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

ID PMID Title PublicationDate abstract
22698185 Role of lymphoid chemokines in the development of functional ectopic lymphoid structures i 2012 Jul 30 A sizeable subset of patients with the two most common organ-specific rheumatic autoimmune diseases, rheumatoid arthritis (RA) and Sjögren's syndrome (SS) develop ectopic lymphoid structures (ELS) in the synovial tissue and salivary glands, respectively. These structures are characterized by perivascular (RA) and periductal (SS) clusters of T and B lymphocytes, differentiation of high endothelial venules and networks of stromal follicular dendritic cells (FDC). Accumulated evidence from other and our group demonstrated that the formation and maintenance of ELS in these chronic inflammatory conditions is critically dependent on the ectopic expression of lymphotoxins (LT) and lymphoid chemokines CXCL13, CCL19, CCL21 and CXCL12. In this review we discuss recent advances highlighting the cellular and molecular mechanisms, which regulate the formation of ELS in RA and SS, with particular emphasis on the role of lymphoid chemokines. In particular, we shall focus on the evidence that in the inflammatory microenvironment of the RA synovium and SS salivary glands, several cell types, including resident epithelial, stromal and endothelial cells as well as different subsets of infiltrating immune cells, have been shown to be capable of producing lymphoid chemokines. Finally, we summarize accumulating data supporting the conclusion that ELS in RA and SS represent functional niches for B cells to undergo affinity maturation, clonal selection and differentiation into plasma cells autoreactive against disease-specific antigens, thus contributing to humoral autoimmunity over and above that of secondary lymphoid organs.
20981317 Suppression of ongoing experimental arthritis by a chinese herbal formula (huo-luo-xiao-li 2011 Rheumatoid arthritis (RA) is one of the major autoimmune diseases of global prevalence. The use of the anti-inflammatory drugs for the treatment of RA is associated with severe adverse reactions and toxicity. This limitation has necessitated the search for novel therapeutic products. We report here a traditional Chinese medicine-based herbal formula, Huo luo xiao ling dan (HLXL), which has potent antiarthritic activity as validated in the rat adjuvant-induced arthritis (AA) model. HLXL (2.3 g/Kg) was fed to Lewis (RT.1(1)) rats daily by gavage beginning at the onset of arthritis and then continued through the observation period. HLXL inhibited the severity of ongoing AA. This suppression of arthritis was associated with significant alterations in the T cell proliferative and cytokine responses as well as the antibody response against the disease-related antigen, mycobacterial heat-shock protein 65 (Bhsp65). There was a reduction in the level of the proinflammatory cytokines IL-17 and IL-1β but enhancement of the anti-inflammatory cytokine IL-10 level. In addition, there was inhibition of both the anti-Bhsp65 antibody response and the serum level of nitric oxide. Thus, HLXL is a promising CAM modality for further testing in RA patients.
22951879 What to take from TREAT? 2012 Sep The TREAT Registry is an updated submission of the 5-year follow-up of Crohn's disease patients from community and academic centers in North America treated with or without infliximab. Over 6,000 patients were followed for risks of mortality and serious infections. Similar to data presented after nearly 2 years of follow-up, mortality was similar for infliximab- and other-treatment-only patients. Infliximab, corticosteroids and narcotics were associated with increased risks of serious infections. Data presented is similar from data reported for controlled trials and observational series in patients with inflammatory bowel disease and rheumatoid arthritis.
22916313 A Case of Palmoplantar Pustulosis Induced by Certolizumab Pegol: New Anti-TNF-alpha Demons 2012 Aug The development of de novo psoriasis in patients treated with tumor necrosis factor-alpha antagonists is well recognized. The authors hereby report a case of palmplantar pustular psoriasis in a patient with rheumatoid arthritis treated with etanercept. The condition responded to topical steroids but re-occurred upon treating the patient with certolizumab pegol. This strongly suggests that the development of de novo psoriasis is a class effect.
