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ID PMID Title PublicationDate abstract
12539709 [The value of diagnosis with technetium-99m sequential scintigraphy of parotid gland in Sj 1999 May OBJECTIVE: To explore the value of diagnosis with 99mTcO4- sequential scintigraphy of parotid gland in Sjögren's syndrome. METHODS: Technetium-99m(99mTcO4-) sequential scintigraphy was used in 52 cases of Sjögren's syndrome. RESULTS: The results were analysed quantitatively with activity curve by using ROI computer program. 46 cases (88.46%) were parotid swelling. The contour was clear in 28 cases (53.85%) and blurred in 18 cases (34.62%). The function of parotid was normal in 7 cases (13.46%), parotids with light damage in 15 cases (28.84%), parotids with middle damage in 17 cases (32.69%), and parotids with serious damage in 13 cases (25%). Most cases of damaged secretary function was present in the early phase, and a few cases of damaged absorption function was found in the following process. CONCLUSION: 99mTcO4- sequential scintigraphy of parotid gland is greatly valuable to diagnosis of Sjögren's syndrome.
11968748 [Spontaneous improvement of subacute exacerbation in a case of sensory ataxic neuropathy a 2001 Sep We reported a 66-year-old man with Sjögren's syndrome (sicca syndrome) presenting a sensory ataxic neuropathy, which showed spontaneous remission. He developed difficulty in standing and walking during recent several months. Neurological examinations showed sensory ataxia with areflexia in all extremities and mild distal-dominant decrease in the superficial sensation. Laboratory examinations of blood, urine, and cerebrospinal fluid were all unremarkable; the blood levels of vitamin B1, B2, B6 and B12 were low normal. Sensory nerve action potentials and somatosensory evoked potentials were absent. Cervical cord MRI revealed no abnormal signals. Severe loss of myelinated fibers and scattered myelin ovoids were seen in sural nerve biopsy. Tentative diagnosis at admission was subacute sensory neuropathy associated with malignancy. Screening examinations for malignancy were undertaken and all revealed negative. Because of coexisting sicca symptoms and positive Shirmer test (0 mm), a lip biopsy was performed and a diagnosis of Sjögren's syndrome was confirmed. Sensory ataxia improved gradually. Two years later, blood B1 levels were low but he remained able to walk. This case is an uncommon example of spontaneous symptomatic remission in sensory ataxic neuropathy associated with Sjögren's syndrome.
11469518 Sjögren's syndrome as seen by an ophthalmologist. 2001 Ocular surface involvement is a frequent feature of Sjögren syndrome characterized by the presence of typical symptoms such as burning and foreign body sensation and by wide spread epithelial damage of the cornea and on the conjunctiva. There is now evidence that local inflammatory changes and lacrymal gland-derived tear-borne pro-inflammatory agents have an important role in the build up and the maintenance, of ocular surface damage by the instauration of self maintaining vicious cycles. Inflammation causing decreased ocular surface sensation, resulting in further decreased tear secretion and decreased tear clearance, with growing concentration of pro inflammatory agents on the ocular surface. From the anatomic pathological point of view there is a not clarified discrepancy between the early highly depressed tear fluid production and the limited extension of involvement of the lacrymal gland. Proper gland stimulatory agents and control of inflammation could result in a better treatment than the palliative therapy available to day.
10406256 Increased prevalence of sicca complex and fibromyalgia in patients with irritable bowel sy 1999 Jul OBJECTIVE: As many as 70% of patients with fibromyalgia complain of the symptoms of irritable bowel syndrome (IBS), but there is a clinical impression that IBS patients do not suffer from fibromyalgia as frequently. The sicca complex (dry eyes and mouth) is also commonly observed in fibromyalgia, but its prevalence in IBS has not been evaluated. Our objective was to assess the frequency of fibromyalgia and sicca complex in secondary care patients with IBS. METHODS: Forty-six secondary care patients with IBS and 46 healthy controls were assessed by a rheumatologist for the presence of fibromyalgia and objective evidence of sicca complex (Schirmer and Rose-Bengal tests). Psychological status was also assessed (HAD questionnaire). RESULTS: Thirteen (28%) IBS patients suffered from fibromyalgia, compared with five (11%) controls, a difference of 17% (95% confidence intervals [CI], 2-33%). Fifteen (33%) IBS patients versus three (6%) controls had sicca complex, a difference of 27% (95% CI, 11-45%). CONCLUSIONS: These results suggest that the prevalence of fibromyalgia in IBS is approximately half that of IBS in fibromyalgia. Furthermore, sicca complex seems to be another complaint that should be added to the list of extracolonic manifestations of IBS. Study of the overlap between functional disorders presenting to different specialties may give new insights into the pathophysiology of these puzzling conditions.
