Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 2198390 | Diagnostic, prognostic and therapeutic aspects of systemic lupus erythematosus and rheumat | 1990 | Rheumatoid arthritis and systemic lupus erythematosus are rheumatic diseases characterized by excessive immunoreactivity. Exaggerated immunity is manifested as auto-antibody production and aberrant cell-mediated reactions directed against autologous tissue. Although the mechanisms and site for abnormal immune responses are not completely understood, risk factors that predispose an individual to develop rheumatoid arthritis or systemic lupus erythematosus can be defined. Genetic factors, especially HLA genes, play an important role in rendering a host susceptible to the sequelae of immunologically mediated diseases. Modern technology, such as T-cell cloning, can be used to dissect polymorphic HLA determinants involved in the genetic susceptibility for rheumatoid arthritis and systemic lupus erythematosus. Mapping of disease-associated determinants in rheumatoid arthritis patients suggests that polymorphic sites within the third hypervariable region of the HLA-DR beta 1-chain are functionally involved in the initiation and perpetuation of the disease. These HLA-determinants function to mediate the contact between the HLA- and the T-cell receptor molecules. In systemic lupus erythematosus patients, the role of disease associated molecules appears to be distinct; genetic susceptibility is correlated to patterns of auto-antibody productions. Immunogenetic studies may provide diagnostic tools to subset patients with rheumatoid arthritis and systemic lupus erythematosus and develop prognostic markers to tailor immunomodulatory therapy. Both diseases are characterized by high levels of morbidity and mortality, but can now be mitigated by the careful and judicious use of immunosuppressives. | |
| 2009677 | Animal models of rheumatoid arthritis. Clues to etiology and treatment. | 1991 Apr | Animal models of rheumatoid arthritis (RA) provide useful systems for the characterization of the immunopathogenic mechanisms of chronic inflammatory synovitis. Although at least eight models have been described, the adjuvant arthritis, streptococcal cell wall-induced arthritis, and collagen-induced arthritis models have provided the most useful insights. Each of these three models has contributed clues to our understanding of RA and have yielded promising new approaches to treatment. These include combination pharmacotherapy, antigen-specific therapy, cell-specific therapy, and monoclonal antibody therapy. All of these immunotherapeutic interventions have been shown to be beneficial in one or more animal systems. This suggests that future therapies for RA and other human autoimmune diseases may be more immunoselective and, potentially, less toxic. | |
| 3142068 | The molecular basis of susceptibility to rheumatoid arthritis: the conformational equivale | 1988 | This is an interpretive review of recent immunologic and molecular biologic data concerning the molecular basis of susceptibility to rheumatoid arthritis. The central point of view was taken that the major histocompatibility complex (MHC) class II molecules encoding disease susceptibility function in an immune recognition event involving an antigen "X" that currently eludes characterization. The problem of understanding the meaning of the association of susceptibility with diverse MHC alleles such as DR4 (Dw4 and Dw14), DR1, and DRw10 is approached by detailed biochemical analysis that led to the identification of common stretches of amino acid sequence, presumably encoding conformationally equivalent structures. Non-classic MHC polymorphisms related to disease susceptibility but not associated with particular alleles such as identified by Ab 109d6 proved especially valuable in suggesting new directions for attempting to understand the significance of these associations. Consideration is given to the possibility that a family of either slightly different or identical conformations encoded in either cis or trans cumulatively confer the liability to develop rheumatoid arthritis, and implying a highly non-classic mode of inheritance. The available data do not permit a distinction between the possibilities that an antigen "X" was being presented to T cells or whether the distinctive conformations of the MHC class II molecule serve the same role as antigen "X" but are directly recognized by T cells. However, with additional data, some limited insight should be able to be inferred about the nature of an antigen "X" that specifically binds to the MHC conformation with a complementary interaction. It seems reasonable to consider the pathogenesis of rheumatoid arthritis as a typical immune response resulting from a simple immune recognition event of a single antigenic molecule. | |
