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ID PMID Title PublicationDate abstract
16868648 Comparison of taurine chloramine and taurine bromamine effects on rheumatoid arthritis syn 2007 Fibroblast-like synoviocytes (FLS) participate in rheumatoid arthritis (RA) chronic synovitis by producing pro-inflammatory cytokines (IL-6, IL-8), growth factors (VEGF) and other inflammatory mediators (PGE2, NO). We have previously reported that Tau-Cl, generated by neutrophils, inhibits in vitro some of these pathogenic RA FLS functions. Taurine bromamine (Tau-Br) originates from eosinophils and neutrophils, and its immunoregulatory activities are poorly known. Therefore, we investigated the effects of Tau-Br on RA FLS functions and compared it to Tau-Cl anti-inflammatory action. When applied at noncytotoxic concentrations: (i) Tau-Br inhibited IL-6 and PGE2 production with potency similar to Tau-Cl (IC50 approximately 250 microM), (ii) Tau-Br failed to affect VEGF and IL-8 synthesis, while Tau-Cl exerted inhibitory effect (IC50 approximately 400 microM), (iii) none of these compounds affected NO generation and iNOS expression. Thus, Tau-Cl is more effective than Tau-Br in normalization of pro-inflammatory RA FLS functions.
17552057 Cystatin C binds serum amyloid A, downregulating its cytokine-generating properties. 2007 Jun OBJECTIVE: To assess the interaction between cystatin C (CysC) and serum amyloid A protein (SAA). METHODS: Levels of CysC and SAA and antibodies against these proteins were assessed in the paired blood and synovial fluid (SF) samples of 90 patients with rheumatoid arthritis (RA). Age and sex matched individuals having normal iohexol clearance (n = 90) and SF following joint trauma (n = 40) were used as controls. In vitro experiments included assessment of interaction between CysC and SAA by ELISA and the influence of CysC on SAA functions. RESULTS: A pilot screening for cystatins C, E, and F in blood and SF of patients with RA found CysC to be by far the predominant extracellular cystatin. Circulating CysC levels were significantly lower in patients with RA compared to the matched controls (0.81 +/- 0.03 vs 1.01 +/- 0.03 mg/l; p = 0.05). These low CysC levels could not be explained by the presence of anti-CysC antibodies in patients with RA. In contrast, concentrations of CysC that accumulated in the inflamed SF were significantly greater in patients with erosive RA (1.66 +/- 0.08 mg/l) compared to nonerosive RA (1.36 +/- 0.06 mg/l; p = 0.003) and controls (1.18 +/- 0.03 mg/l; p = 0.043). In vitro studies showed direct binding of CysC to SAA. CysC/SAA binding impaired proinflammatory effects of SAA, reducing its ability to trigger expression of proinflammatory cytokines. CONCLUSION: Our study shows a relative deficiency of circulating CysC during systemic inflammation in RA. Physical interaction between CysC and the acute-phase protein SAA (1) provides an explanation for CysC deficiency; and (2) suggests that CysC is regulating inflammatory responses. We hypothesize that decreased systemic CysC levels predispose to accelerated atherosclerosis and development of amyloidosis in patients with RA.
17115116 Effects of resveratrol in inflammatory arthritis. 2007 Apr Nuclear factor kappa B (NF-kappaB), is a pivotal transcription factor involved in the activation of the TNF-alpha and IL-1beta genes. Activation of NF-kappaB in synovial cells is a feature seen in arthritis patients. Resveratrol, a polyphenolic, natural phytoalexin found with particularly high levels in grape skin and red wine is potent and specific inhibitor of TNF-alpha and IL-1beta induced NF-kappaB activation. We aimed to determine the in vivo effects of intra-articular injections of resveratrol on cartilage and synovium in an experimental rabbit inflammatory arthritis model. MATERIALS AND METHODS: Arthritis was induced by intra-articular injection of three times of 50 mug lipopolysaccharide (LPS) at day 0, 4 and 8 at 4-day intervals into the knee joints of rabbits. To the test group, 10 muMol/kg resveratrol in the DMSO was injected in the knees at day 0 and then it was continued once daily for 2 weeks. To the control group the same time and amount of DMSO was injected the knees of rabbits. All rabbits were killed 1 week after the last injection and cartilage tissue and synovium were evaluated with semiquantitative scoring histologically. RESULTS: According to control group in the resveratrol group, significantly decreased cartilage destruction was determined by H&E staining (p = 0.04). Loss of matrix proteoglycan content in the cartilage was much lower, as determined by safranin O staining (p = 0.03). We also observed marked synovial inflammation after intra-articular injection to control knees, but not in the resveratrol treated group knees (p = 0.01). CONCLUSION: This study suggests that intra-articular injection of resveratrol may protect cartilage against the development of experimentally induced IA.
