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ID PMID Title PublicationDate abstract
25381413 Acetabular distraction: an alternative approach to pelvic discontinuity in failed total hi 2014 Nov A pelvic discontinuity occurs when the superior and inferior parts of the hemi-pelvis are no longer connected, which is difficult to manage when associated with a failed total hip replacement. Chronic pelvic discontinuity is found in 0.9% to 2.1% of hip revision cases with risk factors including severe pelvic bone loss, female gender, prior pelvic radiation and rheumatoid arthritis. Common treatment options include: pelvic plating with allograft, cage reconstruction, custom triflange implants, and porous tantalum implants with modular augments. The optimal technique is dependent upon the degree of the discontinuity, the amount of available bone stock and the likelihood of achieving stable healing between the two segments. A method of treating pelvic discontinuity using porous tantalum components with a distraction technique that achieves both initial stability and subsequent long-term biological fixation is described.
25046071 [Primary intraosseous squamous cell carcinoma of the mandible]. 2014 Jul Primary intraosseous squamous cell carcinoma is an extremely rare tumor of the mandible. The diagnosis is based on the evidences showing that the tumor is neither originated from a distant metastasis of another primary tumor nor an invasive oral cancer. In this article, we report a 59-year-old female case with a medical history of ductal carcinoma of the breast, lichen planus, and rheumatoid arthritis who was admitted with complaints of a painful and swollen left lower jaw, and was surgically treated for primary intraosseous carcinoma of the mandible and with postoperative adjuvant radiotherapy.
25013413 Histoplasmosis presenting as granulomatous hepatitis: case report and review of the litera 2014 Background. Histoplasma capsulatum is the most common endemic mycosis in the United States and is a frequent cause of opportunistic infection in immunodeficient hosts. Histoplasmosis is most often self-limiting and goes unrecognized in the immunocompetent population but can progress to disseminated histoplasmosis in patients with an impaired immune system. Liver involvement as a part of disseminated histoplasmosis which usually originates in the lung is well known. However, extrapulmonary hepatic histoplasmosis as a primary manifestation is extremely rare. Case Presentation. We report a rare case of histoplasmosis that presented as persistent fever and abnormal liver function tests in a 66-year-old female with rheumatoid arthritis, receiving infliximab. Conclusion. Emphasizing histoplasmosis as a major cause of acute granulomatous hepatitis and fever of unknown origin in cell mediated immunodeficient population, this case highlights the need for high index of suspicion and the importance of prompt diagnosis since any delay of treatment can be life threatening in this population.
24851097 Preclinical efficacy and mechanisms of mesenchymal stem cells in animal models of autoimmu 2014 Apr Mesenchymal stem cells (MSCs) are present in diverse tissues and organs, including bone marrow, umbilical cord, adipose tissue, and placenta. MSCs can expand easily in vitro and have regenerative stem cell properties and potent immunoregulatory activity. They inhibit the functions of dendritic cells, B cells, and T cells, but enhance those of regulatory T cells by producing immunoregulatory molecules such as transforming growth factor-β, hepatic growth factors, prostaglandin E2, interleukin-10, indolamine 2,3-dioxygenase, nitric oxide, heme oxygenase-1, and human leukocyte antigen-G. These properties make MSCs promising therapeutic candidates for the treatment of autoimmune diseases. Here, we review the preclinical studies of MSCs in animal models for systemic lupus erythematosus, rheumatoid arthritis, Crohn's disease, and experimental autoimmune encephalomyelitis, and summarize the underlying immunoregulatory mechanisms.
