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ID PMID Title PublicationDate abstract
28824293 MicroRNA Expression Analysis of Centenarians and Rheumatoid Arthritis Patients Reveals a C 2017 Micro-RNA (miRNA) are a family of small non-coding ribonucleic acids that inhibits post-transcriptionally the expression of their target messenger RNA (mRNA). We are interested in studying the involvement of miRNA in longevity and autoimmune diseases. In this study we compared the different expression of seven microRNAs between human plasma healthy controls, plasma samples of centenarians and samples from patients with rheumatoid arthritis. We used the Life Technologies' protocol to quantify seven miRNAs from 62 plasma samples: 20 healthy human controls, 14 centenarians, 28 patients with rheumatoid arthritis. TaqMan MicroRNA assays were used to analyze the expression profiles of miR-125b-5p, miR-425-5p, miR-200b5p, miR-200c-3p, miR-579-3p, miR-212-3p, miR-21-5p and miR-126-3p. The relative expression of mature miRNAs was analyzed using software REST. Our results show that miR-425-5p, miR-21 and miR-212 significantly decreased in centenarians and in patients with rheumatoid arthritis compared with controls. Furthermore in this work we highlight a connection between corticosteroid treatment and miRNAs expression.
27890175 Malignancy and Janus Kinase Inhibition. 2017 Feb The use of biologics such as anti-tumor necrosis factor and oral Janus kinase inhibitors have revolutionized the treatment of rheumatoid arthritis (RA). The risk of malignancies such as lymphomas, lung cancer, and nonmelanoma skin cancers (NMSCs) is greater in patients with RA compared with the general population. The incidence of all malignancy (excluding NMSC) was similar in tofacitinib users compared with the general population. The rates of overall and site-specific malignancies in patients with RA treated with tofacitinib are similar to what is expected in the RA population and not different from disease-modifying antirheumatic drugs and biologics.
28050748 Development of Diagnostic Techniques for Early Rheumatoid Arthritis Using Positron Emissio 2017 Oct PURPOSE: In vivo detection of pathological insults during the early stages of rheumatoid synovitis is essential to allow early anti-inflammatory treatment for prevention of joint destruction. Whether rheumatoid synovitis pathology and the efficacy of therapies can be visualized by positron emission tomography (PET) tracers specific to the inflammatory process was investigated. PROCEDURES: Using a collagen-induced experimental rat model of rheumatoid arthritis, in vivo imaging using the PET tracers [(11)C]PK11195, which binds to the translocator protein mainly expressed on myeloid cells, and [(11)C]ketoprofen, for cyclooxygenase imaging, was performed. To evaluate therapeutic efficacy, model animals were administered the tumour necrosis factor alpha blocker etanercept subcutaneously. RESULTS: [(11)C]PK11195 and [(11)C]ketoprofen uptakes were significantly higher in inflamed paws of collagen-induced arthritis rats than in normal rats. The data showed a correlation between tracer uptake values and paw swelling. After treatment with etanercept, [(11)C]ketoprofen uptake was significantly lower in treated animals than in untreated ones, whereas [(11)C]PK11195 uptake in the inflamed regions was comparable to that in the untreated group. CONCLUSIONS: With [(11)C]PK11195 and [(11)C]ketoprofen tracers, non-invasive in vivo PET imaging for rheumatoid synovitis can provide diagnostic evidence of early synovitis and allow monitoring inflammatory cell activity during treatment.
