Browse

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

ID PMID Title PublicationDate abstract
23998063 The concomitant consumption of cod liver oil causes a reduction in the daily diclofenac so 2013 Jul OBJECTIVE: To evaluate whether the concomitant consumption of Cod liver oil can reduce the daily dose of Diclofenac Sodium and probably the risk of the side effects which are associated with it in Rheumatoid Arthritis patients. MATERIAL AND METHODS: This longitudinal, prospective, open label study was conducted from April to September 2012 at Mahatma Gandhi Medical College and Hospital, Jaipur, India. 30 Rheumatoid Arthritis patients who were aged between 19 to 60 years, who fulfilled the inclusion criteria, were enrolled. Each patient was given five Cod liver oil capsules twice a day, for a period of 24 weeks. Each capsule which contained 300 mg of Cod liver oil had Eicosapentaenoic acid-20 mg and Docosahexaenoic acid-30 mg. The patients who took different Nonsteroidal anti-inflammatory drugs daily were switched over to Diclofenac Sodium 50 mg as a single dose, up to a maximum dose of 200 mg per day. The dose of Diclofenac Sodium which was consumed per day and the average daily requirement at different visits were recorded in each patient and they were compared. The patients were assessed for their pain scores by using the Visual Analogue Scale (VAS) at different weeks. In addition, the 'Subjective Response' to the pain was evaluated in each patient at the respective visits. The Student's "t"-test was applied for the analysis of the VAS pain score and for the evaluation of the reduction in the mean daily dose of the Diclofenac Sodium consumption. A probability value of less than 0.05 (p< 0.05) was considered to be statistically significant. Moreover, the results of the 'Subjective Response' to the pain were expressed as percentage. RESULTS: A significant decrease (p< 0.05) in the mean VAS pain score from 80.38 ± 6.4 at week 0 to 67.30 ± 5.3 at week 24 was noted in the patients. There was a significant reduction (p<0.05) in mean dose of Diclofenac Sodium consumed from 115.04 ± 24.56 at week 4 to 98.83 ± 22.32 at week 24. Moreover, the percentage of the patients who experienced a 'Better' Subjective Response increased from 15.38% at week 4 to 61.53% at week 24 of the treatment follow up. CONCLUSION: This study revealed that the concurrent use of Cod liver oil which contained n-3 Essential Fatty Acid in Rheumatoid Arthritis patients reduced the mean daily dose of Diclofenac Sodium consumed and probably the incidence of the side effects which were associated with it.
25019624 Long-term outcome of 114 adult JIA patients in a non-pediatric rheumatology institute in J 2015 Jan OBJECTIVE: To evaluate the long-term outcome of patients with juvenile idiopathic arthritis (JIA) using data from a large cohort database, Institute of Rheumatology, Rheumatoid Arthritis, managed by the Tokyo Women's Medical University. METHODS: Of 182 patients identified from the database from 2000 to 2013, 114 were verified as having JIA. The transition of medical care and the contributions of biological DMARDs were evaluated. RESULTS: The mean age of the patients (93 females, 81.6%) at the latest examination was 36.6 ± 13.3 years. The mean age at disease onset and mean disease duration were 11.6 ± 3.4 and 25.0 ± 13.3 years, respectively. Of the 114 patients, 106 (93.0%) had poly- or oligoarthritis. Only one-fourth transferred from general pediatricians or pediatric rheumatologists. More patients with recent disease onset were treated with biological DMARDs (16.7% in the 1970s, vs. 80.0% in the 2000s). Disease activity assessed with DAS28 was significantly lower when disease onset was more recent (3.9 ± 1.3 for onset in the 1960s vs. 2.2 ± 1.1 for onset in the 2000s, p = 0.04). The percentage of patients requiring orthopedic surgery has decreased (53.8% before the 1970s vs. 10.0% in the 2000s). CONCLUSION: Patients with more recent disease onset showed an improved outcome. Establishing and sharing a transition program among pediatric and non-pediatric rheumatologists is desirable.
