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ID PMID Title PublicationDate abstract
21208397 Sex differences in autoimmune diseases. 2011 Jan 4 Women are more susceptible to a variety of autoimmune diseases including systemic lupus erythematosus (SLE), multiple sclerosis (MS), primary biliary cirrhosis, rheumatoid arthritis and Hashimoto's thyroiditis. This increased susceptibility in females compared to males is also present in animal models of autoimmune diseases such as spontaneous SLE in (NZBxNZW)F1 and NZM.2328 mice, experimental autoimmune encephalomyelitis (EAE) in SJL mice, thyroiditis, Sjogren's syndrome in MRL/Mp-lpr/lpr mice and diabetes in non-obese diabetic mice. Indeed, being female confers a greater risk of developing these diseases than any single genetic or environmental risk factor discovered to date. Understanding how the state of being female so profoundly affects autoimmune disease susceptibility would accomplish two major goals. First, it would lead to an insight into the major pathways of disease pathogenesis and, secondly, it would likely lead to novel treatments which would disrupt such pathways.
20850425 IL-7 and lymphopenia. 2011 Jan 14 Interleukin-7 (IL-7) is a growth and anti-apoptotic factor for T-lymphocytes, with potential for clinical use in the treatment of immunodeficiencies due to loss of T-cells. Lymphopenia induced by disease (HIV infection, hemodialysis or Idiopathic CD4+ lymphopenia) or by treatment (high dose chemotherapy or depleting antibodies) for cancer or auto-immune diseases results in increased circulating levels of IL-7 which decline with T-cell recovery, however, the mechanism of such response remains to be elucidated. Furthermore, IL-7 is a major player in the regulation of peripheral T-cell homeostasis and as such is an important candidate cytokine for therapy aimed at improving T-cell reconstitution following lymphopenia. Anti- IL-7 is on the other hand proposed to treat conditions where IL-7 may play a more direct role in pathogenesis such as autoimmune disease like Rheumatoid Arthritis, Multiple Sclerosis or Inflammatory Bowel disease.
20528967 Palisaded neutrophilic and granulomatous dermatitis in association with sarcoidosis. 2011 Apr Palisaded and neutrophilic granulomatous dermatitis (PNGD) has been associated with many conditions including rheumatoid arthritis, systemic lupus erythematosus, systemic vasculitis, and other diseases with circulating immune complexes. Lymphoproliferative conditions, bacterial endocarditis, and various drugs can also induce this condition. Many patients also have symmetric polyarthritis with various serological abnormalities. We present a case of a 46-year-old female who presented with painful erythematous annular plaques and nodules on her legs. The lesions started a week prior to visit and increased in number over the course of the week. The patient had an established history of sarcoidosis with past episodes of uveitis and erythema nodosum. The histopathological findings included a diffuse pandermal infiltrate mostly composed of neutrophils, nuclear debris, and strands of deeply eosinophilic degenerated collagen. Vasculitis was not present. No significant increase in dermal mucin was detected. Based on the clinical and pathological findings, the patient was diagnosed with late-stage PNGD. To our knowledge, this is the first case of PNGD described in an adult patient of sarcoidosis.
23197948 Thyroid storm masked by hemodialysis and glucocorticoid therapy in a patient with rheumato 2012 Jan Thyroid function test values are generally at low levels in patients with end-stage kidney disease. Life-threatening thyrotoxicosis or thyroid storm is rare, especially in hemodialysis (HD) patients, and is characterized by multisystem involvement and a high mortality rate if not immediately recognized and treated. Here, we report a female patient with severe symptomatic thyroid storm, receiving long-term HD and glucocorticoid therapy. Methimazole at a dose of 15 mg per day, β-adrenergic blockade and HD succeeded in controlling the patient's condition by gradually adjusting the target dry weight for hyperthyroidism-induced weight loss. When she was discharged from the hospital, her dry weight was reduced from 47.2 to 39.2 kg. The management of patients with severe symptomatic thyroid storm on HD represents a rare scenario. It is essential to initiate the available treatments as early as possible to reduce its mortality.