28065947 Bone mineral density level by dual energy X-ray absorptiometry in rheumatoid arthritis. 2017 Jan OBJECTIVE: To observe the level of bone mineral density by Dual Energy X-ray Absorptiometry in rheumatoid arthritis patients. METHODS: The observational study was conducted at Liaquat University of Medical and Health Sciences, Jamshoro, Pakistan, from January 2011 to December 2014. Bone mineral density was measured from the femoral neck, ward's triangle and lumbar spine, in patients 25-55 years of age, who were diagnosed with rheumatoid arthritis. All the cases were assessed for bone mineral density from appendicular as well as axial skeleton. Data was collected through a designed proforma and analysis was performed using SPSS 21. RESULTS: Of the 229 rheumatoid arthritis patients, 33(14.4%) were males. Five (15.1%) males had normal bone density, 14(42.4%) had osteopenia and 14(42.4%) had osteoporosis. Of the 196(85.5%) females, 45(29.9%) had normal bone density, 72 (37.7%) had osteopenia and 79(40.30%) had osteoporosis. Of the 123(53.7%) patients aged 30-50 years, 38(30.9%) had normal bone density, 59(48.0%) had osteopenia, and 26(21.1%) had osteoporosis. Of the 106(46.3%) patients over 50 years, 12(11.3%) had normal bone density, 27 (25.5%) had osteopenia and 67(63.2%) had osteoporosis. CONCLUSIONS: Osteoporosis and osteopenia were most common among rheumatoid arthritis patients. Assessment of bone mineral density by Dual Energy X-ray Absorptiometry can lead to quick relief in the clinical symptoms with timely therapy.
28825145 Impact of rheumatoid arthritis on radiation-related toxicity and cosmesis in breast cancer 2017 Dec PURPOSE: To evaluate the impact of rheumatoid arthritis (RA) on toxicity and cosmesis in women undergoing radiotherapy for breast cancer. METHODS: We queried an institutional database for women with RA treated with external beam radiotherapy for breast cancer between 1981 and 2016. Matching each patient to three controls without RA was attempted. Radiation toxicity was graded using CTCAE 4.0. Cosmesis was graded using the Global Harris Scoring System of Excellent, Good, Fair, or Poor. Grade 2+ (G2+) acute and late toxicities were compared between women with RA and their matched pairs using a generalized estimating equation (GEE). Wilcoxon test and mixed effects model were used to compare the cosmesis between two groups. RESULTS: Forty women with RA at time of radiation were matched to 117 controls. The median radiation dose was 60 Gy (50-66 Gy) and the median follow-up was 94 months (1-354 months). When comparing the women with RA to their matched pairs, there was no significant difference in the rates of G2+ acute toxicity (25.0 vs. 13.7%, O 2.1, CI 0.91-4.9) or G2+ late toxicity (7.5 vs. 4.3%, OR 1.8, CI 0.48-6.8). Mean cosmesis was between Good and Excellent for both groups of patients, although women with RA were less likely to get Excellent cosmesis compared to their matched pairs (OR 0.35, CI 0.15-0.84). CONCLUSIONS: Among women with RA, radiation for breast cancer was well tolerated without significantly increased toxicity. Their cosmesis was generally Good to Excellent, although they might be less likely to get Excellent cosmesis compared to their matched pairs.
28665531 Radial Extracorporeal Shock Wave Therapy for Relief of Arthralgia in Rheumatoid Arthritis. 2018 Mar More than one-third of the population with rheumatoid arthritis requires adjuvant analgesic treatment after antirheumatic therapy. In addition to analgesics, another option is radial extracorporeal shock wave therapy (rESWT), a novel physical therapy that has been successfully used in the treatment of many types of chronic soft tissue pain. We report a series of 15 patients who suffered from arthralgia after being on disease-modifying antirheumatic drugs for more than 3 months. Participants received rESWT for 3 months as an adjuvant therapy. Compared to the pretherapy baseline, follow-up at 3 months post-therapy revealed a significant reduction in resting state visual analog scale scores from 2.90 ± 0.74 to 0.80 ± 0.79 (P = 0.004), active state visual analog scale scores from 5.70 ± 1.33 to 2.20 ± 0.63 (P < 0.001), morning stiffness duration from 2.25 ± 0.79 to 1.05 ± 0.69 hours (P = 0.004), disease activity score with 28-joint counts based on erythrocyte sedimentation rate from 6.34 ± 0.72 to 4.19 ± 0.59 (P = 0.001), and Health Assessment Questionnaire scores from 10.20 ± 2.35 to 5.00 ± 2.62 (P = 0.005). The pre-post changes in erythrocyte sedimentation rate and C-reactive protein were not statistically significant. By the end of treatment, 11 participants stopped analgesics completely; the other 4 participants were on a smaller dosage. No severe adverse effects related to rESWT were observed. To our knowledge, this is the first report using this therapy to treat arthralgia in rheumatoid arthritis.
