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ID PMID Title PublicationDate abstract
16414975 Swedish registers to examine drug safety and clinical issues in RA. 2006 Jun Data from several different monitoring systems are examined. The potential for registers based on data obtained from clinical practice, and linkage of such data to national health and population registers, is discussed. The approach described is a possible prototype for long term surveillance systems needed for the safe introduction of new treatments.
16206360 Deaths following methotrexate overdoses by medical staff. 2005 Oct Methotrexate (MTX) is an effective disease modifying antirheumatic drug (DMARD) with a relatively safe profile, and it is widely used to treat neoplastic diseases and dermatologic and rheumatologic disorders. As indications for use of MTX increase, more accidental overdoses are noted to occur. Typical problems include deficiencies in labeling, instructions, or packaging, as well as erroneous use. We describe 5 fatal cases of repeated oral overdose of MTX prescribed by physicians in the treatment of rheumatoid arthritis to focus attention on the design of the underlying system and the organizational practices as sources of problems.
15883763 Fluorescent characteristics of rheumatoid arthritis patients blood lymphocytes. 2005 Mar A fluorescent probe, ABM, aminoderivative of benzanthrone, synthesized in the Department of Organic Chemistry of the Riga Technical University (Latvia), has been successfully used to characterize changes in the structural and functional properties of cell membranes during different pathologies. In the present study the physicochemical properties and the functional activity of the peripheral blood mononuclear cells (lymphocytes-Ly) in patients with rheumatoid arthritis (RA) were studied using the ABM probe. Intensity of the ABM fluorescence in the celi suspension, functional activity of the ly anisotropy of the membranes differ patients with different titres of rheumatoid factor in blood. Patients with seropositive RA had decreased proliferative activity and lower number of iy in blood plasma indicating greater alterations of the immunoregulating processes in these patients as compared to patients with seronegative RA. In the latter the Ly deficiency is compensated to some extent by increased proliferation activity of these cells. The ABM fluorescence intensity correlated not only with membrane anisotropy (r = 0.97, but also with the proliferation activity of the Ly (r = 0.98). The above parameters correlated with the clinical manifestations of the disease. The results indicate that the fluorescent probe ABM is useful for screening the physicochemical status of Ly membranes and the proliferation activity of these cells in RA patients.
15886563 [Worsening of subacute lupus erythematosus induced by infliximab]. 2005 Apr BACKGROUND: Infliximab (Remicade) is an anti-TNF alpha indicated in the treatment of chronic inflammatory rheumatism, notably rheumatoid arthritis. CASE-REPORT: We report the case of a 56 year-old woman who developed severe worsening of an SSA-positive subacute lupus erythematosus on initiation of treatment with infliximab for rheumatoid arthritis. DISCUSSION: A review of the literature found 30 cases of drug-induced lupus and listed the autoimmune modifications induced by anti-TNF alpha. This first case of subacute lupus erythematosus, existing before the introduction of treatment and worsening during the latter, emphasizes the risk of developing a severe flare of an autoimmune disease during treatment with anti-TNF alpha. It raises the question of the relative contraindications of anti-TNF alpha in patients with lupus erythematosus.
16869002 Regulation of interleukin-1beta-induced chemokine production and matrix metalloproteinase 2006 Aug OBJECTIVE: To evaluate the efficacy of epigallocatechin-3-gallate (EGCG), a potent antiinflammatory molecule, in regulating interleukin-1beta (IL-1beta)-induced production of the chemokines RANTES (CCL5), monocyte chemoattractant protein 1 (MCP-1/CCL2), epithelial neutrophil-activating peptide 78 (ENA-78/CXCL5), growth-regulated oncogene alpha (GROalpha/CXCL1), and matrix metalloproteinase 2 (MMP-2) activity in rheumatoid arthritis (RA) synovial fibroblasts. METHODS: Fibroblasts obtained from RA synovium were grown, and conditioned medium was obtained. Cell viability was determined by MTT assay. RANTES, MCP-1, ENA-78, and GROalpha produced in culture supernatants were measured by enzyme-linked immunosorbent assay. MMP-2 activity was analyzed by gelatin zymography. Western blotting was used to study the phosphorylation of protein kinase C (PKC) isoforms and nuclear translocation of NF-kappaB. RESULTS: EGCG was nontoxic to RA synovial fibroblasts. Treatment with EGCG at 10 microM or 20 microM significantly inhibited IL-1beta-induced ENA-78, RANTES, and GROalpha, but not MCP-1 production in a concentration-dependent manner. EGCG at 50 microM caused a complete block of IL-1beta-induced production of RANTES, ENA-78, and GROalpha, and reduced production of MCP-1 by 48% (P < 0.05). Zymography showed that EGCG blocked constitutive, IL-1beta-induced, and chemokine-mediated MMP-2 activity. Evaluation of signaling events revealed that EGCG preferentially blocked the phosphorylation of PKCdelta and inhibited the activation and nuclear translocation of NF-kappaB in IL-1beta-treated RA synovial fibroblasts. CONCLUSION: These results suggest that EGCG may be of potential therapeutic value in inhibiting joint destruction in RA.
