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

PMID	Title	PublicationDate	abstract
2332912	Sudden death in rheumatoid arthritis from vertical subluxation of the odontoid process.	1990 Apr	Rheumatoid arthritis is a chronic, multisystem disease that causes significant morbidity and early mortality. A common source of morbidity in severe rheumatoid arthritis is involvement of the cervical spine. Sudden death due to subluxation of the odontoid process into the medulla oblongata is a dramatic but rare complication. We report the case of a patient who died suddenly. Computerized tomography scan, autopsy, and clinical findings were correlated. Studies of cervical involvement in rheumatoid arthritis were analyzed for cases of vertical subluxation. The case reports of sudden deaths and patients treated for vertical subluxation were reviewed; they revealed a trend toward surgery in patients with neurological abnormalities. However, a comparison of clinical outcome does not demonstrate improved survival with surgical intervention. Randomized trials comparing surgical with nonsurgical therapy are needed.
3722754	Volz total wrist arthroplasty in rheumatoid arthritis: a long-term review.	1986 Jul	The results of 30 Volz total wrist arthroplasties in 23 patients with stage III or stage IV rheumatoid arthritis were reviewed 36 to 106 months after the operation (average 69 months). Sixty percent were rated good or excellent, 27% were rated fair, and 13% were rated poor. Good or excellent results were achieved in 77% with single-prong metacarpal components, but in only 47% of the double-prong group. Wrist imbalance was the primary cause of poorer results with the double-prong metacarpal component. Pain relief and patient satisfaction were achieved in 86% of the cases. Typical radiologic patterns of deterioration were resorption of bone under the collar of the radial component (79%, average 3.7 mm) and metacarpal component loosening (24%). Most patients with component loosening had little or no discomfort. Complications occurred in 12 cases but affected the final outcome in only three patients.
3828195	Naproxen pharmacokinetics in patients with rheumatoid arthritis during active polyarticula	1987 Feb	Patients with rheumatoid arthritis often have hypoalbuminaemia as a sign of disease activity. In view of the extensive binding of naproxen to albumin, the pharmacokinetics of total and unbound drug were studied in eight patients and eight healthy male volunteers during chronic intake of 500 mg twice daily. The area under the serum concentration-time curve of total naproxen during a dose interval, AUC (0,12), smaller in patients (641 +/- 101 mg l-1 h) than in volunteers (896 +/- 85 mg l-1 h; P less than 0.0001). The unbound naproxen AUCu (0,12) was larger in patients (1.9 +/- 0.9 mg l-1 h) than in volunteers (0.7 +/- 0.2 mg l-1 h; P less than 0.01). The higher unbound naproxen concentrations in patients were accompanied by an approximately 40% increase in apparent clearance/bioavailability (CL/F) and a 60% increase in volume of distribution (V/F). Both CL/F and V/F were inversely correlated with the individual serum albumin concentration (r = 0.76, P less than 0.001; r = -0.85, P less than 0.001, respectively). The high unbound naproxen concentration in the serum of patients with active rheumatoid arthritis and concomitant hypoalbuminaemia is not known to be accompanied by an increase in side effects and may be beneficial if anti-inflammatory effects correlate with unbound drug concentration.
3389928	Decreased iron absorption in patients with active rheumatoid arthritis, with and without i	1988 May	Mucosal uptake, mucosal transfer, and retention of a physiological dose of ferrous iron were studied in women with active rheumatoid arthritis (RA): 19 with normal and 17 with depleted bone marrow iron stores. Control subjects were 26 normal women and 20 women with uncomplicated iron deficiency. Iron absorption was measured with 59Fe as a tracer and by whole body counting. Compared with controls, final iron retention was considerably decreased in both groups of patients with RA. Analysis of the two sequential steps of iron absorption showed that mucosal uptake was normal in iron replete patients with RA but was significantly lower in patients with RA with depleted iron stores compared with iron deficient controls. Mucosal transfer of iron was considerably decreased in patients with RA with normal iron stores. The impaired absorption of iron in patients with active RA may delay the correction of the haemoglobin concentration when anaemia of chronic disease is complicated by iron deficiency.