28494788 Comprehensive analysis of treatment response phenotypes in rheumatoid arthritis for pharma 2017 May 12 BACKGROUND: An individual patient's response to a particular drug is influenced by multiple factors, which may include genetic predisposition. Pharmacogenetic studies attempt to discover and estimate the contributions of genetic variants to the variability in response to a drug treatment. The task of identifying the genetic contribution is often complicated by response phenotypes that are based on imprecise or subjective clinical observations. Because the success of a pharmacogenetic study depends on the analysis of a heritable phenotype, it is important to identify phenotypes with a significant heritable component to ensure reliable and reproducible results in subsequent genetic association studies. METHODS: We retrospectively analyzed data collected from 436 rheumatoid arthritis patients treated with golimumab during the phase III GO-FURTHER study. We investigated the reliability of several potential response outcomes after golimumab treatment. Using whole-genome sequencing of the clinical trial cohort, we estimated the heritability of each potential outcome measure. We further performed a longitudinal analysis of the clinical data to estimate variability of outcome measures over time and the degree to which each response metric could be confounded by placebo response. RESULTS: We determined that the high degree of within-patient variation over time makes a single follow-up visit insufficient to assess an individual patient's response to golimumab treatment. We found that different potential response outcomes had varying degrees of heritability and that averaging across multiple follow-up visits yielded higher heritability estimates than single follow-up estimates. Importantly, we found that the change in swollen and tender joint counts were the most heritable outcome metrics we tested; however, we showed that they are also more likely to be confounded by a placebo response than objective phenotypes like the change in C-reactive protein levels. CONCLUSIONS: Our rigorous approach to finding robust and heritable response phenotypes could be beneficial to all pharmacogenetic studies and may lead to more reliable and reproducible results. TRIAL REGISTRATION: Clinicaltrials.gov NCT00973479 . Registered 4 September 2009.
28198158 Only rheumatoid factor-positive subset of anti-citrullinated peptide/protein antibody-nega 2017 Jun AIM: Anti-citrullinated peptide/protein antibody (ACPA) has been reported to occur in about 60% of patients with early rheumatoid arthritis (RA), and about 80% in patients with established RA. While ACPA seroconversion is possible, previous reports have shown that it rarely occurs. We retrospectively determined the proportion of patients who underwent ACPA seroconversion and described the clinical characteristics of these cases. METHODS: ACPA-negative RA patients who had undergone ACPA assessment more than once with an interval of 3 months or longer were investigated for ACPA seroconversion. The clinical characteristics of seroconverted patients were assessed. RESULTS: In 149 ACPA-negative RA patients, only eight patients (5.4%) converted to ACPA-positive during follow-up. We found that all eight of the seroconverted cases were positive for rheumatoid factor (RF) and showed bone erosions by X-ray. Of 56 ACPA-negative RF-positive RA patients, 14.3% of them seroconverted to ACPA-positive. None of the ACPA-negative RF-negative RA patients seroconverted to ACPA-positive. CONCLUSION: The proportion of total RA patients who experienced seroconversion from ACPA-negative to ACPA-positive was 5.4%. When ACPA-negative RA patients were subdivided into RF-negative and RF-positive subsets, only the RF-positive subset seroconverted to ACPA-positive. These results imply that RF-negative and RF-positive patients are distinct subsets within ACPA-negative RA patients.
