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ID PMID Title PublicationDate abstract
25351422 Power Doppler signal calibration between ultrasound machines by use of a capillary-flow ph 2015 Jan Ultrasound allows the detection and grading of inflammation in rheumatology. Despite these advantages of ultrasound in the management of rheumatoid patients, it is well known that there are significant machine-to-machine disagreements regarding signal quantification. In this study, we tried to calibrate the power Doppler (PD) signal of two models of ultrasound machines by using a capillary-flow phantom. After flow velocity analysis in the perfusion cartridge at various injection rates (0.1-0.5 ml/s), we measured the signal count in the perfusion cartridge at various injection rates and pulse repetition frequencies (PRFs) by using PD, perfusing an ultrasound micro-bubble contrast agent diluted with normal saline simulating human blood. By use of the data from two models of ultrasound machines, Aplio 500 (Toshiba) and Avius (Hitachi Aloka), the quantitative PD (QPD) index [the summation of the colored pixels in a 1 cm × 1 cm rectangular region of interest (ROI)] was calculated via Image J (internet free software). We found a positive correlation between the injection rate and the flow velocity. In Aplio 500 and Avius, we found negative correlations between the PRF and the QPD index when the flow velocity was constant, and a positive correlation between flow velocity and the QPD index at constant PRF. The equation for the relationship of the PRF between Aplio 500 and Avius was: y = 0.023x + 0.36 [y = PRF of Avius (kHz), x = PRF of Aplio 500 (kHz)]. Our results suggested that the signal calibration of various models of ultrasound machines is possible by adjustment of the PRF setting.
26727780 [Comparison of early clinical outcomes between mobile-bearing and fixed-bearing total knee 2015 Oct OBJECTIVE: To compare the early clinical outcomes of primary total knee arthroplasty in the valgus knee between mobile-bearing prosthesis and fixed-bearing prosthesis. METHODS: From January 2011 to December 2013, 17 patients (23 knees) treated by the same surgeon were selected for a retrospective study in the First Hospital of Jilin University, including 2 males and 15 females with a mean age of 61.5 years old (48 to 75 years). The pre-operative diagnosis included osteoarthritis (14 patients, 19 knees) and rheumatoid arthritis (3 patients, 4 knees). The patients with valgus deformity were divided into group A and group B. The patients in group A were treated with the fixed-bearing prosthesis (9 patients, 12 knees), and the patients in group B were treated with the mobile-bearing prosthesis (8 patients, 11 knees). The Knee Society Score (KSS), Hosptial for Special Surgery (HSS), Western Ontario MacMaster (WOMAC), the range of motion (ROM) and femorotibial angle were collected at pre-operation and post-operation follow-up for statistical analysis. RESULTS: All the patients were followed up, and the duration ranged from 6 to 36 months (mean 25 months). The valgus deformity was corrected in all patients, and there were significant differences for all patients between pre-operation and post-operation at the latest follow-up with regard to the KSS knee score, function score, HSS score, WOMAC score, ROM and femorotibial angle (P<0.01). There were no significant differences in KSS knee score, function score, HSS score, WOMAC score, improvement in ROM and femorotibial angle between two groups at the latest follow-up. However there were significant differences in ROM (P<0.05) between fixed-bearing group (101.8±8.8)° and mobile-bearing group (108.4±7.2)° at the latest follow-up. No case with spin-out of mobile bearing was observed. There were no complications in any patient, such as infection, common peroneal nerve injury, dislocation and instability. The X-ary imaging showed no osteolysis or implant loosening. CONCLUSION: The early clinical outcomes of primary total knee arthroplasty by using mobile-bearing prosthesis and fixed-bearing prosthesis are satisfactory for the treatment of the valgus knee, and the short term clinical outcomes of mobile-bearing TKA and fixed-bearing TKA are similar.