18846012 [Health-related quality of life in patients with rheumatoid arthritis]. 2008 Jul OBJECTIVES: Rheumatoid arthritis RA is a chronic rheumatic disease of unknown aetiology and greater incidence among the elderly. It can lead to serious consequences regarding functional limitations and patient's ability to work. The purpose of this study was to assess the health-related quality of life in patients with RA. METHODS: Portuguese version of SF-6D and Portuguese translations of EQ-5D and AIMS2-SF were self-administered in a postal survey to a representative sample of the Portuguese population with RA. Data concerning the patients' characteristics and the stage of the disease were also collected. RESULTS: The majority of the patients presented minor problems in some of the instruments dimensions. In a scale from 0.30 to 1.00 the average utility score was 0.77. The lowest utility scores were reported by women those who were divorced or separated individuals with lower educational levels who had lower incomes, were recently diagnosed and those who were not taking new biological therapies. Apart from these, patients who had a more severe RA and co-morbidity also report lower utility scores. CONCLUSIONS: The preference-based utility measures used in this study adequately discriminate across different RA severity and socio-demographic background. Assuming that these values represent the patients' preferences and the utility associated with their health state, the results presented in this paper may be used as an approximation to normative values for the SF-6D in economic evaluation studies as well as in clinical studies.
17937472 Are the 2002 American College of Rheumatology guidelines for the management of rheumatoid 2007 Nov OBJECTIVE: To determine whether rheumatologists working in Canada's largest academic rheumatology center (University Health Network/Mount Sinai Hospital) adhere to the 2002 American College of Rheumatology (ACR) guidelines for the management of rheumatoid arthritis (RA). METHODS: Ten patients with RA seen between January 1 and December 30, 2005, were randomly selected from each rheumatologist. A standardized form was used to verify whether the following items were collected at each visit: (1) degree of joint pain, (2) duration of morning stiffness, (3) degree of fatigue, (4) number of tender/swollen joints, and (5) assessment of function. Items recommended for periodic assessment were also collected and included: (1) examination for joint damage, (2) erythrocyte sedimentation rate and/or C-reactive protein, and (3) radiographic assessment of joint damage (radiograph/magnetic resonance imaging). RESULTS: One hundred thirty charts and 313 total visits met inclusion criteria. No rheumatologist consistently assessed each ACR item. Of the recommended items, tender and swollen joint counts and pain were most commonly assessed (95%, 95%, and 69%, respectively). Functional assessment, morning stiffness, and fatigue were least commonly reported (48%, 46%, and 33%, respectively). Items recommended for periodic assessment were not regularly recorded. There was a trend for the recommended items to be reported more regularly for new patients, patients taking a disease modifying antirheumatic drug (DMARD), and patients for whom a DMARD was added or increased in dosage. CONCLUSION: Rheumatologists follow many but not all of the recommendations included in the revised ACR guidelines. The reasons underlying the noncompliance to some of the recommendations are not fully understood. In order to improve the adoption of future clinical practice guidelines, the ACR may have to plan specific dissemination and implementation strategies and fund studies to formally assess the effect of guideline use on clinical outcomes.
18484700 Incidence and clinical significance of parvovirus B19 infection in patients with rheumatoi 2008 Jul OBJECTIVE: To determine the prevalence and clinical significance of human parvovirus B19 (B19) infection in patients with rheumatoid arthritis (RA). METHODS: One hundred patients with RA and 94 apparently healthy blood donor controls were enrolled for study. Plasma samples of patients and controls were examined for the presence of anti-B19-specific antibodies by ELISA. B19 DNA was detected in plasma and peripheral blood leukocyte (PBL) samples of all patients and controls as well as in synovial fluid cells of 38 RA patients by nested polymerase chain reaction. Disease activity and clinical manifestations were determined in RA patients with and without markers of B19 infection. RESULTS: IgM anti-B19-specific antibodies were detected in 24.0% of RA patients; B19 DNA was found in plasma and/or PBL, synovial fluid cells in 34.0% (34 patients); in 14.0% of the cases (14 patients) both markers were found. In blood donor controls, anti-B19 IgM antibodies were observed in 16.0% (15 donors) and B19 DNA in 6.4% (6 donors); all donors with detectable B19 genomic DNA were IgM-positive. The disease activity in patients with and without B19 infection was similar, while the frequency of clinical complications was significantly higher in the patients with anti-B19 IgM antibodies. Moreover, liver failure and sicca syndrome were observed in the viremic patients only. CONCLUSION: Our study confirms observations regarding a high prevalence of B19 DNA in patients with RA, and a possible role of this viral infection in the pathogenesis of RA.