16331793 Musculoskeletal ultrasound including definitions for ultrasonographic pathology. 2005 Dec Ultrasound (US) has great potential as an outcome in rheumatoid arthritis trials for detecting bone erosions, synovitis, tendon disease, and enthesopathy. It has a number of distinct advantages over magnetic resonance imaging, including good patient tolerability and ability to scan multiple joints in a short period of time. However, there are scarce data regarding its validity, reproducibility, and responsiveness to change, making interpretation and comparison of studies difficult. In particular, there are limited data describing standardized scanning methodology and standardized definitions of US pathologies. This article presents the first report from the OMERACT ultrasound special interest group, which has compared US against the criteria of the OMERACT filter. Also proposed for the first time are consensus US definitions for common pathological lesions seen in patients with inflammatory arthritis.
15804711 Multiplexed AtheNA multi-lyte immunoassay for ANA screening in autoimmune diseases. 2005 Feb BACKGROUND: Multiplexed assays using fluorescence microspheres is an exciting technology with multiple applications including the detection of antinuclear autoantibodies (ANA) and autoantibody profiles. It is a rapid, sensitive and automatic method for simultaneous quantitative detection of several autoantibodies. The aim of our study was to determinate ANA and other autoantibodies to the nine extractable nuclear antigens by the AtheNA Multi-Lyte ANA system and compare the results achieved by this method to the routinely used enzyme immunoassay. METHODS: Four hundred eighteen serum samples were tested utililizing the multiplexed method: 96 healthy donors, 86 requested ANA specimens obtained from routine lab, and 236 samples from patients with known autoimmune diseases (43-scleroderma, 113-systemic lupus erythematosus, 38-Sjogren's syndrome, and 42 rheumatoid arthritis). The ANA and antibodies to nine different analytes (SS/A, SS/B, Sm, RNP, Jo-1, Scl-70, dsDNA, Centromere B and Histone) were tested. RESULTS: ANA screening by AtheNA system revealed high concordance of 99 and 97.7% with the enzyme immunoassay test in samples obtained from healthy donors and ANA requested samples, respectively. Evaluation of autoimmune disease-related samples for ANA by AtheNA technology also confirmed a high rate of concordance of 92-97.7% and correlated with the enzyme immunoassay. Positive discrepant results were found for Scl-70 specificity in 12.7% of SLE specimens by AtheNA technology, while all tested sera were negative for this antibody by enzyme immunoassay. Negative discrepant results were observed by the AtheNA system for anti-dsDNA. The sera (15 randomly obtained samples from SLE patients) were positive for anti-dsDNA in 50% of samples in Farr assay and 55% in enzyme immunoassay, respectively. CONCLUSION: We suggest that the AtheNA technology may be a useful diagnostic tool for ANA screening. Additional investigations are required to compare an analytic performance between AtheNA and routine methods in determination of the individual autoantibody profile.
15850371 Atraumatic disorders of the sternoclavicular joint. 2005 Mar The sternoclavicular joint is the diarthrodial articulation between the axial and appendicular skeletons. It is subject to the same disease processes that occur in joints, including degenerative arthritis, rheumatoid arthritis, infection, and subluxation. Most of these conditions present with swelling of the joint, which may be associated with pain and/or tenderness. Plain radiographs can demonstrate changes on both sides of the joint. Because of variations in anatomy, computed tomography scans and magnetic resonance images are often necessary to clarify the pathology. With the exception of acute infection, most conditions can be managed nonsurgically, with joint resection reserved for patients with persistent symptoms.
