Browse

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

ID PMID Title PublicationDate abstract
15059270 Anti-Sa antibodies: prognostic and pathogenetic significance to rheumatoid arthritis. 2004 Anti-Sa antibodies are detected in the serum of 20-47% of patients with rheumatoid arthritis. These antibodies have a high degree of specificity for the disease, and appear to identify a subset of early rheumatoid arthritis patients destined to have aggressive and destructive disease. It has recently been confirmed that anti-Sa antibodies are directed to citrullinated vimentin, thus placing them in the anti-citrulline family of autoantibodies. The Sa antigen has previously been shown to be present in synovium. This, along with the demonstration of citrullinated proteins in rheumatoid synovium, suggests that anti-Sa antibodies may play a pathogenetic role in the initiation and/or persistence of rheumatoid synovitis.
15098370 [Rheumatoid arthritis and pregnancy]. 2003 The problems of pregnancy in rheumatoid arthritis are presented in this paper.
14621660 Diagnosis and management of early rheumatoid arthritis. 2003 Oct RA is a chronic, progressive, systemic disease that leads to substantial disability when inadequately treated. Successful treatment requires early diagnosis and institution of effective DMARDs, with remission of disease activity being the ultimate goal of therapy. New biologic and immunosuppressive therapies are now available to help achieve this goal, and early consultation with a rheumatologist is advised during institution of therapy or for those not achieving remission with the above noted measures.
15201936 [Advances in immunology and rheumatoid arthritis pathogenesis]. 2004 Jan The pathogenesis of Rheumatoid Arthritis (RA) is still largely unknown. From the seminal experimental studies, suggesting a multifactorial mechanism leaded by an antigen specific activation, the direct role of innate immunity in the disease progression has been recently emphasized. In the natural history of RA, characterized by the three phases of the induction, maintenance and tissue destruction, innate immunity seems to be the central player. On the other hands the recent advances about the molecules involved in the T lymphocyte activation, the T cell role in the mechanism of erosion, and the studies about chemokines in the homing and angiogenesis processes support the theory of an antigen specific activation of the adaptive immune system. Therefore, during RA, the pathogenesis of sinovitis and erosions comes from independent pathways involving either innate and adaptive immunity resulting in the final induction of the articular damage.
12094227 Apoptosis as a therapeutic tool in rheumatoid arthritis. 2002 Jul Rheumatoid arthritis (RA) is a chronic inflammatory synovitis that is dominated by the presence of macrophages, lymphocytes and synovial fibroblasts, which leads to the destruction of bone and cartilage. The effectiveness of therapies that are directed against tumour-necrosis factor and interleukin-1 has identified macrophages as a crucial target for therapeutic intervention. However, not all patients respond to these therapies, and the benefits of this form of treatment are short lived. Recent work indicates that the insufficient apoptosis of inflammatory cells in the RA joint might contribute to pathogenesis. In this article, I characterize the mechanisms that prevent the apoptosis of chronic inflammatory cells in the RA joint, to identify potential new targets for the treatment of RA.
15163106 Epidemiology of extra-articular manifestations in rheumatoid arthritis. 2004 Extra-articular RA (ExRA) includes a wide variety of disease manifestations. Although rheumatologists in general are aware that such events are clinically important, the heterogeneity of available data, including discrepancies in case definitions, has complicated constructive discussions on this aspect of the RA disease phenotype. In recent years, there has been a growing recognition of the importance of co-morbidity in patients with RA. ExRA manifestations are not uncommon, explain excess mortality in RA and are predicted by smoking and autoantibodies. Further studies of the mechanisms underlying these associations are likely to be important in improving our understanding of the systemic nature of RA. This article discusses the methodological issues involved in the study of ExRA manifestations, presents suggested criteria that have been used in clinical studies, and reviews important surveys of the epidemiology of extra-articular RA.