23595241 Juvenile idiopathic arthritis: review of the literature and case report. 2013 Jan Juvenile idiopathic arthritis (JIA), previously known as juvenile chronic arthritis or juvenile rheumatoid arthritis, is a chronic disease of childhood with a spectrum of joint involvement and associated systemic involvement. The cause of JIA is poorly understood, and no drugs can cure the disease currently. Pediatric dentists should be familiar with the symptoms, complications, and oral manifestations of JIA to help manage the disease and provide quality care to these patients. The purpose of this case report is to review the condition and to describe the case of an adolescent with polyarticular juvenile rheumatoid arthritis, focusing on specific recommendations for dental management.
24508497 Arthritis and prolactin: a phylogenetic viewpoint. 2014 Jul 1 Arthritic disorders are family of diseases that have existed since vertebrate life began. Their etiology is multifactorial with genetic, environmental, and gender factors driving chronic joint inflammation. Prolactin is a sexually dimorphic hormone in mammals that can act to both promote and ameliorate rheumatic diseases. It is found in all vertebrate groups where it exerts a wide diversity of actions. This review briefly addresses the presence and features of arthritic diseases in vertebrates, the effects of PRL on joint tissues and immune cells, and whether PRL actions could have contributed to the ubiquity of arthritis in nature. This comparative approach highlights the value of PRL as a biologically conserved factor influencing the development and progression of arthritis.
24151549 Total knee arthroplasty considerations in rheumatoid arthritis. 2013 The definitive treatment for advanced joint destruction in the late stages of rheumatoid arthritis can be successfully treated with total joint arthroplasty. Total knee arthroplasty has been shown to be a well-proven modality that can provide pain relief and restoration of mobility for those with debilitating knee arthritis. It is important for rheumatologists and orthopedic surgeons alike to share an understanding of the special considerations that must be addressed in this unique population of patients to ensure success in the immediate perioperative and postoperative periods including specific modalities to maximize success.
22727543 Clinical features of children with juvenile idiopathic arthritis using the ILAR classifica 2013 Aug BACKGROUND/PURPOSE: The aim of the study was to describe the clinical features of children affected by juvenile idiopathic arthritis (JIA) under the International League of Associations for Rheumatology-derived classification criteria in a community-based setting. METHODS: Consecutive cases of JIA from defined geographic areas of Taiwan were diagnosed and followed in an observational cohort from 1995 to 2010. In addition to the clinical and laboratory data required for the International League of Associations for Rheumatology system, information about the medication and disease activity during the study period was also recorded. RESULTS: Out of 292 children with chronic joint pain, 195 were diagnosed as JIA: systemic arthritis (19%), oligoarthritis (persistent 16.4%; extended 6.7%), polyarthritis rheumatoid factor-negative (11.8%), polyarthritis rheumatoid factor-positive (4.6%), psoriatic arthritis (1.5%), enthesitis-related arthritis (ERA; 37.4%), and undifferentiated arthritis (2.6%). Human leukocyte antigen-B27 was positive in 82.2% of patients with ERA. Uveitis was observed in 6.7% of patients. Disease-modifying anti-rheumatic drugs, including biologic medications, were used in 73.3% of children during the observational period. At the last follow-up, 40% of patients experienced a continuously active or relapsing course. CONCLUSION: Compared with previous reports on Western populations, a remarkably high prevalence was found in the ERA of the Chinese cohort, but a relatively low rate of uveitis. Ongoing disease activity was evident in a substantial number of children. These results provided a good starting point in understanding the epidemiology of this serious disease in the Chinese population.