26924502 The inextricable axis of targeted diagnostic imaging and therapy: An immunological natural 2016 Mar In considering the challenges of approaches to clinical imaging, we are faced with choices that sometimes are impacted by rather dogmatic notions about what is a better or worse technology to achieve the most useful diagnostic image for the patient. For example, is PET or SPECT most useful in imaging any particular disease dissemination? The dictatorial approach would be to choose PET, all other matters being equal. But is such a totalitarian attitude toward imaging selection still valid? In the face of new receptor targeted SPECT agents one must consider the remarkable specificity and sensitivity of these agents. (99m)Tc-Tilmanocept is one of the newest of these agents, now approved for guiding sentinel node biopsy (SLNB) in several solid tumors. Tilmanocept has a Kd of 3×10(-11)M, and it specificity for the CD206 receptor is unlike any other agent to date. This coupled with a number of facts, that specific disease-associated macrophages express this receptor (100 to 150 thousand receptors), that the receptor has multiple binding sites for tilmanocept (>2 sites per receptor) and that these receptors are recycled every 15 min to bind more tilmanocept (acting as intracellular "drug compilers" of tilmanocept into non-degraded vesicles), gives serious pause as to how we select our approaches to diagnostic imaging. Clinically, the size of SLNs varies greatly, some, anatomically, below the machine resolution of SPECT. Yet, with tilmanocept targeting, the SLNs are highly visible with macrophages stably accruing adequate (99m)Tc-tilmanocept counting statistics, as high target-to-background ratios can compensate for spatial resolution blurring. Importantly, it may be targeted imaging agents per se, again such as tilmanocept, which may significantly shrink any perceived chasm between the imaging technologies and anchor the diagnostic considerations in the targeting and specificity of the agent rather than any lingering dogma about the hardware as the basis for imaging approaches. Beyond the elements of imaging applications of these agents is their evolution to therapeutic agents as well, and even in the neo-logical realm of theranostics. Characteristics of agents such as tilmanocept that exploit the natural history of diseases with remarkably high specificity are the expectations for the future of patient- and disease-centered diagnosis and therapy.
25869900 Adjustment in the clinical practice of treat-to-target guidelines for rheumatoid arthritis 2016 Jan OBJECTIVE: To analyze compliance with t2t clinical practice guidelines. METHODS: Cross-sectional observational study in consecutive patients with rheumatoid arthritis (RA) in 5 hospitals in the Canary Islands. Patients filled out activity scales, HAQ and answered the question of whether the doctor had explained the treatment target. The rheumatologist also collected: visits in the past year, use of activity indices and HAQ, DAS28 of current visit and date of the next visit. The percentage of compliance to indicators based on the t2t recommendations (R) 1, 3, 5-7 and 10 was analyzed. RESULTS: A total of 343 patients were recruited, 77% female, mean age 57, RA duration of 10 years. Median visits in the last year were 3 and mean time between last and current visit was 5.6 months. A total of 93% of the patients were treated with DMARDs and 44% were in remission by DAS (R1). In the previous visit, documented joint count was present in 85%, a HAQ in 19%, patient VAS in 41%, and a DAS28 in 35% of the patients (R6). The next visit was scheduled at an average of 4.3 months (R5). In 64% of patients with DAS28> 3.2 a visit between one and 3 months was scheduled (R5). A total of 96% of patients said they had been informed of the treatment target (R10). Variability between centers existed but was moderate. The only factor determining the performance of a DAS28 in the last visit was the patient's center of origin. CONCLUSIONS: The Canary Island centers studied achieved high levels of remission and low activity in their patients. The performance of composite indices and follow-up frequency recommended by the t2t are met, although there is room for improvement.
