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

PMID	Title	PublicationDate	abstract
2287965	[Qualitative and quantitative studies of synovial lesions in early rheumatoid arthritis de	1990 Aug	We investigate the early stage of synovial lesions in 12 cases of rheumatoid arthritis (RA), which were diagnosed according to the criteria refined by America Rheumatism Association in 1987. The purpose of this study was to follow the inflammatory process from beginning to well known typical inflammatory features which are composed of a lot of lymphocytes and proliferated capillaries and the synovial cells. The characteristics of this study were that 1) the arthroscopy was applied for observation and getting synovial tissues, 2) 7 kinds of monoclonal antibodies were used for biopsied synovial tissues in immunohistochemistry study, further 3) qualitative and quantitative methods were adopted for identifying the infiltrating cells. These methods have developed recently in the fields of orthopaedics and immuno-histopathology, respectively. In very early stage, first, HLA/DR positive cells with large elongated cytoplasm accompanied but a few processes were found in pericapillary regions. These were neither macrophages nor lymphocytes. Following them T lymphocytes appeared and B lymphocytes appeared to aggregate in later. Quantitatively the number of HLA/DR positive cells including macrophages, B lymphocytes and a part of T lymphocytes and of Interstitial cells, increase and occupied the fairly large number of ratio in the cells of synovial tissues in RA.
2706418	Elevation of serum aluminium concentrations in patients with rheumatoid arthritis treated	1989 Apr	In a group of 19 rheumatoid arthritis (RA) patients with normal renal function, serum levels of aluminium (AlS) were monitored during treatment with drugs containing this metal (Al). The AlS levels during treatment were significantly higher (0.005 less than p less than 0.01) than those before treatment, i.e. 19.4 (SEM 2.3) micrograms/l and 12.3 (1.7), respectively. This increase in AlS was significantly (0.025 less than p less than 0.05) correlated with the pretreatment serum creatinine level (mean value for the whole group 80.5 (SEM 4.7) mumol/l) but showed no correlation with the predicted creatinine clearance. Although the increase in AlS during therapy with A1 containing drugs is not dramatic in RA patients with normal renal function, the rheumatologist should be aware of the risk of increased AlS concentration in RA patients, especially those with impaired renal function.
3213272	[Antibodies to D-penicillamine in patients with chronic polyarthritis--diagnostic aid in u	1988	Antibodies to D-penicillamine (DPA) were determined in 25 patients with classic rheumatoid arthritis being treated with DPA. Positive results were found before and during therapy with DPA. Antibodies were found in seven out of ten patients without the desired therapeutic effects; in five cases before starting the therapy. It is hypothesized that antibodies against drugs are heterogeneous and influence the effect of the drugs, e.g. inhibition of the desired effect and stimulation of an undesired (adverse) reaction.
2341763	An arginine carboxypeptidase generated during coagulation is diminished or absent in patie	1990 May	A novel arginine carboxypeptidase that is generated during blood coagulation is diminished in sera obtained from patients with rheumatoid arthritis. The enzyme, which is unrelated to carboxypeptidase N, is more effective than lysine in removing terminal arginine from small synthetic substrates and may function in vivo in the removal of terminal arginine from inflammatory peptides such as C3a and C5a. Either diminished levels of this enzyme or an inability to generate it may be an important consideration in the mechanisms involved in the local inflammation that is observed in patients with rheumatoid arthritis.
3711605	Silicone rubber implant arthroplasty of the metacarpophalangeal joint in rheumatoid arthri	1986 May	A retrospective analysis of silicone rubber implant arthroplasty of the metacarpophalangeal joint in 32 patients with rheumatoid arthritis is reported. One hundred seven implants were followed in 37 hands for an average of 44 1/2 (12 to 120) months. Active motion of the metacarpophalangeal joint averaged 34 degrees, with a mean extension deficit of 7 degrees and a mean flexion 41 degrees. Ulnar deviation recurred to more than 10 degrees in 33 of 107 fingers (31%). Fracture of the spacer was confirmed in four joints (4%). One fracture of the proximal phalanx and one of the metacarpal head had occurred. Bone resorption around the stem or a hinge and migration of the implant were found in 26 (24%) fingers. Patient satisfaction was high; 27 patients experienced significant pain relief, the functioning of 31 hands (84%) was improved, and 28 patients (32 hands) thought that the cosmetic appearance of the hand was improved.
