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

PMID	Title	PublicationDate	abstract
3276421	Trabecular bone strength at the knee.	1988 Feb	The axial strength of trabecular bone at the knee is critical for the maintenance of support and fixation of the prosthetic components after total surface knee arthroplasty. The resistance of trabecular bone to penetration was measured posteriorly, centrally, and anteriorly in each of the tibial and femoral condyles in 150 consecutive total knee arthroplasties. Forty-seven rheumatoid knees and 88 osteoarthritic knees were evaluated. The correlation of bone strength with selected clinical parameters was found to be too poor to predict bone strength. Tibial bone strength was lower in rheumatoid than in osteoarthritic knees. Steroid medication did not influence tibial bone strength in rheumatoid arthritis. The distribution of bone strength between the medial and lateral condyles was closely dependent on knee alignment, with high medial strength in varus knees. At the unloaded condyle, strength was reduced relative to the findings for normally aligned knees. At the tibia, strength decreased with depth from the resection surface, while at the femur the converse was true. Tibial bone strength, both condylar and overall average, was lower than values reported in studies of normal cadaver knees. Evaluation of the absolute bone strength at the tibial condyles suggested that the values too low to meet load-bearing requirements after well-aligned knee replacement were infrequent.
2111575	[Cytokines and rheumatoid polyarthritis].	1990 Apr 10	Cytokines play a role in the chronicity of inflammation, the formation of lesions and the persistence of the immune response observed in rheumatoid arthritis (RA). The dysregulation of the cytokines observed in RA is of great immunopathological importance. There is an increase in the macrophage-derived cytokines such as interleukin 1, the tumor necrosis factor alpha and interleukin 6. At the same time, there is a decrease in the lymphocyte-derived cytokines such as interleukin 2, interferon gamma and interleukin 4. Certain growth factors (transforming growth factor beta, platelet derived growth factor, granulocyte macrophage-colony stimulating factor) also play a role in RA. The study of the role of these various cytokines in the formation and maintenance of articular and extra-articular lesions in RA is carried out.
3633512	Human responses to chronic illness: physiologic and psychosocial adaptation.	1986 Mar	To identify factors that promote adaptation, physiological and psychosocial responses to chronic illness were studied. The adaptation to chronic illness model (Pollock, 1984a) served as the theoretical framework for integrating the major variables of chronicity, stress, hardiness, and physiological and psychosocial adaptation. The sample (N = 60) consisted of three equal-sized groups of adults who had been diagnosed with diabetes mellitus, essential hypertension, or rheumatoid arthritis for at least one year. Data were collected from all subjects over a 9-month interval to determine their physiological and psychosocial adaptation and if they had the hardiness characteristic. The hypothesis, that presence of the hardiness characteristic was significantly correlated with physiological adaptation, was supported for the diabetic group but not for the hypertensive or rheumatoid arthritic groups. Physiological and psychosocial adaptation were found to be two independent domains in this study.
3589587	Somatosensory evoked potentials (SSEPs) in rheumatoid cervical subluxation.	1987	Somatosensory evoked potentials (SSEPs) were recorded in 34 patients with severe rheumatoid arthritis. Eighteen had atlanto-axial subluxation and 16 had no roentgenological evidence of cervical subluxation. Four patients in the group with cervical subluxation showed pathological SSEP values from both median and tibial nerves indicating conduction block in the upper cervical medulla. In the group with no cervical subluxation, 6 patients had prolonged SSEP latency, 5 of these on recordings from the tibial nerves with normal median nerve latencies and one with only bilaterally prolonged median nerve latencies. The pathological SSEP findings in the former group of patients we attribute to the cervical subluxation, while the findings in the latter group might be related to spinal cord vasculitis or extradural granulation tissue. The SSEP method can be useful in providing objective evidence for spinal cord lesions in patients with rheumatoid cervical subluxation.
3947416	Methylprednisolone infusion therapy in rheumatoid arthritis patients. The effect on synovi	1986 Jan	Paired samples of synovial fluid (SF) and blood were obtained prior to and at 4 and 24 hours following high-dose methylprednisolone infusion therapy in a group of patients with refractory rheumatoid arthritis. After therapy there was a significant decrease in numbers of polymorphonuclear leukocytes, lymphocytes, immune complexes, and C-reactive protein in the SF. Measurement of lymphocyte subsets, using monoclonal antibodies, revealed that at 4 hours postinfusion, there was a disproportionate decrease in the percentage of SF lymphocytes expressing class II antigens (HLA-DR or Ia-like). These data suggest that glucocorticoids induce rapid changes in SF indices of disease activity and may directly influence T cell activation within the rheumatoid joint.