| 1865588 | Factor V deficiency in a patient with rheumatoid arthritis. | 1991 Mar | Factor V deficiency associated with rheumatoid arthritis was found in a 54-year-old woman. Hereditary factor V deficiency is very rare; only about 150 cases have been reported since its discovery in 1943. This appears to be the first case report of factor V deficiency associated with rheumatoid arthritis in the literature. | |
| 3703763 | Early rheumatoid arthritis. Approach to diagnosis and treatment. | 1986 May 1 | Early rheumatoid arthritis is a diagnosis most often made by history and physical examination and is frequently a diagnosis of exclusion. Differential diagnosis can be difficult because of the wide variation in age, sex, constitutional symptoms, physical findings, and joint distribution. Early, aggressive therapy should include patient education, rest, graded exercise, counseling, and appropriate medication. Absence of subcutaneous nodules and joint erosion may indicate a better prognosis in rheumatoid arthritis. Presence of rheumatoid factor, eosinophilia, thrombocytosis, and/or vasculitis suggests a less favorable course. | |
| 1757925 | Rheumatoid factors antedating clinical rheumatoid arthritis. | 1991 Sep | The relationship between rheumatoid factors (RF) and rheumatoid arthritis (RA) was studied in the Mini-Finland Health Survey. This covered a representative sample of the Finnish population over 30 years of age, initially comprising 8,000 persons, of whom 7,217 participated in the field survey carried out in 1978-80. The participants were followed using record linkage with the Social Insurance Institution's population register to identify patients entitled to free medication. Until the end of 1988, 21 persons had developed new seropositive RA. In 15 cases, preillness specimens contained elevated levels (greater than or equal to 20 IU/ml) of RF. In the remaining 6 cases with RF negative preillness specimens, the interval from taking the blood specimen to the onset of disease was 4 years or more. RF represent a key element in the rheumatoid inflammatory process. Their occurrence in preillness specimens suggests that they may have a primary role in the pathogenesis of the disease. | |
| 3126221 | Nutritional considerations in rheumatoid arthritis. | 1988 Mar | Rheumatoid arthritis is a chronic, systemic, inflammatory disorder of unknown etiology. The severity of the disease process adversely affects nutritional status. Articular changes, such as small joint deformities and temporomandibular joint syndrome, alter the ability to self-feed. The inflammatory process may increase metabolic rate. Ingestion, digestion, absorption, and excretion may be compromised by secondary manifestations of the disease. Comprehensive nutrition assessment incorporates evaluation of disease and treatment-specific factors, along with the usual assessment parameters. Abnormal values for certain assessment parameters do not necessarily reflect nutritional status. Treatment methods, including medications, may have an impact on nutritional status, assessment tools, and self-feeding. Nutrition management goals focus on identification and implementation of feeding strategies. Evaluation of the ability to feed oneself includes consideration of functional status, secondary manifestations, and medical treatment. Multiple feeding modalities may be required. Oral supplements, tube feedings, and parenteral nutrition may be employed to meet the nutrition needs of the individual with rheumatoid arthritis. | |
| 2696743 | Rheumatoid arthritis with forefoot reconstruction. | 1989 May | Rheumatoid arthritis is a systemic disorder affecting joints as well as organ systems. The disease sequellae may result in complete loss of functional capacity. Surgical intervention including reconstruction of the forefoot may provide the patient with the opportunity to return to more activities of daily life. | |
