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ID PMID Title PublicationDate abstract
29767112 Correction: Which patients presenting with arthralgia eventually develop rheumatoid arthri 2018 [This corrects the article DOI: 10.1136/rmdopen-2017-000479.].
30018798 Depressive mood and low social support are not associated with arthritis development in pa 2018 OBJECTIVE: Studies on the role of psychosocial vulnerability in the development of arthritis must be performed early in the disease course to exclude the reverse explanation that arthritis leads to psychological symptoms. Therefore, the objective of this study was to investigate the longitudinal (5-year) association between depressive mood, daily stressors, avoidance coping and social support as predictors, and the development of arthritis and other clinical parameters as outcomes, in persons with seropositive arthralgia at risk of developing rheumatoid arthritis. METHODS: Five-year follow-up data of 231 patients from the Reade seropositive arthralgia cohort were used. Clinical and psychological data were collected using physical examinations and questionnaires. Mixed models and Cox regression analyses were used to assess the 5-year associations between depressive mood, daily stressors, avoidance coping or social support, and the development of arthritis or clinical parameters (tender joint count, Visual Analogue Scale (VAS) pain, VAS morning stiffness and erythrocyte sedimentation rate (ESR)). RESULTS: Higher scores for depressive mood and lower scores for social support were not associated with the development of arthritis nor with ESR. However, they were longitudinally associated with an increase in pain (p<0.001), morning stiffness (p<0.01) and tender joint count (p<0.001). No consistent associations were found between daily stressors, avoidance coping and the development of arthritis or other clinical parameters. CONCLUSION: Although an effect on the development of arthritis could not be demonstrated, a strong longitudinal association was found between high depressive mood, low social support and clinical parameters. In persons with seropositive arthralgia, depressive symptoms and low social support may increase musculoskeletal symptoms.
29752865 Antiarthritic Effects of Sorafenib in Rats with Adjuvant-Induced Arthritis. 2018 Sep Rheumatoid arthritis (RA) is a chronic inflammatory disease affecting the synovial membrane of joints. In this study, we aimed to investigate whether sorafenib exerts antiarthritic effects on RA in vivo. Adjuvant arthritis (AA) was induced (day 0) in male Sprague-Dawley rats by intradermal injection of 0.1 mL of complete Freund's complete adjuvant into the left hind paw. Sorafenib (10, 20, or 40 mg/kg/day) was administered intragastrically from day 10 to 24. Body weight, paw volume, synovial inflammation, and tumor necrosis factor alpha (TNF-α), interleukin-1β (IL-1β), IL-10, and IL-17 serum levels were detected. In addition, microvascular density (MVD) and the expression of vascular endothelial growth factor receptor 2 (VEGFR-2) and fibroblast growth factor receptor 1 (FGFR-1) in synovial tissues were analyzed. Our data revealed that sorafenib administration led to significant body weight gain in AA rats but suppressed paw swelling, synovial hyperplasia, and inflammatory infiltration. Furthermore, it decreased TNF-α, IL-1β, and IL-17 serum levels and upregulated IL-10. MVD and VEGFR-2 and FGFR-1 expression in synovial tissues were significantly reduced. Thus, this study shows that sorafenib exerts anti-arthritic effects in AA rats and therefore has potential in RA treatment. Anat Rec, 301:1519-1526, 2018. © 2018 Wiley Periodicals, Inc.
29632529 Autoantibodies Associated With Connective Tissue Diseases: What Meaning for Clinicians? 2018 Connective tissue diseases (CTDs) such as systemic lupus erythematosus, systemic sclerosis, myositis, Sjögren's syndrome, and rheumatoid arthritis are systemic diseases which are often associated with a challenge in diagnosis. Autoantibodies (AAbs) can be detected in these diseases and help clinicians in their diagnosis. Actually, pathophysiology of these diseases is associated with the presence of antinuclear antibodies. In the last decades, many new antibodies were discovered, but their implication in pathogenesis of CTDs remains unclear. Furthermore, the classification of these AAbs is nowadays misused, as their targets can be localized outside of the nuclear compartment. Interestingly, in most cases, each antibody is associated with a specific phenotype in CTDs and therefore help in better defining either the disease subtypes or diseases activity and outcome. Because of recent progresses in their detection and in the comprehension of their pathogenesis implication in CTD-associated antibodies, clinicians should pay attention to the presence of these different AAbs to improve patient's management. In this review, we propose to focus on the different phenotypes and features associated with each autoantibody used in clinical practice in those CTDs.
