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

ID PMID Title PublicationDate abstract
20433606 Non-length dependent small fiber neuropathy. a prospective case series. 2010 Mar We report the features of non-length dependent small fiber neuropathy (SFN) and compare them to those with distal length-dependent SFN. In a series of 224 consecutive neuropathy patients, we evaluated 44 patients with SFN diagnosed in the presence of both symptoms and signs. Eleven were classified as non-length dependent SFN. Disease associations were Sjögren's syndrome (two patients), impaired glucose tolerance, rheumatoid arthritis, hepatitis C virus, Crohn's disease, and idiopathic (five patients). In the 33 patients with distal SFN, the age of onset was significantly older and more had impaired glucose metabolism (16/33). In both groups, pain was mainly characterized as burning, but patients with non-length dependent SFN more often reported an "itchy" quality and allodynia to light touch.
20356867 Endovascular occlusion of a ruptured popliteal artery aneurysm. 2010 May Popliteal artery aneurysms are the most common of the peripheral aneurysms. Rupture is a rare complication of these aneurysms. Here we present a case of a ruptured popliteal aneurysm in a patient with severe joint disease and immobility due to rheumatoid arthritis. The condition was treated endovascularly with an Amplatzer arterial occlusion device. The aneurysm was successfully thrombosed without inducing critical limb ischemia, as the distal popliteal was chronically occluded. Ligation of peripheral aneurysms is an infrequent treatment without simultaneous bypass graft placement. Endovascular occlusion of ruptured popliteal aneurysms should be considered a valid therapeutic strategy where exclusion bypass is not required due to distal arterial occlusion.
20180968 Comparison of different methods for preparation and characterization of total RNA from car 2010 Jan 18 BACKGROUND: The isolation of intact RNA can be very difficult when tissues are used that contain many RNAses or that are hard to homogenize, e.g. cartilage samples. Additionally, cartilaginous tissues are characterized by a low cellularity and an abundance of extracellular matrix (ECM) molecules. But given the growing interest in understanding pathogenesis of degenerative diseases, e.g. osteoarthritis (OA) and rheumatoid arthritis (RA), studies have to consider expression pattern of cells in its natural environment. FINDINGS: We compared the current RNA isolation methods for the extraction of high-quality RNA of snap-frozen biopsies from limited amounts of hypocellular cartilaginous tissue. The focus of the study was to gather information about procedure-related differences in RNA quality and yield. Here, we describe two protocols, the phenol/chloroform-free filter-based method (RNAqueous kit) and the combined protocol (TRIzol(R)/RNeasy Mini kit), working in a reproducible and reliable manner. CONCLUSIONS: We conclude that preparation, storage, homogenization, and quality control are altogether critical steps for in-depth analysis of differential gene expression, especially in hypocellular tissues with highly crosslinked ECM like cartilage.
19878776 Chapter 8: Clusterin: A multifacet protein at the crossroad of inflammation and autoimmuni 2009 For years, clusterin has been recognized as a secreted protein and a large number of works demonstrated that this ubiquitously expressed protein has multiple activities. Among the described activities several were related to inflammation and immunity such as its regulatory activity on complement. Then it became clear that a nuclear form of the protein with proapoptotic property existed and more recently that a cytoplasmic form could regulate NF-kappaB pathway. Again, these activities have a strong repercussion in inflammation and immunity. On the other hand, data available on the exact role of CLU in these processes and autoimmunity were quite scarce until recently. Indeed, in the last few years, a differential CLU expression in subtype of T cells, the regulation of CLU expression by proinflammatory cytokines and molecules, the regulation of expression and function of CLU depending on its subcellular localization, the interaction of CLU with nuclear and intracellular proteins were all reported. Adding these new roles of CLU to the already reported functions of this protein allows a better understanding of its role and potential involvement in several inflammatory and immunological processes and, in particular, autoimmunity. In this sense, rheumatoid arthritis appears to be a very attractive disease to build a new paradigm of the role and function of CLU because it makes the link between proliferation, inflammation, and autoimmunity. We will try to see in this review how to bring altogether the old and new knowledge on CLU with inflammation and autoimmunity. Nevertheless, it is clear that CLU has not yet revealed all its secrets in inflammation and autoimmunity.
