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ID PMID Title PublicationDate abstract
20627902 Bioreconstructive poly-L/D-lactide implant compared with Swanson prosthesis in metacarpoph 2010 Nov It was hypothesized that the bioresorbable interposition implant might offer a viable alternative to conventional silicone implant arthroplasty in rheumatoid metacarpophalangeal joint destruction. A randomized clinical study was performed to compare a stemless poly-L/D-lactide copolymer 96 : 4 (PLDLA) implant with the Swanson silicone implant. Results in 52 patients (53 hands and 175 joints) at a mean follow-up of 2 years (minimum 1 year) showed that the improvement in clinical assessments was comparable in both groups, except for better maintenance of palmar alignment in the Swanson group. The lack of implant fractures and intramedullary osteolysis were advantages of the PLDLA implant. The bioresorbable PLDLA interposition implant may offer an alternative tool for tailored reconstruction of rheumatoid metacarpophalangeal joints.
20125172 Epidemiology: Interpreting studies of interactions between RA risk factors. 2010 Feb Interactions between HLA and PTPN22 genotypes and smoking have been implicated in overall susceptibility to rheumatoid arthritis as well as the incidence of particular disease phenotypes in case-control and case-only studies. As recent epidemiological evidence shows, deciphering these interactions demands consideration of the analytical approach used.
21113169 Specific Btk inhibition suppresses B cell- and myeloid cell-mediated arthritis. 2011 Jan Bruton's tyrosine kinase (Btk) is a therapeutic target for rheumatoid arthritis, but the cellular and molecular mechanisms by which Btk mediates inflammation are poorly understood. Here we describe the discovery of CGI1746, a small-molecule Btk inhibitor chemotype with a new binding mode that stabilizes an inactive nonphosphorylated enzyme conformation. CGI1746 has exquisite selectivity for Btk and inhibits both auto- and transphosphorylation steps necessary for enzyme activation. Using CGI1746, we demonstrate that Btk regulates inflammatory arthritis by two distinct mechanisms. CGI1746 blocks B cell receptor-dependent B cell proliferation and in prophylactic regimens reduces autoantibody levels in collagen-induced arthritis. In macrophages, Btk inhibition abolishes FcγRIII-induced TNFα, IL-1β and IL-6 production. Accordingly, in myeloid- and FcγR-dependent autoantibody-induced arthritis, CGI1746 decreases cytokine levels within joints and ameliorates disease. These results provide new understanding of the function of Btk in both B cell- or myeloid cell-driven disease processes and provide a compelling rationale for targeting Btk in rheumatoid arthritis.
20419502 The Work Instability Scale for Rheumatoid Arthritis (RA-WIS): Does it work in osteoarthrit 2010 Sep PURPOSE: To validate the 23-item Work Instability Scale for Rheumatoid Arthritis (RA-WIS) for use in osteoarthritis (OA) using both classical test theory and item response theory approaches. METHODS: Baseline and 12-month follow-up data were collected from workers with OA recruited from community and clinical settings (n = 130). Fit of RA-WIS data to the Rasch model was evaluated by item- and person-fit statistics (size of residual, chi-sq), assessments of differential item functioning, and tests of unidimensionality and local independence. Internal consistency was assessed by KR-20. Convergent construct validity (Spearman r, known-groups) was evaluated against theoretical constructs that assess impact of health on work. Responsiveness to global indicators of change was assessed by standardized response means (SRM) and area under the receiver operating characteristic curves. RESULTS: Data structure of the RA-WIS showed adequate fit to the Rasch model (chi-sq = 83.2, P = 0.03) after addressing local dependency in three item pairs by creating testlets. High internal consistency (KR-20 = 0.93) and convergent validity with work-oriented constructs (|r| = 0.55-0.77) were evident. The RA-WIS correlated most strongly with the concept of illness intrusiveness (r = 0.77) and was highly responsive to changes (SRM = 1.05 [deterioration]; -0.78 [improvement]). CONCLUSIONS: Although developed for RA, the RA-WIS is psychometrically sound for OA and demonstrates interval-level property.
