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

ID PMID Title PublicationDate abstract
4019803 Pleural fluid ferritin concentrations in human disease. 1985 Jul The concentration of ferritin was measured in the pleural fluid of 108 patients with pleural effusions. In all groups of patients the ferritin concentration was higher in pleural fluid than in serum. The greatest differences, with up to 100 times more ferritin in the pleural fluid, were found for patients with rheumatoid pleurisy, malignant effusions, and empyema. In patients with non-malignant inflammatory pleural effusions the concentration of ferritin in pleural fluid correlated significantly with other pleural fluid indices of inflammation: there was a positive correlation with lactate dehydrogenase activity and a negative correlation with concentrations of glucose and complement components C3 and C4. Ferritin was detected immunocytochemically only in the macrophages found among the pleural fluid cells. Our study shows that large amounts of ferritin accumulate locally in the pleural cavity in certain types of pleural inflammation. The accumulation is probably partly the result of increased local reticuloendothelial system activity. Determination of the concentration of ferritin in pleural fluid may provide corroborative information for differential diagnosis and may further our understanding of the pathogenetic events that lead to the perpetuation of inflammatory activity in pleural effusions.
7464013 [Twelve theses on the pathogenesis of primary and secondary osteoporosis based on histolog 1981 Jan 2 In spite of a well defined clinical syndrome and a wealth of biochemical information, the pathogenesis of primary osteoporosis is still uncertain. Microscopic evaluation of semithin sections of 1727 bone biopsies from patients suffering from "idiopathic" osteoporosis and 288 from patients with secondary osteoporosis has lead to the recognition of a pathogenetic relationship between changes of the bone marrow capillaries and atrophy of the trabecular bone in these groups. A new hypothesis is proposed for the structural and functional role of the bone marrow capillaries in normal and abnormal osseous remodelling; this is based on comparative morphometric analysis of normal cases and of hypo- and hyperplastic changes of the myelogenous and osseous tissues in various haematological and bone disorders. The hormonal and nervous regulation of the microcirculation of bone marrow may offer a new approach to the understanding and cure of so-called idiopathic osteoporosis.
1125359 Engineering considerations in the design of an ankle joint. 1975 May A prothesis has been designed to replace the articulating surfaces of the human ankle joint. The prothesis is in two parts, each forming a segment of a right circular cylinder with a single axis of rotation. The concave tibial component is manufactured from ultra-high molecular weight polyethylene and the talar component is manufactured from medical grade stainless steel. It is likely, however, that the talar component will be commercially manufactured from cobalt chrome alloy (Vitallium or Vinertia). The two components are secured to the cancellous bone by polymethylmethacrylate bone cement and laboratory tests have indicated that the bond should be strong enough to withstand the loads encountered at the ankle joint in vivo. The tests have also shown that the stability and strength of the ankle are not seriously reduced by implantation of the prosthesis. Laboratory wear tests and clinical experience over the last two years encourage optimism over the long term performance of the prothesis.
915644 Subcutaneous granuloma annulare("pseudorheumatoid nodule") of the eyebrow. 1977 May Subcutaneous granuloma annulare occurs either as a single or multiple lesion. When the ocular adnexa are involved, the lateral aspect of the eyelid and the lateral canthus are sites of predilection. These lesions occur chiefly in children and only rarely in adults. They have the same clinical (and histopathological) appearance as rheumatoid nodules and are, therefore, also known as "pseudorheumatoid nodules." Despite this similarity, these nodules are isolated lesions and are not related to systemic disease, including rheumatoid arthritis and rheumatic fever. The presently reported case exemplifies the characteristic clinical and pathological features of this disorder.
169719 The chemotaxis of selected cell types to connective tissue degradation products. 1975 Jun 13 Because rheumatoid inflammation is associated with the presence of large numbers of leukocytes in joint effusions, the question of whether enzymatic splitting of collagen and fibrin can lead to generation of chemotactic factors was investigated. Fibrinogen was purified from the plasma of four different species, and the homogeneity of the preparations was established by physicochemical and immunologic techniques. Fibrin was prepared and then lysed with plasmin to obtain fibrin degradation products (FDP). Similarly, purified collagenase was used to lyse collagen in vitro, and the chemotactic activity of the reaction mixtures was analyzed. The experiments presented indicate that fibrinogen, fibrin, and plasmin do not possess any intrinsic chemotactic activity. However, when fibrin was split by plasmin, FDP of human, bovine, sheep, and equine origin all proved to be strong leukotactic agents for polymorphonuclear leukocytes (PMN). Purified collagenase per se was found to be a cell type-specific chemotactic agent for PMN. Not only were collagen degradation products not chemotactic, but they also inhibited the leukotactic activity of the purified collagenase. Furthermore, this inhibition of the chemotactic activity of collagenase was independent of its enzymatic activity. The results presented suggest that there is a direct correlation between the process of fibrinolysis and the chemotactic attraction of leukocytes and between the presence of collagenase and leukotaxis. This system may serve as a model to explain the mechanisms by which cells accumulate in inflamed joints.