10363271 [A case of primary Sjögren's syndrome presenting with aseptic meningoencephalitis associa 1999 Apr A 64-year-old Japanese woman with sarcoidosis and primary Sjögren's syndrome was admitted to our hospital in January 1998 for consciousness loss. Physical examination revealed meningeal signs and hyperreflexia in the lower limbs. Laboratory investigations showed hypergammaglobulinemia and high titers of autoantibodies such as RF, ANA, anti SS-A and SS-B antibody. In addition, she had keratoconjunctivitis, and an apple-tree pattern was observed in sialography, but serum ACE was normal. In the cerebrospinal fluid (CSF), the cell count, total protein, and interleukin 6 (IL-6) were increased, but ACE in CSF was normal. We diagnosed the case as primary Sjögren's syndrome presenting with aseptic meningoencephalitis. After treatment with prednisolone, her manifestations and CSF findings including IL-6 resolved. Therefore, the level of IL-6 in CSF may be an indicator for the activity of primary Sjögren's syndrome associated with central nervous manifestations.
9682199 Optical simulations of a noninvasive technique for the diagnosis of diseased salivary glan 1998 Jul A simulation experiment for three-dimensional (3D) imaging of exogenous fluorescinated antibodies that specifically bind to infiltrating lymphocytes in minor salivary glands was carried out. Small (approximately 1 mm3 volume) rhodamine targets, which mimic diseased minor salivary glands labeled with fluorescent antibodies to infiltrating lymphocytes in Sjøgren's syndrome, were embedded in a highly scattering tissue phantom consisting of a thick Delrin disk covered by index matched Delrin slabs of various thickness. In this way the variation of fluorescence profiles on the surface of tissue could be examined corresponding to the range of depths of the salivary glands in vivo. Surface images were obtained for different target depths and radial distances from laser excitation to target fluorophore. These images were analyzed and compared to calculations based on random walk theory in turbid media, using previously determined scattering and absorption coefficients of the Delrin. Excellent agreement between the surface profiles experimentally measured and those predicted by our random walk theory was obtained. Derivation of these theoretical expressions is a necessary step toward devising an inverse algorithm which may have the potential expressions to perform 3D reconstruction of the concentration distribution of fluorescent labels within tissue.
11575610 Central nervous system Sjögren's syndrome in a child: case report and review of the liter 2001 Sep We describe a case of pediatric Sjögren's syndrome with progressive neurologic involvement. At age 4 years, she had been diagnosed with Melkersson-Rosenthal syndrome. After being stable with facial diplegia and swelling for 5 years, she acutely presented with diplopia, vertigo, and ataxia. Cranial magnetic resonance imaging (MRI) showed a left dorsal midbrain lesion. Serologic and histopathologic findings confirmed primary Sjögren's syndrome. She responded well to intravenous methylprednisolone, with subsequent clinical improvement and MRI resolution. This report reviews the pediatric literature and underscores the importance of considering Sjögren's syndrome in a child with unexplained facial weakness and in the differential diagnosis of pediatric stroke.