29630409 A new morphinandienone alkaloid from the stems of Fissistigma tungfangense. 2019 Feb A new morphinandienone alkaloid, fissistigmine A (1), together with three known alkaloids (2-4), were isolated and identified from the stems of Fissistigma tungfangense. Among them, fissistigmine A (1) represents the first example of a novel naturally occurring morphinandienone alkaloid with a unique cleavage of the C-9-N-17 bond. All isolated compounds were evaluated for their anti-rheumatoid arthritis activities via examining their anti-proliferative effects on synoviocytes in vitro. Compound 1 exhibited inhibitory effect on the proliferation of synoviocytes with an IC(50) value of 114.6 ± 2.2 μM.
29051105 Nicotine and autoimmunity: The lotus' flower in tobacco. 2018 Feb Nicotine, the major component of cigarettes, has demonstrated conflicting impact on the immune system: some authors suggest that increases pro-inflammatory cytokines and provokes cellular apoptosis of neutrophils, releasing intracellular components that act as auto-antigens; others claimed that nicotine has a protective and anti-inflammatory effects, especially by binding to α7 subunit of nicotinic acetylcholine receptors. The cholinergic pathway contributes to an anti-inflammatory environment characterized by increasing T regulatory cells response, down-regulating of pro-inflammatory cytokines and a pro-inflammatory cells apoptosis. The effects of nicotine were studied in different autoimmune disease, as multiple sclerosis, type 1 diabetes, rheumatoid arthritis, sarcoidosis, Behçet's disease and inflammatory bowel diseases. The major problems about nicotine are the addiction and the adverse effects of related to each commercialized formulation. We sought in this review to summarize the knowledge accumulated to date concerning the relationship between nicotine and autoimmunity.
29027137 Cubic Liquid Crystalline Gels Based on Glycerol Monooleate for Intra-articular Injection. 2018 Feb In situ gels containing sinomenine hydrochloride (SMH) for intra-articular (IA) administration to treat rheumatoid arthritis (RA) were designed and investigated in this study. Glycerol monooleate (GMO) was used due to the potential to generate viscous crystalline phase structures upon water absorption. The gels were evaluated using different parameters: syringeability, gelation, viscosity, and drug release. And, polarized light microscopy (PLM), small-angle X-ray scattering investigation (SAXS), and rheological studies were used to analyze their internal structures. In vitro drug release studies were performed by the dialysis membrane diffusion method. The syringeability, viscosity, gelation time, and water for gelation of the obtained preparation met the requirements of IA injection. PLM, SAXS, and rheological analysis showed that all samples had transformed from flowable isotropic solution phases to the inverse cubic (V(2)) phases upon excess water. And, the gels were found to be able to maintain the drug release for more than 1 week. Results showed that in situ gels based on GMO liquid crystalline could provide a sustained system for SMH. Due to its sustained release, the in situ cubic gels were suitable for IA injection to treat RA.
29617883 Risk for adverse pregnancy outcome in axial spondyloarthritis and rheumatoid arthritis: di 2018 Jul 1 OBJECTIVE: To analyse pregnancy outcome and delivery mode in patients with RA and axial spondyloarthritis (axSpA) in relation to disease activity and anti-rheumatic drugs. METHODS: Patients with RA and axSpA were compared with age-matched healthy controls (HCs) with respect to pregnancy outcome and delivery mode. Disease activity (DAS28, ASDAS, CRP) and medication use of patients was assessed once at each trimester. ORs with 95% CI were calculated with univariate and multivariate regression models. RESULTS: We analysed 244 pregnancies, of which 96 occurred in patients with RA, 78 in patients with axSpA and 70 in HCs. The adjusted analysis showed that pregnant women with RA and axSpA had a higher risk of pregnancy complications (gestational diabetes, preeclampsia, infection, preterm premature rupture of membranes), small for gestational age infants and preterm deliveries (all P < 0.05). Active disease was a predictor for preterm delivery in both RA [odds ratio (OR) = 3.9, 95% CI: 1.25, 12.15] and axSpA (OR = 13.8, 95% CI: 1.33, 143.94). Regarding delivery mode, most patients had vaginal deliveries. However, women with RA revealed an increased risk of caesarean section compared with HC (P < 0.05), which was not seen in patients with axSpA. CONCLUSION: Our findings show that disease activity of RA and axSpA during pregnancy influences pregnancy outcome. To allow for successful pregnancy a treatment strategy that targets inactive disease beyond conception should be followed.
