Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3068795 | Future trends in the treatment of rheumatoid arthritis in the light of current etiopathoge | 1988 | The current treatment of rheumatoid arthritis is based on the use of synthetic chemical compounds, the mechanism and action of which have been more or less unknown. Usually this therapeutic effectiveness was discovered accidentally. Often the initial use of such compounds was motivated on the basis of generally diffuse ideas about the eventual pathogenesis of rheumatoid arthritis. The main site of action of most of these drugs has recently been elucidated. Depending on their multiple sites of action the polypharmacy frequency relied upon at present seems also to be theoretically motivated. Many new possibilities for treatment which have appeared recently have resulted from the amission of page limitation. These include various thymic (46), steroid and other hormones (67) and various vehicles or new modes of application, e.g. percutaneous, for directing the effects of drugs selectively to the target tissue, organ and cells. The use of specific T cell clones in therapy (68) has been only briefly dealt with in this article, and the development of operative techniques, endoprosthesis technology and orthopedic devices have not been dealth with at all. Chemical synovectomies with 165Dy-FHMA and other agents (69) will be developed further etc. This overview mainly deals with future trends in the treatment of rheumatoid arthritis based on advances made in the evaluation of the etiopathogenesis. Due to advances in basic sciences and medicine, the pathogenetic mechanisms effective in rheumatoid arthritis are better known today than ever before. The same progress in science has for the first time in history provided us with a potential means of producing bioactive mediators and reagents in sufficient amounts to enable their use also for therapeutic trials and treatment. In addition to the need to develop better methods of treatment for the patients crippled by this chronic disease, studies on the pathogenesis will also be of great benefit to our ideas about exactly what is involved in the complex process clinically known as rheumatoid arthritis. | |
| 1676752 | Regulatory T cell activity specific to human type II and III collagens in rheumatoid arthr | 1991 Apr | Fifty-one patients with rheumatoid arthritis (RA) were examined for their immune response potential to human collagen type II and III. It was found that T cells of 57% of patients with RA proliferated to collagen type III whereas only 27% of T cells of patients with osteoarthritis (OA) and healthy controls responded to this antigen by proliferation (p less than 0.04). A lower percentage (38%) of patients with RA had proliferative responses to collagen type II in comparison to 17% of responders in healthy controls. The capability to produce T cell helper factors specific to collagen type III was found to be significantly higher in patients treated with nonsteroidal antiinflammatory drugs (NSAID) (60%) in comparison to patients with OA (16%) and healthy controls (13%). Immunoregulatory drugs affected the specific T helper function in response to collagen type III but did not change the proliferative responses to collagen type II and III in patients with RA. HLA analyses revealed a significant difference in the frequency of HLA-DRw10 between our sample of patients with RA and healthy controls. | |
| 1927044 | [Immunogenetic prognosis of the effectiveness of cytostatic therapy of rheumatoid arthriti | 1991 | The time course of in vitro cellular immune reactions by using cyclophosphane, prospidin , and methotrexate was examined in 39 patients with rheumatoid arthritis to make predictions of the efficacy of its cytostatic therapy. The agents were evaluated for effects on the expression of Ia-like antigens on the peripheral lymphocytes and synovial fluid of the patients. The optimal doses of the agents for this testing had been chosen in the lymphoid cells from MRL31 lpr mice. The active dosage forms of the cytostatics for the experiment were obtained by administering native agents into the retrobulbar plexus of Balb/c mice, followed by blood isolation of active metabolites . The Ia-like antigen pre-expression index which is the ratio of the proportion of Ia-positive lymphocytes in control cultures to that of the cells in the culture after drug addition was used as a marker of the baseline cellular immunity in the patients. The patients having the index more than 1.5 were considered to be sensitive, those with less than 1.5 were insensitive to the drug. Thus, the Ia-like antigen pre-expression index may be used as a predictor in the assessment of the expediency of prospidine use. | |