18398944 Comparison of an interferon-gamma assay with tuberculin skin testing for detection of tube 2008 May OBJECTIVE: Tuberculosis (TB) in patients with rheumatoid arthritis (RA) undergoing treatment with anti-tumor necrosis factor (TNF) agents is commonly the result of reactivation of latent TB infection (LTBI); detection and treatment of LTBI is essential before treatment with anti-TNF agents. We reported previously that the tuberculin skin test (TST) is inaccurate for diagnosis of LTBI in patients with RA. Here, we compare the prevalence of LTBI in RA patients and matched controls according to positive TST and QuantiFeron-TB Gold In-Tube version (QFT) results and determine their agreement. METHODS: A cross-sectional study of 101 RA patients and 93 controls was conducted in Lima, Perú, where the prevalence of LTBI in the general population has been estimated to be 68%. Blood was drawn for QFT assay followed by TST using 2-TU of RT 23 purified protein derivative. TST was deemed positive at >or= 5 mm for RA patients and >or= 10 mm for controls. RESULTS: There were no significant differences between RA patients and controls for age, sex, bacillus Calmette-Guérin vaccination, or history of or contact with TB. 88% of patients had active RA disease and 2 (1.9%) patients had indeterminate QFT results. The number of subjects testing positive with the QuantiFeron assay was comparable between patients and controls (44.6% vs 59.1%, respectively), whereas the TST detected significantly less LTBI among RA patients (26.7%) than controls (65.6%). Thus, the rate of LTBI in RA patients represented 75% and 41% of the rate in their controls using QFT or TST, respectively (p = 0.008). Poor agreement between TST and QFT was seen in RA patients, but in controls, good agreement was observed between these tests. CONCLUSION: In a TB-endemic population, the QuantiFeron-TB Gold In-Tube assay seemed to be a more accurate test for detection of LTBI in RA patients compared with the TST, and may potentially improve the targeting of prophylactic therapy before treatment with anti-TNF agents.
17543151 Rheumatoid arthritis patients have elevated antibodies to cross-reactive and non cross-rea 2007 Mar BACKGROUND AND OBJECTIVE: Although a large number of independent studies have shown a paramount role for Proteus mirabilis in the aetiopathogenesis of rheumatoid arthritis (RA), this hypothesis is still controversial among rheumatologists. The main obstacle to its acceptance is the impression that increased Proteus antibodies in RA patients is a secondary phenomenon, occurring as the result of cross-reactivity between bacterial and self-antigens. To shed light on this problem, we examined the link between antibodies to various cross-reactive and non cross-reactive antigenic peptides from P. mirabilis and analysed the relationship between these antibodies and disease severity in patients with RA. METHODS: Using the ELISA method, serum samples from 70 RA patients and 20 healthy controls were screened for total and class-specific antibodies against three human cross-reactive and non-crossreactive synthetic peptides from P. mirabilis haemolysin, urease C and urease F enzymes. An antibody index, which comprised the total concentration of antibodies against these peptides in each sample, was correlated with the biochemical parameters of disease activity and/or severity, such as the erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and rheumatoid factors (RF). Furthermore, anti-peptide antibody indices were evaluated among RA patients with different levels of disease activity as defined by ESR and CRP. RESULTS: Significantly elevated levels of total and class-specific IgG antibodies against the 3 Proteus peptides were observed among RA patients compared to healthy controls (p < 0.001). Active RA patients had elevated IgM antibodies against all peptides compared to healthy subjects (p < 0.001). However, no such elevation was observed in IgA anti-peptide antibodies in RA patients. A positive correlation was observed between the antibody indices and ESR (p < 0.001) and CRP (p < 0.01) concentrations, but not the RF status or disease duration. Furthermore, more than 90% of active RA patients showed positive values for the Proteus anti-peptide indices. CONCLUSION: The elevated levels of antibodies against Proteus antigenic epitopes (which are cross-reactive or non cross-reactive with human tissue antigens) observed indicates that this enhanced bacterial immune response in RA patients is specifically triggered by Proteus microbes. Furthermore, the correlation of anti-peptide antibody indices with the biochemical markers of disease activity indicates that these antibodies exert damaging cytotoxic effects on joint tissues during the course of the disease.