23119182 Cardiac manifestations of rheumatological conditions: a narrative review. 2012 Cardiovascular diseases are common in systemic rheumatologic diseases. They can be presented at the time of diagnosis or after diagnosis. The cardiac involvements can be the first presentation of rheumatologic conditions. It means that a patient with rheumatologic disease may go to a cardiologist when attacked by this disease at first. These manifestations are very different and involve different structures of the heart, and they can cause mortality and morbidity of patients with rheumatologic diseases. Cardiac involvements in these patients vary from subclinical to severe manifestations. They may need aggressive immunosuppressive therapy. The diagnosis of these conditions is very important for choosing the best treatment. Premature atherosclerosis and ischemic heart disease are increased in rheumatoid arthritis and systemic lupus erythematosus, and may be causes of mortality among them. The aggressive control of systemic inflammation in these diseases can reduce the risk of cardiovascular disease especially ischemic heart disease. Although aggressive treatment of primary rheumatologic diseases can decrease mortality rate and improve them, at this time, there are no specific guidelines and recommendations, to include aggressive control and prevention of traditional risk factors, for them.
23089837 [Expansion of sensitivity area for magnetic resonance imaging of the hand using parallel-a 2012 It is difficult for Rheumatoid Arthritis (RA) patients to remain in a strenuous position for a long time during examinations. The field of view (FOV): 250 mm is needed for hand examinations from the wrist to the finger. Two channel phased array coils are effective to use when examinations of the 'off center' are taken for the upper and lower extremities. The area of the array coils' sensitivity can be expanded by shifting both coil elements 40-60% in the opposite direction of the element's diameter. This method is given credibility due to the increased signal-to-noise ratio (SNR) in the peripheral regions (shifted directions), but loses value in the central area, as indicated by the decrease in SNR. This was confirmed in the image of the hand using visual assessment including the fat suppression technique. It was verified that the sensitivity area was expanded using Scheffe's method of paired comparison (Ura's modified method). An application at the other regions of the body can be expected to be used in the case of using parallel positioned coils during clinical situation.
23063073 The leukotrienes: immune-modulating lipid mediators of disease. 2012 The leukotrienes are important lipid mediators with immune modulatory and proinflammatory properties. Classical bioactions of leukotrienes include chemotaxis, endothelial adherence, and activation of leukocytes, chemokine production, as well as contraction of smooth muscles in the microcirculation and respiratory tract. When formed in excess, these compounds play a pathogenic role in several acute and chronic inflammatory diseases, such as asthma, rheumatoid arthritis, and inflammatory bowel disease. An increasing number of diseases have been linked to inflammation implicating the leukotrienes as potential mediators. For example, recent investigations using genetic, morphological, and biochemical approaches have pointed to the involvement of leukotrienes in cardiovascular diseases including atherosclerosis, myocardial infarction, stroke, and abdominal aortic aneurysm. Moreover, new insights have changed our previous notion of leukotrienes as mediators of inflammatory reactions to molecules that can fine-tune the innate and adaptive immune response. Here, we review the most recent understanding of the leukotriene cascade with emphasis on recently identified roles in immune reactions and pathophysiology.
22927860 Bardet-Biedl Syndrome, Crohn Disease, Primary Sclerosing Cholangitis, and Autoantibody Pos 2012 Bardet-Biedel syndrome (BBS) is a rare autosomal recessive, genetically heterogeneous ciliopathy. Although the disease has been described in a patient with psoriasis, individuals with BBS are not known to be at risk of developing autoimmune disorders. Our objective was to describe a 14-year-old patient with BBS who presented with Crohn disease (CD), primary sclerosing cholangitis (PSC), and thyroiditis in the context of a cohort review at Sainte-Justine Hospital and to alert clinicians to the increased risk of autoimmune disorders in these patients. The cohort contained fifteen patients (9 boys), followed from 1968 to 2009 during a median period of 12 years (range 9 months-26 years). Three of the 15 patients (20%) developed a chronic autoimmune disease: one had juvenile rheumatoid arthritis; a second one had type 1 diabetes mellitus in association with Hashimoto thyroiditis and psoriasis; a third one developed CD, PSC, and Hashimoto thyroiditis. As chronic autoimmune diseases occurred in 20% of our cohort of children with BBS, it is appropriate to keep this association in mind during the followup.