| 3263044 | Differential diagnosis of rheumatoid arthritis. | 1988 Oct 14 | The differential diagnosis of subacute or chronic polyarthritic diseases, including rheumatoid arthritis, is based on recognizing a pattern of changes, with special emphasis placed on certain key features that possess higher specificity. The clinical history is by far the most important diagnostic tool and involves clear assessment of the distribution of joint involvement, whether pain is articular or extra-articular, whether a syndrome follows trauma or infection, and the duration of the process. The distribution of involved joints is a major contributor to differential diagnosis but can be misleading unless a skilled physical examination confirms objective synovitis. If present, nodules, which represent localization of the disease process, also offer a powerful tool in differential diagnosis. Rheumatoid nodules occur in about 20 percent of patients with well-developed rheumatoid arthritis. The effects of inflammation may be clinically detectable, but laboratory tests--e.g., the erythrocyte sedimentation rate and quantitative C-reactive protein--provide the most reliable evidence of inflammation. Synovial fluid analysis may reveal inflammatory changes and other abnormalities permitting diagnosis. Rheumatoid factor is present in about 80 percent of patients with rheumatoid arthritis but is not specific for this diagnosis. | |
| 1711726 | [Antikeratin antibodies in rheumatoid arthritis]. | 1991 May 27 | On the basis of the literature and the author's own investigations the present knowledge about antikeratin antibodies (AKA) in rheumatoid arthritis (RA) is summarized. The specificity of AKA for RA is described between 90% and 100%, but the sensitivity is reported as varying from 36% to 80%. In conclusion, AKA have great diagnostic value in RA and, high titre AKA, were found to be pathognomonic for RA. Further studies are necessary to confirm if AKA are also of prognostic and pathogenetic value in RA. | |
| 2923506 | Rheumatoid arthritis in blacks in South Africa. | 1989 Jan | The spectrum of rheumatoid arthritis (RA) was studied in a group of 52 blacks who attended a rheumatology unit in Cape Town, South Africa. The mean age of the patients was 44.6 years, and the female to male ratio was 3.7:1. Significant radiographic changes were frequently noted, and the mean Larsen scores were 34.9 for the hands, 19.6 for the feet, and 6.6 for the wrists. About two thirds of the patients had received an immunomodulatory drug and 20 (38%) had had one or more surgical procedures for their RA. Anaemia was the commonest extra-articular manifestation, and although the other extra-articular features were uncommon, a variety of features had been detected during the course of the disease. Earlier studies on blacks in Africa suggested that RA was a mild disease; our findings, however, are in agreement with the more recent surveys, which suggest that severe disease is not uncommon. | |
| 1749940 | The rheumatoid hand: orthotics as preventative. | 1991 Oct | The treatment of hand disease in patients with rheumatoid arthritis (RA), with focus on rehabilitation and splinting, is discussed. A review of the data on splinting of hands in RA is included, as is a review of methods for evaluating hand function and staging RA. Recommendations are made for splinting early in the disease course and prior to surgery, rather than late in the course of RA, in an effort to minimize contractures. | |
| 2584728 | Ocular manifestations of rheumatoid arthritis. | 1989 Jun | One hundred and seven patients of definite rheumatoid arthritis were screened for the presence of ocular manifestations of which 21 (19.63%) were observed to have ocular changes. Of these keratoconjunctivitis sicca in 19 (17.7%) patients and episcleritis in one (0.93%) were attributable to rheumatoid arthritis. Bilateral retinal haemorrhage in one patient was due to grade 3 hypertensive retinopathy. Absence of posterior subcapsular cataract in 106 (99.06%) patients who did not receive corticosteroids supports the hypothesis that steroids are the aetiologic agents and not rheumatoid arthritis. | |
| 3607380 | Rheumatoid arthritis and IgA nephropathy. | 1987 Aug | We describe four patients with seropositive rheumatoid arthritis who developed proteinuria and microscopic haematuria. Renal biopsy demonstrated a mesangial proliferative glomerulonephritis with mesangial deposits of IgA. These data suggest a possible causal relationship between rheumatoid arthritis and IgA nephropathy. | |
