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ID PMID Title PublicationDate abstract
15940762 Parenteral gold preparations. Efficacy and safety of therapy after switching from aurothio 2005 Jun OBJECTIVE: For reasons of insufficient quality of the raw material, aurothioglucose was withdrawn from the Dutch market at the end of 2001. Aurothiomalate became available as an alternative preparation. We followed a cohort of patients during the first year after switching from aurothioglucose to aurothiomalate to study efficacy and tolerability. METHODS: Patients were observed at baseline and at 3 and 12 months after switching. At each visit, data on adverse drug reactions (ADR), withdrawal, and disease activity were collected. RESULTS: In total 120 patients were included [age 63(SD 15) yrs, 68% female, 93% with rheumatoid arthritis, duration of disease 15 (SD 9) years, 82% IgM rheumatoid factor-positive, with 9 (SD 9, range 0.1-45) yrs of previous aurothioglucose therapy]. Nineteen patients (16%) reported an ADR taking aurothiomalate not previously experienced with aurothioglucose, the most frequently reported being pruritus, dermatitis/stomatitis, and chrysiasis/hyperpigmentation. Twenty-nine patients (24%) withdrew from aurothiomalate within 12 months of followup for reasons of inefficacy (14%), ADR (7%), or disease in state of remission (3%). Kaplan-Meier estimates show aurothiomalate survival rates of 78.5% after 12 months. No statistically significant differences between the disease activity indicators during followup visits compared with the baseline visit were detected for the patients continuing aurothiomalate. CONCLUSION: Within the first 12 months after switching from aurothioglucose, 24% of patients withdrew from aurothiomalate. Sixteen percent of patients reported novel ADR. For the population continuing to take aurothiomalate no clinically relevant changes in disease activity were recorded after switching.
16014674 Vaccination against influenza in rheumatoid arthritis: the effect of disease modifying dru 2006 Feb OBJECTIVE: To assess the efficacy and safety of vaccination against influenza virus in patients with rheumatoid arthritis, with special emphasis on the effect of disease modifying antirheumatic drugs (DMARDs), including tumour necrosis factor alpha (TNFalpha) blockers. METHODS: 82 rheumatoid patients and 30 healthy controls were vaccinated with a split-virion inactivated vaccine containing 15 mug haemagglutinin (HA) per dose of each of B/Hong Kong/330/2001 (HK), A/Panama/2007/99 (PAN), and A/New Caledonian/20/99 (NC). Disease activity was assessed by tender and swollen joint count, morning stiffness, evaluation of pain, Health Assessment Questionnaire, ESR, and C reactive protein on the day of vaccination and six weeks later. Haemagglutination inhibiting (HI) antibodies were tested by a standard WHO procedure. Response was defined as a fourfold or more rise in HI antibodies six weeks after vaccination, or seroconversion in patients with a non-protective baseline level of antibodies (<1/40). Geometric mean titres (GMT) were calculated to assess the immunity of the whole group. RESULTS: Six weeks after vaccination, a significant increase in GMT for each antigen was observed in both groups, this being higher in the healthy group for HK (p=0.004). The percentage of responders was lower in rheumatoid patients than healthy controls (significant for HK). The percentage of responders was not affected by prednisone or any DMARD, including methotrexate, infliximab, and etanercept. Indices of disease activity remained unchanged. CONCLUSIONS: Influenza virus vaccine generated a good humoral response in rheumatoid patients, although lower than in healthy controls. The response was not affected by the use of prednisone or DMARDs.
16642406 Paraoxonase and arylesterase levels in rheumatoid arthritis. 2007 Mar It was reported that lipid peroxidation (LPO) products increase in rheumatoid arthritis (RA) patients and increased LPO products reduce many antioxidants. Lipid hydroperoxides (LOOHs) are byproduct of LPO. Paraoxonase (PON), arylesterase (ARE), free sulfhydryl (SH) groups, and ceruloplasmin (CP) are enzymes or proteins with antioxidant characteristics. This study aims to determine the levels of LOOHs and SH, and the activities of PON1, ARE, and CP in RA patients. The study included 47 active RA cases and 23 healthy volunteers. The levels of LOOHs and SH, and the activities of PON1, ARE, and CP were determined using appropriate methods. Student's t test and Spearman's correlation analysis methods were employed in the statistical evaluation. The level of LOOHs was found to be higher (p<0.001), while the level of SH and the activities of PON1, ARE, and CP were found to be lower (p<0.001, <0.001, <0.01, and <0.01, respectively) in the RA patient group when compared with the control group. There was a negative correlation between the level of LOOHs and the activity of PON1 in the patient group (r= -0.420 and p<0.01). The results of our study indicate increased oxidant and decreased antioxidant presence in RA patients. PON1 and ARE are known to have antiatherosclerotic effects in addition to their antioxidant characteristics. As the decrease in these antioxidants, resulting from increased oxidative stress in RA patients, development of atherosclerosis besides tissue injury seems inevitable.