25910404 The assessment of lesions of the Achilles tendon by ultrasound imaging in inflammatory art 2015 Aug OBJECTIVE: Ultrasound (US) is a highly sensitive, reliable and non-invasive tool, which allows for the assessment of lesions of tendons and entheseal sites. The aim of this systematic review and meta-analysis is to identify differences in US lesions of the Achilles tendon (AT) between people with inflammatory arthritis (IA) and healthy controls. METHODS: An electronic literature search was performed on Medline, CINAHL, SportDiscus and The Cochrane Library. Methodological quality was assessed using a modified Quality Index. Odds ratios with 95% confidence intervals (CI) were determined. Meta-analysis was conducted on those studies that were considered to be homogenous. RESULTS: A total of 13 high-to-medium quality studies met the inclusion criteria. The majority of studies reported US lesions in spondyloarthropathy (SpA), with limited evidence for other forms of IA. US lesions were not consistently defined with regard to Outcome Measures in Rheumatology Clinical Trials (OMERACT) definitions, and numerous scoring systems were used across the majority of studies. The mean AT thickness at the enthesis in people with SpA was 0.54mm thicker (95% CI: 0.10-0.97mm) with more frequent erosions in people with SpA (odds ratio = 7.43, 95% CI: 1.99-27.77, P = 0.003) and rheumatoid arthritis (RA) (odds ratio = 9.60, 95% CI: 1.23-74.94, P = 0.03), compared to controls. There was no significant difference in the frequency of enthesophyte formation in people with SpA compared to the controls (odds ratio = 2.48, 95% CI: 0.64-9.70, P = 0.19). CONCLUSIONS: The systematic review identified that a majority of studies reporting US lesions were in SpA, but limited evidence relating to other forms of IA. Consistent application of the OMERACT US definitions and scoring of US lesions is required in future studies of AT disease in IA. Further work is also required to distinguish between US lesions reflective of inflammation and structural damage.
26118037 [COMBINED HONDROPROTECTION IN REHABILITATION OF PATIENTS WITH DIABETES MELLITUS WITH DIABE 2015 Jan The efficacy and tolerability of combined chondroprotectors Teraflex® in patients with diabetes mellitus type 1 and 2, complicated by arthropathy were investigated. It was established, that Tera- flex® therapy positively influences on the development of diabetic arthropathy (reducing intensity of pain, increasing the range of movements and reduced volume of the affected joints, increasing the functionality of the patient). In addition, an analysis of the impact of chondroprotectors on the level of sugar among patients.It was found, that it is necessary to control blood sugar while taking chondroprotectors and if needed, increasing the dose of hypoglycohaemic drugs during this period.
26474192 Clinical efficacy, radiographic progression, and safety through 156 weeks of therapy with 2016 Jul OBJECTIVE: To evaluate the safety and efficacy of golimumab + methotrexate (MTX) in Japanese patients with active rheumatoid arthritis (RA). METHODS: Japanese patients with active RA despite MTX were randomized to placebo + MTX (Group 1, n = 88), golimumab 50 mg + MTX (Group 2, n = 86), or golimumab 100 mg + MTX (Group 3, n = 87). Patients with <20% improvement in swollen/tender joint counts entered early escape at week 16. At week 24, all remaining placebo patients crossed over to golimumab 50 mg. Efficacy assessments included ACR20, DAS28-ESR, and HAQ-DI. Radiographic progression was assessed with the van der Heijde-modified Sharp (vdH-S) score. RESULTS: ACR20 response rates in Group 1, Group 2, and Group 3 were 67.9, 86.1, and 82.4%, respectively, at week 52 and were maintained through week 104 (87.1, 94.0, and 88.7%) and week 156 (97.1, 94.1, and 89.5%). Proportions of patients with good/moderate DAS28-ESR response or clinically meaningful improvement in HAQ-DI were also maintained through week 156. The majority of patients did not experience radiographic progression through week 156. Among 257 golimumab-treated patients, 251 (97.7%) had ≥1 AE; 54 (21.0%) had ≥1 serious AE through week 156. Infections were the most common type of AE. CONCLUSIONS: Response to golimumab + MTX was maintained over 3 years in Japanese patients with active RA despite MTX. Safety results were consistent with the known safety profile of golimumab.