24833503 Hot topics in autoimmune diseases: perspectives from the 2013 Asian Congress of Autoimmuni 2014 Aug Our understanding of the pathogenic mechanisms and possible treatments of autoimmune diseases has significantly increased over the past decade. Nonetheless, numerous major issues remain open and such issues span from epidemiology to clinimetrics and from the role of infectious agents to the search for accurate biomarkers in paradigmatic conditions such as systemic lupus erythematosus, rheumatoid arthritis, and spondyloarthropathies. In the case of cardiovascular comorbidities of autoimmune diseases or, more generally, the pathogenesis of atherosclerosis, fascinating evidence points to a central role of autoimmunity and metabolic dysfunctions and a possible role of therapies targeting inflammation to ameliorate both conditions. Basic science and translational medicine contribute to identify common mechanisms that underlie different autoimmune diseases, as in the case of tumor necrosis factor alpha, and more recently vitamin D, autoantibodies, T and B regulatory cells, and microRNA. Finally, new therapies are expected to significantly change our approach to autoimmune diseases, as represented by the recent FDA approval of the first oral JAK inhibitor. The present article moves from the major topics that were discussed at the 2013 Asian Congress of Autoimmunity in Hong Kong to illustrate the most recent data from leading journals in autoimmunity and immunology.
24798014 Perforin and human diseases. 2014 Natural killer (NK) cells and cytotoxic T lymphocytes (CTL) use a highly toxic pore-forming protein perforin (PFN) to destroy cells infected with intracellular pathogens and cells with pre-cancerous transformations. However, mutations of PFN and defects in its expression can cause an abnormal function of the immune system and difficulties in elimination of altered cells. As discussed in this chapter, deficiency of PFN due to the mutations of its gene, PFN1, can be associated with malignancies and severe immune disorders such as familial hemophagocytic lymphohistiocytosis (FHL) and macrophage activation syndrome. On the other hand, overactivity of PFN can turn the immune system against autologous cells resulting in other diseases such as systemic lupus erythematosus, polymyositis, rheumatoid arthritis and cutaneous inflammation. PFN also has a crucial role in the cellular rejection of solid organ allografts and destruction of pancreatic β-cells resulting in type 1 diabetes. These facts highlight the importance of understanding the biochemical characteristics of PFN.
24785099 Multifocal Necrotizing Chorioretinitis Following Phacoemulsification Surgery. 2015 Jun INTRODUCTION: Toxoplasma chorioretinitis is a leading cause of infectious posterior uveitis worldwide. METHODS: We report an atypical presentation of Toxoplasma chorioretinitis presenting after uneventful cataract surgery in an 81-year-old male, with known hypernephroma and rheumatoid arthritis, treated with prednisolone and methotrexate. RESULTS: He was treated for acute retinal necrosis and cytomegalovirus retinitis before Toxoplasma chorioretinitis was confirmed by vitreous biopsy 11 months after presentation. He developed a secondary rhegmatogenous retinal detachment, treated successfully with pars plana vitrectomy, silicone oil and endolaser. Visual acuity at discharge was 6/12 following silicone oil removal. DISCUSSION: Necrotising chorioretinitis in immunosuppressed or elderly patients may present with an atypical phenotype. Clinical diagnosis in this context remains challenging. We discuss the clinical reasoning behind investigation and management of this patient group in whom viral and Toxoplasma retinitis may be clinically indistinguishable. The significance of vitreous PCR results in clinical decision making in the context of infectious posterior uveitis is discussed.
24642104 Open questions in autoimmunity: discussions from the 2013 Controversies in Rheumatology an 2014 Mar 18 The recent CORA (Controversies in Rheumatology and Autoimmunity) meeting held in 2013 represented a unique opportunity for rheumatologists to address several topics. Among these, four topics include: (i) the role of epigenetic changes in the pathogenesis of rheumatoid arthritis (RA), as shown by studies in monozygotic twins; (ii) the cardiovascular and atherosclerotic risk in patients with RA treated with biologics; (iii) the use of new biomarkers for the diagnosis and follow-up of RA and other autoimmune diseases, as represented by the new automatic machines for anti-nuclear antibodies detection, or ultrasound imaging to follow RA progression; and (iv) the latest guidelines on how to use and manage biologic therapies in RA and other autoimmune diseases, such as lupus. In summary, we will herein present these topics of discussion and underline the conclusions obtained by rheumatologists during the 2013 CORA Meeting.
