpha antibody, suggesting a genuine disease-modifying potential of TNF-alpha blockade.
10546794 Hematopoietic stem cell transplantation for autoimmune disorders. 1999 Nov Autologous hemopoietic stem cell transplantation (HSCT) for autoimmune disease has increased lately. Insights into response to immunoablation is found in animal experiments and reports on patients receiving HSCT for concomitant malignancy. Early phase II studies and case reports of HSCT in patients with multiple sclerosis, systemic sclerosis, lupus erythematosus, rheumatoid arthritis, juvenile chronic arthritis and idiopathic thrombocytopenic purpura have been published. Dramatic responses or disease stabilization have been observed in some, but failures and disease relapses, toxic and infectious complications have been observed in others. Whether this treatment can induce true peripheral immunologic tolerance, and which been observed if any patients will benefit long-term from HSCT, remains to be determined.
9381506 [The involvement of the temporomandibular joints in multiple myeloma]. 1997 Four patients with myeloma disease were examined. The debut was characterized by stubborn strong pain in the temporomandibular joint (TMJ). Involvement of the TMJ presents as arthralgia but not arthritis. A specific feature of the disease is possibility of rather long functioning of the joint and absence of any inflammatory changes. X-Ray examinations show multiple round clearly seen 1 to 5 mm defects in the bone without any destructive or degenerative changes. Myeloma disease is to be differentiated from TMJ involvement in systemic lupus erythematosus, rheumatoid arthritis, Bechterew's disease, in elderly patients or patients with a long disease standing from involution involvement of the TMJ (Costen's syndrome) or osteoarthrosis deformans.
11062620 Gene therapy in orthopaedics. 2000 Jan Genes are composed of deoxyribonucleic acid (DNA), the hereditary material of all nucleated cells. One way in which genes function is to direct the synthesis of specific proteins. When a gene is transferred to and expressed within a cell, the recipient cell produces the protein encoded by the transferred gene. This process forms the basis for gene therapy, which can be defined as the transfer of genes to patients for therapeutic purposes. Both genetic and acquired disorders may be treated, or even cured, by gene therapy. Potential orthopaedic applications include the treatment of arthritis, tumors, osteoporosis, and genetic diseases such as osteogenesis imperfecta, as well as the enhancement of tissue repair and regeneration. Impressive preclinical progress has been made in several of these areas. A phase I clinical trial of gene therapy for rheumatoid arthritis has just been completed. Orthopaedic gene therapy should become a clinical reality during the next decade.
10540575 Pyogenic spondylitis. 1999 Aug Twenty-nine patients with pyogenic vertebral osteomyelitis were reviewed retrospectively after an average follow-up of 3.7 years. We identified 17 patients with predisposing factors (10 diabetes, 4 urinary tract infection, 2 HIV-positive, 1 rheumatoid arthritis). No patient presented with a febrile illness. The lumbar spine was involved in 15 patients. Eighteen patients had neurological impairment at presentation. Eleven patients who were neurologically intact had needle biopsies and the remaining 18 patients who were neurologically compromised had an open decompression. Staphylococcus aureus was cultured in 14 patients. Although spinal tuberculosis is relatively common in our environment it is important to obtain a tissue diagnosis in order to exclude pyogenic vertebral osteitis.
19078423 The effect of methotrexate on the temporomandibular joint in polyarticular juvenile rheuma 1999 Dec Temporomandibular joint (TMJ) arthropathy is common in juvenile rehumatoid arthritis (JRA) patients and can cause functional and esthetic problems. The purpose of this pilot study was to begin to evaluate whether methotrexate (MTX) therapy can reduce TMJ arthropathy in patients with polyarticular JRA.There were 27 patients with polyarticular JRA studied. Of these, 18 were receiving MTX and non-steroidal anti-inflammatory drugs and 9 were receiving just non-steroidal anti-inflammatory drugs. A routine physical examination, including a detailed joint evaluation, was performed by their rheumatologist. A craniofacial examination was performed by the orthodontist and included a radiographic TMJ evaluation (panoral and corrected axial tomograms).Radiographic evidence of condylar degeneration was apparent in 83% of all polyarticular JRA patients. The patients receiving MTX showed less severe TMJ involvement than those not receiving MTX.
10387342 Ocular manifestations of rheumatic diseases. 1998 Dec Ocular manifestations of rheumatic disease are common and varied. The presentation of uveitis in psoriatic arthritis and inflammatory bowel disease differ from typical HLA-B27-associated uveitis. Giant cell arteritis continues to be a common cause of visual loss. Early diagnosis is crucial to limiting visual loss. Once visual loss has occurred, the need for oral versus intravenous steroids is controversial. Chronic uveitis associated with juvenile rheumatoid arthritis may be less prevalent than previously shown. However, poor visual outcomes continue to occur and efforts to identify visual prognosticators are being made. Ocular involvement in Behçet's disease, if untreated, leads to blindness. Azathioprine has been shown to improve visual prognosis. Concurrent central nervous system disease has been correlated to a poor visual prognosis.
9420620 Progression of articular destruction and the production of tumour necrosis factor-alpha in 1997 Dec We examined the progression of articular destruction and the production of tumour necrosis factor-alpha (TNF-alpha) in antigen-induced arthritis (AIA) in rabbits, i.e. flare-ups of inflammation induced by repeated intra-articular injections (single, twice and three times) of antigen. A marked progression of articular destruction and an infiltration of inflammatory cells in the synovium were observed with the increase in the number of antigen injections. An immunohistochemical analysis of the synovial lesions following three injections of antigen revealed that the lymphoid follicles consisted mainly of CD4+ T cells and IgG/IgM+ B cells. There were marked infiltrations of IgG+ plasma cells around the lymphoid follicles. In contrast, the production of TNF-alpha in the synovial fluid and the erythrocyte sedimentation rate (ESR), which is a marker of systemic inflammatory activity in rheumatoid arthritis, peaked at 6 h 24 h, respectively, following the last injection of antigen. These values were also greater following the repeated injections of antigen compared with the single injection. The TNF-alpha was produced markedly in the joints at the onset of the flare-ups of arthritis following the repeated injections of antigen, and the elevation of the ESR and an acceleration of the inflammatory response in the synovium were observed with a concomitant progression of severe articular destruction, suggesting that the marked production of TNF-alpha at the time of flare-ups may be involved in the exacerbation of AIA in rabbits.