2884009	Alteration of thiol and superoxide dismutase status in rheumatoid arthritis treated with s	1987 Jun	Intracellular thiols (LSH), superoxide dismutase (SOD) and plasma thiols (PSH) are thought to have an important role in the protection of tissues from damage by oxygen-derived free radicals. The change in the levels of activity of these substances in patients with active rheumatoid arthritis treated with sulphasalazine for 6 months was assessed in 22 patients. Over this time there was a marked improvement in disease activity. This was accompanied by an early increase in red cell LSH and decrease in SOD, although by 6 months these changes had completely reversed. In addition the negative correlation between these indices at week 0 had disappeared by week 6. Over the 6 months there was a steady rise in PSH. The change in PSH is slow and is thus more likely to reflect a change in the disease process rather than an active role for the thiol, but the early changes in intracellular parameters may be of importance in the action of this drug. These changes are similar to changes found with other second-line drugs. It is also of interest that a drug which does not itself possess a thiol group is capable of altering the thiol status of cells.
2524321	[Evaluation of the clinico-therapeutic response to oral gold salts in patients with rheuma	1989 Mar 15	The authors investigated the possible correlation between blood concentrations and clinical outcome in 38 auranofin-treated patients with rheumatoid arthritis, diagnosed according to ARA criteria. The results showed that the whole blood gold concentrations did not correlate with the clinical parameters investigated and some laboratory findings. The authors discuss this lack of correlation, suggesting that a clear genetic disposition can interfere with the clinical response, affecting the metabolism and kinetics of the drug.
3492028	HLA-DR4 as a predictor of outcome three years after onset of rheumatoid arthritis.	1986	Data from 59 patients with early rheumatoid arthritis were analysed to determine the predictive value of the possession of HLA-DR4 for disease severity and functional outcome at 3 years after disease onset. The previously reported association of that antigen with seropositive disease was confirmed. Conversely, however, there was no evidence that functional outcome was worse in the HLA-DR4 positive group as measured by the Stanford Health Assessment Questionnaire. The mean articular index was lower in the HLA-DR4 group which also had a smaller proportion with limited wrist extension. In addition, both patient and physicians' global assessment of disease status were better in the HLA-DR4 group. It is concluded that HLA-DR4 is not a useful predictor of poor outcome at 3 years.
2596882	Localisation of lysozyme mRNA in rheumatoid synovial membrane by in situ hybridisation.	1989 Nov	Type A synovial lining cells have been shown to contain lysozyme in their lysosomes. This might be phagocytosed because synovial fluid contains lysozyme originating from tissue macrophages and articular cartilage but in arthritides, in particular, from neutrophils. In situ hybridisation with 35S labelled cDNA was used to detect mRNA for lysozyme over synovial lining in patients with rheumatoid arthritis. No hybridisation was found with lactoferrin cDNA, which was used as a negative control. Computer search against the EMBL gene bank (release 14) did not show any significant cross hybridisation to a known sequence. In cytological specimens 35S-cDNA:mRNA hybrids were observed in positive but not in negative control cells. The presence of lysozyme and its mRNA suggests that type A synovial lining cells are of mononuclear phagocyte lineage.
2094834	[Nephropathy in rheumatoid arthritis].	1990 Nov	Occurrence of renal involvement in Rheumatoid arthritis is uncommon; when present it has been attributed to amyloid or secondary effects of drugs. Nevertheless, recent observations seem to indicate the existence of primary renal lesions associated with the disease. The purpose of this paper is to review the data suggesting that the kidney can be directly involved in Rheumatoid arthritis. The main points of interest are the occurrence of glomerulonephritis and/or amyloidosis, the presence of vasculitis and other arterial changes, the existence of chronic interstitial nephritis and papillary necrosis and lesions associated with gold and penicillamine therapy.