26324949 Drug trough levels predict therapeutic responses to dose reduction of adalimumab for rheum 2016 Jan OBJECTIVE: To evaluate the impact of adalimumab (ADA) dose-halving on therapeutic responses and drug levels, the differences in drug levels among patients with different therapeutic responses and the optimal baseline cut-off ADA levels for predicting persistent remission or low disease activity (LDA) at week 24 of dose-halving therapy in 64 RA patients who had already achieved LDA or remission at baseline. METHODS: Anti-ADA antibody levels were determined by bridging ELISA, ADA levels were evaluated using sandwich ELISA and therapeutic responses were assessed by the 28-joint DAS change. The optimal cut-off drug levels for predicting persistent remission were determined by receiver operating characteristic curve analysis. RESULTS: At baseline, 25 (39.1%) and 39 (60.9%) patients had achieved remission and LDA, respectively. After 24 week ADA dose-halving, persistent remission was observed in 23 patients, remission turned LDA in 2 patients, persistent LDA in 24 patients and disease flare in 15 (23.5%) patients. Three patients who developed anti-ADA antibodies at week 24 of dose-halving had very low drug levels and disease flare. Among 61 anti-ADA antibody-negative patients, ADA levels declined by half after 24 weeks of dose-halving (median 5.5 vs 2.6 μg/ml). Baseline ADA levels were significantly higher in patients with persistent remission (median 10.5 μg/ml) or LDA (4.5 μg/ml) than in those with disease flare (0.9 μg/ml), indicating associations of ADA levels with therapeutic responses. An ADA level above the cut-off value of 6.4 μg/ml might predict persistent remission after dose-halving with high sensitivity and specificity. CONCLUSION: ADA dose-halving is feasible for patients who have achieved remission and sufficient drug levels. Drug level monitoring may help clinicians optimize the dosing regimen and prevent overtreatment for patients receiving anti-TNF-α therapy.
27958380 Influence of IL6R gene polymorphisms in the effectiveness to treatment with tocilizumab in 2018 Jan In the present study, we aimed to investigate the influence of clinical parameters and single-nucleotide polymorphisms of interleukin-6 receptor (rs12083537, rs2228145, rs4329505 and rs11265618) on response to tocilizumab, TCZ (European League Against Rheumatism (EULAR) response, remission, low disease activity (LDA) and improvement of DAS28). We performed a retrospective cohort study in patients with Rheumatoid Arthritis (RA) treated with TCZ for 12 months. Multivariable analysis showed that the only variable independently associated to satisfactory EULAR response (odds ratio (OR): 0.61; 95% of confidence interval (CI)(95%): 0.42, 0.88; P=0.008), remission (OR: 0.51; CI(95%): 0.35, 0.75; P=0.001), LDA (OR: 0.41; CI(95%): 0.24, 0.72; P=0.002) and improvement in DAS28 (B=-0.32; CI(95%)): -0.47, -0.17; P=7.5 × 10(-5)) at 12 months was lower number of previous biological therapy (BT). High baseline DAS28 was also associated with a greater decrease in DAS28 at 12 months of treatment (B=0.99; CI(95%): 0.79, 1.20; P=1.5 × 10(-14)). Those patients who were carriers of AA genotypes for rs12083537 (OR: 13.0; CI(95%): 2.31, 72.91; P=0.004) and CC for rs11265618 (OR: 12.15; CI(95%): 2.18, 67.81; P=0.004) had better LDA response at 12 months of treatment with TCZ. In conclusion, RA patients treated with TCZ showed better EULAR response, remission, LDA and DAS28 improvement rates when a lower number of BT were previously administered. The AA genotype for rs12083537 and CC for rs11265618 polymorphisms for may act as predictors of good response LDA.