16446940 [Evaluation of sialometry and minor salivary gland biopsy in classification of Sjögren's 2005 May Sjögren's Syndrome is an autoimmune disease of the exocrine glands, mainly salivary and lachrymal glands. There is no gold standard test for diagnosis. AIM: evaluation of the importance of minor salivary gland biopsy and sialometry, isolated or associated, as methods for classification of Sjögren's Syndrome. STUDY DESIGN: Transversal cohort. PATIENTS AND METHOD: Seventy-two patients that reported dry mouth from January 1997 to September 2003 were investigated and classified, based on the established criteria. Non-stimulated sialometry was performed by the swab technique. Histopathology exams were evaluated for the presence of inflammatory focus. RESULTS: Non-stimulated sialometry and minor salivary gland biopsy presented different sensitivities for primary Sjögren's Syndrome and for secondary Sjögren's Syndrome. Focal sialadenitis with higher focus score was characteristic of primary Sjögren's Syndrome. Biopsy and sialometry were compared and it was observed that specificity and positive predictive value of biopsy were higher. Comparing biopsy and biopsy associated with sialometry, it was observed that biopsy had higher sensitivity and negative predictive value. Specificity of biopsy associated with sialometry was higher. Comparing sialometry and biopsy associated with sialometry, it was observed that biopsy associated with sialometry presented higher positive predictive value and higher specificity. Sialometry's sensitivity was higher. CONCLUSIONS: Sialometry and biopsy tests presented different performances in primary Sjögren's Syndrome and secondary Sjögren's Syndrome; the positivity of the association of both tests increases the specificity for Sjögren's Syndrome (95%).
16060203 Effects of homeopathic treatment on salivary flow rate and subjective symptoms in patients 2005 Jul Twenty-eight patients with xerostomia participated in a blind, placebo-controlled longitudinal study of the possible effects of homeopathic medicines on oral discomfort. All patients were first divided in two groups according to their medication. After that the two groups were randomly assigned according to a coin-toss to the experimental or control group. Most patients had systemic diseases, such as rheumatoid arthritis and/or Sjögren's syndrome, and frequent daily medications. The randomly selected experimental group (n=15) got an individually prescribed homeopathic medicine and the control group (n=13) a placebo substance (sugar granules), both for 6 weeks. Neither group knew of the nature of the medicine. Oral dryness was evaluated by measurement of unstimulated and wax-stimulated salivary flow rates and visual analogue scale. With only two exceptions, the experimental group experienced a significant relief of xerostomia whereas no such effect was found in the placebo group. Stimulated salivary flow rate was slightly higher with homeopathy than placebo but no consistent changes occurred in salivary immunoglobulin (IgA, IgG) levels. In an open follow-up period those receiving homeopathic medicine continued treatment and the placebo group patients were treated with individually prescribed homeopathic medicines. The symptoms of xerostomia improved in both groups. Our results suggest that individually prescribed homeopathic medicine could be a valuable adjunct to the treatment of oral discomfort and xerostomic symptoms.
16078338 Health status, cognitive coping, and depressive symptoms: testing for a mediator effect. 2005 Aug OBJECTIVE: Research has established a link between health status and symptoms of depression in persons with rheumatoid arthritis (RA), but the effects of "cognitive coping" variables have not been extensively studied. We examined the mediator effect of a cognitive coping variable (Pain Control and Rational Thinking factor score from the Coping Strategies Questionnaire) over the course of a pharmacological intervention. METHOD: Data were analyzed from 54 persons with RA, all of whom met diagnostic criteria for major depression. Measures of depression, health status, and cognitive coping were collected at 4 different stages of a pharmacological (antidepressant) study as follows: (1) at baseline, (2) postintervention, (3) 6 month followup, and (4) 15 month followup. RESULTS: Results indicated that a direct relationship existed between health status and depression at all 4 time periods. However, this relationship was mediated by cognitive coping only at the postintervention and the 6 month followup. CONCLUSION: A cognitive coping variable was found to mediate the relationship between health status and depression, but only at moderate levels of depression.