17009229 Clinical assessment of the long-term risk of fracture in patients with rheumatoid arthriti 2006 Oct OBJECTIVE: To determine whether patients with rheumatoid arthritis (RA) have an increased risk of fracture, and to estimate their long-term absolute fracture risk. METHODS: We studied patients with RA ages >or=40 years in the British General Practice Research Database, each matched by age, sex, calendar time, and practice to 3 control patients. Incident fractures, as recorded in the computerized medical records, were ascertained over a median followup of 7.6 years. The fracture rate in RA patients compared with controls was adjusted for smoking, body mass index (BMI), and several clinical risk factors, and Cox proportional hazards models were used to calculate the relative risk (RR) of fracture in RA. A risk score was then developed to provide an estimate of the 5- and 10-year fracture risk among RA patients. RESULTS: There were 30,262 patients with RA, of whom 2,460 experienced a fracture during followup. Compared with controls, patients with RA had an increased risk of fracture, which was most marked at the hip (RR 2.0, 95% confidence interval [95% CI] 1.8-2.3) and spine (RR 2.4, 95% CI 2.0-2.8). Indicators of a substantially elevated risk of fracture (at the hip) included >10 years' duration of RA (RR 3.4, 95% CI 3.0-3.9), low BMI (RR 3.9, 95% CI 3.1-4.9), and use of oral glucocorticoids (RR 3.4, 95% CI 3.0-4.0). Modeling of the long-term risk profiles revealed that, for example, in a woman age 65 years with longstanding RA whose risk factors also included low BMI, a history of fracture, and frequent use of oral glucocorticoids, the 5-year risk of hip fracture was 5.7% (95% CI 5.3-6.1%). CONCLUSION: Patients with RA are at increased risk of osteoporotic fractures. This increased risk is attributable to a combination of disease activity and use of oral glucocorticoids.
18793934 Rapid periapical bone destruction during endodontic treatment of a patient with rheumatoid 2008 Oct Rheumatoid arthritis is an autoimmune disease with an unknown etiology. Azathioprine is an immunosuppressive drug that is used to treat rheumatoid arthritis. This case report describes the rapid periapical bone destruction that occurred during the endodontic treatment of a rheumatoid arthritis patient taking azathioprine and a corticosteroid. The cause of the rapid destruction is unclear. However, severe side effects can occur after administering azathioprine to rheumatoid arthritis patients. Therefore, dentists should check the patient's medical state thoroughly in order to prevent side effects when performing endodontic treatment.
17305539 NF-kappaB inhibitors for the treatment of inflammatory diseases and cancer. 2007 The NF-kappaB/Rel signaling system is a paradigm for gene activation in response to inflammatory and menacing stimuli. Given the growing body of evidence showing an important involvement of NF-kappaB for the onset of autoimmune diseases and different types of cancer, NF-kappaB is an important drug target for the adjuvant therapy of these diseases. Great efforts have been made for the development of highly specific NF-kappaB inhibitors, some of them being currently tested in phase II clinical trials. Here we discuss recent progress in the identification of druggable components of the NF-kappaB signaling system and the development and potential use of novel NF-kappaB inhibitors.
16613273 [Clinical observation on liang's anti-rheumatism and rheumatoid granule in rheumatoid arth 2006 Mar OBJECTIVE: To evaluate the therapeutic effect of Liang's anti-rheumatism and rheumatoid granule (LARG) in treating patients with rheumatoid arthritis (RA) at the active stage. METHODS: Fifty patients were administered orally with LARG in the treated group, 30 patients were treated with Wangbi granule in the control group. Symptoms, physical signs and relevant laboratory indexes in the 2 groups were observed and compared before treatment and after being treated for 2 months. RESULTS: The total effective rate and curative-markedly effective rate in the treated groups were superior to those in the control group (P <0.01). The improvement in aspects of integral scoring of symptom and physical signs, including arthragia, tumefaction, dysfunction indexes, morning stiffness and 15m walking time, and laboratory indexes, including blood sedimentation rate, rheumatoid factor, C creative protein, immunoglobin, as well as hemorheology relevant indexes in the treated group after treatment were significantly different to those before treatment and those in the control group (P <0.05 or P <0.01). CONCLUSION: LARG has obvious therapeutic effect on RA at the active stage.