9250787 Primary parotid lymphoma: the effect of International Prognostic Index on outcome. 1997 Jun Since the reported survival and failure-free survival (FFS) of adults with primary parotid non-Hodgkin's lymphoma (NHL) is variable, we reviewed our experience of untreated adults with primary parotid NHL. Patients were eligible if they presented to the University of Texas M. D. Anderson Cancer Center Cancer between 1980 and 1995 with parotid enlargement and if the diagnosis of lymphoma was verified according the Working Formulation. Medical records were reviewed to determine Ann Arbor Stage (AAS), the International Prognostic Index (IPI) score, response to therapy, relapse, FFS, and survival. We identified 39 untreated adults with primary parotid NHL representing 1% of all lymphomas and 8.6% of all untreated parotid neoplasms. Three patients were excluded because of suboptimal therapy, leaving 36 patients eligible for outcome analysis. Of the 18 patients with low-grade NHL, two were treated with radiotherapy, eight with chemotherapy and radiotherapy, seven with chemotherapy only, and one with antibiotics. The complete remission (CR) rate was 94%, and with a median follow-up of 36 months for surviving patients the survival and failure-free survival (FFS) at 5 years were 94% and 78%, respectively. The 5-year FFS were not statistically different between patients with early (I or II) or advanced (III or IV) AAS (83% and 74%, respectively; p > 0.05) and favorable (0 or 1) or unfavorable (> 1) IPI scores (73% and 100%, respectively; p > 0.05). All 18 patients with intermediate-grade NHL were treated with doxorubicin-based chemotherapy which was followed by radiotherapy in six. The CR rate was 89%, and with a median follow-up of 51 months for surviving patients the survival and FFS at 10 years were 80% and 72%, respectively. In this group 10-year FFS was better in early than in advanced AAS (100% vs 0%, respectively; p = 0.01) and in favorable (0 or 1) than in unfavorable (> 1) IPI scores (86% vs 20%, respectively; p < 0.01). We conclude the the FFS of patients with low-grade NHL is 78% and not affected by AAS or IPI score. The FFS of patients with intermediate-grade NHL appears comparable with that of NHLs of other primary sites, being 86% for those with IPI < or = 1 and 20% for those with IPI 1. Patients with IPI > 1 should be entered on investigational protocols aiming to increase FFS.
9039302 Nailfold capillary abnormalities in patients with Sjögren's syndrome and systemic lupus e 1997 Jan It is unknown whether primary Sjögren's syndrome (pSS) and systemic lupus erythematosus (SLE) have the same nailfold capillary abnormality, although they show similarity in several clinical, immunological and genetic aspects. Microscopy of the nailfold capillaries was undertaken in the two diseases and the observed parameters were compared with age- and sex-matched controls using analysis of variance. pSS and SLE showed a different frequency in their clinical and laboratory findings, except for the presence of anti-SS-A/B antibodies. All nailfold capillary parameters showed significantly higher values than those of corresponding normal controls, although between pSS and SLE there was no significant difference. The results may indicate that pSS and SLE are part of a spectrum of disorder.
10332211 [Chlamydia-induced reactive arthritis--HLA-B 27 negative two patients]. 1999 Feb Two cases with HLA-B 27 negative, Chlamydia-induced reactive arthritis (ReA) were described. Case 1: A 30 y.o. male developed balanitis, urethritis, arthritis of both knees, elbows, shoulders and hip joints on May in 1997. Laboratory findings revealed CRP 2.7 mg/dl (normal range < 0.3), ESR 33 mm/h and negative rheumatoid factor (RF) test. Anti-Chlamydia trachomatis antibodies, IgG 2.22, IgA 3.33 were positive. HLA-typing revealed A 2, A 24 (9), B 39 (16), B 52 (5). He was diagnosed as ReA and arthritis subsided with treatment of minocycline and nonsteroidal antiinflammatory drugs (NSAIDs). Case 2: A 40 y.o. Iranian American male developed balanitis, urethritis, lumbago, arthritis of both elbows, knees and foot joints, iridocyclitis on August in 1995. Chlamydia trachomatis was detected in the urethral swab culture. He was diagnosed as ReA and treated with minocycline and NSAIDs. He was referred to our hospital on June in 1996. Arthritis at both knees and feet was detected. Laboratory findings revealed CRP 0.8 mg/dl, negative RF test was revealed. Antibodies to Chlamydia were positive (IgG 1.49, IgA 1.53) positive. HLA typing revealed A 1, A 2, B 37, B 55 (22). He was again treated with minocycline and NSAIDs and ReA ameliorated. Since HLA-B 22, B 37 and B 39 have been reported to cross-react or to have homology with B 27, B 22, B 37 and B 39 are likely to related to inducing ReA.