6178541 Beta-2-microglobulin-specific autoantibodies cause platelet aggregation and interfere with 1982 Jan The anti-platelet activity of beta-2-microglobulin (beta 2m) specific autoantibodies isolated from sera of patients with autoimmune diseases was tested in direct and ADP-induced aggregation assays. It was established that human anti-beta 2m autoantibodies and heterologous rabbit anti-beta 2m antibodies evoke a dose-dependent aggregation of human platelets. Anti-beta 2m autoantibodies also impaired ADP-induced platelet aggregation. Antibodies with anti-beta 2m activity could be desorbed from the platelets and lymphocytes of a patients with systemic lupus erythematosus who was not thrombocytopenic. The possibility that such autoantibodies may alter platelet function is considered.
3875584 Pain relief in the rheumatic and other disorders. 1985 When severe pain is present, so usually is fear. Whether the pain results from a traffic accident, a sports injury, an arthritic exacerbation or a coronary thrombosis, an explanation of what is going on carries considerable reassurance, for uncertainty and fear of the unknown aggravates and increases the pain. I remember well a frightened lady being admitted with acute dorsal backache, the pain of which was not controlled by 6-hourly injections of morphine. She feared she had metastatic malignant disease in the spine, which indeed she did have, but in a calm and reassuring atmosphere and with excellent nursing staff she was maintained only on mild sedation and simple analgesics. For some patients the knowledge that injections are given for serious conditions adds to their anxiety. The pain of metastatic malignant disease is often helped considerably by NSAIDs or simple analgesics. Almost all pains have several components and therefore different therapeutic approaches.
6112936 Brain pathology in the collagen vascular diseases. 1981 Jun Neuropathologic examination of an autopsy series of 54 patients of various types of CVD revealed a very high frequency of pathologic changes both in brain parenchyma (in 81%) and vessels (in 78%). A broad but continuous spectrum of primary vascular alterations was observed, ranging from fibrinoid deposits in intact or necrotizing vessel walls to fibrohyalinosis and endothelial proliferations. In acute SLE showing LE cells within brain tissues, immune complex deposits were observed for the first time in brain vessels, in addition to similar deposits in the plexus chorioideus and in hematoxylin bodies. Secondary complications are frequently affecting the brain in CVD; they are mainly sequels of systemic atherosclerosis, hypertension, thromboemboli from SLE endocarditis, cardiac, hepatic or renal dysfunctions, or infections and should be clinically differentiated from primary brain involvement in CVD to ensure the appropriate therapeutic measures.
955893 [Multiple subcutaneous Trichophyton rubrum abscesses. Pathomorphosis of a generalized supe 1976 Jul A patient with chronic polyarthritis is reported who was treated with corticosteroids over several years and also received azathioprine. The patient developed extensive tinea pedum and corporis which was suddenly complicated by multiple subcutaneous abscesses caused by the same organism, Trichophyton rubrum. This type of dermatophytosis has only rarely been described. It shares some characteristics with the maladie dermatophytique of Hadida and Schousboe. Chronic granulomatous dermatophytoses such as granuloma trichophyticum Majocchi or tinea granulomatosa nodularis cruris or acute suppurative dermatophytoses of the kerion Celsi type present different clinical and histological pictures and develop under different pathogenetic conditions.
6426054 Comparison of oral and parenteral gold therapy and placebo in the treatment of rheumatoid 1983 Two hundred and eight patients entered a prospective, controlled, double-blind multicenter trial comparing auranofin, gold sodium thiomalate (GST), and placebo. One hundred and sixty-one patients completed at least 20 weeks of therapy. No remissions were seen in the trial. Response to a variety of measures of efficacy was generally modest for both gold treatment groups. There was statistically significant improvement with both gold preparations compared to placebo for the number of tender joints, the joint tenderness score, and physician assessment of disease severity. GST was also significantly better than placebo for the joint swelling score. GST demonstrated statistical improvement in patients with anaemia and thrombocytosis compared to the other treatment groups and both gold preparations were statistically superior to placebo in improvement of an elevated erythrocyte sedimentation rate. Approximately 25% of patients on GST were withdrawn from the study for adverse drug reaction with rash and stomatitis being the predominant reaction. Only 6% of patients on auranofin were withdrawn for untoward drug effect. The two gold preparations were similar in efficacy although auranofin was better tolerated.