2674426	Methotrexate pharmacokinetics in patients with rheumatoid arthritis.	1989 Jun	Few studies have evaluated the pharmacokinetics of low dose oral methotrexate (MTX) therapy. MTX pharmacokinetics were studied in 10 patients with classic rheumatoid arthritis (RA) after a single 7.5 mg oral dose. MTX was rapidly absorbed. Peak concentrations varied considerably, ranging from 0.31-0.72 microM. Measurable drug concentration was found in all patients at 24 h after the dose. CL/F-MTX = 145 +/- 52 ml/min/1.73 m2 and elimination half-life was 4.5 +/- 0.89 h. Oral MTX given as a single weekly dose has predictable pharmacokinetics. Further studies to examine what relationship exists, if any, with efficacy and toxicity of MTX in RA must be undertaken.
3685908	The importance of skin vessel wall immune deposits in the course of the systemic and artic	1987	Fifty-one rheumatoid arthritis patients were examined prospectively during a 3-year investigation period by means of immunohistological, histological, and instrumental clinical methods. Skin vessel wall immune deposits (SVWID) were found in 21/51 patients at the first and in 11/35 patients at the concluding investigation. Patients with SVWID showed more extra-articular features, more rapid progress of joint damage, higher mortality frequency, higher inflammatory activity, and higher levels of circulating immune complexes, compared with patients without SVWID.
3594963	Relationship between areas of popliteal cysts and radiological damage in rheumatoid arthri	1987 Jan	Fifty-five patients, (30 Rheumatoid Arthritis (RA) and 25 Osteoarthritis (OA], with knee synovial effusion and popliteal cysts, visualized through arthrograms, were studied. A relationship was sought between radiological findings and area of the cysts, measured through a millimeter grid. Ten radiological parameters were graded and summed up to obtain a "total knee score". A "total geode score" was also obtained by scoring, separately, the geodes. In addition two specific indexes were used--for comparison--the erosive index, modified after Berens and Lin, in RA and the Kelligren's index in OA. In RA a statistically significant, inverse correlation was found between the x-ray scores and the area of the cysts, while such a relationship was not observed in OA. However, only a third of the cysts accounted for the inverse relationship in RA. Furthermore, two control groups of RA and OA patients revealed a striking association between degree of radiological damage and frequency of popliteal cysts. Therefore, the hypothesis that popliteal cysts might have a protective effect against the articular-bone damage in RA, can be held only in few cases.
2658875	Clinical, biochemical, and radiographic effects of aminohydroxypropylidene bisphosphonate	1989 May	A placebo controlled, double blind study of aminohydroxypropylidene bisphosphonate (APD), given by monthly intravenous infusion, was conducted in 40 patients with rheumatoid arthritis. Biochemical markers of increased bone resorption, such as fasting urinary calcium/creatinine ratio and hydroxyproline/creatinine ratio, were suppressed significantly in the APD group to approximately 50% and 60% of the pretreatment level respectively, and serum calcium fell transiently after the first APD infusion. There was no significant effect on disease activity in either the APD or placebo groups as judged by clinical (grip strength, morning stiffness, visual analogue score) or laboratory (haemoglobin, platelet count, erythrocyte sedimentation rate, C reactive protein) criteria. An exception was the articular index which improved to a similar degree in both groups, falling from (mean (SEM] 13.8 (1.8) to 7.2 (2.2) in the APD group and from 13.7 (1.9) to 6.8 (1.5) in the placebo group. Radiological progression occurred to a similar degree in both groups as assessed by the Sharp index (mean (SEM) 86 (13.1) v 95 (12.9)-APD group; 103 (15.1) v 110 (15.8)-placebo group), but there was no significant change in the Larsen index in either group (mean (SEM) 53 (4.2) v 57 (3.8)-APD; 62 (5.8) v 63 (5.6)-placebo). The lack of effect on radiological progression in the APD group indicates that focal erosive disease may either have progressed as the result of a non-osteoclast related mechanism, or that the intensity of bone resorption was too great to be inhibited by the doses of APD used. The biochemical response to APD presumably reflected inhibition of bone resorption at other sites, suggesting that further studies of the effects of bisphosphates on periarticular and systemic osteoporosis in rheumatoid arthritis may be of the interest.