12510370 [The rheumatoid vasculitis and malignant rheumatoid arthritis(MRA)]. 2002 Dec The inflammatory process characteristic of rheumatoid arthritis is typically targeted to the synovial membrane. In a subset of patients, rheumatoid disease is complicated by an inflammatory destruction of blood vessels, rheumatoid vasculitis. Rheumatoid vasculitis has been understood to be the result of severe disease extending beyond the joint, possibly caused by immune complex deposition. However, in Japan malignant rheumatoid arthritis(MRA) is designated as rheumatoid arthritis with vasculitis. Rheumatoid arthritis patients can be separated into two groups: individuals with synovial disease and individuals with synovial plus extra-articular disease, MRA. The model is supported by immunogenetic analysis describing an accumulation of vasculitis patients with rheumatoid arthritis among HLA-DRB10401 homozygotes. Therapy depends upon the clinical manifestation of rheumatoid vasculitis. Then, MRA is usually treated with steroid, and steroid pulse therapy and immunosuppressants are useful for severe MRA.
15119138 Delayed wound healing in patients with rheumatoid arthritis. 2004 Apr 6 Rheumatoid arthritis (RA) is an inflammatory disease that causes pain, swelling, stiffness, and loss of function in the joints. It occurs in a symmetrical pattern, which means that if one knee or hand is involved, the other is also (Box 1). It is a chronic, progressive, inflammatory tissue disorder of unknown origin and in addition to joint stiffness, ankylosis (fixation of a joint), and associated joint deformity, patients may have systemic involvement of the eyes, kidneys, chest, and lungs (Ryan, 1995). It is thought that the autoimmune component of the disease can have significant multi-system effects, including scleritis (inflammation of the white of the eye, the sclera), pericarditis, pleural effusions, vasculitis (patchy inflammation of the walls of small blood vessels), and skin ulceration (Oliver and Mooney, 2002).
12833652 Somatostatin analogs in rheumatoid arthritis and other inflammatory and immune-mediated co 2003 May Somatostatin (SST) is a naturally occurring neuropeptide that has multiple modulatory effects on the immune system and the function of synovial cells, as well as anti-angiogenic, antiproliferative and analgesic properties. These unique and diverse properties make this naturally occurring peptide an attractive candidate for use as a therapeutic agent in immune-mediated diseases, particularly in rheumatoid arthritis (RA). In this disease, proliferation of the synovial membrane, angiogenesis and dysregulated immunological activity lead to joint erosion and destruction. Here we review the postulated modes of action of SST in animal models of inflammation, autoimmunity and RA, as well as in humans. We also discuss the wide distribution of SST and its specific receptors, and the various SST analogs available. Results of a pilot study to evaluate the effect of SST analog treatment in refractory RA is discussed, and future directions for treatment and investigation are suggested.
15144352 Exercise therapy for people with rheumatoid arthritis and osteoarthritis. 2004 Jun Exercise therapy would appear to be effective at increasing aerobic capacity and muscle strength in patients with rheumatoid arthritis (RA), and no detrimental effects on disease activity or pain compared with controls has been observed. Exercise therapy--at least in the short-term, improves pain, muscular strength and function in elderly people with mild osteoarthritis (OA) of the hip or knee. For the treatment of both OA and RA the knowledge of the optimal type, frequency, duration and intensity of exercise is still limited, but the exercise should not include high-impact loads or high injury risk. Long-term compliance is important in achieving long-term benefits. Supervised classes appears to be as effective as treatments provided on a one-to-one basis, group-based exercise programme thus providing a cost-effective alternative. Adherence to home programmes seems to be lower. Future research should focus on finding optimal type and dose of exercise, ways of optimally maintaining the beneficial effects of exercise therapy over time as well as on the effects of exercise on the long-term progression of the disease and cost-effectiveness of the therapy.
12164803 B cells and immunoglobulins dependent mechanisms in rheumatoid arthritis: a possible ratio 2002 Aug Patients with rheumatoid arthritis (RA) have several options for treatment nowadays, although we do not know what types of therapies are effective for these patients because RA is a very heterogenous disease. We discuss several possible mechanisms of RA in this review and explain one possible scenario of autoantibodies dependent arthritis confirmed by anti-glucose-6-phosphate isomerase antibodies. We also propose several efficacious treatments for treating these patients as made-to-order therapies.