28589473 The effect of triclosan on posttranslational modification of proteins through citrullinati 2018 Jan OBJECTIVES: The aim of this study was evaluate the effect of triclosan on citrullination and carbamylation, two important protein posttranslational modifications associated with inflammatory conditions such as periodontitis and rheumatoid arthritis. MATERIALS AND METHODS: A range of triclosan concentrations were incubated in the presence of appropriate substrates used for the generation of either citrullinated or carbamylated proteins. The effect of triclosan on protein citrullination and carbamylation in macrophages was also assessed. RESULTS: Citrullination and carbamylation were both significantly decreased by triclosan at concentrations six times lower than the 0.3% triclosan approved by the FDA to use in mouthwash and toothpaste. When macrophages were exposed to triclosan, carbamylation was significantly deceased (p = 0.01), and while citrullination also decreased, this reduction was not statistically significant (p = 0.06). CONCLUSION: Triclosan reduced the generation of protein citrullination and carbamylation in vitro. CLINICAL RELEVANCE: Triclosan may be useful as an adjunct therapy in the management of inflammatory periodontal diseases and help to reduce posttranslational protein modification citrullination and carbamylation) in these tissues.
30030624 Performance of the 2016 ACR-EULAR classification criteria for primary Sjogren's syndrome i 2018 Sep This study compared the performance of the newly proposed 2016 American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR) criteria to the 2002 American-European Consensus Group (AECG) and 2012 ACR classification criteria for primary Sjogren's syndrome (pSS) in well-characterized Korean patients. Patients with pSS from 12 university-affiliated hospitals in Korea were enrolled from October 2013 to January 2017. Clinical and laboratory data were reviewed. For the validation set, patients who underwent evaluation tests to rule out pSS at Seoul St. Mary's hospital from November 2016 to December 2017 were analyzed. Baseline registry data were available in 458 patients, and 328 patients had sufficient data to determine the fulfillment of each criteria set. All three sets of criteria were met by 307 patients (93.6%). The newly proposed 2016 ACR/EULAR criteria were met by 325 patients (99.1%). The 2002 AECG and 2012 ACR criteria were met by 325 (99.1%) and 310 patients (94.5%), respectively. In a validation cohort consisting of 161 patients with pSS-related symptoms/signs, the sensitivity and specificity of the 2016 ACR/EULAR criteria were 100% [95% confidence interval (CI), 96.11-100.00] and 81.8% [95% CI, 76.15-94.26], respectively. Agreement between the 2016 criteria and 2012 or 2002 criteria was high (Cohen's kappa 0.736 and 0.769, respectively). The newly proposed 2016 ACR/EULAR criteria were met by most patients diagnosed with pSS according to previous criteria and showed higher sensitivity and lower specificity compared with both previous criteria sets.