11764225 Evaluation of ILAR classification criteria for juvenile idiopathic arthritis in Spanish ch 2001 Dec OBJECTIVE: To evaluate the proposed International League of Associations for Rheumatology (ILAR) classification criteria for juvenile idiopathic arthritis in a cohort of Spanish children. METHODS: One hundred twenty-five patients with chronic arthritis were categorized according to one of the traditional classifications and the proposed ILAR classification system after at least 6 months of disease. The traditional classifications included the European League Against Rheumatism (EULAR) criteria for pauciarticular, polyarticular rheumatoid factor (RF) negative, and systemic juvenile chronic arthritis (JCA), as well as for RF+ polyarthritis; the Vancouver criteria for juvenile psoriatic arthritis (JPsA); and the European Spondylarthropathy Study Group (ESSG) preliminary criteria for juvenile spondyloarthropathy (JSpA). RESULTS: The ILAR criteria classified 106/125 patients (84.8%). All patients with systemic and polyarticular JCA, RF+ polyarthritis, and definite juvenile psoriatic arthritis were reclassified in the corresponding ILAR category. In contrast, only 80% of pauciarticular JCA and 47% of JSpA patients could be allocated to the ILAR oligoarthritis (47/59 patients, 35 persistent and 12 extended) and enthesitis related arthritis (ErA. 8/17 patients) categories. Two children with probable PsA were reclassified in the RF- polyarthritis category. Nineteen patients (15.2%) were allocated to the ILAR "other arthritis" group, 13/19 because they did not fulfill criteria for any of the other categories (12 due to family history of psoriasis and one because of family history of HLA-B27 associated disease). The remaining 6 patients met criteria for 2 categories, RF- polyarthritis and either ErA (n = 5) or PsA (n = 1). No differences other than family history of psoriasis were found in any of the variables studied between pauciarticular JCA patients classified in the oligoarthritis (n = 47) and those in the "other arthritis" (n = 11) ILAR categories. CONCLUSION: The proposed ILAR criteria allocated 84.8% of the patients classified by traditional criteria. Family history of psoriasis (n = 12) and polyarticular onset of disease in patients with ErA (n = 5) were responsible for most of the exclusions from other ILAR categories.
9125264 An unusual case of carcinoma polyarthritis with associated vasculitis. 1997 Apr This report describes a patient who presented with an unusual polyarthritis syndrome. After extensive evaluation, squamous cell carcinoma of the lung was diagnosed. During the course of the illness, the patient developed vasculitic features and "rheumatoid-like" nodules. Two months after the administration of combined-modality therapy for stage IIIA non-small cell lung carcinoma, the signs and symptoms of polyarthritis and vasculitis had disappeared completely. Ten months later, the patient remains in clinical remission. This is the first published report of simultaneous vasculitic and polyarticular manifestations in a patient with carcinoma polyarthritis.
