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ID PMID Title PublicationDate abstract
19105420 [Anticitrulline antibodies and wrist joint MRI parameters in patients with early arthritis 2008 AIM: To examine correlations between immunological markers, clinical parameters and MRI data in patients with early rheumatoid arthritis (RA) and undifferentiated arthritis (UDA). MATERIAL AND METHODS: The study was made of 211 patients with early RA (43 males, 168 females) and 47 patients with early UDA (mean age 48.6 +/- 13.4 years), duration of the symptoms 5.5 +/- 4.5 months). RF-positive were 136 (64.5%) patients. X-ray erosions were detected in 45 (21.3%) patients. RA activity was estimated by the integral DAS28 index (by 3 parameters), function--by HAO questionnaire (Russian version). The immunonephelometric analyzer (BN-100, Dade Behring, Germany) determined concentration of C-reactive protein (CRP), IgM. Anticitrulline antibodies (ACAB) were estimated by enzyme immunoassay, the upper limit of the norm was 5.0 U/ml. MR imaging (MRI) of both the wrists in RA patients was made on the 0.2 T Artoscan unit, the assessment was made with the reference atlas OMERACT-RAMRIS. RESULTS: IgM and ACAB levels were much higher in RA than in UDA. Among the patients positive by both tests (RF+ACAB) 95.2% had a typical clinical picture and RA diagnosis while 60% patients negative by RF and ACAB had UDA (p < 0.001); among patients positive by one of the tests the ratio UDA to RA was 1:2 (32.6 and 67.4%). In RA patients with very high ACAB (> 100 U/ml) CRP reached 38.10 +/- 48.29 mg/l while in negative ACAB--17.07 +/- 19.34 mg/l (p = 0.016). Wrist MRI detected synovitis and bone erosions in 93 and 66% cases, respectively. High ACAB level (> 100 U/ml) and CRP levels were associated with high DAS28, RF IgM and MRI erosions number. CONCLUSION: RF and ACAB patients are characterized by a typical RA picture in the disease onset (specificity 93.6%). MRI detects synovitis in the wrist joints in 93 and erosions in 66% early RA patients. Combination of high ACAB and CRP levels is associated with high RA activity, RF IgM and great number of erosions according to MRI and may serve a marker of a severe disease course.
18817364 3-amino-7-phthalazinylbenzoisoxazoles as a novel class of potent, selective, and orally av 2008 Oct 23 The p38 mitogen-activated protein kinase (MAPK) is a central signaling molecule in many proinflammatory pathways, regulating the cellular response to a multitude of external stimuli including heat, ultraviolet radiation, osmotic shock, and a variety of cytokines especially interleukin-1beta and tumor necrosis factor alpha. Thus, inhibitors of this enzyme are postulated to have significant therapeutic potential for the treatment of rheumatoid arthritis, inflammatory bowel disease, osteoporosis, and many other diseases where aberrant cytokine signaling is the driver of disease. Herein, we describe a novel class of 3-amino-7-phthalazinylbenzoisoxazole-based inhibitors. With relatively low molecular weight, these compounds are highly potent in enzyme and cell-based assays, with minimal protein shift in 50% human whole blood. Compound 3c was efficacious (ED 50 = 0.05 mg/kg) in the rat collagen induced arthritis (CIA) model.
16977380 Cytokine production profile of splenocytes derived from zymosan A-treated SKG mice develop 2006 Aug OBJECTIVE: SKG mice have a point mutation of the zeta-associated protein of 70 kD (ZAP-70) and spontaneously develop a severe polyarthritis in the conventional condition, whereas they are healthy under the specific pathogen free (SPF) condition. The purpose of this study was to investigate the cytokine production from splenocytes in SKG mice developing arthritis under the SPF condition. MATERIAL: SKG and BALB/c mice were intraperitoneally injected with zymosan A under the SPF condition. Spleen was isolated 1, 2 or 8 weeks after the intraperitoneal injection of saline or zymosan A. Splenocytes were cultured with concanavalin A. Cytokine production and proliferation were measured 48 and 72 h after the culture. RESULTS: An intraperitoneal injection of zymosan A induced severe polyarthritis with increased levels of rheumatoid factor and interleukin 6 (IL-6) only in SKG mice. Splenocytes from SKG mice did not proliferate well maybe because of less productivity of IL-2. The IL-4 production from splenocytes of SKG mice was higher, while interferon-gamma production was lower than those of BALB/c mice. An injection of zymosan A reduced the IL-4 production only in SKG mice. CONCLUSIONS: SKG mice do not develop arthritis under the SPF condition possibly because of a low proliferative activity of T cells and Th2-predominance.