16512396 [Cerebrovascular disturbances in rheumatoid arthritis]. 2006 Rheumatoid arthritis (RA) is a diffuse connective tissue disease and a multi-system disorder with inflammatory process affecting joints in the first place. RA is found in 1 to 3% of population; the first signs of it are usually found in people aged 35 to 50. Neurological pathology in RA is manifested by cervicocranialgia, cervical myelopathy, pathological changes in the upper cervical spine, and cerebral disorders. However, exact mechanisms of the development of central nervous system (CNS) lesions in RA have not been presented. The aim of this study was to clarify the pathophysiological mechanisms and clinical peculiarities of cerebral disturbances in RA. The subjects were 42 female patients, who underwent clinical, neurological, clinicolaboratory, immunological, and clinicophysiological examination. Subjective and objective symptoms were studied; the following syndromes of CNS pathology were distinguished: initial manifestations of cerebral functional insufficiency; disseminated cerebral micro symptoms; focal cerebral lesion. These disorders were accompanied by changes in biochemical parameters which evidenced the presence of connective tissue destruction and immune inflammation. Immunological tests revealed elevation of the level of myelin basic protein antibodies, which correlated with the degree of neurological disturbances and the duration of the disease. The level of myeloperoxidase was elevated, but the degree of this elevation did not depend on the degree of the cerebral disorder and displayed a negative correlation with the duration of the disease. The results of the study demonstrate primary lesion of small vessels in RA--secondary vasculitis followed by demyelinization of CNS white substance. Thus, three forms of cerebrovascular pathology, caused by acute or chronic cerebral vascular insufficiency in RA can be distinguished: initial manifestations of cerebral circulation insufficiency; discirculatory encephalopathy; transient cerebral circulation disturbances and cerebral stroke.
15458960 Effects of infliximab treatment on insulin resistance in patients with rheumatoid arthriti 2005 May BACKGROUND: Tumour necrosis factor alpha (TNFalpha) may be an important mediator of insulin resistance. Infliximab is a chimeric monoclonal, high affinity antibody against the soluble and transmembrane TNFalpha, which can reduce markedly the biological activity of circulating and tissue TNFalpha and is used to treat various autoimmune disorders. OBJECTIVE: To assess the effects of infliximab infusions on insulin sensitivity in patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS). METHODS: 45 patients (28 with RA, 17 with AS) aged 19-74 years were studied. All patients were treated with intravenous infliximab. A complete biochemical profile was obtained before and after 6 months' treatment with infliximab. The Homoeostasis Model Assessment (HOMA) Index was used to measure insulin resistance and the Quantitative Insulin Sensitivity Check Index (QUICKI) to measure insulin sensitivity. RESULTS: In the whole study group, no significant changes of the HOMA Index or QUICKI were seen. In the tertile of patients with the highest insulin resistance, a significant decrease of the HOMA Index and increase of the QUICKI was found (p<0.01 for both). CONCLUSIONS: The results suggest that infliximab treatment may have beneficial effects on insulin sensitivity in the most insulin resistant patients with RA and AS.
16633707 Articular damage in late rheumatoid arthritis. 2007 Mar This study aims to examine the long-term articular damage in rheumatoid arthritis (RA) patients according to rheumatoid arthritis articular damage (RAAD) score and to evaluate the parameters correlated with this score. The RAAD score was assessed in 85 RA patients who had the disease for more than 10 years. Patients were divided into three groups according to duration of the disease: group 1, 10-14 years; group 2, 15-19 years; and group 3, more than 20 years. Patients were also divided into three groups according to the time of initiation of treatment with disease-modifying antirheumatic drugs: group A, within the first 2 years, group B, between 2 and 5 years; and group C, after 5 years. We investigated the RAAD score relationship between groups 1, 2, 3; groups A, B, C; sex; drug compliance; age of onset of the disease; and Health Assessment Questionnaire (HAQ). We observed significant differences in RAAD scores according to groups 1, 2, 3 (p<0.01), but not to groups A, B, C; sex; or drug compliance (p>0.05). While the RAAD score correlated well with the HAQ (r=0.560, p<0.001), it did not correlate with the age at onset of the disease (p>0.05). As RA is not a benign disease and articular damage progresses over time, the goal of RA therapy must be to maintain a response before the onset of irreversible damage and loss of function.