20114005 Health-related quality of life in Swedish men and women with early rheumatoid arthritis. 2009 Dec BACKGROUND: Rheumatoid arthritis (RA) is a chronic inflammatory joint disorder that may adversely affect health-related quality of life (HRQoL) both in established and early disease. OBJECTIVES: In patients with recent onset (<12 months) of RA, this extension of a previous study assessed HRQoL and the effect of disease activity over time. METHODS: Consecutive patients with recent onset of RA between March 1996 and November 1998 were followed for 6 years at the Department of Rheumatology of the University Hospital of Umeå in Sweden. Patients were requested to complete the 36-item Short Form (SF-36) Health Survey at 0, 24, 48, and 72 months. Gender differences were examined, and correlations between the SF-36 scales (with higher scores indicating better HRQoL) and data reflecting disease activity were analyzed. RESULTS: Fifty-one patients, 34 women and 17 men (mean age, 50.6 years; range, 20-78 years), participated in the study; in all, 41 patients completed the SF-36 at both 0 and 72 months. At inclusion (0 months), women reported significantly higher scores for physical role functioning, bodily pain, and social functioning compared with men (all, P < 0.05). At 72 months compared with 0 months, women reported significantly better mental health (P < 0.05), whereas men reported significantly better physical role functioning (P < 0.05), bodily pain (P < 0.01), mental health (P < 0.01), and vitality (P < 0.01). Additionally, at 72 months, the entire patient group rated physical role functioning and social functioning (both, P < 0.05), bodily pain and vitality (both, P < 0.01), and mental health (P < 0.001) as significantly better compared with the inclusion assessment. Overall improvement with time was significantly better for men than for women (P < 0.05). There were limited correlations between SF-36 point disease activity parameters and the SF-36 scores at 0 months (erythrocyte sedimentation rate vs physical functioning, mental health [both, P < 0.05], and bodily pain [P < 0.01]; 28-joint Disease Activity Score vs bodily pain [P < 0.05] and emotional role functioning [P < 0.01]) and at 72 months (C-reactive protein vs physical role functioning [P < 0.05]). Most of the physical subscales at inclusion correlated with the physical component summary (PCS) of the SF-36 questionnaire at 6 years. CONCLUSIONS: At disease onset, women with early RA reported better HRQoL than did their male counterparts. After 6 years, women and especially men both experienced better HRQoL, and no significant gender differences remained in any of the SF-36 scales or values for disease activity parameters. The PCS score at disease onset was the best predictor of the PCS score after 6 years.
18395775 High adiponectin and adiponectin receptor 1 expression in synovial fluids and synovial tis 2009 Jun OBJECTIVES: The major objectives of this article are first to measure the levels of expression of adiponectin and its 2 receptors (adipoR1 and adipoR2) in the peripheral blood mononuclear cells and in the synovial compartment of rheumatoid arthritis (RA) patients, and second, to assess their pro-inflammatory potential. Osteoarthritis patients and healthy subjects served as controls. METHODS: Expression of adiponectin, adipoR1, and adipoR2 were assayed by real-time polymerase chain reaction, enzyme-linked immunosorbent assay, and immunohistology. The potential pro-inflammatory activity of adiponectin was studied by adding recombinant adiponectin to cultures of synovial fibroblasts. RESULTS: Immunohistology showed that numerous cells in the synovial biopsies of RA expressed adiponectin, adipoR1, and adipoR2. The synovial fibroblasts were distinctly rich in adiponectin. As expected, high adiponectin levels were present in the synovial fluids. In contrast to the synovial compartment, in peripheral blood mononuclear cells, only adipoR1 exceeded those of osteoarthritis and healthy subjects. When recombinant adiponectin was added to cultures of synovial fibroblasts, it induced up to 8.1- and 11.4-fold increase in the release of monocyte chemoattractant protein-1 and interleukin-6. CONCLUSIONS: The adiponectin adipokine axis might play a role in RA.