15744655 [Synovialectomy of the metacarpophalangeal joints with reconstruction of the radial collat 2005 Feb Rheumatoid arthritis may lead to destruction of MP joints and severe alteration of grip and other hand functions. Due to the improvement in medical treatment, synovialectomy of the MP joints is necessary only in late stages. Most centres prefer alloarthroplasties in late stages, as erosion of the cartilage and loosening of the ligaments have already led to destruction of the MP joints and destabilization of grip functions. We do not use alloarthroplasties as our first choice, but pay special attention to the reconstruction of the radial collateral ligaments. Therefore, the elongated radial ligaments are detached near their origin after synovialectomy of the dorsal aspects of the MP joint. After detachment of the radial ligament, the palmar aspects can be cleaned easily. The radial collateral ligaments are shortened and reinserted dorsally to gain slight supination. This study shows the long-term results of our patients. In a period of ten years, 74 patients (87 hands, 347 MP joints) were reexamined after an average of 55 months postoperatively. The loss of active motion was 18 degrees and ulnar deviation could be reduced from 25 degrees to 7 degrees. 71 % of the joints showed stable ligaments, 14 % loose, 15 % unstable ligaments. We saw recurrence of synovialitis in 18 % (10 % mild, 7 % significant, 1 % severe). Radiographs showed amelioration in 14 % of cases and deterioration in 39 %. There was no correlation between active range of motion, synovialitis and X-rays. Results were constant when compared with exams before and five years after surgery. Our investigation shows good and stable results, which can be easily compared with the outcome of other studies after alloarthroplasty. The main advantage in our procedure is the easy access to all parts of the MP joint, which allows complete synovialectomy. By shortening and reinserting the elongated radial collateral ligament, we achieve a mild supination and amelioration of grip strength. The results are constant in long terms. In case of recurrent synovialitis or loosening of the ligaments any other type of auto- and alloarthroplasties can still be performed.
15996504 Impact of medical practices on the costs of management of rheumatoid arthritis by anti-TNF 2005 Dec When the anti-TNFalpha drugs first came onto the market, their high price was the subject of much debate. Moreover, we must add the costs associated with their administration to the purchase price. Variations in medical practices may be the source of substantial variations in these costs. OBJECTIVE: To compare the costs involved with the use of infliximab and etanercept in the treatment of rheumatoid arthritis (RA) and to study the impact of variations in medical practices on them. METHODS: A pragmatic cost minimization analysis was conducted from the payer's perspective to compare the costs of administration, that is, the direct medical costs, of the first two available anti-TNFalpha agents: infliximab and etanercept. Records of 60 patients from three university hospital rheumatology departments were reviewed retrospectively for a 52-week period. This analysis considered the following costs: purchase costs for the drugs and for any co-prescribed disease-modifying drugs, inpatient or outpatient administration, medical follow-up and the transportation costs associated with treatment that were reimbursed by the French health insurance system. Costs that did not differ between the two products were excluded (work-up for inclusion, etc.). RESULTS: Data were collected for 58 patients, 30 treated with infliximab and 28 with etanercept. Patients' mean age was 52 years; 81% were women. RA had first developed on average 15 years earlier; the disease was positive for rheumatoid factors in 68% of cases and erosive in 93%. The total average annual cost of administration did not differ for infliximab and etanercept: 19,469 and 19,619 , respectively (P=0.56). The mean costs of administration nonetheless varied considerably between the three hospital centers: from 16,566 to 24,313 for infliximab (P<0.0001) and from 16,069 to 24,383 for etanercept (P<0.0001). CONCLUSION: The financial burden of biological treatments for RA is strongly influenced by the substantial heterogeneity in medical practices.
15744653 [Results after arthroplasty of the metacarpophalangeal joints with uncemented, unconstrain 2005 Feb PURPOSE: In 80 % of patients with rheumatoid arthritis, the metacarpophalangeal (MP) joints are involved with increasing destruction and loss of function. Silicone arthroplasty of the MP joints leads to a limited range of motion, an increase in osteolysis and fractures of the implants. The cementless, unconstrained design of the HM prosthesis is a new concept for replacing the MP joints of rheumatoid patients. Short-term and midterm results are shown. METHOD AND MATERIAL: In a prospective study, 38 HM prostheses were implanted, 28 in patients with rheumatoid arthritis, four with osteoarthrosis, five with polyarthrosis and one after revision of a silicone implant. The patients were reexamined clinically and radiologically after an average follow-up of 16 months (6 - 37 months). RESULTS: The average active range of motion for extension, flexion increased from 0/15/65 degrees before surgery to 0/9/65 degrees after surgery. The remaining ulnar drift was 12 degrees (preoperative 18 degrees ). The average grip strength after surgery was 80 % of the opposite side. Pain in the verbal analog scale improved from 2.3 to 1.7 postoperatively. One palmar subluxation of an implant of the little finger was recognized. No infection occurred. The X-rays showed complete osteointegration in all metacarpal components. Radiolucent zones were found in progress only at the basis on the phalangeal components without radiological signs of loosening or sinking. CONCLUSION: The short- and midterm results after implantation of the cementless, unconstrained HM prosthesis show an improved hand function and pain relief. The design of the implant may solve the accepted postoperative problem of instability of the MP joints. Until now, no prosthesis had to be exchanged.
