Browse

Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
19500102 More than skin deep: atherosclerosis as a systemic manifestation of psoriasis. 2009 Jul There is now growing evidence that psoriasis, like other inflammatory diseases such as rheumatoid arthritis and systemic lupus erythematosus, is a systemic disorder that is associated with enhanced atherosclerosis and risk of coronary artery disease. Here we summarize the available epidemiological evidence for this association and analyse pathogenic features that are common to psoriasis and atherosclerosis. Further prospective studies are urgently needed to extend knowledge of the risk of cardiovascular morbidity and mortality in patients with psoriasis and to confirm the degree to which treatment of psoriasis reduces this risk. Nevertheless, existing data are sufficient to indicate that severe psoriasis should be more widely recognized as a potential risk factor for cardiovascular disease and should be considered with the established factors when formulating strategies for the management of cardiovascular risk.
19280916 [Epidemiology of collagen diseases]. 2009 Mar Collagen diseases have been generally thought to be rare, but the number of patients with rheumatoid arthritis(RA) becomes over 700,000 in recent days. In addition, the survival rate has markedly increased, but many lupus patients are still suffering from so called intractable organ involvements such as severe lupus nephritis and CNS lupus, etc. The main purposes of the treatment for RA are to prevent bone/cartilage destruction, to improve the quality of life(QOL) of patients, and to improve prognosis. For these purposes, new type of drugs such as biologic agents are introduced, and showing remarkable effects comparing with conventional DMARDs. But the side effects and cost of these agents are becoming problems. To overcome these problems, the epidemiology that can clearly show the benefits of these agents on daily life of patients is becoming much more important issue.
19252515 How do the efficacy and safety of abatacept and infliximab compare in the treatment of act 2009 Mar Since the introduction of biologic therapies that target tumor necrosis factor (TNF), short-term and long-term outlooks for many patients with rheumatoid arthritis have greatly improved. Not all patients, however, respond to therapy with these agents. Furthermore, despite favorable overall profiles for safety and tolerability, some concerns remain in this regard. Following the emergence of next-generation biologic agents with new targets, a key question for clinicians concerns the relative efficacy and safety of the different biologic therapies. A study by Schiff et al. directly compared the biologic T-cell costimulation blocker abatacept and the anti-TNF agent infliximab. The results of the 6-month, placebo-controlled trial demonstrated a similar efficacy for both drugs; however, in the 6-month treatment extension period, outcomes of efficacy differed in favor of abatacept. Overall, abatacept had a relatively more-acceptable safety and tolerability profile compared to infliximab.
19162337 Interleukin-17 as a drug target in human disease. 2009 Feb Interleukin (IL)-17 (now synonymous with IL-17A) is an archetype molecule for an entire family of IL-17 cytokines. Currently believed to be produced mainly by a specific subset of CD4 cells, named Th-17 cells, IL-17 is functionally located at the interface of innate and acquired immunity. Specifically, it induces the release of chemokines and growth factors from mesenchymal cells and is now emerging as an important local orchestrator of neutrophil accumulation in several mammalian organs. Furthermore, there is growing evidence that targeting IL-17 signaling might prove useful in a variety of diseases including asthma, Crohn's disease, multiple sclerosis, psoriatric disease and rheumatoid arthritis. Here, we summarize the key aspects of the biology of IL-17 in mammals and scrutinize the potential pharmacological use of targeting IL-17 in humans.
22049618 Placental membrane as a source of mesenchymal stem cells. 2010 Non-embryonic stem cells have the potential for being used in therapeutic attempts to develop treatments for human diseases and injuries. There is an increasing demand for non invasive treatments for a number of diseases and disorders that strike and disable relatively young people that would otherwise have many active years ahead. As longevity increases and we face new challenges in treating patients who suffers from disorders that reduces their quality of life already at middle age. Simple, secure methods to isolate non-embryonic stem cells from different tissues is one step towards making those treatments available to people suffering from Parkinson's disease, spinal cord injury, stroke, burns, heart disease, diabetes, osteoarthritis, and rheumatoid arthritis.