26872426 Tocilizumab and pregnancy: Four cases of pregnancy in young women with rheumatoid arthriti 2016 Sep OBJECTIVES: To investigate the use of tocilizumab (TCZ) in pregnant patients with active rheumatoid arthritis (RA) refractory to anti-tumour necrosis factor (TNF) agents. METHODS: We retrospectively analysed the medical records of pregnant women with active RA treated between July 2008 and January 2015 by the Division of Maternal Medicine at our hospital. Inclusion criteria for this case series included active RA refractory to anti-TNF agents and exposure to TCZ at the time of conception. RESULTS: Our review of 28 patient hospital records identified four patients who met the inclusion criteria. All four patients had active synovitis before starting treatment with TCZ. Successful TCZ therapy allowed them to plan to become pregnant. When pregnancy was confirmed, TCZ was terminated as soon as possible in all patients. Three patients delivered full-term infants without any adverse outcomes. One patient had a partial molar pregnancy and miscarried during gestational week 11. Two patients remained in clinical remission with low-dose prednisolone (PSL) or no treatment for RA during pregnancy. CONCLUSIONS: TCZ may be a good alternative therapy for RA patients with symptoms that are hard to control with TNF blockers who desire to bear children.
25418272 Meta-analysis of tumor necrosis factor inhibitors and glucocorticoids on bone density in r 2015 May OBJECTIVE: To examine the impact of antirheumatic drugs on bone mineral density (BMD) in rheumatoid arthritis (RA), ankylosing spondylitis (AS), psoriatic arthritis (PsA), and psoriasis using a systematic review. METHODS: Electronic databases were systematically searched for randomized controlled trials. Studies were grouped based on disease, treatment, and site of BMD measurement. Change in BMD (ΔBMD) from baseline to end of study was recorded. Standardized mean difference (SMD) of ΔBMD between treatment and controls was standardized for meta-analyses and 95% confidence intervals (95% CIs) were calculated. RESULTS: Treatment effects on BMD were not the primary outcomes of the trials. Thirteen studies were eligible (11 RA, 2 AS, 0 PsA, and 0 psoriasis). For RA, significantly less hand bone loss was seen with tumor necrosis factor inhibitors (TNFi; SMD ΔBMD 0.33 [95% CI 0.13, 0.53], P = 0.001, I(2)  = 0%) and glucocorticoids (SMD ΔBMD 0.51 [95% CI 0.20, 0.81], P = 0.001, I(2)  = 0%). TNFi had no significant effect on lumbar spine and hip BMD. Glucocorticoids were associated with a negative effect on lumbar spine (SMD ΔBMD -0.30 [95% CI -0.55, -0.04], P = 0.02, I(2)  = 52%), but not hip BMD. For AS, a significant increase in BMD was seen with TNFi at the lumbar spine (SMD ΔBMD 0.96 [95% CI 0.64, 1.27], P < 0.001, I(2)  = 16%) and hip (SMD ΔBMD 0.38 [95% CI 0.13, 0.62], P = 0.003, I(2)  = 0%). Data were insufficient to perform meta-analyses in PsA and psoriasis or for other antirheumatic drugs. CONCLUSION: In RA, TNFi and glucocorticoids appeared to attenuate hand bone loss. TNFi did not impact lumbar spine and hip BMD and glucocorticoids had negative effects on lumbar spine and no effect on hip BMD. In AS, TNFi was associated with improved lumbar spine and hip BMD.
24431391 Expression of FcRL4 defines a pro-inflammatory, RANKL-producing B cell subset in rheumatoi 2015 May OBJECTIVES: The success of B cell targeting therapies has highlighted the importance of B cells in rheumatoid arthritis pathogenesis. We have previously shown that B cells in the RA synovium are capable of producing pro-inflammatory and bone-destructive cytokines including RANKL. Here we sought to characterise the nature and functional relevance of the RANKL-producing B cell subset in the RA synovium. METHODS: Synovial fluid and peripheral blood B cells from patients with RA were analysed by flow cytometry for markers of B cell differentiation and activation and for chemokine receptors. FcRL4(+) and FcRL4(-) B cells sorted from synovial fluid were analysed for cytokine expression using Taqman low-density arrays. Synovial tissue biopsies obtained from patients with RA were analysed by immunofluorescence for CD20, RANKL and FcRL4. FCRL4 mRNA expression was determined in synovial tissue of RA patients and non-inflammatory control subjects by real-time PCR. RESULTS: RANKL-producing B cells in RA synovial tissue and fluid were identified as belonging to a distinct subset of B cells defined by expression of the transmembrane protein FcRL4. FcRL4+ B cells express a distinct combination of cytokines and surface proteins indicating a function distinct from that of FcRL4- B cells. Notably, FcRL4+ B cells expressed high levels of TNF-α and RANKL mRNA. CONCLUSIONS: We have identified a novel pro-inflammatory B cell population in the RA synovium which is defined by expression of FcRL4 and responsible for RANKL production. This B cell population expresses high levels of CD20, and its removal by rituximab may contribute to the anti-inflammatory effect of this drug.
