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ID PMID Title PublicationDate abstract
17476341 APC-derived cytokines and T cell polarization in autoimmune inflammation. 2007 May T cell-mediated autoimmune diseases such as multiple sclerosis and rheumatoid arthritis are driven by autoaggressive Th cells. The pathogenicity of such Th cells has, in the past, been considered to be dictated by their cytokine polarization profile. The polarization of such effector T cells relies critically upon the actions of cytokines secreted by APCs. While Th1 polarization has long been associated with the pathogenesis of autoimmune diseases, recent data obtained in gene-targeted mice and the discovery of Th17 cell involvement in autoimmunity conflict with this hypothesis. In light of these recent developments, we discuss in this review the actions of APC-derived cytokines and their emerging roles in T cell polarization in the context of autoimmune inflammatory responses.
17191049 Scleromyxedema: successful treatment with thalidomide in two patients. 2007 BACKGROUND: Scleromyxedema is an unusual skin disease characterized by mucinous infiltration of the skin. There is no satisfactory treatment for this disorder. CASE REPORT: We report 2 cases of scleromyxedema, both associated with an IgG-lambda paraprotein. Treatment with thalidomide was started and great improvement of the lesion was noted as shown by a quality of life questionnaire similar to those used in rheumatoid arthritis. TNF-alpha value was elevated in both cases during this treatment. DISCUSSION: We hypothesize that the efficiency of thalidomide could be mediated by its costimulatory effect on T cytotoxic lymphocytes.
15941837 Problem of the atherothrombotic potential of non-steroidal anti-inflammatory drugs. 2006 Jan Treatment of pain in rheumatoid arthritis must take into account the gastrointestinal and cardiovascular risk of individual patients. Adequate results are not yet available, and until they are, treatment recommendations must take into account, not only the more favourable gastrointestinal risk profile of selective COX-2 inhibitors, but also the potential atherothrombotic risk of any NSAID or selective COX-2 inhibitor treatment.
18705627 Chronic anterior uveitis following bacille Calmette-Guérin vaccination: molecular mimicry 2008 Jul A 13-year-old girl developed bilateral chronic anterior uveitis following bacille Calmette-Guérin (BCG) vaccination. HLA testing was negative for B27 but positive for DRB1 *0404, a variant of DR4 often associated with rheumatoid arthritis. The authors propose her HLA repertoire allowed for a BCG-induced abnormal autoimmune response by the mechanism of molecular mimicry.
18331230 RAGE as a receptor of HMGB1 (Amphoterin): roles in health and disease. 2007 Dec HMGB1/Amphoterin is a ubiquitous, highly conserved DNA-binding protein that can be also released to the extracellular space by various cell types. Extracellular HMGB1 regulates migratory responses of several cell types through binding to RAGE that communicates with the cytoskeleton to regulate cell motility. HMGB1-induced cell signalling has been associated with mechanisms of several diseases, including cancer, sepsis, rheumatoid arthritis, stroke and atherosclerosis. This article reviews the evidence linking the functional roles of HMGB1 to RAGE signalling. Furthermore, we discuss the molecular and cellular mechanisms that may explain the roles of HMGB1/RAGE in diverse disease processes.
17983147 Identification and isolation of synovial dendritic cells. 2007 In rheumatoid arthritis patients, three compartments need to be considered: peripheral blood, synovial fluid, and synovial tissue. Dendritic cells characterized from each compartment have different properties. The methods given are based on cell sorting for isolation of cells, and flow cytometry and immunohistochemical staining for analysis of cells in these compartments.
20144084 Therapeutic potential of adenosine receptor antagonists and agonists. 2007 Aug The adenosine receptors (A(1), A(2A), A(2B) and A(3)) are important and ubiquitous mediators of cellular signalling, which play vital roles in protecting tissues and organs from damage. Launched drugs include the adenosine receptor antagonists theophylline and doxofylline (both used as bronchodilators in respiratory disorders such as asthma), while several compounds are presently in clinical trials for a range of indications, including heart failure, Parkinson's disease, rheumatoid arthritis, cancer, pain and chronic obstructive pulmonary disease. A host of companies and institutions are addressing the huge potential for the development of selective adenosine receptor agonists and antagonists, so that it appears we are on the verge of a new wave of compounds approaching the market for many unmet medical needs. This review presents an analysis of the patenting activity in the area for 2006 and an interpretation and reflection on the developments that we can expect in the future.
17604980 Bilateral patellar tendon ruptures: a missed diagnosis : case report and literature review 2007 Nov Knee extensor mechanism disruption is an unusual but serious emergency presentation. Rarely disruption can occur within the patellar tendon which is often associated with systemic diseases such as rheumatoid arthritis and systemic lupus erythematosus. Surgical management is required to repair the patellar tendon after clinical assessment and diagnosis. We describe the case of a 75-year-old man without any known predisposing systemic disease presenting on several occasions before accurate diagnosis and treatment. We include a literature review of similar cases and discuss the importance of missed diagnosis and underlying causes. A treatment algorithm to avoid missing similar injuries is also proposed.