2295200	The Bateman bipolar prosthesis in osteoarthritis and rheumatoid arthritis. A review of 400	1990 Feb	Four hundred arthroplasties with the Bateman (or universal) prosthesis were performed from June 1974 to January 1985, including 286 cases with osteoarthritis (OA) and 114 with rheumatoid arthritis (RA). Evaluation was made according to the d'Aubigne-Postel method. The follow-up period was from three to 14 years, with an average duration of eight years, five months. The results were excellent in 230 cases (172 OA, 58 RA), good in 140 (98 OA, 42 RA), fair in eight (four OA, four RA), and poor in 22 (12 OA, ten RA). Radiolucencies were present in the femoral side in 25%. Radiolucency of more than 2 mm was seen in 20 cases (5%). The complications were six cases of fracture of the plastic insert, four cases of protrusio of the acetabulum, four dislocations, eight cases of loosening of the femoral stem, one deep infection, two superficial infections, 15 cases of thrombophlebitis, one pulmonary embolism, and one death. A careful analysis of these complications and a discussion of their treatment are presented. Reoperations were performed in 20 patients (5%). The universal arthroplasty appears to be a safe and reliable procedure.
2911245	[Favourable surgery of cervical neck instability in rheumatism].	1989 Jan 18	A team project commenced 20 years ago can now present results of 150 surgical stabilising procedures for cervical neck instability in rheumatoid arthritis. The favourable results indicate widened indications. MR examination demonstrated regression of soft tissue swelling ("pannus") after surgery, which possibly contributed to the good results.
2980603	Assessment of the relative impact of magnetic resonance imaging on the evaluation of rheum	1986	A study was made of 15 patients with rheumatoid involvement of the neck in whom neurologic symptoms were of sufficient severity that operative intervention was being planned. Magnetic resonance imaging (MRI) was performed in all patients and compared with conventional radiography, conventional tomography, myelography and computed tomography (CT) assisted myelography. MRI clearly demonstrated any deformity or compression of the cord and was able to show the effects of flexion and extension of the neck. It is concluded that MRI could replace myelography for defining cord compression. If details of atlanto-axial alignment and bony outline of the spinal canal are required then CT will provide the appropriate images.
2489253	[Synovectomy of the knee in rheumatoid arthritis].	1989 Apr	Synovectomy of the knee results in a satisfactory degree of pain relief in rheumatoid arthritis. 52 synovectomies were performed in 40 patients. The mean length of follow-up was 7.8 years. We found satisfactory results in 88.4% of the cases and unsatisfactory results in 11.6%. We could see that this procedure is indicated in those cases that have a well preserved articular architecture, while if this is destroyed the result is poorer.
2191935	Detection and measurement of simulated early rheumatoid lesions of the hand using digital	1990 Jun	The ability of digital subtraction radiography, a new technique to detect and quantify small bone lesions, is demonstrated. Discrete lesions in the metacarpals of cadaver hands simulated erosive bone loss. Radiographs made before and after removal of bone were digitized and subtracted. Density changes on subtraction images were determined, and bone loss was estimated by an automatic procedure that compared changes in radiographic density with a calibration wedge included in the radiographs. Comparison of estimated bone loss with the weight of bone removed showed reproducible detection and measurement of bone lesions as small as 4.6 mg, a size undetectable using current radiographic methods. Subtraction radiographs of bone chips overlaid on the hand of a volunteer indicated detection limits were similar in vivo. This technique enhanced the radiographic visibility of erosive lesions and thus has the potential to improve the detection of subtle bone changes in clinical settings.
2923504	Erosion number and area progression in the wrists and hands of rheumatoid patients: a quan	1989 Jan	Microfocal radiography has been used to evaluate the relation between erosion number and erosion area in the hands and wrists of 51 patients with early to moderately advanced rheumatoid arthritis. The hands of these patients showed different patterns of erosion progression, in terms of the relation between changes in number and area, and included those showing a decrease in one or both of the erosion parameters. The mean number of erosions in the group increased between the first and second visits. By the third visit (a mean of 48 months from the onset of symptoms) the mean number of erosions in the wrist and hand of the group had approached a constant value of 75 erosions. Over the same period the mean erosion area of the group continued to increase. Measurement of changes in erosion area is a more sensitive indicator of erosion progression than erosion number, both within the group and in individual patients.