15627197 Anti-TNFalpha therapy in rheumatoid arthritis and autoimmunity. 2006 Jan The aim of the study was to evaluate a panel of autoantibodies in patients affected by rheumatoid arthritis (RA) treated with anti-TNFalpha blockers, and to consider a different autoantibody induction effect by infliximab and etanercept; and in addition to evaluate in these cases a relationship between antinuclear antibody (ANA) titre and both C-reactive protein (CRP) and Blys levels. Fifty-four patients (8 men, 46 women, mean age 51.4 years, mean duration of disease 13.6 years) affected by refractory RA were treated with anti-TNFalpha blockers for 12 consecutive months; 43 patients were given infliximab and 11 etanercept. At baseline and every 4 months a panel of autoantibodies consisting of rheumatoid factor, antinuclear, anti-double-stranded DNA, anti-ENA, anti-mitochondrial, anti-thyroid and anti-neutrophil cytoplasmic antibodies (ANCA) was tested. At the same time CRP level was measured. Blys level was determined at baseline and after 1 year in five cases that developed a strong positivity for ANA during infliximab therapy. In 41 cases (95.3%) treated with infliximab, ANA were detected on at least one occasion, and in almost half of these cases the titre was very high, equal to or higher than 1:1.280. On the other hand, patients treated with etanercept presented ANA positivity in a lower percentage of cases and at a low titre. No correlation was found between ANA titre and CRP level; Blys level did not present a constant trend in patients who developed a very high positivity for ANA. Anti-double-stranded DNA, anti-thyroid or ANCA were found only in a few patients, in the absence of a clinical picture indicative of systemic lupus erythematosus, autoimmune thyroiditis or ANCA-associated vasculitis. A different incidence of ANA positivity was found in infliximab- and etanercept-treated RA patients; this finding might be due to the partially different method of inhibition of TNFalpha between the two drugs. Both CRP and Blys do not seem to participate in this phenomenon. Other autoantibodies were detected in a few patients, but no case of onset of new autoimmune disorders was observed.
17621797 [Role of imaging methods in the early diagnosis of rheumatoid arthritis]. 2006 Oct 19 Because of the good contrast obtained in soft tissues, ultrasound permits differentiation of the exudative and proliferative synovial tissue changes, as well as tenosynovitis. Superficial cartilage and bone lesions or erosions can be detected through ultrasound earlier than with conventional radiodiagnostics. The use of power Doppler sonography with ultrasound contrast agents is especially helpful in the further differentiation of the synovial inflammatory process and hence, progression of the destructive processes in the joint can be more clearly evaluated. Arthrosonography aids in the diagnosis of early arthritis, particularly in patients without pathological radiological findings and suspicious clinical results. Moreover, it permits sound assessment of the disease progression and hence, therapeutic monitoring. The method is patient friendly, has high diagnostic value and is an integral component in the clarification of arthritic symptoms.
16081832 Interaction between synovial inflammatory tissue and bone marrow in rheumatoid arthritis. 2005 Aug 15 Rheumatoid arthritis (RA) leads to destruction of cartilage and bone. Whether rheumatoid arthritis also affects the adjacent bone marrow is less clear. In this study, we investigated subcortical bone marrow changes in joints from patients with RA. We describe penetration of the cortical barrier by synovial inflammatory tissue, invasion into the bone marrow cavity and formation of mononuclear cell aggregates with B cells as the predominant cell phenotype. B cells expressed common B cell markers, such as CD20, CD45RA, and CD79a, and were mature B cells, as indicated by CD27 expression. Plasma cells were also present and were enriched in the regions between aggregates and inflammatory tissue. Moreover, molecules for B cell chemoattraction, such as BCA-1 and CCL-21, homing, mucosal addressin cell adhesion molecule-1 and survival, BAFF, were expressed. Endosteal bone next to subcortical bone marrow aggregates showed an accumulation of osteoblasts and osteoid deposition. In summary, we show that synovial inflammatory tissue can reach the adjacent bone marrow by fully breaking the cortical barrier, which results in formation of B cell-rich aggregates as well as increased formation of new bone. This suggests that bone marrow is an additional compartment in the disease process of RA.