27589350 Phenome-Wide Association Study of Rheumatoid Arthritis Subgroups Identifies Association Be 2017 Feb OBJECTIVE: The differences between seronegative and seropositive rheumatoid arthritis (RA) have not been widely reported. We performed electronic health record (EHR)-based phenome-wide association studies (PheWAS) to identify disease associations in seropositive and seronegative RA. METHODS: A validated algorithm identified RA subjects from the de-identified version of the Vanderbilt University Medical Center EHR. Serotypes were determined by rheumatoid factor (RF) and anti-cyclic citrullinated peptide antibody (ACPA) values. We tested EHR-derived phenotypes using PheWAS comparing seropositive RA and seronegative RA, yielding disease associations. PheWAS was also performed in RF-positive versus RF-negative subjects and ACPA-positive versus ACPA-negative subjects. Following PheWAS, select phenotypes were then manually reviewed, and fibromyalgia was specifically evaluated using a validated algorithm. RESULTS: A total of 2,199 RA individuals with either RF or ACPA testing were identified. Of these, 1,382 patients (63%) were classified as seropositive. Seronegative RA was associated with myalgia and myositis (odds ratio [OR] 2.1, P = 3.7 × 10(-10) ) and back pain. A manual review of the health record showed that among subjects coded for Myalgia and Myositis, ∼80% had fibromyalgia. Follow-up with a specific EHR algorithm for fibromyalgia confirmed that seronegative RA was associated with fibromyalgia (OR 1.8, P = 4.0 × 10(-6) ). Seropositive RA was associated with chronic airway obstruction (OR 2.2, P = 1.4 × 10(-4) ) and tobacco use (OR 2.2, P = 7.0 × 10(-4) ). CONCLUSION: This PheWAS of RA patients identifies a strong association between seronegativity and fibromyalgia. It also affirms relationships between seropositivity and chronic airway obstruction and between seropositivity and tobacco use. These findings demonstrate the utility of the PheWAS approach to discover novel phenotype associations within different subgroups of a disease.
28987824 Economic analysis of a nurse-led programme for comorbidities management of rheumatoid arth 2018 Oct OBJECTIVES: Rheumatoid arthritis (RA) cause major functional, psychological, social and occupational repercussions for patients and has important economic consequences for society. The principal objective of this work was to determine the economic pertinence of a staff nurse specialised in preventive management for these patients. METHODS: The COMEDRA multicentre randomised controlled clinical trial, conducted from March 2011 to June 2012, showed the effectiveness of a nurse-led programme dedicated to the management of comorbidities trough the promotion of 11 preventive procedures. A cost-benefit analysis, from a societal perspective and based on direct medical cost, was conducted to assess the equivalence of the cost of the nurse-led programme and the cost of the additional preventive procedures performed, engendered by the programme. The programme was considered effective if its cost was less than or equal to the costs of the additional preventive procedures. The costs were calculated from the approved health insurance charges. From the total costs induced, a contributive share was measured, corresponding to the ratio of the total costs of each type of procedure to the overall total cost. RESULTS: The cost of the intervention was assessed at €16,804.2. This intervention contributed to the performance of 747 additional preventive procedures, at a cost of €30,184.8. This intervention with these patients is financially balanced when at least 37 patients follow the recommendations for every preventive procedure. CONCLUSIONS: From the hospital's perspective and from both a medical and economic point of view, a nurse-led programme to manage the comorbidities of RA is useful.
28895120 Inflammation: Treatment Progress and Limitations. 2017 Oct There is an increasing understanding on the etiology of chronic immune-mediated inflammatory diseases such as inflammatory bowel disease (IBD), psoriasis, or rheumatoid arthritis. Large consortia contributed to the elucidation of the genetics, for instance, of IBD identifying a number of genes involved in innate mucosal defense and immune tolerance (most prominent, e.g., NOD2) and other related processes. For a number of such diseases, common genetic susceptibility loci were identified, suggesting overlapping immune response pathways, although there is no causality of single genetic traits.(2) In particular, the elucidation of main triggers of inflammation like tumor necrosis factor alpha (TNFα), integrins, specific cytokines like interleukin (IL)-6 or IL-23 launched the successful development of new pharmacological approaches, leading to a tremendous improvement of therapeutic outcomes.
28863826 Impact of anti-rheumatic treatment on cardiovascular risk in Asian patients with rheumatoi 2018 Feb OBJECTIVES: To estimate the incidence of cardiovascular disease (CVD) in Asian patients with rheumatoid arthritis (RA) and to evaluate the impact of anti-rheumatic treatment on the development of CVD. METHODS: A retrospective cohort of Asian patients with RA was established to identify the incidence rate (IR) of CVD in RA patients. The cohort was generated using the Korean National Healthcare claims database, which contained claims from Jan 2009 to Dec 2013. A total of 137,512 RA patients were identified; individuals with a history of CVD for 6 months or more before the index date were excluded. Nested case-control samples were drawn from the full study population with a case:control ratio of 1:4 (n = 7102 cases; n = 27,018 controls without CVD). A conditional multivariate regression model was used to evaluate the impact of anti-rheumatic treatment on the development of CVD in RA patients after matching for age, sex, RA index date, comorbidities, and drug use (e.g., antiplatelet agents and cholesterol-lowering agents). RESULTS: The IR for development of overall CVD in RA patients was 182.1 (95% CI: 178.4-185.9) per 10,000 person-years. In models adjusted for other CVD risk factors, disease-modifying anti-rheumatic drugs (DMARDs) (OR = 0.79) were protective against CVD, and biologic DMARDs were not significantly associated with CVD risk (OR = 0.85). Corticosteroids (OR = 1.26) and NSAIDs (nonselective NSAIDs: OR = 1.32, Cox-2 inhibitors: OR = 1.31) were risk factors for CVD in RA patients. CONCLUSIONS: The use of DMARDs is protective against CVD, while corticosteroids and NSAIDs increased the risk of CVD in RA patients.