22878344 Interleukin-32: a predominantly intracellular proinflammatory mediator that controls cell 2012 Nov In this review, we will discuss the current knowledge on IL-32 and provide new insights regarding the biological function of IL-32. IL-32 is seen as a cytokine that can induce a range of proinflammatory mediators and contribute to autoimmune diseases, such as rheumatoid arthritis, however present knowledge demonstrates that IL-32 is not a classical cytokine. We present the history of this cytokine, the role of IL-32 in several diseases and discuss a possible novel role of intracellular IL-32 in cell homeostasis. Taken into account the observed biological functions of IL-32, it may belong to a class of cytokines, like IL-1α, IL-33, and IL-37, with both intracellular and extracellular functions.
22772884 [Physiotherapy and ergotherapy are indispensable. Concrete prescription of remedies - with 2012 Jul Physical therapy and occupational therapy are essential for the treatment of inflammatory rheumatic diseases equal in rank to any drug therapy. They have enough evidence and are part of all current guidelines even if mostly not specified. In the German social security system the doctor prescribing physical therapy or occupational therapy has to act according to the different rules and forms as described in the current "Heilmittel Richtlinie" (Remedy directive) effective since July 2011. The multiple formal conditions and requirements of prescriptions are described in detail. Of special interest is that the global diagnosis of rheumatoid arthritis can no longer be used as the reason or justification for the individual prescription but detailed sub-diagnoses, regarding the essential ICF domains of structural damage, functional impairment, activity limitation and participation restriction as well as individual context factors are necessary. Of special interest is the fact that the prescribing doctor is no longer responsible for the formal correctness of prescriptions but the performing therapist, who will not be reimbursed if the prescription shows even minor formal errors. Another important improvement is the newly introduced long-term prescription of physical and occupational therapy. This facilitates the application of these therapies in the multimodal treatment regimen of rheumatic diseases.
22706298 Listeria septicaemia following insertion of a dynamic hip screw: A case report and literat 2012 INTRODUCTION: Listeria monocytogenes is a food borne bacterial pathogen which is rarely encountered in the United Kingdom. This rare and potentially life threatening infection has a high mortality rate and therefore requires early antimicrobial intervention. PRESENTATION OF CASE: A case report of a patient who developed Listeria septicaemia following insertion of a dynamic hip screw is described. This 84 year old immunocompromised lady had a mechanical fall at home, from which she sustained a left neck of femur fracture. She had a background of rheumatoid arthritis, and for the last 10 years had been taking 5mg prednisolone daily. After early surgical intervention with a dynamic hip screw, she developed Listeria septicaemia, following which she was treated successfully with ampicillin and gentamicin. DISCUSSION: Infection with unusual pathogens is not uncommon amongst immunocompromised patients. Regardless of the cause, this cohort of patients' requires increased post operative surveillance to ensure that such a complication does not go unnoticed. CONCLUSION: This case report demonstrates the importance of having a low threshold for investigation in immunocompromised patients whilst also stressing the significance of early diagnosis and intervention.
22423182 Role of notch signaling in osteoimmunology--from the standpoint of osteoclast differentiat 2013 Apr The Notch signaling pathway is a highly conserved cell signaling system present in most multicellular organisms. Osteoimmunology comprises the interplay between the immune system and bone metabolism. Osteoclasts, cells that resorb bone, play a crucial role in bone metabolism. In this review, we discuss the role of Notch signaling in osteoimmunology that is crucial for physiological bone remodeling (such as in orthodontic tooth movement, where bone remodeling is in balance) and undue non-physiological Notch signaling which results in pathological bone remodeling (such as in rheumatoid arthritis and periodontitis, where bone remodeling is out of balance) from the point view of osteoclast differentiation. A proposal is made that Notch signaling not only controls immune system reaction but also interferes with osteoclast differentiation involved in the bone remodeling process. Therefore, Notch signaling could be a promising therapeutic target at conditions that cross link the immune system with the skeletal system.