24566013 Are Macedonian chronic patients alexithymic? 2013 Psychological factors have been supposed as an important link in the chain of pathogenesis and the course of many diseases, especially stress-related ones. The field of psychosomatics is concerned with the study of the mind / body relations and, in this context, to the assessment of the influence of psychological factors on bodily changes and, consequently, with the development of illness. Alexithymia, the inability to identify or label emotions, has been shown to be associated with patients with many chronic conditions. The study was performed to obtain a) normal values of TAS-20 in Macedonian healthy people and b) to compare the results with a groups of chronic patients. In this study, TAS-20 was applied as a measure of alexithymia. It was concluded that the alexithymia construct is a permanent personality trait related to neurobiological brain specifics. The construct is important for both, either as a trigger or as the conesquence of the illness. Patients with chronic diseases are more alexithymic than healthy people. In our research alexithymia has been confirmed in patients with cancer, rheumatoid arthritis and dialyzed patients as well as in patients after myocardial infarction. An alexithymia construct can influence the prognosis and outcome of the chronic disease. Anyhow, the psychological support for mediating alexithymia should be included in the therapeutic protocols of all chronic patients.
24517988 Synovial cyst of the antecubital fossa mimicking a brachial artery pseudoaneurysm: report 2014 Jul Pseudoaneurysms of the brachial artery are common following a percutaneous cardiac catheterization. Synovial cysts are a commonly identified entity in patients with rheumatic diseases as well. We present a rare case of a synovial cyst in the elbow masquerading as an iatrogenic pseudoaneurysm of the brachial artery. A 51-year-old female patient presented with a pulsatile and painful mass in the right antecubital fossa. The medical history revealed a recent diagnostic cardiac catheterization at the same site and rheumatoid arthritis under oral treatment. Imaging investigations were not fully diagnostic. Because of the clinical suspicion of a thrombosed pseudoaneurysm, exploratory surgery was indicated. The pathologic examination of the specimen confirmed the diagnosis of a synovial cyst. Ultrasonography and computed tomography imaging are valuable in the everyday clinical practice but they do not always exclude an iatrogenic pseudoaneurysm, especially when the medical history is suspicious. Surgical removal is the proper treatment and pathologic examination sets the final diagnosis in such cases of diagnostic difficulty.
24478551 Characterization of human serum immunoglobulin g modified with singlet oxygen. 2014 Jan Reactive oxygen species, as singlet oxygen ((1)O2), is continuously being generated by aerobic organisms, and react actively with biomolecules. At excessive amounts, (1)O2 induces oxidative stress and shows carcinogenic and toxic effects due to oxidation of lipids, proteins and nucleic acids. In our study, immunoglobulin G (IgG) was modified by (1)O2 generated by the ultraviolet (UV) irradiation of methylene blue. The modified IgG was characterized by UV spectroscopy, carbonyl content determination, thermal denaturation and electrophoretic study. Oxidation induced by modification of IgG by (1)O2 also analyzed by scavenging studies. It was found that ultraviolet absorption spectra of modified IgG shows marked hyperchromicity. The carbonyl content was found to be high in modified IgG as compared to native IgG which confirms its oxidation. Thermal denaturation of modified protein sample shows decrease in Tm value by 3 °C and less intensity banding pattern on polyacrylamide gel electrophoresis. The quenching effect of sodium azide provides clue for modification of IgG by methylene blue, as it is known (1)O2 scavenger. Hence, the IgG modified with (1)O2 may be one of the etiological pathogenic factors for rheumatoid arthritis and diabetes.
24408538 MicroRNA in chronic rhinosinusitis and allergic rhinitis. 2014 Feb Inflammatory upper airway diseases, particularly chronic rhinosinusitis (CRS) and allergic rhinitis (AR), have a high worldwide prevalence. CRS and AR involve sustained and exaggerated inflammation that is associated with marked changes in gene and protein expression under tight regulation. A novel group of gene expression regulators is a class of short single-stranded RNA molecules termed microRNAs (miRNAs). miRNAs can cause gene silencing through degradation of target mRNAs or inhibition of translation. Dysregulated expression of miRNAs has been shown in various human diseases, such as cancer, inflammatory skin and bowel diseases, rheumatoid arthritis, and asthma. Although studies of miRNAs in inflammatory upper airway diseases are relatively new and few, emerging evidence implicates an involvement of miRNAs in shaping the inflammation pattern in upper airways. The purpose of this review is to provide an overview on our current understanding of miRNA expression and function in CRS and AR, and to underscore the potential for clinical usage of miRNAs in CRS and AR.