22911435 [In-vitro study on dissection of inflamed synovial tissue by hydro-jet cutting]. 2012 Oct Surgical synovectomy is a useful therapeutic option for rheumatoid arthritis patients with ongoing active synovitis despite optimal medical therapy. The present experimental study evaluated the novel, minimally invasive surgical technique of hydro-jet cutting in vitro using synovial biopsies. Depending on the selected water pressure (30-100 bar) it is possible to achieve precise and selective dissection of the synovial membrane. It was found that application of a water jet at 60 bar for 15 s is ideal for dissecting the stratum synoviale from the stratum fibrosum without any alteration of the joint capsule. This finding was confirmed by histological analyses. This novel and precise dissection technique promises to be an excellent alternative to the established techniques of synovectomy in the near future.
22900250 Closed sagittal band injury due to low energy trauma. 2012 Aug Sagittal band injury is a relatively common cause of extensor tendon subluxation caused by inflammatory disease or high-energy trauma. However, there are few reports in the literature describing sagittal band injury due to low energy trauma. In this report, we describe successful nonsurgical management of a closed sagittal band injury and extensor tendon subluxation associated with low-energy trauma. Patients in 2 cases had no rheumatoid arthritis or history of inflammatory diseases. Conservative treatment resulted in relief of symptoms and corrected the instabilities with no complications.
22745918 Formulation and in vitro evaluation of ufasomes for dermal administration of methotrexate. 2012 Dermal drug delivery system that is required to localizes methotrexate (MTX) in the synovial joint is needed to treat inflammation in rheumatoid arthritis (RA). The present investigation aims at exploring the potential of fatty acid vesicles for the topical delivery of methotrexate. Vesicles were prepared by film hydration method using oleic acid as a fatty acid principal component. Developed vesicles were characterized for size, size distribution, shape, in vitro release, pH dependent, and storage stability. Interaction between MTX and oleic acid was investigated using differential scanning calorimetry. The MTX amount permeated through rat skin was three- to fourfold higher using oleic acid compared to those from plain drug solution or carbopol gel. At the end of the skin permeation assay using ufasomes, up to 50% of the administered dose was found in the skin. These results suggest that methotrexate encapsulated in oleic acid vesicles may be of value for the topical administration of MTX in the treatment of psoriasis.
22550565 Methotrexate induced lung injury in a patient with primary CNS lymphoma: a case report. 2012 Methotrexate is an antimetabolite commonly used in clinical practice for a variety of indications ranging from rheumatoid arthritis and other connective tissue disorders to high dose regimens in many malignancies. This folate antagonist has got a spectrum of toxicities among which gastrointestinal effects predominate. Lung injury is a well described but rare event and has been reported most often in patients who have been on long term oral therapy for rheumatic disorders. Acute lung injury in a patient receiving a high dose regimen for haematological malignancies has not been reported previously. We present one such case of methotrexate related acute lung injury in a patient of primary CNS lymphoma receiving high dose methotrexate.
22403586 Kinase inhibitors in the treatment of immune-mediated disease. 2012 Protein kinases are fundamental components of diverse signaling pathways, including immune cells. Their essential functions have made them effective therapeutic targets. Initially, the expectation was that a high degree of selectivity would be critical; however, with time, the use of "multikinase" inhibitors has expanded. Moreover, the spectrum of diseases in which kinase inhibitors are used has also expanded to include not only malignancies but also immune-mediated diseases. At present, thirteen kinase inhibitors have been approved in the United States, all for oncologic indications. However, there are a growing number of molecules, including several Janus kinase inhibitors, that are being tested in clinical trials for autoimmune diseases such as rheumatoid arthritis, psoriasis and inflammatory bowel diseases. It appears likely that this new class of immunomodulatory drugs will have a major impact on the treatment of immune-mediated diseases in the near future.