3499707	[CH50, C3 and C4 in the serum and synovial fluid of rheumatoid arthritis patients].	1987	The total hemolytic complement (CH50) was studied in the serum of 54 patients suffering from rheumatoid arthritis (RA) and in the synovia of 30 of them. The C3 complement fraction was examined in the serum of 49 patients and in the synovia of 30 patients. The C4 complement serum-fraction was examined in 42 patients and in the synovia of 30 patients. 40 healthy persons and 21 patients with osteoarthritis served as a control group. The results showed a slight increase of CH50 in the serum and decrease in the synovia of the patients with RA compared to the control groups. The serum values of C3 and C4 of the RA patients did no differ from those of the healthy persons but the synovial C3 and C4 values were lowered. A reverse correlation was found between the CH50 in the synovial fluid and the phagocyte percentage in the fluid (r = -0.43). CH50, C3 and C4 determination is important for clarification of some pathogenetic mechanisms in RA. Their decrease reflects the degree of immunologic activity.
3440556	Forefoot surgery in rheumatoid arthritis: subjective assessment of outcome.	1987 Dec	Forefoot surgical outcomes were evaluated in 26 patients with rheumatoid arthritis. A total of 45 procedures were reviewed with emphasis on first ray intervention. Disease duration and aggressiveness of preceding medical therapy were combined to establish a disease severity index. Patients operated were predominantly in the midrange of disease severity. Subjective data on the relief of pain, callus, and deformity were favorable but this benefit was not long lasting inasmuch as patients were most satisfied in the period immediately following surgery and less so as time elapsed from intervention. Fusion of the first metatarsophalangeal joint seemed better than resection alone, indicating that stability should be the primary goal for surgical intervention of the rheumatoid forefoot.
3345230	Clonal proliferation of large granular lymphocytes in rheumatoid arthritis.	1988 Jan	Some patients with chronically elevated large granular lymphocyte (LGL) numbers have rheumatoid arthritis (RA). Since these patients also may have neutropenia and splenomegaly, their symptoms resemble those of patients diagnosed as having Felty's syndrome (FS). We studied the immunophenotypic and genotypic characteristics of mononuclear cells from patients with RA and neutropenia to better determine the extent of heterogeneity in this condition. Four patients had markedly increased numbers of LGLs, which expressed HNK-1 antigen and IgG Fc receptors. In contrast, the remaining 8 patients, who had FS, had normal LGL counts, and surface marker studies showed normal numbers of HNK-1 and IgG Fc receptor positive cells. Clonal rearrangement of the T cell receptor beta chain gene was demonstrated in all 4 patients with excess LGLs, whereas a germline configuration of this gene was present in all 6 FS patients in whom this was studied. These results suggest that there are diverse groups among patients with RA and neutropenia. Since prognosis may differ, it is important to recognize that some patients who are considered to have Felty's syndrome may have a clonal proliferation of LGLs.
2442197	Spontaneous production of an interleukin 1-like factor by cloned rheumatoid synovial cells	1987 Sep	We have cloned adherent synovial cells from rheumatoid synovitis. These can be generally divided into three types, including cells that have the characteristic features of dendritic cells (DCs), macrophagelike cells (MCs) and fibroblastlike cells (FCs), as classified by morphology and immunofluorescent staining. The cloned cells were able to divide and were cultured for up to 11 mo without any significant morphological changes. All the cloned cells were HLA-DR+ after gamma-interferon treatment. Spontaneous production of a factor with interleukin 1 activity by the cloned cells was detected even after long-term culture (the ability, on a per cell basis, being in the following order: DC greater than MC greater than FC). These synovial cells may be important for bony destruction in rheumatoid joints.
1757932	Treatment of rheumatoid arthritis with methotrexate: a prospective open longterm study of	1991 Sep	One hundred and ninety-one patients with severe rheumatoid arthritis (RA) were included in a prospective open longterm study of the safety, efficacy and maintenance of methotrexate (MTX) treatment. The mean duration of MTX treatment was 19 +/- 13.2 (3-58) months; the mean weekly dose of MTX was 10.2 +/- 0.2 mg. Analysis of the 191 patients in an intent-to-treat manner showed a significant improvement of all the clinical variables and a decrease of erythrocyte sedimentation rate with a steroid sparing effect. The probability of continuing MTX therapy for up to 2 years was 65% and for up to 5 years was 46%. Adverse effects of MTX occurred in 37.1% of the patients, but only 15.7% discontinued MTX permanently.