| 3277683 | Radiological assessment of outcome in rheumatoid arthritis. | 1988 | Radiographs are an accepted method of assessing disease severity and progression in rheumatoid arthritis. The advantages of using radiological damage as an outcome measure are that it reflects the history of the joint pathology, it can be objectively scored, radiographs provide a permanent record necessary for sequential studies and they do relate to other measures of disease outcome. However, measurement of radiological damage is fraught with methodological problems and studies to define what is the best approach have only recently been performed. There is also the problem of differentiating between radiological progression which is unavoidable due to mechanical derangement and that which is due to currently active disease. The effect of treatment on radiological damage remains controversial. A better understanding of how to use this important outcome measure should now provide rheumatologists with a more critical assessment of new therapies as well as providing a better knowledge of the disease process. | |
| 2662372 | [The immunology of rheumatoid arthritis. Influence of basic treatment]. | 1989 Apr 30 | Rheumatoid arthritis is a disease determined and influenced by many factors genetic, environmental, endocrine, psychological and immunological. Immunological mechanisms (hyperexpression of class II HLA antigens, cytokinin anomalies, functional deficiencies of certain lymphocyte categories, polyclonal activation of B lymphocytes with production of antibodies) suffice to maintain between them the immune response, synovial inflammation, and lesions of bone and cartilage. Progress in understanding these diverse pathogenic factors in RA will eventually lead more selectively targeted treatments to supercede the present empirical use of basic treatments. | |
| 3266362 | What is seronegative rheumatoid arthritis? | 1988 | Between classical, erosive, seropositive rheumatoid arthritis (RA) on one hand, and typical, axial ankylosing spondylitis (AS) on the other, there is a variety of seronegative polyarthritides, which are often difficult to diagnose, classify and also to distinguish from each other. During our studies of HLA antigens and their associations with rheumatic diseases, and particularly that of DR4 with RA, we became increasingly concerned with the problem of defining properly patients with seronegative RA. Both the statement of seronegativity with regard to rheumatoid factors (RF), the diagnosis of RA, and particularly the exclusion of cases of seronegative arthritis other than RA were difficult. We felt that such problems might explain the conflicting opinions as to the association between RF and HLA-DR4 in patients with RA. As a basis for discussing these problems, a set of criteria for RF seronegative RA are presented. | |
| 2009663 | Epidemiologic aspects of rheumatoid arthritis. Current immunogenetic approach. | 1991 Apr | Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease of unknown etiology. Pathologically, RA is characterized by a destructive synovitis in multiple diarthrodial joints and immunologically by the presence in serum and joint fluid of autoantibodies to IgG (rheumatoid factor). The diagnosis remains a clinical one and, as such, RA investigations use epidemiologic methodologies. It is now clear that there is an important genetic contribution to the etiology of RA evidenced by the association of the disease with HLA-DR4, an allele of the major histocompatibility complex located on the short arm of chromosome six. HLA associations with RA occur in several different populations. This genetic epidemiologic approach substantiates the HLA association with disease and lays the foundation for recent molecular genetic discoveries that are reviewed, particularly the MHC structure and function. | |
| 2677895 | Rheumatoid hindfoot. | 1989 Oct | Rheumatoid arthritis of the hindfoot is a relatively common problem and should be distinguished from other hindfoot and ankle disorders. Various nonoperative and operative treatments may be used effectively to relieve pain, functional restrictions, and footwear restrictions and, in some instances, to correct deformity. Management demands a multidisciplinary approach coordinated with a rheumatologist or other internist, a pedorthist, and a physiatrist or physical therapist. | |
| 2028435 | Pneumocystis carinii pneumonia complicating low dose methotrexate treatment for rheumatoid | 1991 Mar | Low dose methotrexate has been used effectively for various rheumatic and non-rheumatic diseases. Three cases of Pneumocystis carinii pneumonia occurring during treatment of rheumatoid arthritis with low dose methotrexate are presented. Several mechanisms might contribute to impaired immunity and the rare development of opportunist lung infection with methotrexate. A high degree of suspicion may result in earlier diagnosis and treatment. |