21875000 [Physical therapy in rheumatology]. 2010 Rheumatic diseases are the leading cause of chronic disability. Physical therapy and rehabilitation are an integral part of the strategy of treatment of rheumatic diseases in order to maintain the function of the musculoskeletal system. Early detection of disability provides a more efficient implementation of all measures of physiotherapy treatment. Exercises are the most important form of physiotherapy. Long-term effect of exercise is possible only if patients achieve adherence to the program. Questionnaires activities of daily living asses functional status of patients, can be a guide for planning the rehabilitation program and indicator of the effectiveness of therapeutic intervention as well. Methods of physical therapy and rehabilitation are part of all published guidelines for the management of rheumatoid arthritis, spondyloarthritides, osteoarthritis, osteoporosis, chronic back pain, chronic non-malignant pain and fibromyalgia.
21579762 Methyl 2-methyl-4-(oxiran-2-ylmeth-oxy)-2H-1,2-benzothia-zine-3-carboxyl-ate 1,1-dioxide. 2010 Jan 9 In the title compound, C(14)H(15)NO(6)S, the thia-zine ring adopts a distorted half-chair conformation. The structure displays several cooperative weak inter-molecular C-H⋯O hydrogen-bonding inter-actions, giving rise to a two-dimensional sheet packing motif. The CH(2) group in the meth-oxy linker to the oxirane ring, and the CH group in that ring, exhibit twofold positional disorder. The three-membered oxirane ring is twisted approximately perpendicular with respect to thia-zine ring (dihedral angle = 60/86° for the major/minor disorder components). 1,2-Benzothia-zines of this kind have a wide range of biological activities and are mainly used as medicines in the treatment of inflammation and rheumatoid arthritis.
21789100 Sudden onset proptosis secondary to cavernous sinus thrombosis from underlying mandibular 2009 The present report concerns a patient who presented with a 4-day history of left-sided facial pain arising from a pre-existing dental infection and progressive shortness of breath. The patient had a previous diagnosis of rheumatoid arthritis and was being treated with methotrexate. The rapid development of a right eye proptosis necessitated urgent decompression with a lateral canthotomy and cantholysis. Imaging revealed a left facial abscess, cavernous sinus thrombosis (CST), bilateral internal jugular thrombosis and multiple lung abscesses. Blood cultures yielded Streptococcus constellatus, a member of the Peptostreptococcus family. The patient was admitted to the intensive care unit (ICU) with respiratory failure and septic shock. She was treated with intravenous meropenem and clindamycin, and anticoagulated. Despite early intervention, the patient developed a middle cerebral artery infarct. Over a 3-week period she was gradually weaned from vasopressor and ventilatory support.
21547046 Health traditions of Sikkim Himalaya. 2010 Jul Ancient medical systems are still prevalent in Sikkim, popularly nurtured by Buddhist groups using the traditional Tibetan pharmacopoeia overlapping with Ayurvedic medicine. Traditional medical practices and their associated cultural values are based round Sikkim's three major communities, Lepcha, Bhutia and Nepalis. In this study, a semi-structured questionnaire was prepared for folk healers covering age and sex, educational qualification, source of knowledge, types of practices, experience and generation of practice, and transformation of knowledge. These were administered to forty-eight folk healers identified in different parts of Sikkim.490 medicinal plants find their habitats in Sikkim because of its large variations in altitude and climate. For 31 commonly used by these folk healers, we present botanical name, family, local name, distribution, and parts used, together with their therapeutic uses, mostly Rheumatoid arthritis, Gout, Gonorrhea, Fever, Viral flu, asthma, Cough and Cold, indigestion, Jaundice etc. A case treated by a folk healer is also recounted. This study indicates that, in the studied area, Sikkim's health traditions and folk practices are declining due to shifts in socio-economic patterns, and unwillingness of the younger generation to adopt folk healing as a profession.
20583972 Histone Deacetylase inhibitors: new promise in the treatment of immune and inflammatory di 2010 Nov The development of Histone Deacetylase (HDAC) inhibitors has, until recently, principally been driven by their potential as anti-cancer agents. However, there is emerging evidence that HDAC inhibitors could have utility in the treatment of chronic immune and inflammatory disorders, including rheumatoid arthritis, psoriasis, inflammatory bowel disease, multiple sclerosis, systemic lupus erythematosus, airway hyperresponsiveness and organ transplant rejection. Here we discuss the merits of various, structurally-distinct HDAC inhibitors as potential anti-inflammatory therapeutics and provide examples of the novel medicinal chemistry approaches being undertaken to realize HDAC as a druggable target in this clinical setting.