| 2189417 | A randomized controlled trial of ciamexon versus placebo in the immunomodulatory treatment | 1990 May | To determine the efficacy of the new immunosuppressive agent ciamexon in patients with rheumatoid arthritis (RA), we conducted a 6-month, prospective, double-blind, placebo-controlled study. The study included 21 outpatients with confirmed RA, who were randomized into 3 treatment groups of 7 patients each. Group 1 received 400 mg/day of ciamexon, group 2 received 100 mg/day of ciamexon, and group 3 received placebo. We investigated the influence of ciamexon on the clinical course, the systemic inflammatory activity, and the lymphocyte subsets in the peripheral blood. Significant, dose-dependent improvement was seen in both the clinical and the biochemical activity indexes at the end of the treatment period (P = 0.02 to P = 0.05). The proportion of activated T lymphocytes was significantly decreased (P = 0.05), and the proportion of CD8-positive lymphocytes was significantly increased (P = 0.03) in patients taking ciamexon. The major adverse effects were hepatotoxicity (2 patients) and rash (2 patients). This study documents the clinical efficacy of ciamexon therapy in RA patients and identifies the agent's potential toxicity. | |
| 3394079 | [Immunotropic therapy of rheumatoid arthritis (prerequisites, results and principles)]. | 1988 | The author has summed up many-year investigation and literature data on immunological approaches to RA therapy including a study of the patients' immunological status, evaluation of the clinical efficacy and immunological effects of various therapeutic methods, and a study of the individual sensitivity of drugs in in vitro experiments. An indicator proposed by the author for the evaluation of clinicoimmunological therapeutic efficacy, expresses the true value of the method of RA therapy. Indices of the immune status necessary for a choice of patients and control of immunotropic therapy were defined; methods for the assessment of individual sensitivity to immunoreactive agents and principles of immunotropic therapy were presented. | |
| 3178316 | Lack of objective evidence of stiffness in rheumatoid arthritis. | 1988 Sep | Metacarpophalangeal joint stiffness was measured using a new microprocessor controlled arthrograph in 135 patients with rheumatoid arthritis. Subjects were prospectively subdivided according to the stage of the disease in the joint. Compared with a normal population stiffness variables in active rheumatoid arthritis were decreased, significantly so for non-elastic stiffness. This study casts doubts on the literal interpretation of symptomatic stiffness as an indicator of disease activity in rheumatoid arthritis and suggests a number of explanations for the discordant result. | |
| 3779321 | Peptic ulcer in rheumatoid arthritis--intrinsic or related to drug therapy? | 1986 Nov | The reported incidence of peptic ulcer disease (PUD) in patients with rheumatoid arthritis (RA) is higher than that of the general population. Unusual susceptibility to PUD in RA, independent of therapy, has been suggested. To compare RA patients with others who had similar drug exposure but no known predisposition to PUD, 120 patients hospitalized for treatment of severe arthritis (65 with RA, 55 with osteoarthritis) were assessed by questionnaire for PUD history, drug history and other relevant variables. The relationship of PUD to sex distribution, smoking, alcohol consumption and anti-inflammatory therapy followed expected patterns. We found high but similar PUD rates in RA and osteoarthritis (OA) patients (RA 15%, OA 18%). This suggests that a common factor (probably drugs) is responsible. We feel that the documented high incidence of PUD in RA is most probably related to drug therapy. Available methods cannot determine if PUD ever occurs as a primary manifestation of RA. | |