15229951 Weather effects in rheumatoid arthritis: from controversy to consensus. A review. 2004 Jul OBJECTIVE: To review and evaluate the evidence for the widespread view that signs and symptoms of rheumatoid arthritis (RA) are influenced, or even caused, by the weather. METHODS: A literature search from 1985 to April 2003 was performed using the PubMed database of the US National Library of Medicine. Additional relevant articles were identified from the bibliographies, and from our own archives. Methods and findings of the studies were critically reviewed. RESULTS: Only temperature and humidity appear to have clear influences on the symptoms of RA, although the reported findings do not agree. In many cases, the apparent controversies can be explained by the intimate relationship between temperature and humidity, and by taking local circumstances into account. The differences in the methods applied in studies on effects of weather on RA strongly hampered our evaluation. CONCLUSION: RA variables are positively correlated with the humidity of the microclimate at the patient's skin. High outdoor relative humidity is unfavorable, but has less influence when there are few barriers for water vapor, like clothes, and when air conditioning is used. High temperature is unfavorable since it increases absolute humidity, but beneficial as well, since it reduces the presence of barriers, and stimulates the use of air conditioning. The classic opinion, "Cold and wet is bad, warm and dry is good for RA patients," seems to be true only as far as humidity is concerned.
14974882 [New perspectives in the treatment of rheumatoid arthritis]. 2003 Nov Rheumatoid arthritis affects 0.5% of the Spanish population. It is a disabling, slowly progressive disease which primarily affects joints, and results in functional impairment and important quality of life reductions in most patients. Its etiology is presently unknown. Treatment is aimed at reducing inflammatory activity, preserving function, and delaying joint lesions, which result in high morbidity and mortality. Treatment is usually initiated with NSAIDs and glycocorticoids to relieve symptoms, and then followed by disease-modifying anti-rheumatic drugs. Recent advances in the understanding of etiopathogenic mechanisms have permitted the development of novel, much more specific treatments aimed at modifying disease progression. These include those acting on the tumoral necrosis factor (TNF) - etanercept and infliximab - and more recently an interleukin-1 receptor antagonist - anakinra. Despite their demonstrated improved tolerance and faster onset of action, their high cost warrants further efficacy studies and the establishment of objective criteria for their use.
12027304 Cervical spine involvement in rheumatoid arthritis. A review. 2002 Mar Cervical spine involvement occurs in over half of patients with rheumatoid arthritis (RA). The most common abnormality is atlantoaxial dislocation, followed by atlantooccipital arthritis with cranial settling and by lesions of the lower cervical spine. Cervical spine involvement usually occurs in patients with severe RA. Pain and evidence of spinal cord injury are the main symptoms. The presence of symptoms is not correlated with the severity of radiological abnormalities. Computed tomography and magnetic resonance imaging provide detailed images of the bone and spinal cord lesions. Because the course is unpredictable, conservatively treated patients usually require regular follow-up. Surgery is in order in patients with pain unresponsive to major narcotics or with progressive neurological impairment. The choice between the anterior and the posterior route depends on the experience of the surgical team. It is reasonable to stabilize the spine before the development of cranial settling or major neurological loss (Ranawat's stage III). The good functional results of spinal surgery are frequently overshadowed by major impairments related to severe peripheral joint disease. Safety is acceptable when somatosensory evoked responses are monitored intraoperatively. Surgery can provide substantial improvements in symptoms, particularly pain.
14557050 Association of PADI4 and rheumatoid arthritis: a successful multidisciplinary approach. 2003 Oct The identification of functionally relevant polymorphisms of peptidylarginine deiminase 4, an enzyme that catalyzes the post-translational citrullination of proteins, as a rheumatoid arthritis gene is one of the most convincing success stories of complex disease gene mapping to date. In addition to an extensive single nucleotide polymorphism-based association study in a Japanese cohort, a range of techniques have been used to validate this finding.