29370863 Application of the international league against rheumatism classification criteria for sys 2018 Jan 25 BACKGROUND: Adult-onset Still's disease (AOSD) is an adult form of systemic juvenile idiopathic arthritis (JIA) that differs from the latter in its classification. This study evaluated the concordance between the International League Against Rheumatism (ILAR) criteria for systemic JIA and the Yamaguchi criteria and then compared their possible prognostic value in patients with AOSD. METHODS: In a retrospective review of 169 adults with suspected AOSD, patients were classified according to the Yamaguchi or ILAR criteria. Then the concordance in cross-referencing the other group with the different criteria was investigated and the sensitivity and specificity of each set of criteria were determined. Disease activity markers in AOSD patients were correlated with positivity according to both systems. RESULTS: Concordance was good in patients with suspected AOSD (k = 0.7144, p <  0.001) and low in those with a diagnosis of AOSD (k = 0.3787, p <  0.001). The sensitivity of the ILAR criteria in AOSD patients was 0.8864 (95% confidence interval (CI): 0.8322-0.9405), and the specificity was 0.7838 (0.6511, 0.9164). Positivity according to the ILAR criteria correlated with the systemic score (r = 0.763, p <  0.0001) and C-reactive protein levels (r = 0.183, p = 0.0356) and was associated with a relapse (odds ratio: 1.589, 95% CI: 1.043-2.421), macrophage activation syndrome (MAS; odds ratio: 1.993, 95% CI: 1.218-3.263) and care in the intensive care unit (ICU; odds ratio: 2.087, 95% CI: 1.086-4.011). CONCLUSIONS: In AOSD patients, there is fair concordance between the Yamaguchi and ILAR criteria for systemic JIA. Positive ILAR criteria may be useful for identifying AOSD patients at high risk for relapse, MAS and the need for ICU care. Further studies including larger populations from several centers are needed to confirm our results regarding the utility of the ILAR criteria in AOSD patients.
29733534 Adult-onset Still's disease initially thought to be an odontogenic infection: A case repor 2018 Jun OBJECTIVE: To present a case of Adult-onset Still's disease (AOSD) initially suspected to be odontogenic inflammation. BACKGROUND: Adult-onset Still's disease is a rare, complex autoinflammatory disease and a known cause of fever of unknown origin. MATERIALS AND METHODS: The patient had both a fever and dental pain. Following meticulous examination, the patient was diagnosed with AOSD. CONCLUSION: Clinicians should keep in mind that a patient such as AOSD may visit their clinics.
30423813 Interferons and Dry Eye in Sjögren's Syndrome. 2018 Nov 10 Various cytokines, including interferon (IFN)-γ and IL-17, are augmented, and autoreactive T cells and B cells are activated in the immune pathogenesis of Sjögren's syndrome (SS). In particular, IFNs are involved in both the early stages of innate immunity by high level of type I IFN in glandular tissue and sera and the later stages of disease progression by type I and type II IFN producing T cells and B cells through B cell activating factor in SS. Genetically modified mouse models for some of these molecules have been reported and will be discussed in this review. New findings from human SS and animal models of SS have elucidated some of the mechanisms underlying SS-related dry eye. We will discuss IFN-γ and several other molecules that represent candidate targets for treating inflammation in SS-related dry eye.
30170790 Case report of primary Sjögren Syndrome with simple trigeminal lesion as initial symptom. 2018 Nov 15 PURPOSE: It will provide a reference for early detection, early diagnosis and early treatment of atypical primary Sjogren syndrome with neurological impairment as the first symptom. METHODS: Case report and Literature review. RESULTS: Here we report a 30-year-old woman diagnosed with trigeminal damage secondary to pSS who presented atypical trigeminal neuralgia of numbness of the right head and face and persistent prickling-like pain not associated with eating, talking or tooth-brushing, and had no "trigger point". The patient further received rheumatoid immune factor tests, ophthalmic examinations, salivary gland emissioncomputed tomography(ECT) and lip biopsy, and found positive antinuclear antibodies (1:320), atypical xerophthalmia, impaired intake and excretion of bilateral salivary glands and degree II of lip biopsy. The patient received methylprednisolone and antiviral therapy, which showed very good outcome. CONCLUSIONS: Clinically primary Sjögren Syndrome (pSS) combined with trigeminal lesion is common, but cases of pSS with trigeminal involvement as initial symptom have rarely been reported, which is easy to misdiagnose. This case suggested that the signs of simple trigeminal lesion, especially those with atypical manifestations, could be the early manifestation of other systemic diseases. Attention should be paid to identification of the pathogeny of the primary disease to achieve early identification, diagnosis and treatment.