| 2405864 | The effect of folic acid supplementation on the toxicity of low-dose methotrexate in patie | 1990 Jan | Thirty-two patients with rheumatoid arthritis completed a 24-week, placebo-controlled, double-blind trial of folic acid (FA) supplementation during low-dose methotrexate (MTX) therapy. Administration of the daily FA supplement significantly lowered toxicity scores without affecting efficacy, as measured by joint counts, joint indices, and patient and physician evaluation of disease activity. Fifteen patients experienced some sort of toxicity; 67% were in the placebo group, and 33% were in the FA supplement group. Four patients in the placebo group had toxicity levels serious enough to require discontinuation of the MTX, while no patients in the FA supplement group discontinued MTX because of toxicity. Low-normal initial plasma and red blood cell folate levels were predictive of future toxicity with MTX therapy. We conclude that a daily supplement of 1 mg of FA during low-dose MTX therapy (median dose 7.5 mg/week [16.4 mumoles]) is usefull in lessening toxicity without altering efficacy during the first 6 months of treatment. | |
| 2467353 | The MRL-lpr/lpr mouse. A model for the study of rheumatoid arthritis. | 1988 | Autoimmune MRL-lpr/lpr mice develop a spontaneous destructive arthropathy sharing some features with rheumatoid arthritis including synovial cell proliferation, pannus formation, rheumatoid nodule-like lesions and circulating rheumatoid factors. Rheumatoid factors elaborated by MRL-lpr/lpr mice exhibit binding characteristics similar to those found in the sera of patients with rheumatoid arthritis; however, these autoantibodies do not appear to be essential for the induction of arthritis in MRL-lpr/lpr mice. Molecular studies, indicating that VH genes from several VH families are capable of encoding these rheumatoid factors, argue against the existence of unique "autoantibody genes" in the germline of MRL-lpr/lpr mice. Although the mechanisms underlying cartilage injury in MRL-lpr/lpr mice have not been elucidated, available evidence suggests that invading synovial cells play an important role. Delineation of the cellular and molecular mechanisms responsible for articular destruction in MRL-lpr/lpr mice may provide important insights concerning the pathogenesis of rheumatoid arthritis. | |
| 2284522 | Construction of a simple test for assessment of hand function in primary care. Theories an | 1990 Dec | This paper describes a hand test consisting of three steps to test the subject's ability to grasp firmly another person's hand to hold a pencil firmly with fingers II-V with straight knuckles and maximally flexed finger joints, while the investigator pulls the pencil to hold on to a piece of paper with a rounded pinch grip between thumb and index finger while the investigator pulls the paper with a rounded pinch grip with submaximal strength. All three steps must be performed with each hand without causing pain. The test was an adequate parameter for the grip function, and at the same time could register work-load elicited pain, strength, and mobility. The test can be carried out by healthy subjects, but not by patients with rheumatoid arthritis. The test is logically constructed and has a high validity and reliability. | |
| 2624928 | [Immunologic examination of the blood in the differential diagnosis of acute gouty arthrit | 1989 Dec 1 | In 16 patients with acute gouty arthritis, 30 IgM RF seropositive cases of rheumatoid arthritis (RA) and 20 IgM RF seronegative cases of RA the values of 14 indicators of antibody and natural immunity were assessed in serum. The assembled data were evaluated by step-wise discrimination analysis. This made it possible to select consecutively signs important for the differentiation of acute gouty arthritis from IgM RF seropositive RA (immunocomplexes, beta-2 microglobulin, C3) and for its differentiation from IgM RF seronegative RA (IgE, C3, transferrin, free SH groups). Thus obtained classification functions make it possible to classify correctly, random subjects with a probability of 76.7-93.7%. | |
| 2073503 | The relationship of oral contraceptive use to rheumatoid arthritis. | 1990 Mar | Current use of oral contraceptives among 71 women aged 17 to 45 diagnosed for the first time as having definite or probable rheumatoid arthritis at Group Health Cooperative of Puget Sound was compared with oral contraceptive use among matched controls. Twenty-three percent of cases and 13% of controls were current users of oral contraceptives at the index date (relative risk estimate = 2.0, 95% CI = 0.97-4.21). We conclude that current oral contraceptive use was not protective against the development of rheumatoid arthritis in this population. | |