20173024 IL-17 contributes to angiogenesis in rheumatoid arthritis. 2010 Mar 15 Angiogenesis is an early and a critical event in the pathogenesis of rheumatoid arthritis (RA). Neovascularization is dependent on endothelial cell activation, migration and proliferation, and inhibition of angiogenesis may provide a novel therapeutic approach in RA. In this study, we document a novel role of IL-17 in mediating angiogenesis. Local expression of IL-17 in mouse ankles increases vascularity. We further demonstrate that IL-17 is angiogenic by showing its ability to promote blood vessel growth in Matrigel plugs in vivo. Additionally, IL-17, in concentrations present in the RA joint, induces human lung microvascular endothelial cell (HMVEC) migration mediated through the PI3K/AKT1 pathway. Furthermore, suppression of the PI3K pathway markedly reduces IL-17-induced tube formation. We also show that both IL-17-induced HMVEC chemotaxis and tube formation are mediated primarily through IL-17 receptor C. Neutralization of either IL-17 in RA synovial fluids or IL-17 receptor C on HMVECs significantly reduces the induction of HMVEC migration by RA synovial fluid. Finally, RA synovial fluid immunoneutralized with anti-IL-17 and antivascular endothelial growth factor does not reduce HMVEC migration beyond the effect detected by immunodepleting each factor alone. These observations identify a novel function for IL-17 as an angiogenic mediator in RA, supporting IL-17 as a therapeutic target in RA.
19247593 [A novel treatment option in rheumatoid arthritis: abatacept, a selective modulator of T-c 2009 Abatacept is the first drug in a new class of disease-modifying anti-rheumatic drugs known as selective modulators of T-cell costimulation. The efficacy of abatacept in the treatment of rheumatoid arthritis (RA) has been shown in several clinical phase II and phase III trials, wherein abatacept was used in monotherapy, either in combination with methotrexate (MTX) after MTX-failure, in combination with MTX after failure of anti-TNF-alpha therapy or in combination with TNF-alpha blockers. In addition, the combination of abatacept/MTX was directly compared with infliximab/MTX. Current data on abatacept demonstrate an encouraging safety profile of this drug. The number of adverse events in patients on abatacept is comparable to that in patients treated with other biologics. Severe infections, however, are more common in abatacept-treated patients than in placebo-treated patients. Opportunistic infections are rare in patients with abatacept and the frequency of malignancies is not higher than expected in RA-patients. Additional studies are now warranted to get more information on rare adverse events and long-term unwanted effects.
19822041 Genetics of ankylosing spondylitis and rheumatoid arthritis: where are we at currently, an 2009 Jul Both ankylosing spondylitis (AS) and rheumatoid arthritis (RA) are common, highly heritable conditions, the pathogenesis of which are incompletely understood. Gene-mapping studies in both conditions have over the last couple of years made major breakthroughs in identifying the mechanisms by which these diseases occur. Considering RA, there is an over-representation of genes involved in TNF signalling and the NFKappaB pathway that have been shown to influence the disease risk. There is also considerable sharing of susceptibility genes between RA and other autoimmune diseases such as systemic lupus erythematosus, type 1 diabetes, autoimmune thyroid disease and celiac disease, with thus far little overlap with AS. In AS, genes involved in response to IL12/IL23, and in endoplasmic reticulum peptide presentation, have been identified, but a full genomewide association study has not yet been reported.