3350435	Total ankle arthroplasty in rheumatoid arthritis: a long-term follow-up study.	1988 Feb	Patients with rheumatoid arthritis who had undergone total ankle arthroplasty and had a minimum of 2 yr follow-up were studied. Of the original 21 patients 17 were available for review. Twenty-three ankle replacements with an average follow-up of 5.6 yr were studied. On follow-up 2 ankles were rated excellent, 13 were rated good, 4 were rated fair, and 4 were rated poor. Thus, 83% were satisfactory on follow-up. Radiographic analysis revealed migration and settling of the talar component in 14 of 15 cases. Bone cement radiolucencies were found in 14 of 15 cases. Bone cement radiolucencies were found in 14 of 15 tibial components with tilting in 12 of these components. The postoperative position of the implant did not correlate with the development of radiolucencies or migration of the implant.
3441593	[Rheumatoid serology: insufficient using a single test].	1987 Mar	The rheumatoid factor research restricted to only a test finds evident limitation not only in clinical field, but also on epidemiological investigations. The problem may find a solution by contemporary employment of a tests pool both in epidemiology and in the different physiopathological conditions present in rheumatology. Such kind of proposal has been verified on rheumatic diseases (rheumatoid arthritis classic or probable, polyarthritic syndrome, polyarthritis, spondylitis, psoriatic arthritis) and not rheumatic ones and in control group population (2901 subjects controlled). The results obtained emphasize the eventual presence of rheumatoid factor in the control group population, usually documented by the isolate positivity of three or more tests is preponderant for the same occurrence. By the statistical analysis applied to the conditions with equivalent number in the positive tests, is resulted that the possibility to discriminate the population, apparently health from the sick one is realized in a significative way of the positive tests, and starting from the positivity of two or more tests at least. It can be concluded confirming the already historical datum that the rheumatoid factor research with a test only has a limited orientation power to the diagnosis purpose.
2119587	Immunologic parameters of response in patients with rheumatoid arthritis treated with cycl	1990 Sep	Thirty-one patients with seropositive rheumatoid arthritis treated with cyclosporin A (CsA) were evaluated for immune function prior to, during, and after 1 year of therapy. Patients whose pretreatment peripheral blood mononuclear cells were hypoproliferative in vitro to soluble recall antigens responded better clinically to CsA treatment than did the other patients. During therapy, proliferative responses became normal and remained so until 1-2 months after CsA was discontinued. At that time, the lymphocyte proliferation defect reappeared. In addition, patients who responded clinically to CsA had a higher percentage of Leu-7+ natural killer cells in their peripheral blood prior to therapy. All patients exhibited greater frequencies of cells that expressed interleukin-2 receptors, which decreased with CsA treatment. The clinical response to CsA appears to be associated with distinct immunologic parameters in rheumatoid arthritis.
2639796	[TMJ and rheumatoid arthritis. Clinical study].	1989 Jun 15	A clinical and epidemiological investigation was performed on a sample of randomly selected rheumatic patients in order to identify the prevalence of signs and symptoms of mandibular dysfunction. The collected data were used to calculate the Helkimo Anamnestic and Clinical Dysfunction Index. Signs of dysfunction were found in all the subjects (except one) and were significantly commoner in women than in men (p less than 0.01). The commonest clinical findings were: sound from the TMJ (crepitus or grating noise), impaired mandibular mobility, tenderness to palpation of the masticatory muscles. The comparison with a sample of a non-selected control-group was statistically significant (p less than 0.001). Contemporary radiographic examination demonstrated in many cases extreme resorbtion and remodelling of the condyle, increase of joint space and erosion of the fossa, otherwise reduced joint space and sclerosis, depending on superimposed degenerative arthritis (usually more painful). The survey showed a significant incidence of structural as well as functional involvement of TMJ in RA and suggested a more careful diagnostic and therapeutic approach.
2211072	Rheumatoid arthritis, hypochondriasis, depression and sewing.	1990	Six female postmenopausal psychiatric inpatients with rheumatoid arthritis (RA), domineering personality, hypochondriasis, alexithymia and perfectionism are presented. None of the patients fully responded to antidepressant drug treatment. Five of the six women were professionally engaged in sewing, which might be considered a mechanical risk factor for rheumatoid arthritis. Several psychiatric aspects of RA are discussed, particularly the existence of the "arthritic personality" and the influence of psychological stress in RA patients.
2694400	Potential mechanisms for coordinate gene activation in the rheumatoid synoviocyte: implica	1989	Evidence is reviewed to support the concept that synovial cells in rheumatoid arthritis have undergone distinctive alterations at the cellular and subcellular level that result in their taking on some of the characteristics that are also manifest by transformed cells. These phenotypic modulations could be indirectly driven by cytokines in a paracrine or autocrine fashion. Specific regional patterns of cell phenotype modulation were used to argue against a simple widely diffusing direct inductive effect to cytokines and in favor of microenvironmental determinants. It is hypothesized that these extracellular factors induce novel activation in a coordinate manner by acting through master regulatory genes operating in cells with specific microenvironmental interactions. Two of these regulatory genes, fos and jun, are discussed in detail because of their induction by growth factors and their central role in the transactivation of genes which have been implicated in rheumatoid synovitis. A model for gene activation in the rheumatoid synovium is proposed based on the premise that fos and jun are an important link in the intracellular transduction pathways used by cytokines to induce cellular phenotypic changes.