24082909 Serum interleukin-6 expression level and its clinical significance in patients with dermat 2013 OBJECTIVE: To analyze serum interleukin-6 (IL-6) expression level and its clinical significance in patients with dermatomyositis. METHODS: Blood samples from 23 adult patients with dermatomyositis (DM), 22 with systemic lupus erythematosus (SLE), 22 with rheumatoid arthritis (RA), 16 with Sjögren's syndrome (SS), and 20 healthy controls were collected. The IL-6 concentration was detected by chemiluminescence immunoassay. Correlations between IL-6 expression levels and clinical features or laboratory findings in patients with DM were investigated. RESULTS: IL-6 expression level of DM patients was significantly higher than that of normal controls, significantly lower than that of RA patients, and slightly lower than that of SLE or SS patients with no significant differences. The incidence of fever was significantly higher in the IL-6 elevated group. Serum ferritin (SF) and C-reactive protein (CRP) were positively correlated with IL-6. CONCLUSIONS: IL-6 plays a less important role in DM than in RA. IL-6 monoclonal antibodies may have poor effect in patients with DM.
23813176 Total hip arthroplasty with porous metal cups following acetabular fracture. 2013 Sep Total hip arthroplasty (THA) after acetabular fracture presents unique challenges, including acetabular fixation. Twelve patients with a history of acetabular fracture underwent THA with porous metal cups. The average age was 57 years (range 24-88). THA was performed at an average 20 months from initial fracture. Average follow-up was 39 months (range 24-49). Average WOMAC scores improved from 32 to 79; UCLA scores improved from 1.75 to 5.25. There was one case of acetabular loosening in a renal transplant patient with rheumatoid arthritis. No other patients showed progressive radiolucent lines. At average three-year follow-up, porous metal components afforded improved clinical and radiographic outcomes in the majority of patients. Longer follow-up will determine whether porous metal is a durable option in the management of prior acetabular fracture.
23686187 The effects of sustained delivery of corticosterone on the adrenal gland of male and femal 2013 Glucocorticoids have long been recognized to have beneficial effects in rheumatoid arthritis and asthma. Numerous clinical trials show the efficacy of short term low dose treatment to resolve inflammation. Despite the success of short term use, there is concern regarding chronic use of glucocorticoids because of the development of exogenous CushingÂ’s syndrome. Chronic variable stress models have detailed the effects of chronic stress exposure on body weight, plasma corticosteroid levels, ACTH levels, and adrenal weights, but limited studies detail the effects of the body systems induced by continuous exposure to glucocorticoids similar to that seen in exogenous CushingÂ’s syndrome. The present study uses a TCPL drug delivery system to administer corticosterone (CS) continuously in male and female animals for 24 days and evaluates long term chronic use effects on body weight, adrenal weight, and adrenal ultrastructure. Continuous release of CS resulted in slight decreases in body weight in both male and female rats and decreases in adrenal wet weight in the female rats. Ultrastructural changes were seen in the adrenal histology in both female and male rats. Male rat adrenal glands showed atrophy of the zona glomerulosa and hypertrophy of the adrenal medulla. Female rats showed disorganization of all zones within the adrenal gland and an increase in fat around the gland. The information is important for understanding physiological differences in males and females during stress. The continuous release of CS may provide insight into the pathology of exogenous CushingÂ’s syndrome.
23572428 Statins and autoimmunity. 2013 Jul Statins have immunomodulatory effects. Hence, they could be advantageous for different reasons. First, statins can serve as adjunct therapy in autoimmune diseases. Second, they may play a role in the prevention of accelerated atherosclerosis in the same population. In this review, we discuss the mechanisms of immune regulation by statins and review the literature for their benefit in many autoimmune diseases. In these studies, statins lead to an improvement in the disease activity scores in rheumatoid arthritis patients; a reduction in prothrombotic factors in anti-phospholipid syndrome patients; changes in vasculature, proteinuria, and cardiac events in systemic lupus erythematosus patients; changes in vasculature and proteinuria in patients with vasculitis; disease activity scores in ankylosing spondylitis; and finally vascular changes in patients with systemic sclerosis. Hence, these studies suggest that statins could be used as adjuncts to standard therapy due to their anti-inflammatory, immunomodulatory, and anti-thrombogenic effects. More evidence-based research is required to determine whether statin regimens will become the standard of care in patients with autoimmune diseases.