15290086 Lp(a) lipoprotein and lipids in patients with rheumatoid arthritis: serum levels and relat 2005 May OBJECTIVES: Changes in lipid profiles, Lp(a) lipoprotein, and acute phase reactants are associated with early atherosclerosis in rheumatoid arthritis (RA). The associations of Lp(a) levels with atherosclerotic disorders, diabetes, RA, and renal diseases suggest that Lp(a) might be involved in autoimmune reactions. METHODS: Eighty-seven women with RA diagnosed according to American Rheumatism Association criteria (mean age 45.4+/-9.4 years) were recruited and 50 healthy women (mean age 44+/-10.7 years) included as a control group. Serum Lp(a), total cholesterol (TC), triglyceride (TG), LDL cholesterol (LDL-C), HDL cholesterol (HDL-C), and C-reactive protein levels were analyzed. RESULTS: In the RA and C groups, serum Lp(a) levels were 39.2+/-20.6 mg/dl and 14.8+/-9.7 mg/dl, respectively (P<0.001). The TC levels were 188.4+/-41.8 mg/dl and 185.3+/-19.3 mg/dl (P>0.05), TG levels were 124.5+/-50.1 mg/dl and 94.6+/-24.9 mg/dl (P<0.01), HDL-C levels were 40.0+/-7.4 mg/dl and 52.8+/-4.8 mg/dl (P<0.01), and LDL-C levels were 123.4+/-24.6 mg/dl and 113.3+/-21.1 mg/dl (P>0.05). While serum CRP levels showed a positive correlation with Lp(a), they correlated negatively with HDL-C levels (r=0.83 and P<0.0001, r=-0.49 and P<0.0001, respectively). It was meaningful that Lp(a) correlated negatively with serum HDL-C level (r=-0.36, P<0.001). CONCLUSIONS: It is suggested that higher serum Lp(a), lower HDL-C, higher TG level, and a high ratio of TC/HDL-C might show high risk of atherosclerosis. Inflammation in RA may cause changes in HDL-C and Lp(a) metabolisms.
15660236 A case of idiopathic hypertrophic cranial pachymeningitis manifested only by positive rheu 2005 Apr In this report, we present a rare case of a 52-year-old man with a unique form of hypertrophic pachymeningitis involving the anterior part of the falx and who was positive for rheumatoid factor. The clinical symptom was only headache, without any cranial nerve palsies or ataxia. Diagnosis was made by gallium scintigraphy and magnet resonance imaging but was not confirmed by dural biopsy. Treatment with corticosteroid alone was extremely effective for him, while in most cases hypertrophic pachymeningitis recurs or progresses despite the treatment.
15888503 Clinical associations of autoantibodies to human muscarinic acetylcholine receptor 3(213-2 2005 Aug OBJECTIVES: The authors have previously identified a peptide of the human muscarinic acetylcholine receptor-3 (m3AChR) as a suitable antigen for the immunodetection of antimuscarinic acetylcholine receptor autoantibodies in primary Sjögren's syndrome (pSS). The aim of this study was to assess the clinical correlations and disease specificity of these antibodies. METHODS: Seventy-three pSS, 40 rheumatoid arthritis (RA), 19 systemic lupus erythematosus (SLE), 14 secondary Sjögren's syndrome (sSS) patients, 22 subjects in whom pSS was suspected but in whom the diagnosis not could eventually be established (suspSS) and 40 healthy subjects were investigated. An enzyme-linked immunosorbent assay system developed by the authors using a 16-mer peptide of the m3AChR (m3AChR(213-228)) in a recombinant fusion peptide form was used as the antigen. RESULTS: Anti-m3AChR(213-228) antibody positivity was observed in 66 (90%) of the pSS patients. The antibody levels correlated positively with the number of extraglandular organ manifestations. Both the mean antibody levels and the occurrence of anti-m3AChR(213-228) positivity were significantly higher in pSS than in the comparison groups. The test discriminated the pSS patients from the various comparison groups with specificities of 65, 68, 71 and 50% for RA, SLE, sSS and suspSS, respectively. CONCLUSIONS: The presence of m3AChR(213-228) antibodies is a common feature in pSS. Although it is significantly more common in pSS than in the comparison groups, anti-m3AChR(213-228) positivity is not exclusive to pSS.