29480635 Comparative analysis of the 2016 ACR-EULAR and the 2002 AECG classification criteria for S 2018 Mar INTRODUCTION: The introduction of new classification criteria for Sjögren's syndrome, known as the 2016 American College of Rheumatology/European League against Rheumatism Classification Criteria (ACR-EULAR), created a need for the evaluation of its performance in an external cohort. The purpose of this study was to compare the performance of the 2016 ACR-EULAR classification set with the widely used American-European Consensus Group Classification criteria (AECG) in the cohort at the National Institutes of Health, USA, and to compare the performance of the sets in classifying both primary and secondary Sjögren's syndrome (pSS and sSS). METHODS: The study cohort at the NIH (N = 1,303) was enrolled for clinical suspicion of SS. Participants were classified as SS, pSS, and sSS according to both classification sets. Performance of 2016 ACR-EULAR and AECG sets was compared holding each as gold standard to the other. Statistical analysis of test diagnostics and agreement between the two sets were undertaken. RESULTS: By the AECG set, 701 were classified as having SS (627 pSS, 74 sSS) and 714 were classified with SS (647 pSS, 67 sSS) by the 2016 ACR-EULAR set. Sensitivity and specificity of the two sets were comparable in classifying SS, pSS, and sSS. There was high agreement between the two sets for classifying SS (κ = 0.79), pSS (κ = 0.81), and sSS (κ = 0.87). The specificity of the 2016 ACR-EULAR set was significantly higher for classifying sSS than pSS, while the sensitivity was similar for the two disease groups. However, this pattern was also exhibited by the AECG set. CONCLUSION: There was high agreement between the two classification sets with comparable performance diagnostics. There was no evidence of superior performance value by the new 2016 ACR-EULAR set over the AECG set, and the two sets were found to be equivalent. Findings from our cohort indicate that 2016 ACR-EULAR classification could be extended to classification of sSS.
29384877 Acute appendicitis complicated with necrotizing fasciitis in a patient with adult-onset St 2018 Feb RATIONALE: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disease of unknown etiology characterized by evanescent salmon-pink rash, spiking fever, arthralgia/ arthritis, and lymphadenopathy. AOSD sometimes was fatal when it is complicated by macrophage activation syndrome (MAS) or hemophagocytic lymphohistiocytosis (HLH). Nonetheless, the literature provides no recommendations for treatment of AOSD patients with severe sepsis. PATIENT CONCERNS: A previously healthy 65-year-old man with history of AOSD was referred to our hospital for persistent right lower quadrant abdominal pain for 2 days. One week later, an abdominal wall abscess and hematoma developed by extravasation from the inferior epigastric vessels, complicated by necrotizing fasciitis of the right thigh and groin region. To our best knowledge, this case was the first reported case of a perforated appendix complicated with necrotizing fasciitis in a patient with AOSD. DIAGNOSES: The patient was diagnosed as acute appendicitis complicated with necrotizing fasciitis and abdominal wall abscess. INTERVENTIONS: This case received intravenous tigecycline injection and daily 10 mg prednisolone initially, and shifted to daily intravenous hydrocortisone 200 mg for suspected MAS or HLH. This patient underwent surgical intervention and debridement for necrotizing fasciitis. OUTCOMES: The patient's symptoms progressed worse rapidly. He died from cytomegalovirus viremia and bacterial necrotizing fasciitis complicated by septic shock. LESSONS: (1) The steroid dose was difficult to titrate when AOSD complicated by sepsis. The differential diagnosis from MAS/HLH with bacterial/viral infection related severe sepsis was difficult but critical for decision making from clinicians and rheumatologists. (2) The conservative treatment with antibiotics for perforated appendix is safe but has a higher failure rate in immunocomprised patients such as systemic lupus erythematosus and AOSD. Early surgical intervention might contribute to better outcome. (3) The abdominal wall abscess can be spread from intra-abdominal lesion through the inferior epigastric vessels which were as weak points of abdominal wall. Imaging examinations contribute to acute diagnosis and help surgeons perform surgical interventions to prevent morbidity and mortality.