20196735 Autoantibodies in autoimmune diseases. 2010 May The occurrence of autoantibodies is a common feature of autoimmune diseases. This review is intended to give an overview of the most important autoantibodies and their role in diagnosis, disease activity and prognosis in rheumatoid arthritis (RA), systemic lupus erythematodes (SLE) and multiple sclerosis (MS). Whereas in RA and SLE these antibodies are meaningful for diagnosis and partially for the prognosis of the disease, the situation is quite different in the case of MS. Up to date, no specific antibody is known to be exclusively present in the serum or cerebrospinal fluid (CSF) of MS-patients compared to the respective fluids of healthy individuals. Nevertheless, there are some antigens that are reported to be bound significantly more often by MS-patients' serum or CSF than by comparable samples of healthy volunteers. In addition to the importance of several autoantibodies for diagnosis of the respective disease, the serum concentration of certain antibodies in RA and SLE is associated with therapy response. Since therapy with biologicals (e. g. TNF-alpha blockade, B-cell depletion) is expensive, monitoring these autoantibodies seems to be an additional useful tool for early identification of therapy responders or non-responders.
20018047 Memory management in genome-wide association studies. 2009 Dec 15 Genome-wide association is a powerful tool for the identification of genes that underlie common diseases. Genome-wide association studies generate billions of genotypes and pose significant computational challenges for most users including limited computer memory. We applied a recently developed memory management tool to two analyses of North American Rheumatoid Arthritis Consortium studies and measured the performance in terms of central processing unit and memory usage. We conclude that our memory management approach is simple, efficient, and effective for genome-wide association studies.
19883249 Drug delivery technologies for chronotherapeutic applications. 2009 It has been proven that the body follows a 24-hour cycle called a circadian rhythm. This cycle is coordinated by the suprachiasmatic nucleus and controls nearly all bodily functions including those related to drug delivery. Knowledge of the body's circadian rhythm leads to an improved understanding of diseases and their treatment, known as chronotherapy, such that synchronizing drug application in accordance with the natural rhythm of the body leads to improved disease management and a greater patient therapeutic outcome. Chronotherapeutic diseases include asthma, cardiovascular diseases, glaucoma, rheumatoid arthritis and cancers. In order to treat these diseases numerous chronotherapeutic drug delivery systems have been developed, such that drug is released in the period when it is most needed. This review paper attempts to concisely explicate the role of circadian rhythms in various disease states and furthermore describes the various oral drug delivery technologies that have been employed for the treatment of chronotherapeutic diseases.
19572257 Bayesian inference from incomplete longitudinal data: a simple method to quantify sensitiv 2009 Sep 30 Bayesian approach has been increasingly used for analyzing longitudinal data. When dropout occurs in the study, analysis often relies on the assumption of ignorable dropout. Because ignorability is a critical and untestable assumption without obtaining additional data or making other unverifiable assumptions, it is important to assess the impact of departures from the ignorability assumption on the key Bayesian inferences. In this paper, we extend the Bayesian index of local sensitivity to non-ignorability (ISNI) method proposed by Zhang and Heitjan to longitudinal data with dropout. We derive formulas for the Bayesian ISNI when the complete longitudinal data follow a linear mixed-effect model. The calculation of the index only requires the posterior draws or summary statistics of these draws from the standard analysis of the ignorable model. Thus, our approach avoids fitting any complicated nonignorable model. One can use the method to evaluate which Bayesian parameter estimates or functions of these estimates in a linear mixed-effect model are susceptible to nonignorable dropout and which ones are not. We illustrate the method using a simulation study and two real examples: rats data set and rheumatoid arthritis clinical trial data set.
19491514 [Estimation of absolute risk for fracture]. 2009 Mar Osteoporosis treatment aims to prevent fractures and maintain the QOL of the elderly. However, persons at high risk of future fracture cannot be effectively identified on the basis of bone density (BMD) alone, although BMD is used as an diagnostic criterion. Therefore, the WHO recommended that absolute risk for fracture (10-year probability of fracture) for each individual be evaluated and used as an index for intervention threshold. The 10-year probability of fracture is calculated based on age, sex, BMD at the femoral neck (body mass index if BMD is not available), history of previous fractures, parental hip fracture history, smoking, steroid use, rheumatoid arthritis, secondary osteoporosis and alcohol consumption. The WHO has just announced the development of a calculation tool (FRAX: WHO Fracture Risk Assessment Tool) in February this year. Fractures could be prevented more effectively if, based on each country's medical circumstances, an absolute risk value for fracture to determine when to start medical treatment is established and persons at high risk of fracture are identified and treated accordingly.