23610748 Distinguishing erosive osteoarthritis and calcium pyrophosphate deposition disease. 2013 Apr 18 Erosive osteoarthritis is a term utilized to describe a specific inflammatory condition of the interphalangeal and first carpal metacarpal joints of the hands. The term has become a part of medical philosophical semantics and paradigms, but the issue is actually more complicated. Even the term osteoarthritis (non-erosive) has been controversial, with some suggesting osteoarthrosis to be more appropriate in view of the perspective that it is a non-inflammatory process undeserving of the "itis" suffix. The term "erosion" has also been a source of confusion in osteoarthritis, as it has been used to describe cartilage, not bone lesions. Inflammation in individuals with osteoarthritis actually appears to be related to complicating phenomena, such as calcium pyrophosphate and hydroxyapatite crystal deposition producing arthritis. Erosive osteoarthritis is the contentious term. It is used to describe a specific form of joint damage to specific joints. The damage has been termed erosions and the distribution of the damage is to the interphalangeal joints of the hand and first carpal metacarpal joint. Inflammation is recognized by joint redness and warmth, while X-rays reveal alteration of the articular surfaces, producing a smudged appearance. This ill-defined, joint damage has a crumbling appearance and is quite distinct from the sharply defined erosions of rheumatoid arthritis and spondyloarthropathy. The appearance is identical to those found with calcium pyrophosphate deposition disease, both in character and their unique responsiveness to hydroxychloroquine treatment. Low doses of the latter often resolve symptoms within weeks, in contrast to higher doses and the months required for response in other forms of inflammatory arthritis. Reconsidering erosive osteoarthritis as a form of calcium pyrophosphate deposition disease guides physicians to more effective therapeutic intervention.
25300256 CCR5 small interfering RNA ameliorated joint inflammation in rats with adjuvant-induced ar 2014 Dec Rheumatoid arthritis (RA) is a systemic inflammatory disease. C-C chemokine receptor type 5 (CCR5) is found in inflamed synovium of RA patients and is necessary for formation of RA. We aimed to check whether delivery of CCR5-specific small interfering RNA (siRNA) via electroporation suppresses local inflammation in arthritis rats. Vectors encoding siRNA that target CCR5 or negative control siRNA were constructed for gene silencing and the silencing effects of suppressing CCR5 expression in synovium examined by western blot. The vector with strongest effect was delivered into the knee joint of adjuvant-induced arthritis (AIA) rats by the in vivo electroporation method 7, 10, 13, and 16 days after immunization with Complete Freund's adjuvant. During an observation of 28 days, behavior, paw swelling, arthritis and histopathologic scoring were estimated. The expression level of CCR5 in synovium was evaluated by western blot and real-time PCR. Anti-CCR5 D1 siRNA was effectively inhibited CCR5 expression in vitro. Moreover, delivery of the siRNA into inflammatory joint also suppressed the expression of CCR5 in vivo and markedly suppressed paw swelling and inflammation. Local electroporation of anti-CCR5 siRNA into the left inflamed joints could achieve the silencing of CCR5 gene and alleviate local inflammation just in the knee joint injected with siRNA other than the opposite joint. Inhibition of CCR5 expression may provide a potential for treatment of RA.
23569570 Appearance of ANCA - associated vasculitis under Tumor necrosis factor-alpha inhibitors tr 2013 BACKGROUND: Tumor necrosis factor-alpha inhibitors treatment is accosiated with several side effects. The most common are injection side reactions, headache, nausea and infections. The more rare are development of systemic autoimmune diseases. CASE REPORT: We describe two patients, who developed ANCA associated vasculitis during Tumor necrosis factor alpha inhibitors treatment. The diagnosis was confirmed by appropriate tissue picture, CT scan and laboratory findings. CONCLUSIONS: Our case series are unique, because vasculitis appeared after many years of the treatment and during complete patient's remission of there main illness.