9676203 [Hoffa's disease of the adipose pad: magnetic resonance versus surgical findings]. 1998 Apr INTRODUCTION: Hoffa's fat pad disease is characterized by chronic knee pain mostly under the patella. Acute cases are generally post-traumatic; the clinical picture consists of especially anterior pain and functional impairment mimicking a ligament injury, often in the presence of a bulky effusion even with blood from mucous ligament arteriole rupture. In chronic cases, recurrent episodes of hydrarthrosis are reported, together with joint weakening and subpatellar discomfort. At clinical examination, Hoffa's sign is difficult to observe but can be highly specific. Extending a bent knee putting pressure on the patellar tendon margins elicits a strong pain, an antalgic block and a defensive behavior of the patient. MRI clearly depicts Hoffa's infrapatellar fat pad and its findings may suggest the frequently ignored diagnosis of Hoffa's syndrome, alone or associated with other local or systemic conditions. This is really important for a complete and correct surgical planning, since the classic anterolateral arthroscopy and arthrotomy never visualize the pad itself and, at any rate, give no information on the possible changes. MATERIAL AND METHODS: June 30, 1995, to June 30, 1997, one hundred and ninety-three arthroscopies were performed at the Service of Orthopedics of Argenta Hospital. The present retrospective study excluded 107 patients (65.45%) who had not undergone MRI. In the remaining 86 patients (44.55%) who underwent MRI, the surgical, arthroscopic and nonarthroscopic patterns of Hoffa's pad were studied and 17 patients selected for surgical curettage of Hoffa's pad which was the site of isolated or associated conditions. All 17 MR examinations were reviewed to assess the patterns of the various pad abnormalities in the light of the surgical picture and of the latest indications from the international literature. RESULTS: T1-weighted sequences showed the fibrotic trabeculae of the pad thanks to the contrast offered by hyperintense fat and T2-weighted sequences demonstrated liquid infiltration in the pad and various synovial recesses. Despite the limitations of a retrospective study, MRI had high sensitivity in Hoffa's fat pad studies in our 17 patients; its specificity depended on the condition. MRI was particularly reliable in acute (Hoffa's pad rupture-detachment) and chronic conditions with aspecific hypertrophy (chondromatosis, pigmented villonodular synovitis), as well as in systemic disorders (rheumatoid arthritis). CONCLUSIONS: Accurate studies of Hoffa's fat pad are mandatory because different pad injuries may require a different arthroscopic approach from the classic ones. MRI was a useful tool in the study of Hoffa's fat pad, whose local and systematic involvement is an often ignored cause of anterior knee pain.
11336575 Celecoxib: a new option in the treatment of arthropathies and familial adenomatous polypos 2001 Jan The discovery of the two isoenzymes of cyclooxygenase (COX) has recently lead to the development and clinical introduction of specific inhibitors of cyclooxygenase-2 (COX-2), such as celecoxib, onto the market. Celecoxib is an effective anti-inflammatory, analgesic and antipyretic agent therapeutically utilised in the management of osteoarthritis and rheumatoid arthritis. In addition, celecoxib has some novel therapeutic and pharmacological activities. Celecoxib inhibits anti-apoptotic kinase activation and is the first specific COX-2 inhibitor to be marketed for familial adenomatous polyposis, an inheritable predisposition for colorectal cancer. Celecoxib is not without gastrointestinal (GI) side effects but demonstrates markedly reduced GI ulceration in clinical trials when compared to traditional non-specific non-steroidal anti-inflammatory drugs (NSAIDs). The specific COX-2 inhibitors each have distinctive pharmacokinetic properties. Celecoxib can be given either once or twice daily. Racial differences in drug disposition, and pharmacokinetic changes in elderly patients, patients with chronic renal insufficiency and patients with mild to moderate hepatic impairment, are evident with celecoxib. Despite the specific action of these drugs, there remains the potential for significant drug interactions. Celecoxib has demonstrated interactions with fluconazole, lithium and warfarin. Increased clinical vigilance should be maintained when co-prescribing medications with celecoxib until further clinical experience is gained. Celecoxib represents a major therapeutic advance in terms of GI safety. However, long-term safety in other organ systems, safety with concomitant drug administration, and pharmacoeconomic benefits still remain to be proven.