19716672 Assessment of fracture risk. 2009 Sep Fractures are a common complication of osteoporosis. Although osteoporosis is defined by bone mineral density at the femoral neck, other sites and validated techniques can be used for fracture prediction. Several clinical risk factors contribute to fracture risk independently of BMD. These include age, prior fragility fracture, smoking, excess alcohol, family history of hip fracture, rheumatoid arthritis and the use of oral glucocorticoids. These risk factors in conjunction with BMD can be integrated to provide estimates of fracture probability using the FRAX tool. Fracture probability rather than BMD alone can be used to fashion strategies for the assessment and treatment of osteoporosis.
19517358 [Recommendations for tuberculosis screening before initiation of TNF-alpha-inhibitor treat 2009 Jun Due to the increased risk of tuberculosis (TB) under treatment with TNF-alpha-inhibitors for rheumatoid arthritis and other autoimmune diseases, precautionary measures are required before initiating TNF-alpha-inhibitor therapy. Patients should have active TB ruled out and screening for latent TB infection should be performed. The screening should include chest X-ray, complete medical history, and the administration of a highly specific Interferon-gamma-Release Assay (IGRA). As tuberculin skin test (TST) results can be expected to be either false-positive or false-negative in these patients, the TST, as commonly performed in the past, is recommended only for exceptional situations. For chemopreventive treatment of latent TB infection (LTBI), isoniazid is usually given for 9 months.
19348180 [A young patient with ischemic stroke due to carotid artery dissection in whom number of m 2009 Feb A 23-year-old Japanese man with rheumatoid arthritis experienced attacks of the right hand weakness during the latest month. Megaloblastic anemia was diagnosed and he was admitted in the department of hematology. Seven days after admission, he developed mild consciousness disturbance and hemiparesis on the right side. Brain MRI revealed the cortical watershed infarction in the left cerebral hemisphere. The cause of the infarction was diagnosed spontaneous dissection of the left internal carotid artery. We detected 11 microembolic signals (MES) during 30 minutes' monitoring in the left middle cerebral artery using transcranial Doppler. MES decreased gradually with anticoagulant therapy. However, surgical therapy was performed to prevent progression of dissection or arterial rupture. MES detected on transcranial Doppler would be important to assess the risk of embolism and to discuss therapeutic strategy.
20651970 Leukocytapheresis Therapy Improved Cholestasis in a Patient Suffering from Primary Scleros 2009 Apr 15 Primary sclerosing cholangitis (PSC) is an autoimmune disease of the hepatobiliary system for which effective therapy has not been established. Leukocytapheresis (LCAP) therapy is known to effective in patients with ulcerative colitis (UC). In addition, effects of LCAP therapy were reported on some autoimmune diseases such as Crohn's disease, rheumatoid arthritis and rapidly progressive glomerulonephritis. Here we report the case of a 29-year-old man with PSC associated with UC who was treated with LCAP therapy. He had a 16-year history of UC and a 12-year history of PSC. Although he was under treatment with prednisolone and ursodeoxycholic acid, exacerbation of UC and PSC-associated cholestasis were seen. Since he showed side effects of prednisolone, he was treated with LCAP. Not only improvement of UC, but also decreased serum alkaline phosphatase, gamma-guanosine triphosphate and total bile acids, suggesting improvement of PSC-associated cholestaisis, were seen after treatment with LCAP. Our experience with this case suggests that LCAP therapy could be a new effective therapeutic strategy for patients with PSC associated with UC.
21073830 [Antibiotic prophylaxis in relation to dental treatment of patients with hip or knee joint 2010 Nov 15 A review of the literature with respect to whether antibiotic prophylaxis should be recommended in relation to dental treatment of patients with hip or knee joint prosthesis. We find no evidence for such a general recommendation. As neutropenic patients and patients with rheumatoid arthritis are generally more prone to develop periprosthetic infections it can be considered in these cases to give prophylactic antibiotics before more extensive dental treatments.
20981225 A case of phlegmonous gastritis associated with marked gastric distension. 2010 Sep Phlegmonous gastritis is an acute and severe infectious disease that is occasionally fatal if the diagnosis is delayed. Alcohol consumption, an immunocompromised state (e.g., due to HIV infection, rheumatoid arthritis, diabetes mellitus, or adult T-cell lymphoma), and mucosal injury of the stomach are reported to be predisposing factors. The main treatments for phlegmonous gastritis are antibiotics administration or surgery. In this case, the patient's stomach was markedly distended due to long-lasting gastric-outlet obstruction, which is thought to be the predisposing factor for phlegmonous gastritis. We inserted a metal stent at the obstructed site palliatively due to strong refusal by the patient for surgery. The patient recovered after stenting and antibiotic therapy.