16735027 Differential expression of WNTs and FRPs in the synovium of rheumatoid arthritis and osteo 2006 Jul 14 Synovial cells of the joint play a key role in the progression of rheumatoid arthritis (RA). However, the mechanism(s) that triggers aggression of RA synovial cells but not other arthropathies such as osteoarthritis (OA) is not clear. Here we examined expression of WNT and the WNT inhibitor, secreted frizzled-related protein (FRP), in RA and OA synovium by reverse transcription-PCR. WNT10B was most frequently detected in RA synovium, and FRP1, FRP2, and FRP4 in OA synovium. Immunohistochemistry localized WNT10B and FRP1 in synovial lining cells, fibroblasts, and endothelial cells in RA and OA synovium, respectively, and WNT10B expression was increased in parallel with the degree of inflammatory cell infiltration and tissue fibrosis. Membrane-type 1 matrix metalloproteinse (MT1MMP) was upregulated by WNT10B and activation of WNT signaling. MT1MMP immunolocalized to cells identical to WNT10B and beta-catenin staining. The present study demonstrated that WNTs and FRPs are differentially expressed in RA and OA synovium, and suggests an involvement in the pathology of these diseases.
15708882 Anti-tumour necrosis factor antibody treatment does not change serum levels of cortisol bi 2005 Sep BACKGROUND: Cortisol binding globulin (CBG) is produced by liver cells and is inhibited by proinflammatory cytokines such as interleukin (IL) 6. CBG serum levels are typically low during prolonged inflammatory processes. Thus, observed changes of cortisol during anti-tumour necrosis factor (TNF) treatment may be related to changes of CBG in rheumatoid arthritis (RA). OBJECTIVE: To investigate the course of CBG during anti-TNF treatment in RA. METHODS: 13 patients with longstanding RA, without prior prednisolone treatment, were included in this longitudinal study with subcutaneous adalimumab. RESULTS: Treatment with anti-TNF markedly decreased clinical markers of inflammation and serum IL6. Serum levels of cortisol, CBG, and the ratio of cortisol/CBG did not change markedly, whereas the ratio of serum CBG/IL6 increased (p = 0.004). In parallel, levels of adrenocorticotropic hormone decreased during the observation period. The ratio serum androstenedione/serum cortisol increased during the study (p = 0.036). CONCLUSIONS: During anti-TNF treatment relatively normal levels of CBG and a normal ratio of CBG/cortisol are found. Changes of cortisol in relation to IL6 during anti-TNF treatment, seen previously, may not be related to changes of CBG.
16060666 Kinetic characterization of protein arginine deiminase 4: a transcriptional corepressor im 2005 Aug 9 Protein arginine deiminase 4 (PAD4) is a Ca(2+)-dependent enzyme that catalyzes the posttranslational conversion of arginine to citrulline (Arg --> Cit) in a number of proteins, including histones. While the gene encoding this enzyme has been implicated in the pathophysiology of rheumatoid arthritis (RA), little is known about its mechanism of catalysis, its in vivo role, or its role in the pathophysiology of RA; however, recent reports suggest that this enzyme can act as a transcriptional corepressor for the estrogen receptor. Herein, we report our initial kinetic and mechanistic characterization of human PAD4. Specifically, these studies confirm that PAD4 catalyzes the hydrolytic deimination of Arg residues to produce Cit and ammonia. The metal dependence of PAD4 has also been evaluated, and the results indicate that PAD4 activity is highly specific for calcium. Calcium activation of PAD4 catalysis exhibits positive cooperativity with K(0.5) values in the mid to high micromolar range. Evidence indicating that calcium binding causes a conformational change is also presented. Additionally, the steady-state kinetic parameters for a number of histone H4-based peptide substrates and benzoylated Arg derivatives have been determined. K(m) values for these compounds are in the high micromolar to the low millimolar range with k(cat) values ranging from 2.8 to 6.6 s(-)(1). The ability of PAD4 to catalyze the deimination of methylated Arg residues has also been evaluated, and the results indicate that these compounds are poor PAD4 substrates (V/K
15996053 Selective IgA immune unresponsiveness to Proteus mirabilis fumarate reductase A-chain in r 2005 Jul OBJECTIVE: To determine if selective immune unresponsiveness to microbial antigens is associated with predisposition to rheumatoid arthritis (RA). METHODS: Proteins from Proteus mirabilis lysate were isolated by SDS-PAGE and examined by Western blotting for antibody responses in sera from patients with RA compared to healthy subjects and patients with psoriatic arthritis (PsA). RESULTS: Although RA patients had marked IgA immune responses to many P. mirabilis proteins compared to healthy subjects, selective unresponsiveness was found in RA to a 66 kDa protein identified as fumarate reductase A-chain (FRD-A) by mass spectroscopy. This was confirmed in Western blots with recombinant FRD-A from P. mirabilis. IgA unresponsiveness to FRD-A was found in 21/59 (35.6%) RA patients compared to 7/63 (11.1%) healthy individuals (p < 0.01) and 6/52 (11.5%) patients with PsA (p < 0.01). IgA unresponsiveness to FRD-A was present in 20/46 (43.5%) RA patients with IgA rheumatoid factors (RF) compared to 1/13 (7.7%) without RF (p < 0.025). CONCLUSION: Our results identify a selective hole in the IgA immune repertoire for P. mirabilis FRD-A in a subset of IgA RF-positive patients with RA.