17530723 Epidemiology of juvenile idiopathic arthritis in a multiethnic cohort: ethnicity as a risk 2007 Jun OBJECTIVE: To study the influence of ethnicity on the risk of developing juvenile idiopathic arthritis (JIA) in a multiethnic community of patients with unrestricted access to health care. METHODS: A questionnaire on ethnicity was distributed to all patients with JIA being followed up at the Hospital for Sick Children in Toronto, Ontario, Canada. Of 1,082 patients, 859 (79.4%) responded to the questionnaire. To calculate the relative risk (RR) of developing JIA in this study cohort, the results were compared with data from the age-matched general population of the Toronto metropolitan area (TMA) as provided in the 2001 census from Statistics Canada. RESULTS: European descent was reported by 69.7% of the patients with JIA compared with a frequency of 54.7% in the TMA general population, whereas a statistically significantly lower than expected percentage of the patients with JIA reported having black, Asian, or Indian subcontinent origin. Children of European origin had a higher RR for developing any of the JIA subtypes except polyarticular rheumatoid factor (RF)-positive JIA, and were particularly more likely to develop the extended oligoarticular and psoriatic subtypes. A higher frequency of enthesitis-related JIA was observed among patients of Asian origin, while those of black origin or native North American origin were more likely to develop polyarticular RF-positive JIA. CONCLUSION: In this multiethnic cohort, European descent was associated with a significantly increased risk of developing JIA, and the distribution of JIA subtypes differed significantly across ethnic groups.
19093736 Emerging role of interleukin-1 in cardiovascular diseases. 2009 There is an increasing evidence linking dysbalance between various proinflammatory mediators and higher risk of cardiovascular events and pathologies. Likewise, some of the cardiovascular diseases lately appeared to have an autoimmune component. Interleukin-1 (IL-1), a master regulator of diverse inflammatory processes in higher eukaryotes and the key player in numerous autoimmune disorders including rheumatoid arthritis, diabetes mellitus or systemic sclerosis, has recently been proved to be involved in development of several cardiovascular diseases as well. This report aims to give a summary on current knowledge about the IL-1 signaling pathways and about the implication of IL-1 and the IL-1 receptor antagonist (IL-1Ra) in some of the diseases of the cardiovascular system.
18936127 Idiopathic carpal tunnel syndrome and trigger finger: is there an association? 2009 Feb Carpal tunnel syndrome (CTS) and trigger finger are known to occur together in association with conditions such as diabetes mellitus, rheumatoid arthritis and hypothyroidism. Although most cases that present to a hand clinic have no obvious predisposing cause, the two conditions often appear together in the same patient. We performed a prospective study of the prevalence of CTS in hospital outpatients presenting with trigger finger. Six hundred and eighty-one patients with CTS, trigger finger or both conditions were recruited prospectively. Diagnosis of both disorders was made on clinical grounds. The study group comprised 551 patients with no obvious predisposing cause. Of 211 patients with trigger finger, 91 (43%) also had CTS. This prevalence is substantially higher than the population prevalence of CTS of approximately 4%. Our data support an association between idiopathic CTS and idiopathic trigger finger and lend support to common pathophysiological factors.