| 1787498 | The coexistence of active classic rheumatoid arthritis and AIDS. | 1991 Nov | The lack of previous reports documenting the coexistence of active rheumatoid arthritis (RA) and acquired immunodeficiency syndrome (AIDS) despite an abundance of other HIV associated autoimmune phenomena has generated a hypothesis regarding the necessity of the T4 cell for the development or continued activity of RA. We are the first to describe a patient in whom AIDS did not induce a remission of active synovitis. This observation emphasizes the complexity of the pathogenesis of RA. | |
| 1898545 | Rheumatoid arthritis of the knee: value of gadopentetate dimeglumine-enhanced MR imaging. | 1991 Jan | In an attempt to differentiate among joint effusion, synovitis, pannus, and subchondral sclerosis in patients with clinically proved chronic rheumatoid arthritis, we used gadopentetate dimeglumine-enhanced MR imaging to examine 23 patients with acute knee symptoms. All patients had had rheumatoid arthritis for more than 6 months and satisfied four or more of the criteria of the American Rheumatism Association for rheumatoid arthritis. MR imaging was performed on a 1.5-T machine by using unenhanced T1-weighted spin-echo imaging, unenhanced T2*-weighted gradient-echo imaging, and unenhanced and enhanced T1-weighted gradient-echo imaging. Signal intensities of the synovium and bone marrow were measured with the region-of-interest technique on unenhanced and enhanced T1-weighted gradient-echo scans. Conventional radiographs were available for each patient. Joint effusion, synovitis, intraarticular pannus, subchondral sclerosis, and subchondral pannus had the same signal intensities on unenhanced T1-weighted spin-echo, unenhanced T1-weighted gradient-echo, and unenhanced T2*-weighted gradient-echo MR images, and could not be differentiated from one another. On enhanced T1-weighted gradient-echo sequences, pannus and synovitis showed marked enhancement in 15 patients, whereas joint effusion and sclerosis did not. Synovitis was diagnosed if the synovial membrane showed high enhancement; pannus was diagnosed if enhancing masses were seen within the joint space or in the subchondral area. In eight of the 23 joints, there was no enhancement of the synovium or intraarticular or subchondral tissue. We conclude that gadopentetate dimeglumine-enhanced MR imaging allows differentiation between synovitis and joint effusion and between subchondral pannus and subchondral sclerosis. Enhancement of the synovium and pannus indicates acute inflammation of the joint. | |
| 3488714 | Immunocytology of synovial fluid cells may be of diagnostic and prognostic value in arthri | 1986 Jul | Cells of the synovial fluid (SF) have been examined by immunocytochemical methods. Samples were aspirated from four groups of patients with knee effusions: (a) seropositive inflammatory arthritis (n = 9); (b) seronegative inflammatory arthritis (n = 9); (c) osteoarthritic patients (n = 5); and (d) patients with traumatised knees (n = 4). The proportions of lymphocyte and macrophage subsets within the SF were determined with a panel of monoclonal antibodies. Patients with inflammatory arthritis had significantly larger proportions of activated T cells (RFT2+) and macrophages with the phenotype of interdigitating cells (RFD1+). No significant difference between groups could be found on differential count or when T4+/T8+ subset ratios were calculated. No significant difference in proportions of lymphocyte or macrophage subsets was found between the groups with seropositive and seronegative inflammatory arthritis. In two of three patients, where immunocytochemical analysis was performed before and after intra-articular steroids, reductions in the proportions of RFT2+ T cells and RFD1+ macrophage like cells were seen. It is suggested that such analysis may be of diagnostic or prognostic value. | |
| 3704085 | A cross-modality approach for treatment of chronic pain: a preliminary report. | 1986 Mar | Three subjects, presenting a variety of chronic pain problems, were treated with a cross-modality feedback technique. Their presenting pain intensity was matched to a pure tone auditory stimulus decibel level and in each session this stimulus was progressively reduced in loudness, with the subjects having the task of reducing their pain to match each new, lower decibel levels. Audiometric measures, responses to pain assessment scales, self-reports, reports from hospital staff, and reductions in pain medications all demonstrated marked pain reduction in all cases. Follow-up assessments revealed that the improvements were maintained long after treatment had been discontinued. | |