24723984 Polyglycerolsulfate functionalized gold nanorods as optoacoustic signal nanoamplifiers for 2014 We have synthesized a targeted imaging agent for rheumatoid arthritis based on polysulfated gold nanorods. The CTAB layer on gold nanorods was first replaced with PEG-thiol and then with dendritic polyglycerolsulfate at elevated temperature, which resulted in significantly reduced cytotoxicity compared to polyanionic gold nanorods functionalized by non-covalent approaches. In addition to classical characterization methods, we have established a facile UV-VIS based BaCl2 agglomeration assay to confirm a quantitative removal of unbound ligand. With the help of a competitive surface plasmon resonance-based L-selectin binding assay and a leukocyte adhesion-based flow cell assay, we have demonstrated the high inflammation targeting potential of the synthesized gold nanorods in vitro. In combination with the surface plasmon resonance band of AuNRs at 780 nm, these findings permitted the imaging of inflammation in an in vivo mouse model for rheumatoid arthritis with high contrast using multispectral optoacoustic tomography. The study offers a robust method for otherwise difficult to obtain covalently functionalized polyanionic gold nanorods, which are suitable for biological applications as well as a low-cost, actively targeted, and high contrast imaging agent for the diagnosis of rheumatoid arthritis. This paves the way for further research in other inflammation associated pathologies, in particular, when photothermal therapy can be applied.
25856933 Comparison of intra-articular glucocorticoid injections with DMARDs versus DMARDs alone in 2014 Aug BACKGROUND: Intra-articular triamcinolone in combination with DMARDs may be able to achieve faster and tighter control of disease activity in early rheumatoid arthritis that may be the key to preventing or minimizing later deformities. OBJECTIVE: To compare the efficacy of a combination of Disease Modifying Anti-Rheumatoid Drugs (DMARDs) with Intra-articular Glucocorticoids versus only DMARDs in a group of patients with early Rheumatoid Arthritis (RA). METHODS: Fifty patients diagnosed as Rheumatoid Arthritis (RA) by American Rheumatology Association (ARA) criteria (1987) with disease duration less than two years were randomized into two groups. The Control group received a combination of Methotrexate 15 mg daily with Sulfasalazine 2 gm daily for 3 months and the Study group received the above combination along with Intra-articular injections of Triamcinolone acetate (40 mg per ml) in each of the swollen joints at the start of the study. Outcome was assessed in terms of Disease Activity Score (DAS-28), American College of Rheumatology (ACR) 20/50/70 criteria and number of rescue medications used at the end of 3 months. RESULTS: The study group had significant reductions in DAS 28 scores (3.39 versus 4.99 in control group) and significantly more subjects achieved the ACR 20/50/70 criteria at the end of 3 months (100/60/36% versus 84/20/0%) Secondary end-points like tender and swollen joint count, ESR, early morning stiffness, health assessment questionnaire (HAQ) scores and general health status were significantly reduced in the study group. Also, significantly lesser rescue medications were needed in the study group. CONCLUSION: Combination of DMARDs with Intra-articular corticosteroids is significantly better than DMARDs alone in early RA.
24974758 [Adult-onset Stills disease - a difficult path to diagnosis through fever and effusions of 2014 May Fever of unknown origin, pleural and pericardial effusions can be caused by a variety of independent agents. On the other hand, we can identify a common causative condition in other cases. Infectious diseases, malignancies and autoimmune diseases are the most common etiological factors. Considering the pleural and pericardial effusion, we also have to think of cardiovascular and pulmonary diseases. The basis of every diagnostic process is thorough medical history and detailed clinical examination followed by laboratory and imaging methods. In spite of that, the right diagnosis sometimes stays long time hidden. One of such conditions is Adult-onset Stills disease (AOSD). It is a rare inflammatory, potentially life-threatening disease with unclear pathogenesis and heterogeneous symptoms. It has some features similar to systemic form of juvenile idiopathic arthritis. Diagnosis is established so called per exclusionem by fulfilling a set of clinical criteria and ruling out other diseases with similar symptomatology. In our article, we present an example of such an arduous diagnostic journey to final diagnosis.