18828292 Assessing the effect of fibromyalgia on patients' sexual activity. 2008 Sep 17 AIMS: The primary aim of this study was to investigate whether a questionnaire developed for patients with rheumatoid arthritis (RA) could also be used with patients who have fibromyalgia. A secondary aim was to assess the impact of fibromyalgia on sexuality. METHOD: In the first of two phases the face and content validity of a sexuality questionnaire already being used in patients with RA were assessed in a qualitative, audio-taped, interview study of five patients with fibromyalgia. The second phase consisted of a self-report questionnaire distributed to 60 patients with fibromyalgia. FINDINGS: The interview data confirmed that the content of the RA sexuality questionnaire was relevant to patients with fibromyalgia. A total of 43 (72%) questionnaires were returned and, of these, 41 (95%) were usable. Patients reported that fibromyalgia had altered their sexual relationship. They cited pain, stiffness, fatigue, reduced sexual drive and the impact of drug therapy as the main reasons. CONCLUSION: The symptoms associated with fibromyalgia had a negative effect on sexual enjoyment. The questionnaire appears to be useful in addressing sexuality in patients with fibromyalgia.
18783739 Epidemiology of rheumatic musculoskeletal disorders in the developing world. 2008 Aug The epidemiology of rheumatic musculoskeletal (MSK) disorders in the developing world is much less well known than it is in the developed world. We expect ethnicity, traditions, socioeconomics and lifestyles to have an impact, but overall data are sparse. This report focuses on the WHO-ILAR COPCORD (community-oriented programme for control of rheumatic diseases). COPCORD was designed to collect community data on pain and disability in the developing economies. Several countries in Asia-Pacific and Central South America have completed COPCORD surveys. Despite some limitations in methodology, COPCORD provides a fair estimate of the spectrum and extent of rheumatic MSK disorders. We digress from a general overview to highlight the scenario for rheumatoid arthritis, and draw a few parallels with known statistics from the developed world. Overall, the emerging spectrum and severity are not very different, but in the developing countries the burden of disease, worsened by dismal rheumatology services, is likely to be staggering.
18774339 Arachidonic-acid-derived eicosanoids: roles in biology and immunopathology. 2008 Oct Arachidonic acid (AA)-derived eicosanoids belong to a complex family of lipid mediators that regulate a wide variety of physiological responses and pathological processes. They are produced by various cell types through distinct enzymatic pathways and act on target cells via specific G-protein-coupled receptors. Although originally recognized for their capacity to elicit biological responses such as vascular homeostasis, protection of the gastric mucosa and platelet aggregation, eicosanoids are now understood to regulate immunopathological processes ranging from inflammatory responses to chronic tissue remodelling, cancer, asthma, rheumatoid arthritis and autoimmune disorders. Here, we review the major properties of eicosanoids and their expanding roles in biology and medicine.
19595870 Optimal design of clinical trials for drugs designed to slow the course of Alzheimer's dis 2006 Jul Compounds now in clinical development are hypothesized to slow the clinical progression and pathogenesis of Alzheimer's disease (AD) by their effects to diminish production, increase clearance, or decrease aggregation of amyloid beta protein. Options for investigating the effects of these and other drugs on clinical progression and pathogenesis of AD were examined at a conference that included: (1) a review of experimental methods used to investigate disease-modifying drugs for multiple sclerosis, rheumatoid arthritis, cardiovascular disease, and osteoporosis; (2) discussion of possible study designs and outcome measures for trials in patients with AD; and (3) discussion of biomarkers available for AD. There is no uniformly best way to investigate a drug's impact on AD progression but characteristics of studies supportive of a disease-slowing effect can be specified. Relevant clinical outcomes in drug-treated patients versus placebo-treated patients should be compared over at least 1 and possibly as long as 2 years with biomarkers reflective of pathogenesis and of the drug's mechanistic effects measured concurrently.
20477084 Adalimumab for the treatment of Crohn's disease. 2006 Jan Crohn's disease is a chronic inflammatory intestinal disorder characterized by chronic, recurrent, often granulomatous inflammation affecting any part of the intestines, but most frequently involving the small bowel and colon. The development of novel biologic agents targeting tumor necrosis factor has revolutionized the treatment of patients with moderate-to-severe Crohn's disease. Adalimumab, a fully human anti-tumor necrosis factor monoclonal antibody, has recently been evaluated for Crohn's disease and was found to be effective for induction of clinical response and remission in patients with active inflammatory disease. Preliminary experience also indicates that adalimumab is useful in patients with prior intolerance or loss of response to infliximab. The rate of adverse events is comparable to other tumor necrosis factor antagonists in rheumatoid arthritis, but longer studies are needed to evaluate both the long-term efficacy and safety of adalimumab in the treatment of Crohn's disease.