3382447	What are we measuring? An examination of self-reported functional status measures.	1988 Jun	Functional status questionnaires are being used in various types of studies. To determine factors related to self-reported functional ability for rheumatoid arthritis patients, we examined the relationship between a functional and mental health questionnaire and objective disease-specific measures. Using 3-5 predictor variables, we explained 43-57% of the variance in patients' self-reported functioning. Mental and physical health perceptions were significant predictors for each self-reported functional measure. The relationships among mental health and self-reported functioning should be considered when interpreting studies that use functional status questionnaires.
2781489	[The status of the pituitary-gonadal system and immunologic parameters in patients with rh	1989	Male and female patients suffering from rheumatoid arthritis demonstrated disorders in the pituitary-gonadal system, which manifested in the body estrogenization in the presence of androgenic deficiency. The correlations between the levels of estradiol, testosterone and the parameters of the cellular and humoral immunity were analyzed. The authors discuss the problem of the participation of the disorders in the pituitary-gonadal system in the development of an autoimmune process underlying rheumatoid arthritis.
1857427	The University of North Carolina Arthritis Center.	1991 May	The University of North Carolina Arthritis Center combines the broadly-based research agenda of the Thurston Arthritis Research Center with comprehensive interdisciplinary clinical programs in rheumatology, orthopaedics, and pediatric rheumatology. In keeping with the University's long tradition of service to the people of North Carolina, a primary aim of the Center is to provide the citizens of this state with the best available arthritis care and prevention strategies. The approach here is twofold. New knowledge is created by laboratory investigation of basic disease mechanisms, by clinical studies of new therapies, by social and behavioral research to better understand how patients and their families cope and adjust to chronic arthritis, and by health services research that examines arthritis from a societal perspective. This information, together with advances in rheumatology and related fields from Duke and other institutions, is then applied to optimum clinical and educational services for North Carolina patients and their physicians.
2309103	A retrospective clinical and neuroimmunohistochemical study of rheumatoid arthritic patien	1990	In a retrospective study of 87 RA patients with radiographically documented anterior atlanto-axial subluxation (AAS) in flexion-extension radiographs, 40 had been studied radiographically before they developed AAS. Of these 40 patients, 34 had had occipitocervical pain already before the subluxation. This shows that pain early in the course of the rheumatoid cervical spine is not caused by or associated with AAS itself. In a separate operatively treated group of 5 patients, ligament neuroanatomy in AAS was more closely studied, using specific heteroantisera to cytoskeletal neurofilaments and various transmitter neuropeptides as neural markers and the highly sensitive avidin-biotin-peroxidase complex (ABC) immunohistochemical staining procedure. These specimens were obtained from the ligamentous structures between the posterior arch of the atlas and the spinous process of C2, corresponding to the C1-C2 interspinal non-inflammatory ligament, during atlanto-axial stabilizing operations. This ligamentous tissue contained, in addition to focal inflammatory cell infiltrates, neurofilament and/or neuropeptide immunoreactive neural elements. This finding may suggest that pain early in anterior AAS could be caused not only by synovitis, for example, but also by local ligamentary involvement leading to irritation of local neural elements. This phenomenon may have contributed to the local occipitocervical pain experienced by 34/40 patients who later developed AAS.
2023197	The relationship of pain and deformity of the rheumatoid foot to gait and an index of func	1991 Jan	We evaluated the relationships among pain, structural deformity of the foot, 4 variables of gait, and an index of functional ambulation in 31 patients with rheumatoid arthritis. We saw significant correlations between the ambulation index and all gait variables (p less than 0.005). For the group as a whole, pain in the foot did not correlate with structural deformity. However, when patients were grouped according to the relative preponderance of pain or deformity and duration of disease, we found correlations between the sites of pain and deformity. Pain in the lower extremity, and the knee or hindfoot separately, showed correlations with functional ambulation. Foot deformity did not correlate with functional ambulation at all. Foot pain correlated well with velocity and especially stride length (p less than 0.005), and not as well with cadence and double stance time. Fewer correlations were seen between foot deformity and gait. In general, hindfoot disease was associated with greater impairment of gait and mobility than forefoot disease.