20369738 [The pirymethamine influence on hexosoaminidase gene expression in synovial cell culture-- 2010 Feb Inflammation process is leading to increasing of synovial fluid and value of its pressure. Moreover, the impairment of vascular flow within synovial membrane and increased permeability of blood vessels were described. The activity of lysosomal enzymes, such as N-acetyl-beta-glucosaminidase (HEX), was increased in patients with rheumatoid arthritis in comparison to health synovial fluid. It is supposed, that HEX takes part in joint destruction. The using of HEX inhibitors in synovial cell culture and evaluation of HEX mRNA expression before and after the adding of inhibitor may contribute in showing the new ways of understanding pathogenetic pathways of motion organ disorders. THE AIM of the study was to evaluate the expression of HEXA and HEXB genes in the synovial cell culture derived from human synovial inflammatory fluid obtained from patients suffered from rheumatoid arthritis. MATERIAL AND METHODS: The inflamed synovial fluid was taken from patients suffered from rheumatoid arthritis. The following solutions of potential inhibitor--pyrimethamine were used: 20 microg/ml, 10 microg/ml, 3 microg/ml and 1.5 microg/ml. Two separate control groups were established: control group 1 where only 0.6% of ethanol was added to the synovial cell culture; control group 2 where only 0.5% DMSO was added to the synovial cell culture. The relative quantitative real-time reverse transcriptase polymerase chain reaction (RT-PCR) was carried out. RESULTS. The difference in HEXA and HEXB expression was observed in synoviocytes obtained in synovial cell culture. Five time higher relative HEXA expression was determined after applying 3 microg/ml of pirymethamine compared with the control 1. The highest concentration of pirymethamine (10 and 20 microg/ml) caused the least elevation of HEXA expression. The slight decreased of HEXB expression was observed under the concentration of pirymethamine: 1.3 and 3 microg/ml. CONCLUSIONS. Pyrimethamine contributes to regulating the HEX gene expression from synovial cells. The change in gene expression level is dependent on the concentration of the pirymethamine. Our preliminary data don't let us establish the concentration of pyrimethamine that may significantly inhibit HEXA and HEXB expression. Further study may be conducted to put new insight into the pathogenesis of joint destruction in the course of rheumatoid arthritis.
21159834 The functional polymorphism 844 A>G in FcαRI (CD89) does not contribute to systemic scler 2011 Mar OBJECTIVE: To investigate the role of the Fc(α)RI 844 A>G functional polymorphism in the genetic predisposition to rheumatoid arthritis (RA) and systemic sclerosis (SSc) susceptibility. METHODS: The study population was composed of 1401 patients with SSc, 642 patients with RA, and 1317 healthy controls. The Fc(α)RI (CD89) single-nucleotide polymorphism rs16986050 was genotyped by pyrosequencing. RESULTS: We observed no significant deviation of the genotype and allele frequencies in RA and SSc compared to controls. A metaanalysis and a recessive and dominant model yielded similar negative results. CONCLUSION: Our data show that the Fc(α)RI 844 A>G polymorphism is not associated with SSc or RA susceptibility.
19854705 Statin use in rheumatoid arthritis in relation to actual cardiovascular risk: evidence for 2010 Apr BACKGROUND: Cardiovascular disease (CVD) is partially attributed to traditional cardiovascular risk factors, which can be identified and managed based on risk stratification algorithms (Framingham Risk Score, National Cholesterol Education Program, Systematic Cardiovascular Risk Evaluation and Reynolds Risk Score). We aimed to (a) identify the proportion of at risk patients with rheumatoid arthritis (RA) requiring statin therapy identified by conventional risk calculators, and (b) assess whether patients at risk were receiving statins. METHODS: Patients at high CVD risk (excluding patients with established CVD or diabetes) were identified from a cohort of 400 well characterised patients with RA, by applying risk calculators with or without a x1.5 multiplier in specific patient subgroups. Actual statin use versus numbers eligible for statins was also calculated. RESULTS: The percentage of patients identified as being at risk ranged significantly depending on the method, from 1.6% (for 20% threshold global CVD risk) to 15.5% (for CVD and cerebrovascular morbidity and mortality) to 21.8% (for 10% global CVD risk) and 25.9% (for 5% CVD mortality), with the majority of them (58.1% to 94.8%) not receiving statins. The application of a 1.5 multiplier identified 17% to 78% more at risk patients. CONCLUSIONS: Depending on the risk stratification method, 2% to 26% of patients with RA without CVD have sufficiently high risk to require statin therapy, yet most of them remain untreated. To address this issue, we would recommend annual systematic screening using the nationally applicable risk calculator, combined with regular audit of whether treatment targets have been achieved.