| 2873694 | [Dipeptidyl peptidase IV activity in the serum and synovia of patients with rheumatoid art | 1986 Mar | Over 90 patients with rheumatoid arthritis (RA) were examined to ascertain the activity of the enzyme dipeptidylpeptidase IV (DP IV) (EC number: 3.4.14.-) in serum and synovial fluid. If the activity stage of RA (clinical and paraclinical picture) is on the increase, the gly-pro-NHNp-hydrolysis in serum and synovial fluid decreases. Indirect statistical connections between the cytological activity stage and the DP IV activity are detectable. Although the enzyme from the serum with the molecular weight of 270 kD can only filter scantily into the synovia, there is an intraindividual connection between the enzyme activity in the synovial fluid and serum. With the aid of combined experiments the effect of the endogenous inhibitors can be excluded. | |
| 3664159 | Anticardiolipin antibodies in rheumatoid arthritis. | 1987 Oct | Anticardiolipin antibody (ACA) was present in the sera of 49% of 90 consecutive patients with rheumatoid arthritis (RA). The ACA was absent in 30 control patients with osteoarthritis. C-reactive protein levels equal to or exceeding 7 mg/dl were found in 10 patients all of whom were ACA positive. ACA was present in a larger proportion of rheumatoid factor (RF) positive than of RF negative patients. Male sex and extra-articular manifestations of RA were both more common in ACA positive than ACA negative patients. In the ACA positive group the lupus anticoagulant and VDRL tests were negative. However, a small number of patients had evidence of vascular events. | |
| 3508328 | Naproxen: antirheumatic efficacy and safety in patients with pre-existing gastrointestinal | 1988 Feb | Nonsteroidal antiinflammatory drugs (NSAIDs) effectively reduce pain and inflammation of rheumatoid arthritis (RA). To further refine the appropriate uses of NSAID therapy, NSAIDs have been evaluated for possible gastrotoxicity, particularly in patients who have pre-existing gastrointestinal (GI) disease. In the present study, 58 such RA patients (36 women, 22 men) treated long-term with naproxen were monitored for periods up to 2.5 years to determine if any gastrotoxicity were induced by naproxen. We found an extremely low incidence of fecal occult blood, patient complaints of GI discomfort, complications documented by GI studies, and patient discontinuance of naproxen therapy because of complaints. Studies reported in the medical literature support our observations that naproxen can be well tolerated and is effective as long-term RA treatment when patients who have clinically significant pre-existing GI disease are managed with conventional treatments and appropriate monitoring. | |
| 3689000 | Clinical and serological features of severe vasculitis in rheumatoid arthritis: prognostic | 1987 Oct | Sixteen patients with classic rheumatoid arthritis (RA) complicated by severe vasculitis were studied and compared with a matched control group of 16 RA patients without vasculitis. Seven of the patients with vasculitis died within 4 to 120 months (median 32 months) after developing vasculitic symptoms. Gangrene of digits and extremities, bowel ulcers or bowel perforation, or both, and cardiac involvement were more common among the patients who died than among those with a more favourable course. The present data suggest that large vessel vasculitis in RA is associated with high frequency of arteriosclerotic vascular disease. The serum concentrations of complement components C3 and C4 were lower, and concentrations of IgM rheumatoid factor, complement activating rheumatoid factor, and C1q binding immune complexes (C1q solid and C1q fluid phase assay) were significantly higher among vasculitic patients than in the control group. Laboratory data provided little prognostic information with regard to rheumatoid vasculitis, with the exception that IgM and IgG rheumatoid factors were significantly higher among patients with fatal course of disease than in those who achieved remission. |