28365578 Patients with Early Rheumatoid Arthritis in the 2000s Have Equal Disability and Pain Despi 2017 Jun OBJECTIVE: To compare outcomes over the first 8 years in patients with early rheumatoid arthritis (RA) recruited in the 1990s and the 2000s, with a special focus on functional disability and its possible predictors. METHODS: Data were acquired from 1938 patients with early RA (American College of Rheumatology 1987 criteria) included in the BARFOT study, who had completed the 8-year followup. The patients were divided into 2 cohorts: cohort 1 (n = 928, 68% women) included from 1992 to 1999 and cohort 2 (n = 1010, 70% women) included from 2000 to 2006. Health Assessment Questionnaire (HAQ), 28-joint Disease Activity Score (DAS28), visual analog scale pain, and radiographs of hands and feet scored by the van der Heijde modified Sharp method were assessed during the 8 years. Longitudinal data analyses were performed using a generalized linear model. RESULTS: Despite more active medical treatment during the 2000s, the courses of HAQ and pain showed no difference between the cohorts during followup, in either women or in men, with significantly higher levels in women compared with men. However, as expected, disease activity decreased more over time in cohort 2 compared with cohort 1, for both sexes, and women in cohort 2 had less radiographic progression compared with cohort 1. HAQ was associated with DAS28, pain, radiological scores, and sex in both cohorts, and in cohort 2 also with age and smoking. CONCLUSION: Patients included in the 2000s had lower disease activity, but not less activity limitation and pain over 8 years of followup despite more active treatment. Pain, aging, and smoking might explain why patients included in the 2000s still had the same disability levels as those included in the 1990s.
29152874 Concordance and correlation of activity indices in patients with rheumatoid arthritis in n 2018 Nov AIM: To determine the correlation and concordance between different clinimetric scores in patients with rheumatoid arthritis in two high-complexity reference centers in northwestern Colombia. METHOD: A cross-sectional study in adults diagnosed with rheumatoid arthritis was conducted according to the 2010 American College of Rheumatology and European League Against Rheumatism Classification Criteria, between January and June, 2013. The correlation was evaluated using Spearman's correlation coefficient, and concordance with quadratic weighted kappa with the respective confidence intervals, for which patients were classified into different categories of disease activity. RESULTS: One hundred patients were included, of whom 83% were women; 58 and 75% received methotrexate and glucocorticoids, respectively. Most individuals were in remission or low activity. High correlations between Disease Activity Score of 28 joints - erythrocyte sedimentation rate (DAS28-ESR) values with DAS28 C-reactive protein and Simple Disease Activity Index (SDAI) with Clinical Disease Activity Index (P < 0.0001; r = 0.82 and r = 0.86, respectively) were observed; likewise, the scores obtained with different indices correlated well with gold standard values for remission (SDAI), where the correlation with DAS28-ESR was slightly lower. Excellent concordance among all clinimetric scores was observed, although it was lower among DAS28-ESR and SDAI. CONCLUSION: Clinimetric indices had high concordance and correlation, especially for rheumatoid arthritis patients in remission or low disease activity, without being interchangeable among them.