18484062 [Which ultrasound scan is the best to detect glenohumeral joint effusions?]. 2008 Dec PURPOSE: It has not yet been systematically investigated which ultrasound scan is the best for detecting effusions of the glenohumeral joint. This question will be addressed by this study. Furthermore, this study determines reference values for distances to distinguish effusions from normal findings. METHODS: Ultrasound was performed according to extended DEGUM and EULAR guidelines on 200 shoulders of 100 consecutive patients with shoulder complaints and on 40 shoulders of 20 healthy controls. Distances were measured between the surface of the humerus and the joint capsule in 3 positions: Axillary recess, dorsal transverse scan with 60 degrees internal rotation and with maximum external rotation. Normal values were calculated by ROC analysis. RESULTS: The mean age of patients and controls was 58 and 55 years, and 67 % and 70 % were female, respectively. Ultrasound detected effusions in 81 shoulders of 56 patients. Effusions were seen in the dorsal scan with 60 degrees internal rotation in 30 %, in the axillary scan in 49 %, and in the dorsal scan in maximum external rotation in 94 % (p < 0.001, respectively). Five percent of the effusions were exclusively detected in the axillary scan. The upper normal limits for the distance between bone surface and joint capsule were 3.7 mm for the axillary recess, 2.7 mm for the dorsal region in 60 degrees internal rotation and 3.1 mm for the dorsal region in maximum external rotation . CONCLUSIONS: Dynamic ultrasound examination including the dorsal scan with maximum external rotation is essential for detecting glenohumeral joint effusions. The axillary scan is superior to the dorsal transverse scan with 60 degrees internal rotation.
19109035 Inflammatory demyelinating events following treatment with anti-tumor necrosis factor. 2009 Feb BACKGROUND: Tumor necrosis factor alpha (TNF-alpha) is an inflammatory cytokine involved in certain inflammatory diseases including multiple sclerosis (MS), rheumatoid arthritis (RA), and Crohn's disease. The anti-TNF-alpha treatments used for RA may be associated with inflammatory demyelinating events affecting the central nervous system and may possibly aggravate known MS. OBJECTIVE: We report here three new cases of inflammatory demyelinating events of the central nervous system following treatment with anti-TNF-alpha. RESULTS: The neurological symptoms appeared on average 5 months after initiation of the treatment. For all patients, the inflammatory process was confirmed by brain magnetic resonance imaging. The symptoms totally or partially regressed as soon as anti-TNF-alpha treatment was stopped except for one patient who developed clinically defined MS. CONCLUSIONS: Inflammatory demyelination of the central nervous system may be associated with the use of anti-TNF-alpha. Patients with rheumatoid arthritis treated with these treatments should benefit from a follow-up which includes brain MRI.
18328139 Ultrasound imaging for the rheumatologist. XIII. New trends. Three-dimensional ultrasonogr 2008 Jan Despite its indubitable potential, ultrasonography still has limited diffusion in rheumatology related principally to the image acquisition process due to at least five main factors: the steep learning curve, lack of standardisation of the technique, intra- and inter-observer variability, time consumption and the high initial cost of top quality sonographic equipment. Of all these barriers, the first four are undoubtedly the most difficult to overcome. This review discusses the available evidence supporting the potential of three-dimensional ultrasound with high-frequency volumetric probe to overcome the first four barriers. The challenge to three-dimensional ultrasound is to prove itself to be a method that requires no particular skills that can be mastered in just a few minutes and is not operator-dependant [corrected]
19108379 [Efficacy of Lugua polypeptide injection on active rheumatoid arthritis]. 2008 Aug OBJECTIVE: To investigate the therapeutic effect of Lugua polypeptide on active rheumatoid arthritis (RA). METHODS: Fifty patients with active RA were selected for the study and were randomly divided into study group and control group. Patients in study group were treated with Lugua polypeptide intravenously at a dose of 16 mg per day and those in control group were given Celecoxib 200 mg twice a day for successive 2 weeks. Two groups were given the same basic treatment. Tenderness and swelling of joints, morning stiffness, erythrocyte sedimentation rate, C-reactive protein,rheumatoid factor and so on were recorded before and after treatment. RESULTS: The above index on joints in study group was significantly improved compared with that in control group and the level before treament. No apparent side effects were observed. CONCLUSION: Lugua polypeptide is effective and safe on active RA. It is a promising agent in the treatment of RA.