21794636 [Non-cytokine therapeutic targets]. 2009 Apr The arrival of anti-TNF-α to the clinic has been the most successful example of translational research. However, clinical experience has shown that these compounds do not induce clinical remission in half of rheumatoid arthritis (RA) patients. Recently, new biological drugs against non-cytokine targets have been available for RA patients. These compounds deplete B cells or interfere with the activation of T cells and have also shown effectiveness in controlling signs, symptoms and structural damage progression in RA. Second generation B-cell depletion therapies are progressing in the pipeline of several pharmaceutical companies. These compounds will likely improve the immunogenicity and formulation of rituximab, but it is improbable that they will improve the remission rate achieved by the anti-TNF-α δρυγσ. Currently, regulation of signal transduction has evolved into an important field of drug research, and small molecule inhibitors for a number of pathways are tested as new anti-inflammatory agents. For rheumatic diseases, specific Jak3 and Syk inhibitors are, so far, the most successful compounds representing a significant advance over p38 mitogen-activated protein kinase (MAPK) inhibitors.
18848698 The role of interferon gamma in regulation of CD4+ T-cells and its clinical implications. 2009 Interferon gamma (IFNgamma) plays a central role in the immune response against infection and tumur immune surveillance. Its functions include not only activation of the host immune system to control microbial infections but also repression of autoimmune responses by turning on T-regulatory cells and increasing T effector cell apoptosis. Defects in IFNgamma and IFNgamma receptor genes have been associated with autoimmune diseases such as rheumatoid arthritis, type 1 diabetes and multiple sclerosis. However, treatment of autoimmune diseases by supplementing with IFNgamma has been satisfactory due to its broad biological effects. Instead, its target T-regulatory cells may be used for the clinical treatment of autoimmune diseases. Future study could also focus on promotion of the beneficial effects of IFNgamma and blocking those unwanted IFNgamma-induced activities.
19556955 Animal-assisted therapy--a new trend in the treatment of children and adults. 2009 Jun Animal-assisted therapy is a familiar method of treatment in the rehabilitation of many illnesses and conditions, but is still not applied sufficiently in our milieu. This paper gives an overview of the available literature and some of the research which demonstrates that the interaction between the patient, animal and therapist provides a context which improves communication, elevates self-confidence, reduces the symptoms of diseases, and improves the quality of life. The dog, cat, horse, birds and toy animals are most often used in therapy. Short-term contacts with animals are used, as well as long term keeping of animals, which are looked after by patients following a particular methodology. The therapy is used in the treatment of psychiatric patients afflicted with depression, schizophrenia, phobias and addiction problems. Loneliness is easier to endure in the company of animals. It is also applied in cardiovascular diseases, dementia, Alzheimer's disease, child cerebral paralysis, rheumatoid arthritis, AIDS, and other diseases. Research shows a more rapid reduction of symptoms of many diseases when animals are included in the therapeutic process.
19398919 Infliximab-associated alveolitis after treatment for severe left-sided ulcerative colitis. 2009 Jul Here we describe a patient with ulcerative colitis who developed alveolitis after infliximab therapy. With earlier case reports of development of alveolitis in rheumatoid arthritis patients after infliximab infusion, the temporal relationship between the infliximab therapy and the development of alveolitis in this case, raises the possibility that the two might be causally related. With an increasing trend towards treating moderate to severely active ulcerative colitis patients with infliximab as a rescue therapy, clinicians should be aware of this potentially serious complication.
20120123 Garlic: empiricism or science? 2009 Dec Garlic (Allium sativum L. fam. Alliaceae) is one of the best-researched, best-selling herbal remedies and is also commonly used as a food and a spice. Garlic constituents include enzymes (for example, alliinase) and sulfur-containing compounds, including alliin, and compounds produced enzymatically from alliin (for example, allicin). Traditionally, it has been employed to treat infections, wounds, diarrhea, rheumatism, heart disease, diabetes, and many other disorders. Experimentally, it has been shown to exert antilipidemic, antihypertensive, antineoplastic, antibacterial, immunostimulant and hypoglycemic actions. Clinically, garlic has been evaluated for a number of conditions, including hypertension, hypercholesterolemia, intermittent claudication, diabetes, rheumatoid arthritis, common cold, as an insect repellent, and for the prevention of arteriosclerosis and cancer. Systematic reviews are available for the possible antilipidemic, antihypertensive, antithrombotic and chemopreventive effects. However, the clinical evidence is far from compelling. Garlic appears to be generally safe although allergic reactions may occur.