17556910 Cutaneous amyloidosis associated with primary biliary cirrhosis. 2007 Jul Primary cutaneous amyloidosis is defined as the deposition of amyloid in the skin in the absence of systemic involvement. The association between primary cutaneous amyloidosis and other diseases, although rare, has been documented for connective tissue disorders such as systemic sclerosis, systemic lupus erythematosus and rheumatoid arthritis. We report the case of a 41-year-old woman who developed primary biliary cirrhosis in association with primary cutaneous amyloidosis. This association has not been reported before in the literature.
17223048 A centrofacial B lymphoma in a rheumatoid arthritis patient. 2007 Jan We report on a 65-year-old man who was hospitalized for polyarthritis with deterioration of his general state of health and chronic sinusitis. Clinical and biological signs led to the diagnosis of RA associated with localized Wegener's granulomatosis. Methotrexate and corticosteroids led to a distinct improvement in the patient's articular symptoms and in his general condition. One year after the start of treatment, a tumefaction of the right maxillary sinus appeared. Scans revealed a tumoral lesion in the right maxillary sinus. This proved to be a large B-cell lymphoma. The patient received chemotherapy (CHOP) and radiotherapy. This centrofacial lymphoma may be regarded as a B lymphoma of the MALT (mucosal associated lymphoma tumor) type, mimicking a relapse of Wegener's granulomatosis.
17124551 Measuring quality of life in rheumatic conditions. 2007 May Musculoskeletal disorders often have associated pain, functional impairment and work disability, and, not surprisingly, are the most common reasons for utilizing healthcare resources. Rheumatoid arthritis (RA) and fibromyalgia (FM) are causes of musculoskeletal pain and disability. Research indicates that there is a widespread impact of RA and FM on physical, psychological and social factors in affected individuals, and thus, outcome measures that encompass multiple aspects of quality of life are needed. Generic measures of quality of life identify associations between physical conditions and mental health and highlight the need to address psychological functioning to ultimately improve the individuals' quality of life.
17061078 [Gene therapy in orthopaedic surgery]. 2006 Nov Gene therapy in orthopaedic surgery is being intensively studied in the context of different genetic and nonmendelian diseases. Experimental progress in this area is characterized by the complexity of gene vector selection and production, gene transfer technology, application routes, choice of animal models, and evaluation of its efficacy using structural and functional parameters. The first clinical studies for gene therapy of rheumatoid arthritis already demonstrated their practical feasibility. Current data indicate that gene-based therapies are effective in promoting the repair of articular cartilage, and bone defects. Such strategies may lead to the development of novel molecular therapies treatments in orthopaedic surgery.
16952873 Therapeutic application of long-circulating liposomal glucocorticoids in auto-immune disea 2006 Glucorticoids are potent drugs that have a multitude of pharmacological actions both at genomic and non-genomic levels. Many of the diseases in which glucorticoids are routinely administered are featured by angiogenesis and enhanced capillary permeability, permitting targeted delivery using long-circulating drug delivery systems. By encapsulation of glucorticoids in long-circulating liposomes, drug levels at the site of the pathology are markedly higher, increasing and prolonging therapeutic efficacy in models of rheumatoid arthritis, multiple sclerosis, and cancer.
16832997 [Renal amyloidosis complicating Crohn's disease: report of two cases and review of literat 2006 Apr Secondary amyloidosis is caused by the extracellular store of the fragment AA of the circulatory protein in serum amyloid-A. It can complicate diseases such as family mediterranean fever, rheumatoid arthritis or Crohn's disease. Renal amyloidosis is a rare but serious complication of Crohn's disease. We report two cases of Crohn's disease associated with a nephrotic syndrome due to renal amyloidosis. It is important to recognize this complication, especially since Colchicine has been proposed as a possible treatment. So, the search for proteinuria seems to be important for an early diagnosis of renal amyloidosis in Crohn's disease.
18984417 Treatment of dry eye disease by the non-ophthalmologist. 2008 Nov Physicians caring for patients who have Sjögren's syndrome often face a particularly difficult task in managing the dry eye that occurs with this disease. The discomfort produced by the condition and the fluctuation of vision attendant to tear film instability are often the most annoying of the clinical symptoms. The understanding of dry eye disease in both its clinical expression and underlying etiopathology has expanded over the past 10 years with implications for management and therapy. The array of potential treatments both topical and systemic has evolved to provide a much more targeted and effective arsenal from which the clinician may choose.
18708979 Apparently persistent weakness after recurrent hypokalemic paralysis: a tale of two disord 2008 Sep A 19-year-old woman presented with recurrent hypokalemic paralysis, followed by apparently persistent symptoms due to coexisting osteomalacia. Distal renal tubular acidosis type 1 (dRTA1) linked the metabolic abnormalities and occurred as an extraglandular feature of Sjögren syndrome (SS). This case highlights the fact that in the setting of recurrent hypokalemia, apparently progressive weakness should be distinguished from primary hypokalemic paralysis and evaluated for dRTA1, as the metabolic alterations are potentially treatable. Further dRTA1 may precede the occurrence of sicca syndrome in SS.