15157002 Patient-reported outcomes and their role in the assessment of rheumatoid arthritis. 2004 Patients with rheumatoid arthritis (RA) face considerable physical, social and emotional disabilities. In this chronic disease, for which a cure is not yet available, improving patients' health-related quality of life (HRQoL) is of the utmost concern, particularly as the use of long-term and potentially toxic therapy increases. Early HRQoL outcome measures in RA focused on physical functioning, but the social and emotional aspects of the disease are now increasingly important. Thus, several generic and RA-specific HRQoL instruments have been developed, but no one tool covers all areas of HRQoL that affect the patient with RA. For this reason, a combination of generic and disease-specific tools is currently recommended for RA clinical trials.
12473269 Epidemiology of rheumatoid arthritis: determinants of onset, persistence and outcome. 2002 Dec Rheumatoid arthritis (RA) is the most common chronic inflammatory joint disease. There is some evidence that it may have been brought from North America to Europe during the 18th century. Its arrival in rural parts of the developing world is still more recent. The incidence and prevalence of RA appear to have fallen in Europe, North America and Japan in the last 50 years. During this time the peak age of onset has risen. Risk factors for the development of RA include genetic factors, an adverse pregnancy outcome, smoking, obesity and recent infections. The oral contraceptive pill and some dietary constituents may be protective. Older age and female gender are risk factors both for the development of RA and for a worse outcome. This risk factor profile offers some opportunities for primary and secondary prevention. However, treatment is the greatest determinant of RA outcome.
14770099 Effectiveness and safety of strength training in rheumatoid arthritis. 2004 Mar PURPOSE OF REVIEW: As muscle weakness is common in patients with rheumatoid arthritis (RA), strength training is considered to be an important cornerstone of the nonpharmacological treatment. The training methods have varied widely between the studies. Thus, the purpose of this review is to discuss effectiveness and safety but also basic principles and specificity of strength training. RECENT FINDINGS: Moderate or high-intensity strength training has been effective and well-tolerated method to increase or maintain muscle strength in patients with rheumatoid arthritis. No deleterious effects on disease activity and pain were observed. More information is needed regarding long-term effects of strength training on functional capacity, bone mineral density, and radiologic progression. SUMMARY: Moderate or high-intensity strength training programs have better training effects on muscle strength in RA than low-intensity programs. The type of exercises, intensity, and frequency of training are key factors in the effectiveness of training. It is, however, essential to maintain the training routine to obtain long-term benefits from it.
12817091 Determinants of physical function in rheumatoid arthritis: association with the disease pr 2003 May Rheumatoid arthritis (RA) is a chronic, debilitating disease that follows a progressive course characterized by persistent inflammation and erosive joint damage leading to functional disability. The Health Assessment Questionnaire is now viewed as a key instrument to measure physical function, based on its reliability and ease of use. It has been demonstrated that multiple variables affect physical function, of which those most frequently indicated are disease activity, joint damage and the psychosocial characteristics of the patient. When these variables are pooled together the variation observed in a patient's physical function over the long term can be explained mainly by disease activity, partially by joint damage and additionally by psychosocial factors. Therefore, to maintain or improve physical function in long-standing RA, it is imperative to control disease activity and joint damage by early initiation of treatment.
12823846 In vivo imaging approaches in animal models of rheumatoid arthritis. 2003 The interaction of activated leukocytes with the rheumatoid synovial environment is a key process in arthritis. Understanding this process will play an important role in designing effective treatments. In vivo imaging approaches combined with molecular genetics in animal models provide important tools to address these issues. The present review will focus on approaches to in vivo imaging, with particular attention to approaches that are proving useful for, or have promise for, research on animal models of rheumatoid arthritis. These approaches will probably shed light on the specific local mechanisms involved in chronic inflammation and provide real time monitoring approaches to follow cellular and molecular events related to disease development.