6610527 Myositis in other connective tissue disorders. 1984 Apr The clinical features, laboratory tests, EMG and muscle biopsy findings are notably similar in many patients with primary and overlap polymyositis. Studies of the immunological abnormalities and immunopathology in both types of inflammatory skeletal muscle conditions are closely related. Thus, there can be little doubt that both primary and overlap myositis are part of the spectrum of autoimmune rheumatic disease. With the recent introduction of monoclonal antibodies that are capable of defining more precisely the cells in a myositis infiltrate, and the development of more refined in vitro tests to study effector cell populations, the precise mechanisms that cause muscle damage are much closer to being identified.
6602425 [Neopterin, a new biochemical marker for the detection of activated T lymphocytes]. 1983 Mar 4 In this review evidence is summarized indicating that the pteridine compound, neopterin represents a new and clinically useful biochemical tool to detect activated T-lymphocytes. T-cells stimulated in vivo or in vitro by allogeneic or virally or chemically modified autologous cells produce large amounts of this molecule. Other mononuclear blood cells, in contrast, lack this capacity. These findings suggested that evaluation of neopterin levels might represent a means for the biochemical monitoring of disease states mediated by or associated with activated T-cells. Our clinical data obtained on patients suffering from allograft rejection, viral disease, or autoimmune states strongly support this concept.
7346043 Septic and aseptic olecranon bursitis in patients on maintenance hemodialysis. 1981 Over a period of four years, seven of 110 maintenance hemodialysis patients developed olecranon bursitis. In all patients it appeared in the arm on which AV access was constructed but one patient also had bilateral bursitis. None of the patients gave a history of trauma or gout. Despite similar clinical presentation, culture of bursal aspirate demonstrated septic bursitis in two patients. (One diabetic, the other on steroids). Sustained pressure on the olecranon bursa during maintenance hemodialysis and/or milk trauma in the anticoagulated state may be responsible for the lesion. Infection can occur in susceptible individuals despite no visible skin infection. Local steroid instillation and patient education to avoid putting pressure on bursa during dialysis was effective therapy in the aseptic group. Multiple aspirations and antibiotics were necessary in the septic group.
433584 Total hip replacement with a trunnion bearing prosthesis. Biomechanical principles and pre 1979 Apr The biomechanics are presented of a bushing principle forming the basis for a trunnion bearing prosthesis in total hip replacement. The femoral stem is equipped with a trunnion on to which a cylindrical plastic sleeve is applied. On top of this a metal casing is placed which forms the femoral head. On flexion-extension this remains stationary in the acetabular cup and motion occurs between the trunnion and the cylindrical sleeve. Friction between head and cup is reduced to a minimum, decreasing the risk of loosening. A follow-up study of 61 hips replaced by the trunnion bearing prosthesis was performed 2.5 years postoperatively. Eighty-eight per cent were considerably improved. There was one deep infection and two femoral stem loosenings.
887896 [Hydroxyapatite rheumatism (multiple tendon calcification disease). II. - Microscopic stud 1977 May Optical and electron microscopic studies of the articular fluid in multiple calcification disease reveals the existence of rounded intra- and extracellular crystalline formations. These crystalline formations of calcium and phosphorus are made up of accumulations of tiny crystals shaped like fine needles 200 nm X 15-20 nm and are highly suggestive of hydroxyapatite. Crystals injected into the plantar pads of rats or the knees of rabbits induce an acute inflammatory reaction maximal at 5 hours and recovering in 24 72 hours. Hydroxyapatite crystals are swiftly dissolved in serum and more rapidly still when cells are present. Their dissolution releases calcium into the surrounding area. HLA typing of patients with multiple tendinous calcification (28 cases) or single tendinous calcification (10 cases) shows an increased frequency of HLA A2 and BW 35 in comparison with controls.
1124954 Virus antibodies in serum and synovial fluid of patients with rheumatoid arthritis and oth 1975 Feb Rubella and influenza A (H3N2) haemagglutination inhibition (HI) antibody titres and measles complement-fixing (CF), haemagglutination inhibition (HI), haemolysis inhibition (HLI), and ribonucleoprotein gel precipitation (RNP-GP) antibody titres were studied in the serum and synovial fluid of twenty patients with rheumatoid arthritis (RA), two patients with ankylosing spondylitis, and two patients with Reiter's syndrome. Antibody titres were also studied in the serum and CSF of four patients with systemic lupus erythematosus (SLE), one patient with dermatomyositis, and in the synovial fluid only of five patients with osteoarthritic knee effusions. Antibodies were found with each serological technique used in the synovial fluid of RA patients and the antibody titres were usually at about the same level as in the serum. The mean measles (HI, HLI, and RNP-GP) antibody titres were 4 to 6 times higher in the synovial fluid of RA patients than in synovial fluid of patients with osteoarthritic knee effusions, but a corresponding difference was not found in rubella and influenza A antibody titres. The mean measles antibody titres (CF, HI, HKI, and RNP-GP) were consistently higher in the synovial fluid of RA patients without rheumatoid factor than in the synovial fluid of RA patients with rheumatoid factor. In serum this difference was observed only with measles CF titres. The mean measles, antibody titres were consistently lower in the serum and synovial fluid of the RA patients without the synovial fluid haemolytic complement than in the RA patients with this haemolytic complement. No similar differences were found in the rubella and influenza antibody titres. No significant measles antibody titres were found in the CSF of patients with SLE or dermatomyositis.