1700672	Tumour necrosis factor in serum and synovial fluid of patients with active and severe rheu	1990 Sep	Fifteen serum samples and 29 synovial fluids of patients with rheumatoid arthritis (RA) were examined for the presence of tumour necrosis factor (TNF). The assay for TNF was based on the cytotoxic activity of this cytokine for human melanoma cells in tissue culture. High concentrations of TNF were found in serum samples of patients with severe RA, who had increased erythrocyte sedimentation rate and serum alpha 2 macroglobulin, but decreased haemoglobin and serum iron concentrations. Tumour necrosis factor was also found in the synovial fluid of 16 out of 29 patients. High TNF concentrations were found in fluids with greater than 10(10) leucocytes/l. Tumour necrosis factor was not detected in the serum of normal subjects or in synovial fluid of patients with osteoarthritis. A mediator of inflammation, such as TNF, may contribute to the severity of RA.
2661578	The rheumatoid metacarpophalangeal joint.	1989 May	Reconstruction of the MP joint affected by rheumatoid disease can pose a challenge to the surgeon and therapist. The multiple initiating and aggravating factors must be taken into consideration during the planning phase before they can be addressed surgically. The results following surgery at the MP joint are dependent on a number of factors. The most important of these is the general activity of the rheumatoid disease and the patient's response to medical treatment. The individual who requires steroids and antimetabolites may observe a general worsening of his disease state, which will be uninfluenced by surgery at the MP joints. Patients demonstrating vasculitis may have problems with wound healing and remobilization following MP joint surgery. The surgeon's ability to rebalance the MP joint is directly related to the quality of the periarticular soft tissues needed for the reconstructive procedure. The ability of an individual to cooperate in a postoperative program and to apply the principles of joint protection is absolutely necessary. The eventual joint motion is related to tendon function in the hand.
3460283	[Immunogenetic studies in patients with IgM rheumatoid factor negative erosive chronic pol	1986 Mar	40 patients with erosive rheumatoid arthritis (RA), 20 of whom were IgM-negative and 20 IgM-positive, were studied prospectively with regard to their association with HLA-B-CREGs (B5-, B8-, B12-, B16-, B27-CREG). We found a highly significant association of IgM-negative RA patients and B5-CREG-antigens (Chi2 = 28.6; p less than 0.001).
3482983	A multicase family study of rheumatoid arthritis in south west Ireland.	1986 Jun	A study of 26 families with multiple cases of RA was conducted in South West Ireland. In 149 relatives examined, 67 cases of RA were identified. An analysis of affected sibling pairs and trios revealed significant linkage between HLA and RA (p less than 0.05). A high frequency of DR4 was observed in probands (80.7 per cent) and affected members (74.6 per cent) compared with controls (18 per cent). An elevated frequency of the haplotypes A2-B44-DR4 (19.2 per cent) and A2-Bw62-DR4 (5.7 per cent) was seen in the affected sample. HLA-Bw62 was at raised frequency in probands (19.2 per cent) compared with controls (9 per cent). The haplotype frequency of A2-B44-DR4 was raised in affected females and A2-Bw62-DR4 in affected males. A low haplotype frequency of A1-B8-DR3 was found in all RA subjects. Disease severity (clinical and radiological criteria) was associated with DR4, but this did not reach statistical significance. A high incidence of extra-articular features of RA was observed, with DR4 occurring in all cases of vasculitis (75 per cent of whom were DR4 homozygous).
1973321	[The effect of combined drug treatment using gold preparations on indices of lipid peroxid	1990 Mar	Results are reported of changes of the level of lipid peroxidation in 51 patients with rheumatoid arthritis depending on the stage of activity of the inflammatory process and employment of non-steroid antirheumatic agents and gold preparations (crysanol). The authors discusses the problem of relative antioxidant insufficiency in rheumatoid arthritis and antioxidant properties of crysanol.