16014545 Association of anti-cyclic citrullinated peptide antibodies, anti-citrullin antibodies, an 2005 Jun We evaluated the association of anti-cyclic citrullinated peptide (CCP) antibody titers with serological markers of disease activity. We also compared three different anti-CCP antibody ELISAs with an anti-citrullin ELISA and the IgM and the IgA rheumatoid factor (RF) in their performance of discriminating between rheumatoid arthritis (RA) and other rheumatic diseases. Sera from 333 consecutive patients of the Rheumaeinheit der Medizinischen Poliklinik Munchen, an outpatient clinic for rheumatic diseases, were collected and tested. Anti-CCP antibodies were assayed with three different commercially available ELISAs. Antifilaggrin antibodies were tested with a commercially available ELISA using in vitro deiminated recombinant rat filaggrin. IgA-RF was analyzed with an ELISA, whereas IgM-RF was measured by latex-enhanced turbidimetry. Rheumatoid arthritis (RA) was diagnosed in 87 patients according to the revised classification criteria of the American College of Rheumatology (ACR), probable RA was diagnosed in 23 patients in an early phase not (yet) fulfilling the ACR criteria, and 223 patients had other rheumatic diseases. Differences in sensitivity and specificity were calculated using McNemar's test. A measure of agreement (kappa statistic) was used to examine whether the tests tended to identify the same patients as positive or negative. Correlations between CCP titers and other tests were analyzed by Spearman nonparametric rank correlation. No significant differences in sensitivity and specificity were found between the tested CCP assays (80.0-80.9% and 97.3-98.1%, respectively). All three CCP tests were slightly but not significantly more sensitive and specific than the anti-citrullin assay (77% and 92%, respectively), comparably sensitive but significantly more specific compared with the IgM-RF (86% and 82%, respectively), and significantly more sensitive but comparably specific compared with the IgA-RF (63% and 94.4%, respectively) in detecting the patients with RA. There was no significant correlation between anti-CCP, anti-citrullin, or IgM-RF or IgA-RF antibody titers and C-reactive protein, erythrocyte sedimentation rate, or white blood cell count. A weak but significant linear correlation was found between anti-CCP titers and IgM-RF titers (r = 0.2, P = 0.03). We could not find a significant difference between the three tested anti-CCP assays and the anti-citrullin test in terms of sensitivity and specificity. Compared with the IgM-RF, all the anti-CCP assays were superior in specificity and comparable in sensitivity. Compared with the IgA-RF, they were more sensitive and comparably specific in the discrimination of patients with RA from other rheumatic diseases. No correlation of any tested autoantibody titer with serological parameters of inflammation was found.
17074464 Prevalence and relative risk of dysphonia in rheumatoid arthritis. 2008 Mar Laryngeal involvement in rheumatoid arthritis is not uncommon and may include cricoarytenoid arthritis or vocal fold lesions such as vocal fold rheumatoid nodules or bamboo nodes. Dysphonia or voicing problems can be the result of such laryngeal involvement. This cohort study investigates the prevalence and the relative risk of dysphonia when suffering from rheumatoid arthritis compared to that of healthy subjects. One hundred and sixty-six subjects with rheumatic arthritis and 148 healthy control subjects completed two quality-of-life questionnaires: the Voice Handicap Index and a three-item outcome scale. Both instruments measure the quality of the voice itself and the extent of impairment resulting from dysphonia as experienced by the patient in social and occupational settings. Patients proved to have statistically significant higher prevalence and relative risk of dysphonia. Depending on the questionnaire being used, prevalence data of dysphonia in patients varied between 12% and 27%, whereas the healthy subjects showed prevalence data varying from about 3% to 8%. A patient's relative risk varied from about 3 to 4 when compared to healthy subjects. Patients suffering from rheumatoid arthritis have a clearly higher risk of dysphonia compared to healthy subjects.