25900041 Circadian Clocks in the Immune System. 2015 Aug The immune system is a complex set of physiological mechanisms whose general aim is to defend the organism against non-self-bodies, such as pathogens (bacteria, viruses, parasites), as well as cancer cells. Circadian rhythms are endogenous 24-h variations found in virtually all physiological processes. These circadian rhythms are generated by circadian clocks, located in most cell types, including cells of the immune system. This review presents an overview of the clocks in the immune system and of the circadian regulation of the function of immune cells. Most immune cells express circadian clock genes and present a wide array of genes expressed with a 24-h rhythm. This has profound impacts on cellular functions, including a daily rhythm in the synthesis and release of cytokines, chemokines and cytolytic factors, the daily gating of the response occurring through pattern recognition receptors, circadian rhythms of cellular functions such as phagocytosis, migration to inflamed or infected tissue, cytolytic activity, and proliferative response to antigens. Consequently, alterations of circadian rhythms (e.g., clock gene mutation in mice or environmental disruption similar to shift work) lead to disturbed immune responses. We discuss the implications of these data for human health and the areas that future research should aim to address.
27897259 Artemisinin analogue SM934 attenuate collagen-induced arthritis by suppressing T follicula 2016 Nov 29 SM934 is an artemisinin analogue with immunosuppressive properties and potent therapeutic activity against lupus-like diseases in autoimmune mice. In this report, the therapeutic efficacy and underlying mechanisms of SM934 on rheumatoid arthritis (RA) was investigated using collagen-induced arthritis (CIA) in DBA/1J mice. We demonstrated that SM934 treatment alleviate the severity of arthritis in CIA mice with established manifestations. The therapeutic benefits were associated with ameliorated joint swelling and reduced extent of bone erosion and destruction. Further, administration of SM934 diminished the development of T follicular helper (Tfh) cells and Th17 cells and suppressed the production of pathogenic antibodies, without altering the proportion of germinal center B cells. Ex vivo, SM934 treatment inhibited the bovine type II collagen (CII) induced proliferation and inflammatory cytokines secretion of CII -reactive T cells. In vitro, SM934 impeded the polarization of naïve CD4(+) T cells into Tfh cells and the expression of its transcript factor Bcl-6. Moreover, SM934 decreased the IL-21-producing CD4(+) T cells and dampened the IL-21 downstream signaling through STAT3. These finding offered the convincing evidence that artemisinin derivative might attenuate RA by simultaneously interfering with the generation of Tfh cells and Th17 cells as well as the subsequent antibody-mediated immune responses.
27886691 Pharmacotherapy Pearls for the Geriatrician: Focus on Oral Disease-Modifying Antirheumatic 2017 Feb Providing safe and effective pharmacotherapy to the geriatric patients with rheumatological disorders is an ongoing struggle for the rheumatologist and geriatrician alike. Cohesive communication and partnership can improve the care of these patients and subvert adverse outcomes. Disease-modifying antirheumatic drugs, including methotrexate, hydroxychloroquine, sulfasalazine, and leflunomide, and the newest oral agent for treatment of rheumatoid arthritis, tofacitinib, have distinctive monitoring and adverse effect profiles. This article provides the general practitioner or geriatrician with clinically relevant pearls regarding the use of these interventions in older patients.