2261703	Depressed cutaneous cell-mediated immunity in early rheumatoid arthritis.	1990 Sep	To study the role of cellular immunity in recent-onset rheumatoid arthritis (RA), 26 patients with early RA were examined by skin testing with seven common recall antigens. The skin test was performed before the administration of second-line antirheumatic therapy and was repeated after six months of medication. Controls included healthy individuals and patients without known immunological abnormalities or malignancies. 50% of the RA patients were classified as anergic compared to 7% of the controls. In the RA patients, depression of cell-mediated immunity was related to gender but not to disease activity. Anergic and reactive patients showed similar clinical improvement after six months of therapy. The frequency of anergy at six months was not statistically different from that before therapy. HLA-DR4 was more frequent in the reactive patient group (92%) compared with anergic patients (53%). We conclude that cell-mediated immunity is impaired in early RA but the impairment does not correlate with disease activity or with the response to treatment and does not return to normal during treatment with second-line antirheumatic drugs.
3474091	Quantitative scintigraphy using radiophosphate and radiogallium in patients with rheumatoi	1987 Jan	Quantitative scintigraphy of the wrist, MCP, and knee joints in patients with RA was performed using Tc-99m-MDP and Ga-67 citrate. Radiopharmaceutical uptake in affected joints was compared with uptake at 2 control reference sites (juxta-articular bone and soft tissue). Following a 6-week course of therapy with Sulindac, the patients' overall assessment of disease was improved, but the results of joint/bone and joint/soft tissue ratios were variable. Improvement using Tc-99m-MDP during the first 2 weeks of NSAID therapy was noted in the minimally inflamed wrist by joint/soft tissue measurement and in the maximally affected MCP joint by joint/bone ratio. There was no change in the joint ratios employing the Ga-67 citrate radiopharmaceutical. The initial qualitative score assigned to a joint using Tc-99m-MDP was in agreement with the calculated quantitative ratio except for the knee joint. Our results suggest that quantitative scintigraphy in its present format cannot be used as a reliable indicator to monitor the course of rheumatoid arthritis during NSAID therapy and subjective measurements are still the best judge of effective treatment.
3957977	Loosening of the porous coating of bicompartmental prostheses in patients with rheumatoid	1986 Apr	Thirty-four porous-coated anatomical (PCA) total knee arthroplasties in twenty-eight patients with rheumatoid arthritis were followed for an average of seventeen months. In these thirty-four knees, twenty-three tibial and fifteen femoral components were cemented. The rest were uncemented. At follow-up, more than half of the knees (nineteen of thirty-four) showed radiographic evidence of displacement of some of the beads from the porous coating. In fourteen knees the beads loosened more than three months postoperatively, and all of these knees had a radiolucent zone. Six knees had beads within the joint. Eight of nine non-cemented tibial components (excluding one tibial component) and five of the nineteen femoral components that were not cemented showed late loosening of beads (after three months). This study indicates that the metallurgical technique for porous coating with heat-sintered cobalt-chromium beads does not produce a coating that is sufficiently strong to prevent loosening in the case of the porous-coated anatomical prosthesis. The long-term clinical relevance of our findings is unclear. The mechanical strength of the porous coating on the prosthetic surface should be improved and the prosthesis should be tested in limited clinical studies before cementless fixation can be recommended.
1871446	[Acute congestive heart failure due to malignant rheumatoid arthritis].	1991 Jun	A 54-year-old woman with malignant rheumatoid arthritis was admitted with acute congestive heart failure and pulmonary hypertension. The precipitating antibody to nuclear ribonucleoprotein (nRNP) was highly positive. Her hands and feet showed typical rheumatoid deformities and Raynaud's phenomenon. In a few days her feet became to necrosis due to vasculitis. "Pulse" methylprednisolone and prednisone therapy resulted in normalization of seropositivity, and left ventricular ejection fraction with symptoms of congestive heart failure, and the elimination of ECG abnormalities. Recognition of symptoms of left ventricular dysfunction in patients with rheumatoid arthritis should prompt testing for active arteritis and/or myocarditis, because dramatic improvement may result from immunosuppressive therapy.