20001558 Novel TNF antagonists for the treatment of rheumatoid arthritis. 2010 Jan IMPORTANCE OF THE FIELD: TNF antagonists have become an integral part of the standard of care for patients with rheumatoid arthritis (RA). Two additional TNF antagonists have recently been approved in the US for this indication, and clinicians will need to understand the data on the efficacy and safety of these agents in order to properly place them into the clinical treatment algorithm. AREAS COVERED IN THIS REVIEW: This review covers the published clinical trial data on the use of certolizumab and golimumab for RA. The literature search included manuscripts published through September 2009 and abstracts from major meetings (ACR and EULAR) in 2007 - 2009. WHAT THE READER WILL GAIN: This paper will review the efficacy and safety of golimumab and certolizumab in the treatment of RA at various stages of disease. Use of these agents will be described in the context of other available alternatives, including other TNF antagonists and other biologic therapies. TAKE HOME MESSAGE: Certolizumab and golimumab have comparable efficacy and safety profiles compared with previously approved TNF antagonists. These two agents have several unique theoretical benefits when compared to existing agents, but the available published data do not suggest a clear clinical advantage at this time.
18556221 A tool for the assessment of hand involvement in rheumatic disorders in daily routine--the 2009 Jan OBJECTIVE: To establish a questionnaire for quantification of hand involvement in osteoarthritis (OA) of the hands and rheumatoid arthritis (RA) meeting daily routine requirements. PATIENTS AND METHODS: The smallest number of questions of the modified score for the assessment and quantification of chronic rheumatic affections of the hands (M-SACRAH) providing reasonable reliability was identified by factor analysis and calculating Cronbach's alpha, subsequently resulting in a five-item scale, the short form-SACRAH (SF-SACRAH), which was then administered to 176 RA and 71 hand-OA (HOA) patients simultaneously with the M-SACRAH. Additionally, patient's satisfaction (PatSAT) with disease status was assessed (according to the Austrian school marking system from 1 to 5). Gamma was calculated to assess the agreement of the SF-SACRAH with the M-SACRAH and between the single corresponding questions of different formats. The Wilcoxon rank test was applied to estimate the relationship between PatSAT and the SF-SACRAH. RESULTS: Alpha for the SF-SACRAH in 176 RA and 71 HOA patients amounted to 0.869 and to 0.897, respectively, indicating high internal consistency. In both patient groups the SF-SACRAH was found to be significantly correlated to the M-SACRAH (both P(s)<0.01). Agreement between the corresponding questions of both scales was significant in both patient groups by calculating gamma (average gamma 0.683 in HOA and 0.847 in RA). PatSAT and SF-SACRAH values were highly significantly correlated (P<0.001) proving the score's external validity. CONCLUSION: The SF-SACRAH proved to be a brief and practicable tool to assess hand involvement in OA and RA meeting the requirements of daily routine.
20482894 Accelerated hand bone mineral density loss is associated with progressive joint damage in 2010 INTRODUCTION: To investigate whether accelerated hand bone mineral density (BMD) loss is associated with progressive joint damage in hands and feet in the first year of rheumatoid arthritis (RA) and whether it is an independent predictor of subsequent progressive total joint damage after 4 years. METHODS: In 256 recent-onset RA patients, baseline and 1-year hand BMD was measured in metacarpals 2-4 by digital X-ray radiogrammetry. Joint damage in hands and feet were scored in random order according to the Sharp-van der Heijde method at baseline and yearly up to 4 years. RESULTS: 68% of the patients had accelerated hand BMD loss (>-0.003 g/cm2) in the first year of RA. Hand BMD loss was associated with progressive joint damage after 1 year both in hands and feet with odds ratios (OR) (95% confidence intervals [CI]) of 5.3 (1.3-20.9) and 3.1 (1.0-9.7). In univariate analysis, hand BMD loss in the first year was a predictor of subsequent progressive total joint damage after 4 years with an OR (95% CI) of 3.1 (1.3-7.6). Multivariate analysis showed that only progressive joint damage in the first year and anti-citrullinated protein antibody positivity were independent predictors of long-term progressive joint damage. CONCLUSIONS: In the first year of RA, accelerated hand BMD loss is associated with progressive joint damage in both hands and feet. Hand BMD loss in the first year of recent-onset RA predicts subsequent progressive total joint damage, however not independent of progressive joint damage in the first year.