18533206 [Should minor salivary gland biopsy still be performed?]. 2008 Jun INTRODUCTION: Labial salivary gland biopsy (LSGB) is a very useful technique that is often performed in our specialty. A lot of these LSGB yield normal results and the interest of this technique may be discussed. This study was made to answer two questions: one on the diagnostic interest of LSGB for the suspected pathology, secondly to verify if there was a correlation between the results of LSGB assessment and the patient's final diagnosis. MATERIAL AND METHODS: Ninety-six LSGB were performed in 2004 for Sjögren syndrome, sarcoidosis, amyloidosis and other auto-immune diseases. The histological study assessed the Chisholm-Mason score and screened for amyloidosis and sarcoidosic granuloma. The prescribing unit gave the final diagnosis. RESULTS: The LSGB was very specific (100% of specificity) and there were no false positive results; conversely, its sensitivity was lower, that is 75% for Sjögren syndrome, 67% for amyloidosis, 60% for sarcoidosis and 14% for other auto-immune disease (not defined). DISCUSSION: LSGB can be recommended for Sjögren syndrome; it is also useful for amyloidosis. In sarcoidosis it gives poor results and presents no interest for other auto-immune diseases. The LSGB prescribed for patients with a suspected initial single diagnosis (Sjögren syndrome only, or amyloidosis only, or sarcoidosis only, or an other auto-immune disease only) significantly increases the specificity and the sensitivity of the technique and suggests that specificity and sensitivity are linked to patient selection and not to LSGB itself.
18311531 Hodgkin lymphoma as a complication of primary Sjögren's syndrome. 2008 Sjögren's syndrome (SS) is a chronic autoimmune disease that is characterized by lymphocytic infiltration of the exocrine glands, mainly the salivary and lachrymal glands, usually manifesting with xerostomia and xerophthalmia. Around 50% of patients with primary SS develop systemic complications, lymphoma being the most feared of these. The majority of these neoplasias originate from B cells and are of the non-Hodgkin type. We describe here a rare case of SS in which the patient developed a Hodgkin lymphoma. We also review the literature on this subject.
18093245 Leukaemic dissemination of Merkel cell carcinoma in a patient with systemic lupus erythema 2008 May We describe an unusual bone-marrow metastasis of Merkel cell carcinoma (MCC) arising in the right cheek of a 73-year-old woman with systemic lupus erythematosus (SLE) and Sjögren's syndrome, who had been treated with oral prednisolone and methotrexate for 10 years. Seven months after wide local excision followed by local irradiation, the patient presented with thrombocytopaenia. Her bone marrow had been completely replaced by metastatic MCC cells, and metastatic cytokeratin 20-positive cells were also identified in the peripheral blood. To our knowledge, in the English literature, only six cases have been described previously of MCC bone-marrow involvement. Of these six cases, four were immunosuppressed, similar to our case. The high incidence of MCC in immunosuppressed patients such as those with SLE has been discussed previously. We consider that immunosuppression might be associated with bone-marrow metastasis, which is a rare form of MCC.
17963171 Dysphagia and dysmotility of the pharynx and oesophagus in patients with primary Sjögren' 2007 Sep OBJECTIVES: To assess the prevalence of pharyngeal and oesophageal symptoms and dysmotility in patients with primary Sjögren's syndrome (pSS) and relate these to autonomic nervous function. METHODS: Twenty consecutive pSS patients, according to the American-European Consensus Criteria (AECC), and 30 age- and sex-matched controls from the Swedish general population registry were studied. All subjects completed a pharyngeal and oesophageal symptoms questionnaire and were examined by pharyngeal and oesophageal video radiography. In addition, the pSS patients were examined by two different autonomic nervous function tests, the deep breathing test [calculating the expiration/inspiration (E/I) ratio] and the finger skin blood flow test [the vasoconstriction (VAC) index]. RESULTS: pSS patients experienced significantly more dysphagia compared with controls (65% vs. 3%; p<0.001). Pharyngeal (45% vs. 7%; p<0.01), oesophageal (80% vs. 7%; p<0.001) and gastro-oesophageal reflux symptoms (60% vs. 23%; p<0.01) were also more prevalent in pSS patients compared with controls while pharyngeal (15% vs. 17%; p = NS) and oesophageal dysmotility (40% vs. 30%; p = NS) were not. Dysphagia was not associated with dysmotility but was found to be associated with a decreased E/I ratio [-1.05 (-1.51 to -0.40) in patients with dysphagia vs. -0.21 (-0.39 to 0.65) in patients without dysphagia; p<0.01]. CONCLUSION: Subjective swallowing difficulties were more common in pSS patients than in controls while objective signs of pharyngeal and oesophageal dysmotility were not. Dysphagia in pSS patients does not seem to be related to video radiographical signs of dysmotility but may be related to an impaired parasympathetic function.