18665148 Is there a 'window of opportunity' for intervention to reduce risk of coronary artery dise 2008 Sep Patients with systemic lupus erythematosus (SLE) have a substantially enhanced risk for cardiovascular complications, especially coronary artery disease (CAD). Evidence from a recent study by Urowitz et al. indicates that the incidence not only of classic CAD risk factors but also of nontraditional CAD risk factors increases within the first 3 years after onset of SLE. The data indicate that patients with SLE require careful management of hypertension and hypercholesterolemia, smoking cessation, and increased physical activity in order to reduce the risk of CAD. Intensive immune intervention is likely to be related to reduction of risk from nontraditional CAD risk factors, but it is not known if this treatment approach also affects classic CAD risk factors. Although established in patients with rheumatoid arthritis in recent years, the effect of immune intervention on classic risk factors for CAD needs to be evaluated in patients with SLE, through either clinical studies or international registries.
18209635 Use of conjunctiva-Müller muscle pedicle flap in surgical treatment of necrotizing scleri 2008 Jan PURPOSE: To describe a new surgical technique for scleral repair in eyes with necrotizing scleritis. METHODS: The surgical technique involved placing an autologous fascia lata graft over the scleral defect and covering the graft with an inferiorly based conjunctiva-Müller muscle pedicle flap from the upper eyelid. The flap pedicle was divided 2 months after the initial procedure. The medical records of 2 patients (2 eyes) who underwent a scleral repair with this technique were reviewed. RESULTS: Both patients had progressive, diffuse scleral necrosis secondary to rheumatoid arthritis, and were receiving immunosupressive therapy. One patient had previously undergone unsuccessful scleral reconstructions with patch grafting. In both cases, the eye integrity was preserved after repair with conjunctiva-Müller muscle flap, and postoperative visual acuity improved. No complication developed during follow-up periods of 28 and 54 months. CONCLUSION: Conjunctiva-Müller muscle pedicle flap may provide efficient and safe scleral repair in eyes with necrotizing scleritis.
17892577 Inflammatory pseudotumor of the Kidney. 2007 Sep 24 BACKGROUND: Inflammatory pseudotumor of the kidney or inflammatory myofibroblastic tumor (IMT) is composed of spindle cells admixed with variable amount of proliferating myofibroblasts, fibroblasts, extracellular collagen, lymphocytes and plasma cells. This mainly affects the urinary bladder or prostate. Renal involvement is rare. CASE PRESENTATION: A 56 year-old man was diagnosed with asymptomatic left sided hydronephrosis while being investigated for rheumatoid arthritis. CT scan imaging showed ill defined fascial plains around the kidney and thickening around the renal hilum suggestive of localized inflammatory change. Worsening intermittent left loin pain with increasing hydronephrosis, significant cortical thinning and marked deterioration of renal function necessitated nephrectomy. Macroscopy showed a hydronephrotic fibrotic kidney with microscopy and immunohistochemistry consistent with a histological diagnosis of IMT. CONCLUSION: We report a case of an inflammatory pseudotumor of the kidney. It is unique in that the patient presented with painless hydronephrosis followed two years later with progressive deterioration in renal function and worsening loin pain.
17875071 Pulmonary lymphoma developed during long-term methotrexate therapy for psoriasis. 2007 Sep Low dose weekly administration of methotrexate has been thought to be effective for both rheumatoid arthritis (RA) and psoriasis. However, there is a possibility that methotrexate therapy may be oncogenic. This report presents a case of pulmonary lymphoma developed during long-term methotrexate therapy for psoriasis. Physicians should be aware that Epstein-Barr virus-associated lymphoproliferative disorders that occur during treatment with methotrexate are not specific to patients with RA.