19586548 Effect of interleukin-1beta on spinal cord nociceptive transmission of normal and monoarth 2009 INTRODUCTION: Cytokines produced by spinal cord glia after peripheral injuries have a relevant role in the maintenance of pain states. Thus, while IL-1beta is overexpressed in the spinal cords of animals submitted to experimental arthritis and other chronic pain models, intrathecal administration of IL-1beta to healthy animals induces hyperalgesia and allodynia and enhances wind-up activity in dorsal horn neurons. METHODS: To investigate the functional contribution of glial cells in the spinal cord nociceptive transmission, the effect of intrathecally administered IL-1beta was studied in both normal and adjuvant-induced arthritic rats with or without glial inhibition. Four weeks after induction of monoarthritis, rats were treated with the glial cell inhibitor propentofylline (10 microg i.t. daily during 10 days) and submitted to a C-fiber-mediated reflex paradigm evoked by single and repetitive (wind-up) electric stimulation. RESULTS: Both the propentofylline treatment and the monoarthritic condition modified the stimulating current required for threshold activation of C reflex responses. Intrathecal IL-1beta increased spinal cord wind-up activity in normal and monoarthritic rats without propentofylline pre-treatment, but resulted in decreased wind-up activity in normal and monoarthritic propentofylline-treated animals. Intrathecal saline did not produce any effect. Thus, glial inactivation reverted into inhibition the excitatory effect of IL-1beta on spinal cord wind-up, irrespective of the normal or monoarthritic condition of rats. CONCLUSIONS: The results suggest that the excitatory effect of nanomolar doses of IL-1beta on spinal wind-up in healthy rats is produced by an unidentified glial mediator, while the inhibitory effects of IL-1beta on wind-up activity in animals with inactivated glia resulted from a direct effect of the cytokine on dorsal horn neurons. The present study failed to demonstrate a differential sensitivity of normal and monoarthritic rats to IL-1beta administration into the spinal cord and to disruption of beta glial function, as both normal and monoarthritic animals changes wind-up activity in the same direction after propentofylline treatment, suggesting that after glial inhibition normal and monoarthritic animals behave similarly relative to the capability of dorsal horn neurons to generate wind-up activity when repeatedly stimulated by C-fibers.
19478659 Diagnostic validity of space available for the spinal cord at C1 level for cervical myelop 2009 Jun 1 STUDY DESIGN: Retrospective cohort study. OBJECTIVE: To evaluate diagnostic validity of space available for the spinal cord (SAC) at C1 level for myelopathy in patients with rheumatoid arthritis (RA). SUMMARY OF BACKGROUND DATA: The relationship of SAC at C1 level with myelopathy has been evaluated by relatively small number of the patients, and 2 criteria have been proposed. METHODS: Two cohorts of the patients with RA were established. Group A consisted of 140 patients with myeopathy due to upper cervical involvement selected from the database. Group B consisted of 99 patients with upper cervical subluxation, but not associated with myelopathy selected from the consecutive series of the hospitalized patients. Distributions of SAC at C1 level in both groups were evaluated. Efficacy indexes for screening (sensitivity, specificity, etc.) were calculated for these patients' population by previously demonstrated 2 criteria. In addition, analysis according to receiver operating characteristic (ROC) curve was performed. RESULTS: The average values of SAC were 11.1 mm in Group A and 16.5 mm in Group B. When cut-off point for myelopathy was defined as 13 mm or less, sensitivity and specificity were 82% and 85%, respectively. When it was defined as 14 mm or less, sensitivity increased (88%) while specificity decreased (74%). Accuracies by these 2 criteria were almost the same (83%, 82%). The left upper corner point of ROC curve was located between these 2 cut-off points. CONCLUSION: Distributions of SAC showed that SAC was a reliable parameter for relating myelopathy in patients with upper cervical subluxation in RA. The plots according to ROC curve showed adequacy of previously demonstrated 2 cut-off points. For the purpose to screen the patients with high risk for myelopathy, 14 mm or less was recommended as a cut-off point of SAC.