22352284 [Medical cannabis: the opportunity versus the temptation]. 2011 Dec The cannabis plant has been known to humanity for centuries as a remedy for pain, diarrhea, and inflammation. Current research has shown cannabis to be a useful remedy for many diseases, including multiple sclerosis, dystonia, and chronic pain. Cannabinoids are used to improve food intake in anorexia of AIDS patients and to prevent vomiting due to cancer chemotherapy. In inflammatory conditions cannabinoids improve pain in rheumatoid arthritis and pain and diarrhea in Crohn's disease. Cannabinoids reduce the size of brain infarct and cardiac reperfusion injury. However, cannabinoid treatment is not free of side effects including euphoria, psychosis, anxiety, paranoia, dependence and abuse. Since the cannabinoid system is involved in many physiological and pathological processes, the therapeutic potential is great. We must not be blind to the opportunity offered to us by medical cannabis just because it is an illicit drug, nor should we be temped by the quick response of patients to the central effect of cannabis. More research is warranted to explore the full potential of cannabis as medicine.
22334973 A young female patient of neuromyelitis optica presenting with hypocalcemic tetany. 2011 Sep Neuromyelitis optica, a variant of multiple sclerosis, presenting with hypocalcemic tetany is an unusual presentation. We report here a case of 25 years old female who was a case of neuromyelitis optica and had hypocalcemic tetany as the initial presentation among others. The case is interesting in that the hypocalcemic tetany was not coincidental. The patient had low vitamin D status and probably, this was correlated etiologically to neuromyelitis optica. Vitamin D has immunomodulatory effect and low vitamin D status has been implicated in the etiology of autoimmune diseases such as multiple sclerosis, rheumatoid arthritis, insulin-dependent diabetes mellitus, and inflammatory bowel disease.
22265266 Molecular serum and urine marker repertoire supporting clinical research on joint diseases 2011 Dec The need for improved analytical techniques in the study of slow, degenerative diseases such as rheumatoid arthritis and osteoarthritis has driven major efforts aimed at identifying biochemical markers of pathological processes in both diseases. A series of novel biochemical markers has surfaced and their careful validation has become a critical requirement for further use in clinical research. This report aims at providing a critical review of biochemical markers applied in clinical research of joint diseases, in particular those markers reflecting the turnover of cartilage tissue.
21985356 Anti-inflammatory activity of Gentiana striata Maxim. 2012 The anti-inflammatory activity and the mechanism of action of Gentiana striata Maxim. has been investigated. The most active phase, the ethyl acetate extract of Gentiana striata Maxim. (EGS), displayed potent inhibitory activity on feet oedema of rheumatoid arthritis (RA) inflicted rats. This anti-inflammatory activity might be partly based on the notable reduction of prostaglandin E2 (PGEâ‚‚) and nitric oxide (NO) levels. Six further compounds isolated from EGS have previously been reported as having anti-inflammatory activity.
21760804 Targeting Nuclear Hormone Receptors: PPARα Agonists as Potential Disease-Modifying Drugs 2011 In recent years, peroxisome proliferator-activated receptors (PPARs) have received growing interest due to the broad spectrum of their biological activities. PPARα, an isoform of PPAR, plays an important role in lipid homeostasis and inflammation, which makes it a potential target for the treatment of chronic inflammatory disorders, including RA. This paper reviews studies on the properties of PPARα agonists which may be pertinent to the treatment of RA. These properties include effects on lipid metabolism, inflammation, and angiogenesis, as well as interference with glucocorticoid effects, and a potential role in gender dimorphism of autoimmune disorders. However, current clinical experience with this class of drugs in RA is limited. New studies are needed to elucidate whether PPARα agonism may be an effective treatment strategy for RA patients.
21228730 Annual drug update: 2010 in review. 2011 Feb In 2010, the FDA approved several new drugs and new indications for use in primary care. From new therapies for adults with rheumatoid arthritis to a combination drug for benign prostatic hyperplasia, NPs need to be aware of the latest medications now available.