6772422 Diclofenac sodium: a review of its pharmacological properties and therapeutic use in rheum 1980 Jul Diclofenac sodium, a phenylacetic acid derivative, is a non-steroidal, anti-inflammatory, analgesic agent advocated for use in rheumatoid arthritis, degenerative joint disease, ankylosing spondylitis and allied conditions, and in the treatment of pain resulting from minor surgery, trauma and dysmenorrhoea. Published data indicate that diclofenac 75 to 150mg daily (25 to 50mg 3 times daily) is comparable in efficacy with ordinary aspirin 3 to 5g daily and indomethacin 75 to 150mg daily in rheumatoid arthritis and with indomethacin in osteoarthritis. Available data suggest that in patients with osteoarthritis diclofenac sodium is comparable in efficacy and tolerability with naproxen, ibuprofen, sulindac and diflunisal. As oral diclofenac is generally given in 3 divided daily doses it may be at a disadvantage relative to less frequent administration with naproxen, diflunisal and sulindac in rheumatoid arthritis, although there is some evidence of diclofenac's efficacy when administered twice daily, or once daily as a slow release tablet. The drug is also available as suppositories and ampoules for intramuscular injection. No one of the non-steroidal anti-inflammatory agents is the most suitable drug for all patients requiring such therapy, and diclofenac should be considered along with other drugs of its type in the arthritic patient.
4441864 Possible role of laxatives in analgesic nephropathy. 1974 Dec 21 Eight out of ten of patients with analgesic nephropathy were regular and usually heavy laxative takers compared with 12 out of 200 controls from the general population and four out of 70 patients attending a renal clinic. The finding that regular laxative taking was greatly increased in patients with analgesic nephropathy suggests that this condition may often be due to the combined abuse of both laxatives and analgesics. In a series of 40 patients with rheumatoid arthritis all were found to have normal renal function and no patient took laxatives regularly. This finding would explain why analgesic nephropathy is so uncommon in patients with rheumatoid arthritis despite the fact that they are regular and heavy analgesic takers.
1084750 Identification of antibodies to nuclear acidic antigens by counterimmunoelectrophoresis. 1976 May Saline extracts of rabbit thymus were found to contain many nuclear antigens that reacted with antibodies in the sera of patients with systemic rheumatic diseases. Counterimmunoelectrophoresis (CIE) was used to detect antibodies to nuclear acidic protein (Sm), nuclear ribonucleoprotein (RNP), and antibody to nuclear antigen B, which was reported previously in Sjögren's syndrome. All these nuclear antigens behaved as anions with different mobilities in CIE and could be distinguished from one another by the locations of the precipitin lines. They could also be distinguished by the facts that the nuclear RNP precipitin lines were abolished by digestion with ribonuclease whereas others were unaffected, and that Sm precipitin lines developed later than other precipitin lines. With this technique antibody to nuclear RNP was detected in 46% of patients with systemic lupus erythematosus (SLE) compared to 26% detected by the hemagglutination technique. Similarly the increased sensitivity of the CIE technique was able to show that antibody to B antigen was present in 12% of SLE patients, whereas this antibody was not detectable in the same group of patients by immunodiffusion. This study shows that CIE is a rapid and sensitive technique for detecting precipitating antibodies to a number of nuclear acidic antigens. Methods are described to identify the immunochemical specificities of the precipitin lines by the use of standard reference sera.
6607159 Factors determining efficacy of NSAIDs. 1984 Jan This article reviews the efficacy of NSAIDs and their pharmacokinetic and pharmacodynamic properties. The assumption that classic pharmacokinetic dose/plasma concentration response relationships can be applied to NSAIDs has tenuous support in the biomedical literature. Comparative efficacy studies, using ASA and indomethacin as the standards for comparison, ignore the fact that the major outcome variables are subjective responses among patients, not among drugs. Comparing inhibition of platelet malonyldialdehyde, synovial drug concentrations, urinary prostaglandin metabolites, and plasma free and total concentration with the clinical outcome provides no guidelines to serve as predictors of response. The individual agents, indomethacin, salicylates, sulindac, piroxicam, and naproxen, illustrate the complexities of NSAID pharmacotherapy. Recent proliferation of newer NSAIDs will not add significantly to the efficacy of these agents in the treatment of pain and inflammatory disease states. However, knowledge of pharmacokinetic population parameters for the individual NSAIDs will increase the likelihood of therapeutic success and diminish the possibilities for adverse reactions.