16699051 Decreased density of serotonin 5-HT2A receptors in rheumatoid arthritis. 2006 Jun BACKGROUND: Animal studies have indicated that 5-HT2A receptors could play a role in arthritic diseases. OBJECTIVE: To analyse the binding properties of 5-HT2A receptors in patients with rheumatoid arthritis. METHODS: Using a radioactive binding assay, 43 patients with rheumatoid arthritis were compared with 49 sex and age matched controls for density and affinity (measured as Bmax and Kd) of 5-HT2A serotonin receptors. Genotyping, using polymerase chain reaction, was undertaken to exclude the possibility that differences in the genetic polymorphism T102C for the 5-HT2A receptor determine differences in receptor density. RESULTS: Mean of Bmax of 5-HT2A receptors in rheumatoid patients was significantly lower than in controls, at 45.3 v 57.4 fmol/mg protein (p = 0.004), but there was no significant difference in Kd. The T102C receptor polymorphism genotypes showed a skewed distribution between the two groups. Even when adjusted for this, there was a significant difference in Bmax between the groups. CONCLUSIONS: The density of 5-HT2A serotonin receptors in patients with rheumatoid arthritis is markedly reduced. This could either reflect a difference involved in the susceptibility to the disease or be a secondary effect of the disease.
17906416 [Osteoporosis in the patients with rheumatoid arthritis (3) : the efficacy and the selecti 2007 Oct Osteoporosis and fragile fractures are common and preventable complication in rheumatoid arthritis (RA) . We recently reported that the frequency of osteoporosis among RA patients was 53.3%, that of vertebral fractures was 19.3%. They were much higher rates than those of general population. Earlier drug intervention is necessary to prevent these complications. RA patients with glucocorticoid (GC) should be treated according to "Guidelines on the management and treatment of glucocorticoid-induced osteoporosis" published by JBMSR in 2004. The bone of RA patients are likely to be in high-turnover state. Consequently bisphosphonates, especially alendronate and risedronate, are recommended to regulate bone metabolism, to increase bone mineral density and prevent incidental fractures in RA patients.
16397069 Acquired haemophilia heralded by bleeding into the oral mucosa in a patient with bullous p 2006 Jan Acquired haemophilia is rare and potentially fatal, with a mortality of 20% if left untreated. There is a strong association with other autoimmune diseases. This report describes a patient with rheumatoid arthritis, vitiligo, and bullous pemphigoid where the diagnosis of acquired haemophilia was made after an extensive bleed into a bullous lesion in the buccal mucosa. This case highlights some of the potential complications of acquired haemophilia and its treatment.
17092341 Differential effects on BAFF and APRIL levels in rituximab-treated patients with systemic 2006 The objective of this study was to investigate the interaction between levels of BAFF (B-cell activation factor of the tumour necrosis factor [TNF] family) and APRIL (a proliferation-inducing ligand) and B-cell frequencies in patients with systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) treated with the B-cell-depleting agent rituximab. Ten patients with SLE were treated with rituximab in combination with cyclophosphamide and corticosteroids. They were followed longitudinally up to 6 months after B-cell repopulation. Nine patients with RA, resistant or intolerant to anti-TNF therapy, treated with rituximab plus methotrexate were investigated up to 6 months after treatment. The B-cell frequency was determined by flow cytometry, and serum levels of BAFF and APRIL were measured by enzyme-linked immunosorbent assays. BAFF levels rose significantly during B-cell depletion in both patient groups, and in patients with SLE the BAFF levels declined close to pre-treatment levels upon B-cell repopulation. Patients with SLE had normal levels of APRIL at baseline, and during depletion there was a significant decrease. In contrast, patients with RA had APRIL levels 10-fold higher than normal, which did not change during depletion. At baseline, correlations between levels of B cells and APRIL, and DAS28 (disease activity score using 28 joint counts) and BAFF were observed in patients with RA. In summary, increased BAFF levels were observed during absence of circulating B cells in our SLE and RA patient cohorts. In spite of the limited number of patients, our data suggest that BAFF and APRIL are differentially regulated in different autoimmune diseases and, in addition, differently affected by rituximab treatment.