28880707 Relationship between achievement of physical activity goal and characteristics of patients 2018 Jul OBJECTIVES: We aimed to identify the relationship between achievement of a physical activity goal and the characteristics of patients with rheumatoid arthritis (RA). METHODS: Overall, 137 patients with RA who performed physical activity were enrolled. Statistical analysis was performed to examine relationship between patient characteristics and achievement of physical activity goal by univariate analysis, multivariate logistic regression analysis and the receiver operating characteristic method. RESULTS: The significant factors considered for univariate analysis performed to compare RA patients with and without achievement in physical activity goal were age, disease duration, BMI, global VAS, pain VAS, CRP, DAS28-CRP, and HAQ-DI. The significant related factors by multivariate logistic regression analysis were age (OR: 0.926), BMI (OR: 1.180), pain VAS (OR: 0.969), and HAQ-DI (OR: 0.229). The cutoff values were 62.0 years for age (sensitivity 72.5%, specificity 59.6%), 19.7 for BMI (sensitivity 91.2%, specificity 36.2%), 20.0 for pain VAS (sensitivity 63.7%, specificity 71.9%), and 0.30 for HAQ-DI (sensitivity 48.8%, specificity 89.5%). CONCLUSION: We aim to preserve activities of daily living in patients with RA. To achieve physical activity goal, we should control pain VAS, and HAQ-DI. Further, the patients the value of HAQ-DI should be kept very low.
28363822 Lewis-Sumner syndrome in a patient with rheumatoid arthritis: Link between rheumatoid arth 2017 Jul Chronic inflammatory demyelinating polyradiculoneuropathies are a group of autoimmune neuropathies with a chronic course. Lewis-Sumner syndrome is a variant of this disease, characterized by an asymmetrical distal and mostly motor involvement, predominating at upper limb. We report the case of a patient who developed almost currently rheumatoid arthritis and Lewis-Sumner syndrome, which raised the problem of therapeutic intensification for his rheumatism when methotrexate proved to be ineffective. Finally, rituximab had been introduced by common consent with neurologists, and the patient noticed an improvement fifteen days after the first infusion. Even if it is striking that both dysimmune diseases had declared within a few months, the association between chronic inflammatory demyelinating polyradiculoneuropathies and rheumatoid arthritis is exceptional, since the only cases reported in the literature are secondary to TNF-alpha inhibitors. Given the potential demyelinating impact of some biologics, rituximab and perhaps abatacept seem to be the best therapeutic options when DMARDs had proven insufficient to control the rheumatism activity.
28730681 Histone variants expression in peripheral blood mononuclear cells of patients with rheumat 2018 Oct AIM: The purpose of the present study was to analyze the expression of four histone variants, implicated in the regulation of gene expression, in peripheral blood mononuclear cell (PBMC) samples of patients with rheumatoid arthritis and healthy controls. METHOD: We analyzed the expression of three genes encoding histone variants H3.3, H2A.Z, macroH2A1.1 and macroH2A1.2 in PBMC samples of 50 patients with RA, diagnosed according to American College of Rheumatology (ACR) criteria, and 51 matched healthy controls using SYBR green real-time polymerase chain reaction. Mann-Whitney U-test and Spearman correlation were used for data analysis. RESULTS: The expression of H2A.Z was increased by 1.51-fold (P < 0.001) and the expression of H3.3 was increased by 1.13-fold (P = 0.048) in PBMCs of patients with RA compared to healthy controls. Furthermore, we found a positive correlation between Disease Activity Score (DAS-28) based on erythrocyte sedimentation rate and the expression of H2A.Z. CONCLUSIONS: Given the role of H3.3 and H2A.Z in nucleosome positioning, chromatin structure and transcription regulation, we suggest that lymphocytes and monocytes, the main cell subtypes in PBMCs of RA patients, possess a more accessible chromatin.