16131428 Role of the immune system in postmenopausal bone loss. 2005 Sep Postmenopausal osteoporosis stems from estrogen deficiency. The mechanisms by which estrogen deficiency drives bone destruction are complex and poorly understood. Recent findings from animal models suggest that postmenopausal bone loss may stem in large measure from a pathologic upregulation of the adaptive immune response. While the role of activated T cells in the bone loss driven by inflammatory conditions such as rheumatoid arthritis has been well documented, only recently has the role of T cells in the bone destruction associated with estrogen deficiency begun to be appreciated. In vivo and in vitro models of postmenopausal osteoporosis demonstrate that the activation and expansion of tumor necrosis factor-a producing T cells is a key step in estrogen deficiency driven bone loss and is regulated by multiple interacting cytokines including transforming growth factor-b, interleukin-7, and interferon-g, as well as by the process of antigen presentation. This paper presents recent findings pertaining to this new view of postmenopausal osteoporosis.
16508933 Circulating levels of B lymphocyte stimulator in patients with rheumatoid arthritis follow 2006 Mar OBJECTIVE: To assess the effects of B lymphocyte depletion on serum B lymphocyte stimulator (BLyS; trademark of Human Genome Sciences, Rockville, MD) levels in patients with rheumatoid arthritis (RA), and to assess the relationship of serum BLyS levels with peripheral blood B cell depletion, levels of autoantibodies and antimicrobial antibodies, the return of peripheral blood B cells, and clinical relapse. METHODS: Fifteen patients with active RA underwent rituximab-based B cell depletion therapy (BCDT). Disease activity was assessed clinically, peripheral blood CD19+ B cell counts were determined by flow cytometry, and serum levels of BLyS, IgM, IgA, and IgG rheumatoid factors (RFs), anti-cyclic citrullinated peptide, and antimicrobial antibodies were assessed using enzyme-linked immunosorbent assays. RESULTS: Peripheral blood B cell depletion was achieved in all 15 patients, and an American College of Rheumatology 20% response was achieved in 13 patients. Following clinical relapse, 7 patients underwent at least 1 additional cycle of BCDT. In every case, serum BLyS levels markedly rose post-BCDT and remained elevated for at least 1-2 months. Serum levels of RF, but not those of anti-tetanus toxoid or anti-pneumococcal polysaccharide antibodies, fell significantly. A decline in serum BLyS levels was associated with the reemergence of B cells in peripheral blood, which, in turn, antedated clinical relapse by variable periods of time. The patterns of B cell depletion, serum BLyS and antibody levels, and clinical relapse for each BCDT cycle were remarkably similar in re-treated patients. CONCLUSION: Rituximab-based BCDT leads to marked increases in serum BLyS levels. This may contribute significantly to the survival and/or regeneration of B cell populations capable of triggering clinical relapse.
16508970 Effects of a novel tylophorine analog on collagen-induced arthritis through inhibition of 2006 Mar OBJECTIVE: To test the effects of a novel tylophorine analog, DCB 3503, on the prevention and treatment of collagen-induced arthritis (CIA) and to elucidate its underlying mechanisms. METHODS: DBA/1J mice were immunized with type II collagen, and in some cases, lipopolysaccharide (LPS) was used to boost the development of arthritis. DCB 3503 was injected intraperitoneally before or after the onset of CIA. Mice were monitored to assess the effects of DCB 3503 on the clinical severity of the disease, and pathologic changes in the joints were examined histologically. Levels of tumor necrosis factor alpha (TNFalpha) and interleukin-1beta (IL-1beta) in serum and joint tissues were measured by enzyme-linked immunosorbent assay and by cytometric bead array analysis. The effect of DCB 3503 on LPS-induced proinflammatory cytokines from bone marrow-derived dendritic cells was determined by flow cytometry. RESULTS: DCB 3503 significantly suppressed the development and progression of CIA. Moreover, DCB 3503 completely blocked the LPS-triggered acceleration of joint inflammation and destruction. Consistent with its effects in vivo, DCB 3503 significantly suppressed the synthesis of proinflammatory cytokines in inflamed joints as well as cytokine synthesis by macrophages examined ex vivo. Treatment also reduced the levels of inflammatory cytokines (IL-6, IL-12, TNFalpha, and monocyte chemotactic protein 1) produced by bone marrow-derived dendritic cells in vitro. However, DCB 3503 showed no direct effects on T cell proliferation and B cell antibody response. CONCLUSION: Because of its ability to specifically suppress innate immune responses, DCB 3503 may be a novel therapeutic agent for inflammatory arthritis in humans.