22257920 [A short history of anti-rheumatic therapy--VII. Biological agents]. 2011 Nov 9 The introduction of biological agents has been a major turning-point in the treatment of rheumatic diseases, particularly in rheumatoid arthritis. This review describes the principle milestones that have led, through the knowledge of the structure and functions of nucleic acids, to the development of production techniques of the three major families of biological agents: proteins, monoclonal antibodies and fusion proteins. A brief history has also been traced of the cytokines most involved in the pathogenesis of inflammatory rheumatic diseases (IL-1 and TNF) and the steps which have led to the use of the main biological drugs in rheumatology: anakinra, infliximab, adalimumab, etanercept and rituximab.
22096324 Feverfew (Tanacetum parthenium L.): A systematic review. 2011 Jan Feverfew (Tanacetum parthenium L.) (Asteraceae) is a medicinal plant traditionally used for the treatment of fevers, migraine headaches, rheumatoid arthritis, stomach aches, toothaches, insect bites, infertility, and problems with menstruation and labor during childbirth. The feverfew herb has a long history of use in traditional and folk medicine, especially among Greek and early European herbalists. Feverfew has also been used for psoriasis, allergies, asthma, tinnitus, dizziness, nausea, and vomiting. The plant contains a large number of natural products, but the active principles probably include one or more of the sesquiterpene lactones known to be present, including parthenolide. Other potentially active constituents include flavonoid glycosides and pinenes. It has multiple pharmacologic properties, such as anticancer, anti-inflammatory, cardiotonic, antispasmodic, an emmenagogue, and as an enema for worms. In this review, we have explored the various dimensions of the feverfew plant and compiled its vast pharmacologic applications to comprehend and synthesize the subject of its potential image of multipurpose medicinal agent. The plant is widely cultivated to large regions of the world and its importance as a medicinal plant is growing substantially with increasing and stronger reports in support of its multifarious therapeutic uses.
22019788 Evaluation of the genotoxic potential of standardized extract of Glycyrrhiza glabra (GutGa 2011 Dec Glycyrrhiza glabra Linn. (licorice) is widespread throughout the Mediterranean region and certain areas of Asia. Historically, the dried rhizome and root of the plant were used by the Chinese, Egyptian, Greek, Indian, and Roman civilizations as expectorant and carminative. In the modern medicinal system, licorice is used to treat liver ailments, dyspepsia, bronchitis, rheumatoid arthritis etc. Despite the extensive pharmacological applications, the genotoxic potential of G. glabra extract (GutGardâ„¢) has not been evaluated. Hence, this study was conducted to investigate the genotoxic potential of GutGardâ„¢ using battery of in vitro test systems: bacterial reverse mutation test (Ames IIâ„¢), chromosome aberration (CA) and micronucleus (MN) tests. GutGardâ„¢ did not show significant increase in number of revertant colonies in Salmonella typhimurium strains (TA98 and TAMix) with/without S9 fraction. In CA and MN studies, GutGardâ„¢ did not show clastogenic effect at 4 and 18 h treatments with and without S9 fraction. Results indicated that GutGardâ„¢ is not mutagenic in a battery of genotoxicity tests.
22566871 Pathological role of fractalkine/CX3CL1 in rheumatic diseases: a unique chemokine with mul 2011 Understanding rheumatic diseases from the perspective of chemokine biology has shaped and will continue to shape our approach for targeted drug design. Among different kinds of chemokines, fractalkine/CX3CL1 has been found to play an important role in inflammation, portraying unique functional, and structural characteristics. This review summarizes the emerging role of fractalkine/CX3CL1 from a functional and clinical perspective and provides evidence to validate it as a potential therapeutic target in rheumatic diseases such as rheumatoid arthritis, Sjögren's syndrome, systemic lupus erythematosus, scleroderma, as well as diseases related to vascular inflammation. From this, recent studies investigating potential therapeutic agents against fractalkine/CX3CL1's role in pathology have shown promise.