20980971 Influence of statins on effector and regulatory immune mechanisms and their potential clin 2010 Nov Studies have shown that HMG-CoA reductase inhibitors possess anti-inflammatory properties, for example, decreasing serum levels of proinflammatory cytokines (e.g., TNF-α, IL-1β, and IL-6) or decreasing the activity of numerous effector mechanisms. However, they also may influence the immune system by affecting a wide range of regulatory actions, for example, Treg- and Th2-type response activation as well as Th1 and Th17 response diminishing. These features provide the rationale for potential application of statins in treating chronic inflammatory diseases and other disorders with the involvement of the immune system. This article seeks to review the immunomodulatory actions of statins and their possible implementation in treating rheumatoid arthritis, multiple sclerosis, and other autoimmune disorders in humans.
20797713 Endometriosis and autoimmune disease: association of susceptibility to moderate/severe end 2011 Jan This study investigates the association of rheumatoid arthritis-associated single nucleotide polymorphisms in endometriosis. We found an association of CCL21 (rs2812378) and HLA-DRB1 (rs660895) with moderate to severe endometriosis.
20678594 Neuropilins and semaphorins - from angiogenesis to autoimmunity. 2010 Oct Angiogenesis, the growth of new blood vessels from preexisting ones, is an important process in health and disease. The persistence of neovascularization in inflammatory diseases, such as rheumatoid arthritis (RA), might facilitate the entrance of inflammatory cells into the synovium and stimulate pannus formation. Several potent pro-angiogenic cytokines have been implicated in inflammatory angiogenesis. Of these, vascular endothelial growth factor (VEGF) and its receptors (VEGFRs) have been demonstrated to play a central role in RA, systemic lupus erythematosus (SLE) and multiple sclerosis (MS). Increased serum levels of VEGF were found to correlate with disease activity and severity of these diseases whereas, remission was associated with decreased levels. In the last few years, other molecules, initially found in neurodevelopment, were found to be involved in angiogenesis and recently also in the immune system and autoimmunity. Neuropilins (NPs) are VEGF receptors, while some of the semaphorins (SEMAs) are neuropilins' ligands. Their involvement in the development of autoimmune diseases and the various mechanisms by which they may induce autoimmunity will be discussed in this review.
20477691 Certolizumab pegol for the treatment of Crohn's disease. 2009 Nov Certolizumab pegol is a polyethylene glycolated FAb' fragment of a humanized anti-TNF-alpha monoclonal antibody. This pegylated molecule binds with circulating TNF-alpha and forms an inactive complex that is then eliminated from the body. The drug has been shown to be better than placebo in the treatment of Crohn's disease and maintaining a clinical response in adult patients with moderate-to-severe active disease who have had an inadequate response to conventional therapy, and the treatment of adults with moderately to severely active rheumatoid arthritis. Comparative trials with an active control group are lacking. The most common adverse reactions include abdominal pain, diarrhea, injection site reactions and infection. All necessary live and attenuated vaccines should be given prior to the initiation of certolizumab pegol therapy, patients should be evaluated for TB risk factors and tested for latent TB prior to initiating therapy, and the initiation of therapy should be avoided if the patient has an active infection. Concomitant use with anakinra is not recommended because of the increased risk of serious infections and neutropenia. Therapy should be discontinued if the patient develops a serious infection during therapy.
20431264 Midkine, a heparin-binding cytokine with multiple roles in development, repair and disease 2010 Midkine is a heparin-binding cytokine or a growth factor with a molecular weight of 13 kDa. Midkine binds to oversulfated structures in heparan sulfate and chondroitin sulfate. The midkine receptor is a molecular complex containing proteoglycans. Midkine promotes migration, survival and other activities of target cells. Midkine has about 50% sequence identity with pleiotrophin. Mice deficient in both factors exhibit severe abnormalities including female infertility. In adults, midkine is expressed in damaged tissues and involved in the reparative process. It is also involved in inflammatory reactions by promoting the migration of leukocytes, induction of chemokines and suppression of regulatory T cells. Midkine is expressed in a variety of malignant tumors and promotes their growth and invasion. Midkine appears to be helpful for the treatment of injuries in the heart, brain, spinal cord and retina. Midkine inhibitors are expected to be effective in the treatment of malignancies, rheumatoid arthritis, multiple sclerosis, renal diseases, restenosis, hypertension and adhesion after surgery.