26894028 A case of membranous nephropathy associated with relapsing polychondritis. 2012 Dec Relapsing polychondritis (RP) is a rare, chronic, and potentially fatal multisystemic inflammatory disorder targeting cartilaginous structures. This disorder is frequently associated with rheumatoid arthritis, systemic vasculitis, connective tissue diseases, and hematologic disorders, but renal involvement is unusual. In the literature, associated renal pathology includes mesangial expansion, IgA nephropathy, tubulointerstitial nephritis, and segmental necrotizing crescentic glomerulonephritis. We report a case of a 49-year-old male found to have RP and nephrotic syndrome, with confirmed membranous nephropathy on kidney biopsy. He responded well to corticosteroids and cyclosporine. This is the first case of renal associated RP confirmed by renal biopsy in Korea. Membranous nephropathy associated with RP has never before been reported.
23138556 [Prosthesis loosening]. 2012 Nov Prosthesis loosening is becoming more and more important due to increasing numbers of primary arthroplasty. Especially in patients suffering from rheumatoid arthritis this is a major topic due to younger age and multiple affected joints. A carefully performed diagnostic regimen is essential for ruling out septic loosening of the prosthesis. Preoperative planning is crucial for revision surgery. Revision implants should be available as back-up. Revision arthroplasty is a technically and economically demanding procedure. Costs for revision surgery are much higher than for primary arthroplasty due to longer hospital stay, intensive care, microbiology, histology, diagnostic imaging, implants and antibiotics. Revision arthroplasty should be performed in highly specialized centers.
22368703 Pulmonary manifestations of systemic autoimmune diseases. 2011 Jul Systemic autoimmune diseases (SAD) are a heterogeneous group of immunologically mediated inflammatory disorders including multiorgan involvement. As expected in a multisystem disease, the entire pulmonary system is vulnerable to injury. Any of its compartments may be independently or simultaneously affected. It is difficult to assess the true prevalence of lung disease in cases of SAD. In this article, we will review the pulmonary manifestations caused by systemic lupus erithematosus, rheumatoid arthritis, systemic sclerosis, polymyositis/dermatomyositis, Sjögren's syndrome, mixed connective tissue disease, Wegener's granulomatosis, Churg-Strauss syndrome, Goodpasture's syndrome, and ankylosing spondylitis.
23646452 [Connective tissue diseases during pregnancy - therapeutic aspect. Part 2: the other conne 2012 Pregnancy in women with connective tissue diseases is classified as a high risk pregnancy. Therefore, a proper treatment which is safe both for mother and child, arouses a problem. The second part of the article presents main pregnancy complications among women with systemic sclerosis, rheumatoid arthritis, ankylosing spondylitis and dermatomyositis. General groups of medications are discussed, which are most frequently used in treatment of pregnant women with connective tissue diseases. Furthermore, the article presents treatment schedule which obtained the United States Food and Drug Administration (FDA) recommendation. Nowadays, advancing technology and treatment improved outcomes in connective tissue diseases pregnancies.
22191024 The prevalence of fibromyalgia in other chronic pain conditions. 2012 Central sensitivity syndromes (CSS) include fibromyalgia syndrome (FMS), irritable bowel syndrome, temporomandibular disorder, restless legs syndrome, chronic fatigue syndrome, and other similar chronic painful conditions that are based on central sensitization (CS). CSS are mutually associated. In this paper, prevalence of FMS among other members of CSS has been described. An important recent recognition is an increased prevalence of FMS in other chronic pain conditions with structural pathology, for example, rheumatoid arthritis, systemic lupus, ankylosing spondylitis, osteoarthritis, diabetes mellitus, and inflammatory bowel disease. Diagnosis and proper management of FMS among these diseases are of crucial importance so that unwarranted use of such medications as corticosteroids can be avoided, since FMS often occurs when RA or SLE is relatively mild.