9627009 Regulation of cartilage oligomeric matrix protein synthesis in human synovial cells and ar 1998 Jun OBJECTIVE: Cartilage oligomeric matrix protein (COMP) is a component of the extracellular matrix of articular cartilage. Its increased presence in synovial fluid and serum has been associated with accelerated joint damage in patients with rheumatoid arthritis (RA) and osteoarthritis. To fully understand the reasons for fluctuations of COMP levels, we studied the biosynthesis of this molecule in cells derived from joint tissues. METHODS: Synovial cells were derived from synovial tissues of patients with RA, and human articular chondrocytes were prepared from normal articular cartilage. Analysis by Northern blotting was used to evaluate steady-state levels of COMP messenger RNA (mRNA), while secretion of the protein into culture media was analyzed by Western blotting. Expression of COMP in synovial tissues was studied by reverse transcriptase-polymerase chain reaction analysis and by in situ hybridization. RESULTS: COMP was synthesized and secreted by synovial cells as well as by articular chondrocytes in culture. The basal rate of synthesis was very low; however, COMP biosynthesis in both cell populations was induced very strongly by transforming growth factor beta1 (TGFbeta1). Interleukin-1beta counteracted COMP induction by TGF-beta1. COMP was not detected in culture media of skin or fetal lung fibroblasts, either in the absence or the presence of TGFbeta1. COMP mRNA was also present in fresh synovial tissue specimens obtained from patients with RA. CONCLUSION: COMP is synthesized and secreted not only by articular chondrocytes, but also by synovial fibroblasts. The demonstration of COMP expression in surgical specimens of synovial tissues suggests that the inflamed synovium may provide an additional source for the elevated levels of COMP observed in arthritis. Thus, increased COMP levels in body fluids may be indicative of active synovitis as well as of accelerated joint erosion.
11030821 Chronic infantile neurological cutaneous and articular/neonatal onset multisystem inflamma 2000 Oct OBJECTIVE: To report on the ocular manifestations of the Chronic Infantile Neurological Cutaneous and Articular/Neonatal Onset Multisystem Inflammatory Disease (CINCA/NOMID) syndrome, a rare, recently identified, pediatric multisystem inflammatory disease with chronic cutaneous, neurological, and articular manifestations. DESIGN: Descriptive case-report study. SETTING: International collaborative study based on a questionnaire. RESULTS: We included 31 patients. The mean age at onset of eye manifestations was 4.5 years. Optic disc changes were the most common feature, occurring in 26 patients (83%), including optic disc edema, pseudopapilledema, and optic atrophy. Anterior segment manifestations varying from mild to severe were seen in 13 patients (42%); chronic anterior uveitis, in 17 patients (55%). Moderate to severe visual acuity loss in at least 1 eye was seen in 8 patients (26%) as a consequence of the disease. Posterior synechia, glaucoma, and white iritis were not observed in any patient. CONCLUSION: Ocular manifestations with potentially sight-threatening complications occur commonly in the CINCA/NOMID syndrome. The distinctive nature of these complications may assist the ophthalmologist in recognizing this rare disorder and distinguishing it from juvenile rheumatoid arthritis.
10947942 Adeno-associated virus mediates long-term gene transfer and delivery of chondroprotective 2000 Aug Treatments for rheumatoid arthritis and other inflammatory arthropathies are often ineffective at preventing joint destruction. Long-term genetic modification of the cells lining the joint space (synoviocytes) in vivo represents a potential method for the treatment of these chronic conditions. However, a vector capable of efficiently transducing synoviocytes in vivo for a persistent period has not been available. The present report describes the genetic modification of synoviocytes in vivo using recombinant adeno-associated virus. High-titer adeno-associated virus encoding the gene for Escherichia coli beta-galactosidase was injected into the knee joints of mice. Synovial tissues were then examined for beta-galactosidase transgene expression by in situ staining and by fluorometry. High-efficiency, persistent transgene expression was observed in the synovium with no evidence of vector-induced inflammation. Expression was observed for at least 7 months and was higher in arthritic than nonarthritic mice. Gene transfer of murine IL-4 to the joints of mice with collagen-induced arthritis led to detectable levels of IL-4 in the joint and protection from articular cartilage destruction. These data suggest that adeno-associated virus may be a useful vector for gene delivery to the synovium for the treatment of inflammatory arthropathies.