20380038 Targeting Toll-like receptors: emerging therapeutics? 2010 Apr There is a growing interest in the targeting of Toll-like receptors (TLRs) for the prevention and treatment of cancer, rheumatoid arthritis, inflammatory bowel disease and systemic lupus erythematosus (SLE). Several new compounds are now undergoing preclinical and clinical evaluation, with a particular focus on TLR7 and TLR9 activators as adjuvants in infection and cancer, and inhibitors of TLR2, TLR4, TLR7 and TLR9 for the treatment of sepsis and inflammatory diseases. Here, we focus on TLRs that hold the most promise for drug discovery research, highlighting agents that are in the discovery phase and in clinical trials,and on the emerging new aspects of TLR-mediated signalling - such as control by ubiquitination and regulation by microRNAs - that might offer further possibilities of therapeutic manipulation.
20364256 Solitary osseous sarcoidosis: a rare reason for pathologic fracture. 2012 Aug Sarcoidosis with osseous involvement as the initial manifestation is rare. Due to lack of other organ involvements, the diagnosis is somehow difficult to establish. We report a case with osseous sarcoidosis as the initial and major manifestation that developed spontaneous bone fracture. Our case emphasizes the importance of histological evidence and exclusion of other diseases i.e. rheumatoid arthritis, before making the diagnosis of osseous sarcoidosis.
20012302 [Oral hygiene, prophylaxis and therapy in patients with inflammatory rheumatic diseases]. 2010 Mar Inflammatory disorders of the periodontium are often associated with chronic systemic diseases, which can demonstrate a reciprocal influence. Within the adult population at present, 74% of younger adults and 88% of older individuals require periodontal treatment. Due to inflammatory processes, patients with rheumatoid arthritis or other chronic polyarthritides frequently suffer from pain in the temporomandibular joint and, since finger mobility is often limited, their ability to perform oral hygiene measures is impeded. However, diligent and constant oral hygiene is of crucial importance both for maintaining a healthy periodontium and to prevent the development of caries. For their daily dental care, these patients should favor the use of electric toothbrushes, products for interdental cleaning and mouth rinses. The dentist should be informed immediately about increased and constant gingival bleeding, gingival hyperplasia, loosening or migration of teeth associated with gingival recession or other irritations in the oral cavity. Professional dental cleaning should be routinely performed at 3- to 6-month intervals in order to prevent an increase in the risk for periodontal disease.
19837186 The TNF superfamily in 2009: new pathways, new indications, and new drugs. 2009 Dec Today's most successful class of biologics targets the inflammatory cytokine tumor necrosis factor in autoimmune diseases including rheumatoid arthritis, psoriasis and Crohn's. With five anti-TNF biologics now on the market, attention has turned toward novel strategies to improve the safety and efficacy of next-generation TNF inhibitors. Beyond TNF, drugs are under development that modulate many other ligands and receptors of the TNF superfamily. Biologics targeting at least 16 of the approximately 22 known ligand-receptor pairs are now in clinical development for autoimmune diseases, cancers and osteoporosis. A deeper understanding of intracellular signaling has also facilitated small-molecule interventions, opening the door to oral therapies. This report summarizes recent developments in this highly druggable superfamily, including highlights of the latest international TNF conference.
19564713 [Biologics in current therapy for inflammatory bowel disease]. 2009 Jun Recent advance of molecular biology and immunology contributes to the development biologics such as anti-TNFalpha agent in the treatment for inflammatory bowel disease (IBD). Although therapeutic strategy of IBD has not been changed for a long time, success of Infliximab, first anti-TNFalpha agent, now changes therapeutic strategy of IBD dramatically. Top-down strategy has been considered to improve patients' natural history in the therapy for Crohn's disease as well as in rheumatoid arthritis. Infliximab also has been expected as a promising medicine for pediatric Crohn's disease. Furthermore, Infliximab has been approved for the therapy of ulcerative colitis. These tremendous successes of Infliximab have encouraged us to develop other anti-TNF agents and other biologics. In this review, we describe current topics of biologics in IBD treatment and discuss future direction.