28535893 Falls and their association with physical tests, functional capacity, clinical and demogra 2017 May OBJECTIVE: To evaluate the occurrence of falls reported by rheumatoid arthritis patients and its relation to disease activity, functional capacity and physical fitness. MATERIALS AND METHODS: A cross-sectional study constituted by a sample of 97 rheumatoid arthritis patients from the city of Marília (SP) from 2012 to 2013, were assessed for disease activity. Instruments validated for Brazilian population in order to evaluate physical and functional capacity were used. Data analysis was carried out with descriptive statistics, Spearman correlation and Chi-squared test, considering p<0.05. RESULTS: 88.7% were female subjects with a mean age of 56 (±11.7) years. The median duration of rheumatoid arthritis was 10 years (P25=6 and P75=17) and the mean of disease activity was 3.6 (±1.3), what was considered a moderate activity. In the last 12 months 37.1% of patients experienced at least one fall, with a total of 52 episodes, and fear of falling was reported by 74.2% of them, but this was not associated to the occurrence of a fall (χ(2)=1.19, p=0.27). Gender, number of medications, age, disease activity, duration of rheumatoid arthritis, functional capacity, and physical tests showed no associations with history of falls in the past year. CONCLUSION: It was observed that the occurrence of falls and the fear of falling are quite common in this population. The occurrence of falls in this sample of rheumatoid arthritis patients bears no relation to disease activity, functional capacity, or physical fitness tests.
28809379 Periodontal, salivary and IL-6 status in rheumatoid arthritis patients. A cross-sectional 2017 Sep 1 BACKGROUND: The aim of this study was to determine whether saliva interleukin-6 (IL-6) levels are elevated in patients with rheumatoid arthritis versus a control group and examine the possible relationship between the oral condition and the risk of RA. MATERIAL AND METHODS: In 30 patients with RA and 30 healthy controls, different periodontal indices were recorded; sialometric measurements were taken to determine resting whole saliva, stimulated whole saliva and stimulated parotid saliva flow; and the saliva IL-6 levels were measured. Logistic regression analysis was performed, with the presence or absence of RA as dependent variable. RESULTS: The patients with RA had a greater presence of bacterial plaque, a greater periodontal pocket depth, a larger percentage of medium-sized pockets, and greater periodontal attachment loss compared with the controls. Likewise, a decrease in resting and stimulated saliva flow was observed, together with an increase in saliva IL-6 levels. Logistic regression analysis reported that the plaque index is the principal differentiating factor of patients with RA. Stimulated parotid saliva flow was also significantly correlated to the presence of RA. CONCLUSIONS: The patients with RA showed a greater tendency to develop periodontal disease than the controls, with lower salivary flow and higher levels of IL-6 in saliva.
28207326 Micro RNA-146a But Not IRAK1 is Associated with Rheumatoid Arthritis in the Tunisian Popul 2017 Feb BACKGROUND: Rheumatoid arthritis (RA) is characterized by the production of an array of proinflammatory cytokines through the nuclear factor kappa-light-chain-enhancer of activated B cells (NF-κB) signaling pathway. Interleukin-1 receptor (IL-1R) and Toll-like receptors contain a common cytoplasmic motif the Toll/IL-1R (TIR) homology domain. This motif is required for NF-κB activation. IL-1R-associated kinase 1 (IRAK1) is a key adapter molecule recruited during the signaling cascade of the TIR. Its gene expression is regulated by the micro-RNA (miR)-146a. OBJECTIVE: We investigated the role of IRAK1 single-nucleotide polymorphism (SNP) rs3027898 (IRAK1 rs3027898) and miR-146a SNP rs2910164 (miR-146a rs2910164) in Tunisian patients with RA and their association with C reactive protein (CRP), rheumatoid factor (RF), anticyclic citrullinated peptide (anti-CCP) antibodies, and erosion. PATIENTS AND METHODS: In a cohort of 172 adult RA patients and 224 matched controls, IRAK1 rs3027898 genotyping was determined by mutagenically separated polymerase chain reaction (MS-PCR) with newly designed primers, and miR-146a rs2910164 genotyping was determined by fragment length polymorphism PCR-restriction (RFLP-PCR). RESULTS: The IRAK1 rs3027898 A allele was detected in 67% of RA patients and 70% of controls indicating that it is not associated with RA in codominant, dominant, or recessive models even after stratification by age and gender. The miR-146a rs2910164 G allele was detected in 76% of RA patients and 68% of controls, thus the C allele confers some protection based on a dominant model [CC+GC (odds ratio (95% confidence interval) = 0.6 (0.3-0.9), p = 0.03)]. No association with CRP, RF, anti-CCP, or erosion was found for either SNPs. CONCLUSION: The IRAK1 rs3027898 was not associated with RA, whereas C allele of miR-146a rs2910164 was found to be protective. Functional studies are required to investigate the exact role of miR-146a rs2910164 during RA.