20732364 Fc receptor-like 3 gene polymorphisms confer susceptibility to rheumatoid arthritis in a C 2010 Dec Polymorphisms in the Fc receptor-like 3 (FCRL3) gene have been reported to be associated with rheumatoid arthritis (RA) in Japanese populations. However subsequent studies have yielded conflicting results. Hence the aim of present study was to clarify whether these genetic variants in FCRL3 gene are associated with RA in a Chinese population. We conducted a case-control study of 234 RA patients and 260 controls by genotyping four polymorphisms in FCRL3. The genotype and allele distributions of four polymorphisms were significantly different in RA patients compared with controls (uncorrected p = 0.021 and p = 0.031; 0.027 and 0.008; 0.028 and 0.042; and 0.019 and 0.029, respectively). The FCRL3-169 C allele was significantly associated with rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP)-positive RA, but no association was detected for RF and anti-CCP-negative RA. Furthermore, the frequency of the -169C allele was increased disproportionately in female patients, and the resulting odds ratio for female homozygote was increased to 2.375 (uncorrected p = 0.006). Haplotype analysis showed that the most common haplotype TGGG was associated with decreased risk of RA (uncorrected p = 0.001, odds ratio = 0.656). However CACA appeared to be a risk haplotype for RA cases (uncorrected p = 0.031, odds ratio = 1.398). Taken together, these results suggest that FCRL3 polymorphisms and haplotypes may contribute to genetic susceptibility to RA in Chinese population.
20522855 The use of abatacept in debilitating cavitating lung disease associated with rheumatoid ar 2010 Jun A case of debilitating cavitating lung disease associated with rheumatoid arthritis and bronchocentric granulomatosis, which failed to respond to conventional medical or surgical treatment, is described. The patient was treated over 10 years with steroids, antimicrobial agents, disease-modifying antirheumatoid drugs and surgery. Lung function continued to decline and the patient presented for admission with recurrent pneumonia. Abatacept was initiated to modify the underlying immunopathology. Following 12 months of treatment with abatacept the patient has demonstrable improvement in lung function and lung anatomy, and has not presented to hospital with pneumonia. She has tolerated the treatment without complication. The use of abatacept has stabilised the lung disease in this case in the medium term and prevented readmission to hospital. These results suggest a larger role for abatacept in those with such disease in the future and may warrant further investigation.
21165753 Visfatin levels and intima-media thicknesses in rheumatic diseases. 2011 Jun Chronic inflammatory rheumatic diseases lead to increased prevalence of atherosclerosis. However, this early and accelerated atherosclerosis cannot be explained by traditional cardiovascular risk factors alone. The permanent overexpression of cellular adhesion molecules and pro-inflammatory cytokines in chronic inflammatory conditions may participate in accelerated atherosclerosis. Visfatin, a novel adipocytokine, has a potential insulin-like action and pro-inflammatory effects. Therefore, the aim of the study was to determine serum visfatin level and its association with common carotid intima-media thickness (IMT), which is a predictor of atherosclerosis, in patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), systemic sclerosis (SSc), and Behçet's disease (BD). The study involved 29 RA, 26 SLE, 25 SSc, 30 BD patients, and 29 healthy controls (HC). Serum levels of TNF-α, IL-6, and visfatin were analyzed using enzyme-linked immunosorbent assay method and homeostasis model assessment for insulin resistance (HOMA-IR) indexes, and IMTs were determined. Serum visfatin level was higher in the RA group than all the other groups. In addition, visfatin level was higher in the active BD subgroup than the inactive BD subgroup. In the study groups, visfatin levels were not correlated with HOMA-IR indexes and IMTs. Whereas visfatin serum concentration was not associated with insulin resistance and carotid atherosclerosis in selected rheumatic diseases, it was higher in the RA and active BD groups, but not in the SLE and SSc groups. Visfatin levels may be associated with Th1/Th2 balance. Further studies are needed for more precise elucidation of the pro-inflammatory activities of visfatin.