16905577 Differential effect of methotrexate on the increased CCR2 density on circulating CD4 T lym 2007 Feb OBJECTIVES: To evaluate the effect of orally administered methotrexate (MTX) on the density of CC chemokine receptor 2 (CCR2) and CXC chemokine receptor 3 (CXCR3) on circulating monocytes, and the coexpression of CXCR3 and CCR2 on CD4 T lymphocytes in patients with active chronic rheumatoid arthritis. METHODS: All 34 patients with rheumatoid arthritis fulfilled the 1987 American Rheumatism Association criteria and were followed for 16 weeks after starting MTX. Peripheral blood mononuclear cells were analysed for CCR2 and CXCR3 density by three-colour flow cytometry before initiation of MTX and at week 12. RESULTS: 22 (65%) patients were non-responders, 12 (35%) patients responded to MTX by American College of Rheumatology (ACR)20% criteria, and 8 (24%) of these patients responded by ACR50%. In patients with active rheumatoid arthritis before starting MTX, CCR2 density on circulating monocytes, CD4(+) CXCR3(+) and CD4(+) CXCR3(-) T lymphocytes was increased compared with controls. During 12 weeks of MTX treatment, the CCR2 density on monocytes decreased significantly in the ACR50% group but not in the ACR20% and non-responder groups. The increased CCR2 density on CD4(+) CXCR3(+) and CD4(+) CXCR3(-) T lymphocytes was unaffected by the reduction in disease activity measured in relation to MTX treatment. The percentage of both monocytes and CD4(+) CXCR3(+) and CD4+ CXCR3(-) T lymphocytes among the peripheral circulating mononuclear cells did not change during MTX treatment. CONCLUSIONS: Active chronic rheumatoid arthritis is characterised by enhanced CCR2 density on circulating monocytes and CD4(+) CXCR3(+) and CD4(+) CXCR3(-) T lymphocytes. During MTX treatment, a decrease in CCR2 density on monocytes in the ACR50% responder group was associated with decreased disease activity. The increased CCR2 density on CD4(+) CXCR3(+) and CD4(+) CXCR3(-) T lymphocytes was uninfluenced by MTX and disease activity.
16602440 [Copper content in rheumatoid arthritis patients]. 2005 The aim of the study was to test the content serum, erythrocytes and hair copper and the relation between the level of copper and the activity disease in the rheumatoid arthritis (RA) patients. The subjects of this research were 58 persons with RA. In the control group there were 27 healthy subjects. The concentration of copper were determined by atomic absorption spectroscopy. The obtained results showed significant increase of the mean concentration of serum copper in RA patients (19.1 +/- 4.5 micromol/L) in comparison with control group (14.2 +/- 2.7 micromol/L, p < 0.001). The mean level of hair copper was also significantly increased in the examined group (14.3 +/- 4.2 microg/g dry mass) in comparison with healthy subjects (10.4 +/- 3.7 microg/g dry mass, p < 0.01) and considerably lower in erythrocytes (RA patients - 67.6 +/- 13.4 microg/dL, control group--84.2 +/- 8.2 microg/dL, p < 0.001). Moreover, it was established that mean serum copper concentration in the examined group was significantly correlated with erythrocyte sedimentation rate (r = 0.48, p < 0.001) and Ritchie articular index (r = 0.36, p < 0.01) and negatively with hemoglobin (r = -0.41, p < 0.01). Copper content is not dependent on sex, age and disease duration.