24811471 Fever of unknown origin and leukemoid reaction as initial presentation of adult-onset Stil 2014 Jan Adult Still's Disease has been reported as cause of Fever of Unknown Origin. Leukocytosis has been described as a common haematological abnormality in Adult Still's Disease. In some rare cases, leukemoid reaction has been reported associated to Still's Disease. We report the case of Adult Still's Disease presenting as Fever of Unknown Origin and leukemoid reaction in a patient with Down Syndrome. The patient needed high dosage of corticosteroids to control the disease and haematological findings.
24646087 Classification criteria and treatment modalities in primary Sjögren's syndrome. 2014 Apr Primary Sjögren's syndrome is a systemic autoimmune disease, characterized by a lymphocytic exocrinopathy. Oral and ocular dryness, asthenia and pain represent hallmarks of the disease. Systemic manifestations concern a third of patients, including lymphoma in 5% of the patients. The American European Consensus Group classification criteria have been used in current practice and clinical trials since 2002. New classification criteria were recently proposed by the American Congress of Rheumatology. A group of international experts are currently working to reach a new consensus between the American European Consensus Group classification criteria and the American Congress of Rheumatology proposal for disease classification. In addition, international consensus disease activity scores were recently established. Regarding treatment modalities, symptomatic treatments remain the cornerstone of therapy in pSS, but new biologic treatments are currently evaluated.
26030959 [Pathogenesis of Sjögren's syndrome]. 2014 Sjögren's syndrome (SS--Sjögren's Syndrom) is an autoimmune systemic disease of connective tissue. The aim of this study was to present the contemporary literature on the basis of the pathophysiology of the Sjögren's syndrome, with particular reference to the pathogenesis of the damage to the salivary glands. It also discusses the criteria for classification, aetiology and pathogenesis of the SS, as well as the clinical symptoms of the disease in the oral cavity and its influence on the composition of the saliva. The knowledge of the Sjbgren's syndrome is important for the diagnosis and treatment of this disease.
26316924 Preventing Heart Failure in Inflammatory and Immune Disorders. 2014 Jun Patients with chronic inflammatory diseases are at increased risk for heart failure due to ischemic heart disease and other causes including heart failure with preserved ejection fraction. Using rheumatoid arthritis and treated HIV infection as two prototypical examples, we review the epidemiology and potential therapies to prevent heart failure in these populations. Particular focus is given to anti-inflammatory therapies including statins and biologic disease modifying drugs. There is also limited evidence for lifestyle changes and blockade of the renin-angiotensin-aldosterone system. We conclude by proposing how a strategy for heart failure prevention, such as the model tested in the Screening To Prevent Heart Failure (STOP-HF) trial, may be adapted to chronic inflammatory disease.
24115960 Current imaging techniques in rheumatology: MRI, scintigraphy and PET. 2013 Jul The first-line imaging technique for diagnosis inflammation in musculo-skeletal organs in rheumatoid arthritis (RA) is planar X-ray examination, which was for many years the first and the only single tool for RA diagnostics and response evaluation. Today, in the era of more aggressive RA treatment, ultrasound examination (US) and magnetic resonance imaging (MRI) are also frequently used. US is used to detect early signs of inflammation within the soft tissue. MRI allows to assess the soft tissue and bone marrow involvement in case of inflammation and/or infection. MRI is capable of detecting more inflammatory lesions and erosions than US, X-ray, or CT. Standard scintigraphy plays a crucial role, and data from positron emission tomography (PET) are also promising. These functional imaging techniques are used in detection of inflammation and/or infection in case of ambiguous results being obtained by other techniques or at other clinics. In patients with RA, scintigraphy plays a key role in the differential diagnosis of hip, knee, etc. endoprosthesis disorders, including mechanical or septic loosening.