15742441 Absence of cyclic citrullinated peptide antibody in nonarthritic patients with chronic hep 2005 Mar OBJECTIVE: The increased prevalence of rheumatoid factor (RF) in patients with chronic hepatitis C virus (HCV) infection markedly diminishes the diagnostic specificity of serum rheumatoid factor (RF) for rheumatoid arthritis (RA) in patients with HCV. Cyclic citrullinated peptide (CCP) antibody, a highly specific biomarker for RA in the general population, may have better diagnostic utility for RA in the HCV population. To investigate if CCP antibody retains its specificity for RA in HCV infection, we determined the prevalence of CCP antibodies and examined the relationship between RF production and CCP antibody levels in a population of nonarthritic patients with chronic HCV infection. METHODS: CCP antibody and IgM, IgG, and IgA RF isotypes were determined by ELISA in serum from nonarthritic patients with chronic HCV infection. RESULTS: In a series of 50 HCV patients, IgG-RF, IgM-RF, and IgA-RF were detectable in 52%, 26%, and 14%, respectively, with a total seropositivity rate of 54%. Marginally elevated CCP antibody was detected in a single patient (2%). By regression analysis, serum levels of CCP antibodies did not correlate with RF levels. CONCLUSION: In contrast to RF, CCP antibody is not increased in HCV infection. CCP antibody may have improved utility for the diagnosis of RA in this patient population.
16900844 Proposal of a questionnaire to evaluate the foot in the rheumatic diseases. 2006 May OBJECTIVE: To compile a simple questionnaire, named 'Foot Health Questionnaire-1' (FHQ1), which would evaluate the state of the foot in rheumatic diseases, such as osteoarthritis (OA) and rheumatoid arthritis (RA). MATERIALS AND METHODS: Sixty-three consecutive subjects entered the study: 25 with RA; 14 with OA; 10 with CTD and 14 healthy control subjects. RESULTS: It was possible to establish that the highest mean value of FHQ1 refers to RA patients (median FHQ1 value, 41) and OA patients (median FHQ1 value, 37) whereas for CTD patients the mean value was 14 and for healthy subjects was = 0, as expected. It results that 72% of RA patients and 65% of OA patients enter classes III and IV of FHQ1, whereas 70% of CTD patients were in class I. CONCLUSIONS: An evaluation questionnaire regarding the algo-functioning of the foot could be a useful tool in routine rheumatologic clinical practice.
16804866 Prospective study of fetal DNA in serum and disease activity during pregnancy in women wit 2006 Jul OBJECTIVE: Rheumatoid arthritis (RA) usually improves during pregnancy and recurs postpartum. Fetal cells and cell-free DNA reach the maternal circulation during normal pregnancy. The present study investigated dynamic changes in levels of fetal DNA in serum from women with RA and inflammatory arthritis during and after pregnancy to test the hypothesis that the levels of circulating fetal DNA correlate with arthritis improvement. METHODS: Twenty-five pregnant patients were prospectively studied. A real-time quantitative polymerase chain reaction panel targeting unshared, paternally transmitted HLA sequences, a Y chromosome-specific sequence, or an insertion sequence within the glutathione S-transferase M1 gene was used to measure cell-free fetal DNA. Results were expressed as fetal genomic equivalents per milliliter (gE/ml) of maternal serum. Physical examinations were conducted during and after pregnancy. RESULTS: Levels of fetal DNA in women with improvement in or remission of arthritis were higher than those in women with active disease, especially in the third trimester. Overall, an inverse relationship between serum fetal DNA levels and disease activity was observed (P < 0.001). Serum fetal DNA increased with advancing gestation, reaching median levels of 24 gE/ml (range 0-334), 61 gE/ml (range 0-689), and 199 gE/ml (range 0-2,576) in the first, second, and third trimesters, respectively, with fetal DNA clearance observed postpartum. Arthritis improvement was initially noted in the first trimester for most patients, increased further or was sustained with advancing gestation, and was active postpartum. CONCLUSION: Changes in serum fetal DNA levels correlated with arthritis improvement during pregnancy and recurrence postpartum. Immunologic mechanisms by which pregnancy might modulate RA activity are described.