22907627 Is every joint symptom related to acromegaly? 2013 Apr Acromegaly is a chronic endocrinopathy characterized by the hypersecretion of growth hormone and insulin-like growth factor-1. Musculoskeletal pain is a frequent problem encountered in acromegaly and is associated with a reduction in the quality of life. In this study, the presence of inflammatory and degenerative rheumatologic diseases in acromegaly has been retrospectively evaluated. Forty patients with acromegaly who were in remission according to laboratory findings, but still having joint and back pain problems, were referred to rheumatology outpatient clinic and all the patients were examined by clinical, radiological, and laboratory data. Mean age was 47.1 years (22-75). When the radiological data were evaluated, erosions of the left sacroiliac joint were found by means of magnetic resonance imaging in 1 patient and degenerative joint changes were observed in 24 patients by X-ray imaging. However, there was no pathology in the radiological data of 15 patients. Laboratory data revealed antinuclear antibody positivity (3 nucleolar and 1 homogeneous) in 4 patients, rheumatoid factor positivity in 4, and cyclic citrullinated peptide positivity only in 1 patient. The diagnosis of an inflammatory rheumatologic disease, including rheumatoid arthritis, ankylosing spondylitis, or undifferentiated connective tissue disease was made in 3 patients. Besides, the diagnosis of diffuse idiopathic skeletal hyperostosis was also established in 6 patients. While degenerative joint diseases were frequently observed in our group similar to the literature, inflammatory rheumatologic diseases were also found in three patients. Distinguishing these two diseases is important because response to medical treatment is dramatically better in inflammatory diseases than in degenerative pathologies. A multidisciplinary approach is imperative for appropriate management of these patients.
23389871 Heterogeneity of chronic pain. 2012 Feb Chronic pain is a widespread public health issue that has many effects on physical, emotional and cognitive functions. An estimated 10-55% of all adults are thought to have chronic pain. Chronic pain is a multifactorial condition, caused by the complex interplay of nociceptive, neuropathic or mixed pathogenic mechanisms. Chronic pain is associated with specific and non-specific medical conditions such as cancer, HIV/AIDS, rheumatoid arthritis, fibromyalgia, osteoarthritis, low back pain or spinal stenosis and is broadly categorized as cancer pain and non-cancer pain. Evaluation of chronic pain requires a clear understanding of the nature of the pain and its underlying pathophysiology. Adequate assessment of pain, using validated tools, is an essential prerequisite of successful pain management. Unidimensional scales are useful for the measurement of pain intensity, while multidimensional scales measure both pain intensity and the extent to which pain interferes with life activity and emotional functioning. Patients should be reassessed and followed up in order to monitor progress and measure improvements in pain.
23394028 [Depression or apathy? A diagnostic trap: a huge right frontal lobe meningioma diagnosed a 2012 Sep Neurobehavioral changes observed in patients with brain tumours may appear as cognitive deficits, mood disturbances, changes in behaviour or decreased adaptability (e.g., drowsiness, apathy, loss of spontaneity, fatigue). They are initially subtle, develop insidiously, and their severity often changes. Serious diagnostic problems can be caused by mood disorders, psychotic symptoms, personality changes, from disinhibition to apathy, observed in such patients. The problem in distinguishing them from organic psychiatric disorders, often poses a challenge for psychiatrists, neurologists and general practitioners. We describe a case difficult to diagnose because of apathy, due to a brain tumour in the right frontal lobe, diagnosed as depression. Another difficulty, rather suggesting mood disorder, was rheumatoid arthritis. Thorough and meticulous analysis of clinical data, neuropsychological assessment and neuroimaging diagnosis may help to assess aetiology of the observed disorders which can have similar clinical pictures but various causes.
23072706 Treat-to-target in systemic lupus erythematosus: where are we today? 2012 Jul Multiple clinical trials performed over twenty years in the treatment of rheumatoid arthritis (RA) have clearly demonstrated that patients have better outcomes if their disease activity at each time-point for follow-up includes a pre-specified target. A European SLE expert panel met in Zurich on May 8, 2012 to discuss whether a treat-to-target approach could be applied in the treatment of systemic lupus erythematosus (SLE) (T2T/SLE), define a research agenda, and establish a plan for moving forward. In the present paper, observations raised at the meeting and literature data on potential therapeutic targets are reported. The working group on T2T/SLE will continue work over the coming year.