17824335 Advances in knee arthroplasty for younger patients: traditional knee arthroplasty is prolo 2007 Aug Total knee arthroplasty (TKA) was a remarkable development in orthopedic surgery. Joint arthroplasty and arthroscopy were perhaps the greatest innovations in orthopedics in the 20th century and occurred without the advantages of today's technology. Initially, TKA was performed only on elderly patients and those with advanced rheumatoid arthritis because of concerns with long-term wear of polyethylene. Surgeons strongly discouraged this surgery for patients younger than age 60 years because both patients and many orthopedic surgeons believed that knee implants would last only for approximately 10 years, particularly in younger and more active patients. Reports in the late 1980s and early 1990s about accelerated polyethylene wear and osteolysis substantiated the conviction that TKA was contraindicated in younger patients. This led to complacency toward TKA, thus inhibiting technological advances in the procedure to develop implants for younger and more active patients.
17785342 Anti-cardiolipin and anti-beta2-glycoprotein I antibodies: performance of new commercial E 2007 Aug Antiphospholipid antibodies (aPL) are known to be pathogenic in experimental models and are predictive of thrombosis and miscarriages in patients, so it is important to correctly evaluate their presence for identifying patients at risk. Despite many years of work, the standardization of aPL ELISA remains an open problem, so evaluation of newly introduced commercial preparations is mandatory. A total of 80 sera were collected (10 primary antiphospholipid syndromes (APSs), 10 APSs associated with systemic lupus erythematosus, 20 infectious diseases, 20 rheumatoid arthritis and 20 normal blood donors) and tested for IgG/IgM anti-cardiolipin and anti-beta2GPI antibodies on commercial ELISA kits (ETI) by DiaSorin and on home-made ELISA. Both methods displayed good sensitivity and specificity for APS and were found to be concordant, especially in determining antibodies of IgG class.
17718058 [Two year investigation of glycosylation profiles in serum IgG from a patient with multipl 2007 Jul Although abnormalities of glycosylation profile in serum IgG have been demonstrated in a variety of inflammatory autoimmune diseases such as rheumatoid arthritis, there are only a few reports describing long term monitoring of N-glycosylation profiles in such patients. Here we report the serial finding of N-glycosylation profiles of IgG-kappa M-protein in a patient with multiple myeloma monitored for two years. In this patient, serum formed a gel precipitation upon exposure to air. The HPLC mapping method demonstrated that IgG M-protein in the patient exhibited a significant decrease in the ratio of fucosyl to afucosyl N-glycans compared with that in a healthy control. With remission, the IgG M-protein showed an increase in this ratio, becoming closer to that in the healthy control. However, the gel-precipitation persisted. This finding suggested that this unique property of serum may not be related to the glycosylation profile of the M-protein.
17350549 Strategies for prevention and management of musculoskeletal conditions. Lower limb pain. 2007 Feb This article summarises lower limb pathology, which results in lower limb pain. It mainly addresses injuries and deliberately omits osteoarthritis and rheumatoid arthritis, since these entities are described in detail in other chapters in this volume. As major trauma is not a focal point for rheumatologists and repetitive strain injuries of the lower limb are rare, sports and leisure injuries are the main focus. Regarding lower limb pain, this chapter describes the most important problems and quantifies the size of the problem. Furthermore, it informs the reader about different treatment modalities, their goals and methods of measuring the effectiveness of the treatment. Evidence is given for different interventions, such as lifestyle, pharmacological, surgery and rehabilitation. In addition, opportunities to apply these interventions for prevention and treatment to those who will potentially benefit most are shown. Finally, strategies (care pathways) are given for prevention and treatment based on this evidence.
17327474 Collagen fragments modulate innate immunity. 2007 Mar Activation of the innate immune response in diseases such as rheumatoid arthritis and atherosclerosis leads to the production of proinflammatory cytokines that can promote collagenolysis. While a number of studies suggest that inflammation plays a major role in initiating collagen degradation, the effect of collagen and collagen-degradation fragments on the inflammatory response is not well understood. We now demonstrate that different collagen fragments can either augment or suppress IL-1beta production from human peripheral-blood monocytes. These data have wide-ranging implications for how amino acid variation in collagen affects disease and suggest that collagen degradation leads to the production of peptides that can modulate inflammation.