25505569 Methotrexate and a spleen tyrosine kinase inhibitor cooperate to inhibit responses to peri 2013 Dec BACKGROUND: Selective disruption of the spleen tyrosine kinase (Syk) represents a novel strategy to control B-cell functional responses by inhibition of B-cell antigen receptor (BCR) signaling. PRT062607 (P505-15) is a highly selective small molecule Syk inhibitor that potently suppresses B-cell function in human and rodent blood, and reduces inflammation in rodent models of rheumatoid arthritis (RA). AIMS: In this study, we sought to determine the potency of Syk inhibition by PRT062607 in whole blood from RA patients, and elucidate covariates that affect the potency of immune-regulation by this compound. MATERIALS AND METHODS: Whole blood was collected from 30 patients diagnosed with RA as part of a single-center outpatient study. Disease severity, serum protein markers of inflammation, and co-medications were related to each other, and to PRT062607 activity in ex vivo Syk-mediated immune function assays. RESULTS: We report here that PRT062607 exhibited greater potency in suppressing BCR mediated B-cell functional responses in whole blood from RA patients who received stable methotrexate (MTX) therapy. We demonstrate that the B-cell functional response to BCR ligation is influenced by cytokines and JAK/STAT signaling. DISCUSSION: MTX is a known cytokine modulating agent, and this mechanism may act in concert with PRT062607 to control B-cell function. CONCLUSION: These data have important implications for the co-administration of Syk inhibitors and MTX for the treatment of RA.
25371875 Assessment of protein tyrosine phosphatases number 22 polymorphism prevalence among rheuma 2014 BACKGROUND: It has been proposed that Trp (620) allotype of protein tyrosine phosphatases number 22 (PTPN22) gene can intensify the susceptibility to rheumatoid arthritis (RA) and other autoimmune diseases. Thus, in this study, the prevalence of this polymorphism has been surveyed among RA patients compared with healthy persons. The samples were selected from Isfahan province (one of the most populated area of Iran). MATERIALS AND METHODS: In this study, 100 patients (case group) and 100 healthy persons (control group) were participated voluntarily. The case group was selected from people who had referred to the rheumatology clinic of AlZahra University Hospital to follow-up their treatment and change their drugs dosage. The control group members, who were living in Isfahan province, mutually had similar age with patients. On a total, 22% of the case group was male and 75% of the control group was female. DNA was extracted from the blood sample of all cases and controls and the PTPN22 single nucleotide polymorphism (SNP) C1858> T gene polymorphism were studied using the polymerase chain reaction-restriction fragment length polymorphism method. RESULTS: PTPN22 SNP C1858> T gene polymorphism was observed in 11 persons (11%) of the case group and 8 persons (8%) of the control group. CONCLUSION: The results show that the difference was not statistically significant in Isfahan RA population (P = 0.47; OR = 1.42; 95% CI 0.55-3.69). Although, another study on Iranian population had shown that this polymorphism confers susceptibility to RA.
25162763 IL-21 as a therapeutic target in inflammatory disorders. 2014 Nov INTRODUCTION: IL-21, a cytokine produced by activated CD4(+) cells, activated natural killer T cells and T helper cells in the germinal centers, is involved in the control of the function of both immune and parenchymal cells. AREAS COVERED: IL-21 is overproduced in many chronic inflammatory disorders, including inflammatory bowel diseases, psoriasis, rheumatoid arthritis, type I diabetes and systemic lupus erythematosus, and studies in experimental models indicate that IL-21 plays an important role in sustaining tissue-damaging immune responses in such pathologies. However, genetic deficiency of IL-21 associates with inflammatory bowel diseases and blockade of IL-21 in the early phases exacerbates the disease progression in some models of rheumatoid arthritis and systemic lupus erythematosus, thus suggesting a dual role of IL-21 in the control of immune-mediated diseases. IL-21 can exert additional protective functions for the host as it promotes cytotoxic responses against tumors and viruses. EXPERT OPINION: We here review the available data on the role of IL-21 in chronic inflammatory diseases and discuss the therapeutic benefit of IL-21 inhibitors in such diseases as well as the potential risks of such treatments.