33418814 Reduction-Responsive Polypeptide Nanogel for Intracellular Drug Delivery in Relieving Coll 2018 Dec 10 Rheumatoid arthritis (RA) induces the destruction of cartilage and bone. Methotrexate (MTX) functions as an effective first-line drug to relieve RA in the clinic. However, patients treated with MTX often suffer from severe side effects mainly due to its off-target effects. Therefore, selective delivery of MTX to the affected joints may achieve upregulated efficacy and safety. The affected joints of RA feature hypoxic microenvironment and increased level of glutathione (GSH), resulting from synovial proliferation, lymphocyte infiltration, and neovascularization. In this study, a disulfide-cross-linked nanogel (NG) of methoxy poly(ethylene glycol)-poly(L-phenylalanine-co-L-cystine) (mPEG-P(LP-co-LC)) was synthesized as an intracellular delivery system of MTX. The loading nanogel NG/MTX exhibited apparent reduction-responsiveness and GSH-triggered release behavior of MTX. It also showed efficient internalization and high cytotoxicity toward activated macrophages. Moreover, NG/MTX possessed selective biodistribution in the inflammatory joints of collagen-induced arthritis mouse model. The clinical and histological scores of the mice after NG/MTX treatment were lower than those of the other groups, and the progress of collagen-induced arthritis was overall relieved. To conclude, the controlled delivery of MTX by smart polymer nanoparticles to the RA-affected joints may be a promising approach in the clinical therapy of RA.
29602803 Comment on "Synovial fibroblast-neutrophil interactions promote pathogenic adaptive immuni 2018 Mar 30 Discrepancies on the role of citrullination in the induction of experimental arthritis by neutrophils extracellular traps.
30545432 Management of Primary Sjögren's Syndrome. 2018 Dec 1 OBJECTIVE: Review the clinical manifestations and treatment of primary Sjögren's syndrome. DATA SOURCES: Articles indexed in PubMed, Scopus, and the Cochrane Library in the past 10 years using the key words "Sjögren," "Sjögren's syndrome," "Sjögren's disease," and "Sjögren's syndrome AND treatment." Primary sources were used to locate additional resources. STUDY SELECTION AND DATA EXTRACTION: Forty-six publications were reviewed and criteria supporting the primary objective were used to identify useful resources. DATA SYNTHESIS: The literature included practice guidelines, review articles, original research articles, and prescribing information for the manifestations, diagnosis, and treatment of primary Sjögren's syndrome. CONCLUSION: Primary Sjögren's syndrome is a chronic autoimmune disease with various clinical manifestations, notably dry eye, dry mouth, fatigue, and inflammatory musculoskeletal pain. Most patients are under the care of a dentist, ophthalmologist, and rheumatologist. There is currently no cure; therapy is tailored for each patient to reduce symptoms, avoid complications, and improve quality of life. Respondents to a recent survey conducted by the Sjögren's Syndrome Foundation reported using more than eight medications and treatments for their symptoms; more than 60% of respondents were older than 60 years of age. Pharmacists familiar with recommended treatment options can provide advice and counseling to Sjögren's syndrome patients on multi-drug regimens prescribed by different health care practitioners.
30154719 Integrated Serum and Fecal Metabolomics Study of Collagen-Induced Arthritis Rats and the T 2018 The Zushima tablet (ZT) has been used for decades in the clinical treatment of rheumatoid arthritis (RA) in China. However, its therapeutic mechanism is unclear. In this study, we aimed to explore the distinctive metabolic patterns in collagen-induced arthritis (CIA) rats and evaluate the therapeutic effects of ZT on RA using untargeted serum and fecal metabolomics approaches based on gas chromatography coupled with mass spectrometry. Body weight, hind paw swelling, TNF-α and IL-1β levels, arthritis scores, and histopathological parameters were assessed. In the metabolomics study, 31 altered metabolites in the serum and 30 in the feces were identified by comparing the model with the control group using statistical processing. These altered metabolites revealed that the tricarboxylic acid cycle, glycolysis metabolism, fatty acid metabolism, and purine metabolism were disturbed in CIA rats, and most of these altered metabolites including l-isoleucine, l-aspartic acid, pyruvic acid, cholic acid, and hypoxanthine, were rectified by ZT. Furthermore, short-chain fatty acids in feces were quantitatively determined, and the results showed that ZT could regulate the levels of propionate, butyrate, and valerate in CIA rats. Then, gut microbiota were analyzed by 16S rRNA analysis. Our results showed that Firmicutes and Bacteroidetes were the most abundant bacteria in rats. The levels of 19 types of bacteria at the family level were altered in RA rats, and most of them could be regulated by ZT. This study demonstrated that metabolomics analysis is a powerful tool for providing novel insight into RA and for elucidating the potential mechanism of ZT.