24584757 Therapeutic effect of dimethyl dimethoxy biphenyl dicarboxylate on collagen-induced arthri 2015 Nov OBJECTIVE: To study the effect of oral administration of dimethyl dimethoxy biphenyl dicarboxylate (DDB) on adjusting angiogeneic/inflammatory mediators and ameliorating the pathology of bones in rats with collagen-induced arthritis (CIA). METHODS: Wistar rat model of CIA was set up using bovine collagen type II. Fifty rats were divided into five groups randomly: normal, CIA model, DDB treatment, methotrexate (MTX) treatment, and combined DDB+MTX treatment. Ankle joints of rats were imaged with digital X-ray machine to show the destruction of joints. Fore and hind paw and knee joints were removed above the ankle joint then processed for haematoxylin and eosin staining. Plasma levels of vascular endothelial growth factor (VEGF), platelet derived growth factor, interleukin-8 (IL-8), IL-4, tumor necrosis factor α (TNF-α), and cyclooxygenase-2 (COX-2) were quantified by enzyme-linked immunosorbent assay. Nitric oxide levels were detected by Griess reagent. RESULTS: Compared with the CIA model group, a remarkable reduction in various angiogenic (VEGF and IL-8) and inflammatory mediators (TNF-α, IL-4 and COX-2) after treatment with DDB either alone or combined with MTX P<0.05 or P<0.01). Histopathological and X-ray findings were confirmatory to the observed DDB anti-arthritic effect. The DDB-treated group showed amelioration in signs of arthritis which appeared essentially similar to normal. CONCLUSION: Our data shed light on the therapeutic efficacy of DDB in experimental rheumatoid arthritis (RA) compared with a choice drug (MTX) and it may be offered as a second-line drug in the treatment of RA.
26408612 Association of TNF-α gene polymorphisms with 
the risk of rheumatoid arthritis in 
Ha 2015 Sep OBJECTIVE: To investigate the association of TNF-α-308 gene polymorphism with the risk of RA in Hunan's Han Chinese population.
 METHODS: A total of 112 patients with RA from Han Chinese population in Hunan were recruited, along with 129 healthy controls. TNF-α-308 (rs1800629) gene polymorphisms were analyzed by PCR-RFLP. Serum levels of TNF-α were detected by ELISA.
 RESULTS: TNF-α-308 A allele carrier was 3.6% in RA patients and 10.5% in controls (P=0.004); male RA patients displayed noticeably lower rates of TNF-α-308 A allele than that in the male controls (2.8% vs 15.6%, OR=0.179, P=0.007). Patients containing both HLA-DRB1*04 and TNF-α-308 GG genotype showed a significant increase in risk for RA (OR=6.107), no matter they were male (OR=7.273) or female (OR=5.029). Female RA patients with both HLA-DRB1*04 and TNF-α-308 GG showed earlier disease onset and higher TNF-α level.
 CONCLUSION: In Han Chinese population from Hunan, susceptibility of RA was increased in patients with TNF-α-308 G allele, especially in the female carrier of genotypes; TNF-α-308 A allele may play a positive role in reduction of RA risk in males.
25996429 ASSOCIATIONS BETWEEN AGE-RELATED MACULAR DEGENERATION, OSTEOARTHRITIS AND RHEUMATOID ARTHR 2015 Dec PURPOSE: The epidemiologic relationship between age-related macular degeneration (AMD) and arthritis is unknown and has implications for understanding disease pathogenesis and treatment strategies. METHODS: An AMD cohort of 245,912 people was constructed from English linked hospital episode statistics (1999-2011), principally comprising neovascular AMD patients undergoing anti-vascular endothelial growth factor therapy. We compared the AMD cohort with a reference cohort (2,134,771 people) for rates of subsequent osteoarthritis (OA) and rheumatoid arthritis. Osteoarthritis (2,032,472 people) and rheumatoid arthritis (261,232 people) cohorts were also constructed and compared with the reference cohort for rates of subsequent AMD. RESULTS: Risk of arthritis after AMD was not elevated. The rate ratio for OA was 0.96 (95% confidence interval 0.95-0.97) and for rheumatoid arthritis was 0.98 (0.94-1.02). However, risk of AMD after arthritis was modestly raised. For OA, the rate ratio was 1.06 (1.04-1.08), but risk increased with longer OA duration, for example, 1.15 (1.08-1.23) for >10 years. For rheumatoid arthritis, the rate ratio was also modestly elevated at 1.15 (1.12-1.19). CONCLUSION: Age-related macular degeneration and arthritis are degenerative aging conditions that share some disease mechanisms and extracellular matrix involvement. However, considering arthritis after AMD, they are not positively associated. By contrast, people with OA experience modestly increased AMD risk, perhaps owing to medical treatments for OA.