23499971 Matrix-assisted laser desorption ionization-time of flight mass spectrometry identificatio 2013 Jun 1 Enzymatic conversion of arginine to citrulline by peptidyl arginine deiminase is associated with peptide presentation and development of autoimmunity in rheumatoid arthritis. In order to facilitate identification of the citrullination site, citrulline residue was modified using 4-bromophenyl glyoxal, and 194Da mass increase and incorporation of the Br signature were confirmed by MALDI-TOF MS. Using this approach, we identified four and five citrullination sites of bovine serum albumin and bovine fibrinogen, respectively. MALDI-TOF/TOF MS was used to unambiguously identify two citrullination sites from bovine fibrinogen.
23429360 Negative regulatory approaches to the attenuation of Toll-like receptor signaling. 2013 Feb 22 Toll-like receptors (TLRs) are pivotal components of the innate immune response, which is responsible for eradicating invading microorganisms through the induction of inflammatory molecules. These receptors are also involved in responding to harmful endogenous molecules and have crucial roles in the activation of the innate immune system and shaping the adaptive immune response. However, TLR signaling pathways must be tightly regulated because undue TLR stimulation may disrupt the fine balance between pro- and anti-inflammatory responses. Such disruptions may harm the host through the development of autoimmune and inflammatory diseases, such as rheumatoid arthritis and systemic lupus erythematosus. Several studies have investigated the regulatory pathways of TLRs that are essential for modulating proinflammatory responses. These studies reported several pathways and molecules that act individually or in combination to regulate immune responses. In this review, we have summarized recent advancements in the elucidation of the negative regulation of TLR signaling. Moreover, this review covers the modulation of TLR signaling at multiple levels, including adaptor complex destabilization, phosphorylation and ubiquitin-mediated degradation of signal proteins, manipulation of other receptors, and transcriptional regulation. Lastly, synthetic inhibitors have also been briefly discussed to highlight negative regulatory approaches in the treatment of inflammatory diseases.
23253433 B-cell targeted therapy with rituximab for thyroid eye disease: closer to the clinic. 2013 May The management of thyroid eye disease (TED) remains a therapeutic challenge. The current established therapies are unsatisfactory in one-third of the patients and have many limitations. Rituximab (RTX) is a CD20+ B-cell-depleting monoclonal antibody approved for the treatment of non-Hodgkin lymphomas, chronic lymphocytic leukemia, and rheumatoid arthritis. The early experience with RTX suggests that it is a promising alternative therapy for TED. Rituximab may compare favorably to the conventional glucocorticoid therapy and causes less collateral damage than retrobulbar orbital radiation and decompression surgery. In addition, the preliminary studies on RTX's proposed mechanism of action have revealed new insights into the pathogenic role of B-cells in TED. We summarize the current literature on the clinical application of RTX in TED and discuss its putative mechanisms of action.
21170606 Role of autoimmunity and autoinflammation in the pathogenesis of idiopathic recurrent peri 2013 Feb Idiopathic recurrent pericarditis is the most common and troublesome complication of acute pericarditis affecting about one third of such patients. The pericardium may be involved in different systemic autoimmune diseases (i.e., systemic lupus erythematosus, rheumatoid arthritis, progressive systemic sclerosis, mixed connective tissue disease, Sjogren's Syndrome, polyarteritis, giant cell arteritis, other systemic vasculitides) either in a symptomatic form (usually during the active phase of the disease) or as asymptomatic pericardial effusion. Moreover, idiopathic recurrent pericarditis mimicks hereditary periodic fever syndromes (HPFSs). HPFSs are a group of disorders characterized by primary dysfunction of the innate immune system mostly caused by mutations of genes involved in the regulation or activation of the inflammatory response, without any apparent involvement of antigen-specific T cells or significant production of autoantibodies. These disorders usually manifest in the pediatric population, with onset ranging from the first hours to the first decade of life, however a limited number of patients experience disease onset during adulthood.