10679126 Accumulation of common T cell clonotypes in the salivary glands of patients with human T l 2000 Mar 1 To clarify the pathogenesis of human T lymphotropic virus type I (HTLV-I)-associated Sjögren's syndrome (SS), the TCR Vbeta gene usage by the infiltrating lymphocytes in the target organ was examined. The Vbeta families predominantly used in the labial salivary gland (LSG) from the HTLV-I-seropositive (HTLV-I+) SS patients were more restricted than those from the HTLV-I-seronegative (idiopathic) SS patients, and were commonly Vbeta5.2, Vbeta6, and Vbeta7. The single-strand conformation polymorphism analysis revealed that T cell clonotypes with Vbeta5.2, Vbeta6, and Vbeta7 accumulate in the LSG from the HTLV-I+ and idiopathic SS patients. Among junctional sequences of the most dominant Vbeta7 transcripts, the conserved amino acid motif (QDXG: X is any amino acid) was found in six of the five HTLV-I+ SS patients and was also detected in two of the five idiopathic SS patients. Using the probes specific to the motif, the Vbeta7 transcripts with the motif were detected in the LSG from all of the seven HTLV-I+ and five of the six idiopathic SS patients, but not from eight healthy subjects. The Vbeta7 transcripts with this motif were also detected in the HTLV-I-infected T cell lines obtained from the LSG of an HTLV-I+ SS patient. The accumulation of HTLV-I-infected T cells expressing TCR with the conserved motif was thus indicated. These T cells were commonly present in patients with idiopathic SS and are strongly suggested to most likely be involved in the pathogenesis of both HTLV-I-associated and idiopathic SS.
9401721 The effect of TRK-530 on experimental arthritis in mice. 1997 Nov TRK-530 is a newly synthesized diphosphonate derivative. We investigated the effect of TRK-530 on type II collagen-induced arthritis (CIA) in mice in comparison to that of prednisolone and indomethacin. TRK-530 at a dose of 25 mg/kg showed a tendency to inhibit CIA. TRK-530 at a dose of 50 mg/kg inhibited the development of the CIA in terms of the progression of footpad swelling, bone damage and histopathological changes. TRK-530 at a dose of 50 mg/kg also significantly inhibited the delayed type hypersensitivity (DTH) response to type II collagen, but not the production of anti-type II collagen IgG antibody in arthritic mice. To investigate the inhibitory mechanism of TRK-530, the type of effect of TRK-530 on the production of IL-1 beta in vitro was studied. TRK-530 at a concentration of 10(-4) M inhibited LPS-induced IL-1 beta production from J774.1 cells. In conclusion, TRK-530 inhibited CIA in mice. The inhibition of the DTH reaction to type II collagen and the inhibition of IL-1 beta production may partly participate the anti-rheumatoid action of TRK-530.
9551943 T helper 1 response is dominant and localized to the synovial fluid in patients with Lyme 1998 Jan 15 Cytokines produced by subsets of CD4+ T helper cells responding to an infection influences the efficiency with which the host is able to mount a protective immune response. In an attempt to elucidate the population of active cells involved in the propagation of Lyme arthritis we have utilized intracellular cytokine staining to analyze the polyclonal immune response at the single cell level. We have determined the Th phenotype in the synovial fluid of patients with a variety of chronic inflammatory arthritides, including patients representative of the spectrum of Lyme arthritis. Th1 cells dominate the immune response in the synovial fluid of patients with Lyme as well as those with rheumatoid or other types of chronic inflammatory arthritis. In addition, the severity of Lyme arthritis directly correlates with the ratio of Th1 to Th2 cells in the synovial fluid, such that the larger the effusion, the higher the ratio (r = 0.67, p < 0.05). These results suggest that Th1 cells play a direct role in the pathogenesis of the inflammatory process seen in Lyme arthritis, and that Th2 cells modulate the pro-inflammatory response generated by Th1 cells in the joint. Finally, we identify Th1 cells specific for outer surface protein A of Borrelia burgdorferi, the agent of Lyme disease. These cells are restricted to patients with Lyme arthritis and are localized to the joint. Furthermore, they persist in patients with prolonged antibiotic treatment-resistant Lyme arthritis, suggesting the possibility of an autoimmune process.