28043761 The effect of body mass index on clinical response to abatacept as a first-line biologic f 2017 Oct OBJECTIVE: To assess the impact of baseline body mass index (BMI) on the efficacy and retention of intravenous abatacept at 6 months in biologic-naïve patients with rheumatoid arthritis (RA). METHODS: This was a 6-month analysis of a 2-year, non-interventional, international, prospective study. Baseline characteristics, clinical response and retention rates were compared by BMI subgroup: underweight/normal, overweight and obese (<25, 25 to <30 and ≥30kg/m(2), respectively). RESULTS: BMI was reported in 643/672 (96%) patients: 264 (41%) were underweight/normal, 224 (35%) overweight and 155 (24%) obese. At baseline, the obese group had more active disease (mean [95% confidence intervals] 28-joint Disease Activity Score [C-reactive protein; derived] 4.6 [4.5, 4.7], 4.8 [4.7, 5.0] and 5.1 [4.9, 5.2] for underweight/normal, overweight and obese groups, respectively), a higher prevalence of metabolic disorders, a greater proportion of women and a lower proportion of patients with rheumatoid factor positivity. There were no significant differences in the percentages of patients achieving a good/moderate European League Against Rheumatism response by BMI group (80.7, 86.1 and 77.0% for underweight/normal, overweight and obese groups, respectively; P=0.178). Overall retention rates at 6 months did not differ across groups (89, 92 and 89% for underweight/normal, overweight and obese groups, respectively; log-rank P=0.382). After adjustment for baseline characteristics, BMI was not significantly associated with risk of discontinuation (reference BMI<25kg/m(2); hazard ratio [95% confidence intervals] 0.46 [0.22, 0.99] and 0.69 [0.34, 1.41] for overweight and obese patients, respectively). CONCLUSION: BMI does not impact abatacept clinical response or retention in biologic-naïve patients with RA.
25856512 Genetic variants of SLC11A1 are associated with both autoimmune and infectious diseases: s 2015 Jun A systematic review and meta-analyses were undertaken to investigate the association of SLC11A1 genetic variants with disease occurrence. Literature searching indentified 109 publications to include in the meta-analyses assessing the association of 11 SLC11A1 variants with autoimmune and infectious disease. The (GT)n promoter alleles 2 and 3 (rs534448891), which alter SLC11A1 expression, were significantly associated with tuberculosis (OR=1.47 (1.30-1.66), OR=0.76 (0.65-0.89), respectively) and infectious disease (OR=1.25 (1.10-1.42), OR=0.83 (0.74-0.93), respectively). However, although no association was observed with autoimmune disease, a modest significant association was observed with type 1 diabetes (allele 2 OR=0.94 (0.89-0.98)). On the basis of a stronger association of (GT)n allele 2 with tuberculosis, compared with the protective effect of allele 3, we hypothesise that allele 2 is likely the disease-causing variant influencing disease susceptibility. Significant associations were observed between the 469+14G/C polymorphism (rs3731865) and autoimmune disease (OR=1.30 (1.04-1.64)) and rheumatoid arthritis (OR=1.60 (1.20-2.13)) and between the -237C/T polymorphism (rs7573065) and inflammatory bowel disease (OR=0.60 (0.43-0.84)). Further, significant associations were identified between the 469+14G/C, 1730G/A and 1729+55del4 polymorphisms (rs3731865, rs17235409 and rs17235416, respectively) and both infectious disease per se and tuberculosis. These findings show a clear association between variants in the SLC11A1 locus and autoimmune and infectious disease susceptibility.