2565997	Effects of hydroxychloroquine and sulphasalazine on progression of joint damage in rheumat	1989 May 13	The effects of hydroxychloroquine and sulphasalazine on progression of joint damage shown by X-rays were compared in a double-blind, randomised trial in 60 patients with rheumatoid arthritis not previously treated with slow-acting antirheumatic drugs. X-rays of the hands and feet at the start and after 24 and 48 weeks of treatment were available for 28 patients treated with hydroxychloroquine and 22 treated with sulphasalazine. Erosions and joint space narrowing were scored by a single observer unaware of treatment. At baseline there were no significant differences in demographic, clinical, or radiographic characteristics between the treatment groups. Patients withdrawn because of lack of effect were included in the analysis. The median number of erosions was lower in the sulphasalazine than the hydroxychloroquine group at 24 weeks of treatment (2.5 vs 10) and the difference was significant at 48 weeks (5 vs 16; p less than 0.02). The difference in median total score of joint damage was significant at 24 weeks (6.5 vs 17; p less than 0.02) and at 48 weeks (8 vs 33; p less than 0.02). The increase in number of erosions and total score was significantly greater in the hydroxychloroquine than the sulphasalazine group, both after 24 weeks and after 48 weeks of treatment.
3058055	Perivascular infiltration in normal skin of patients with rheumatoid arthritis: associatio	1988 Oct	The relation between immunohistological findings in biopsy specimens of apparently normal skin, HLA antigens, and rheumatoid factors (RF) was studied in 120 patients with rheumatoid arthritis (RA), selected for treatment with D-penicillamine. Perivascular infiltration (PVI) of more than three mononuclear cells was present in 77 (68%) of 114 patients, accompanied usually by the presence of IgM or C3, or both, in immunofluorescence studies. The number of perivascular cells was associated significantly with the titre of circulating RF. A weak relation of both perivascular cellular infiltration and RF with HLA-DR3 and DR4 did not reach statistical significance. It is concluded that the histological presence of perivascular inflammation is associated mainly with deposition of RF. It is suggested that the first is merely an epiphenomenon of the latter. PVI was not prognostic for the occurrence of the clinical syndrome of rheumatoid vasculitis. For practical purposes skin biopsies do not appear to be useful in the evaluation of individual patients with RA.
3509983	Rheumatoid lymphedema.	1987 Dec	Edema of the upper limbs is described in 3 men with rheumatoid arthritis. In all cases abnormal lymph vessels were documented on lymphography. Lymphangitis may explain the anomaly.
3235959	Nine rheumatoid factor assays compared.	1988 Dec	In this study we have investigated five quantitative and three semi-quantitative rheumatoid factor assays and the Rose-Waaler assay in 120 patients suffering from rheumatoid arthritis and in 76 with other systemic diseases. All tests measure the IgM anti-IgG antibodies. The correlations between the quantitative tests were all higher than 0.86 and much better than between the quantitative and semi-quantitative tests and the semi-quantitative tests themselves (r between 0.22 and 0.85). The within run and between run precision studies for the quantitative tests showed CV values lower than 16%. In spite of the standardisation on the WHO and the Center of Disease Control Reference Preparation we found important differences in patient results. From an analytical point of view, the quantitative assays for rheumatoid factors show certain advantages over the traditional haemagglutination tests.
3426289	Iliac crest trabecular bone mass and structure in patients with non-steroid treated rheuma	1987 Nov	Iliac crest trabecular bone volume and structure have been studied in bone biopsy specimens from 48 patients with classical or definite rheumatoid arthritis, none of whom had received steroids. Results were compared with those obtained from healthy controls matched for age and sex. The mean trabecular bone volume in female patients aged 34-50 years was significantly lower than in controls (p less than 0.01); in male patients aged 34-50 years values were also lower than those in controls (mean (SD) 17.8 (3.2) v 22.4 (5.6)% total medullary volume), though this difference was not statistically significant. Values in older patients were similar to those of controls. The mean trabecular plate thickness was significantly lower in female patients in all three age groups when compared with the controls (p less than 0.005, 0.05, and 0.005). Similar but non-significant changes were seen in male patients. The mean trabecular plate density, an index of trabecular number, and the mean trabecular plate separation showed no age related change in either male or female patients, in contrast with the female control group, in whom the mean trabecular plate density decreased and separation increased with age. These results suggest that non-steroid treated rheumatoid arthritis is associated with premature bone loss, the structural basis of which is trabecular thinning.
1993719	Valgus deformities of the feet and characteristics of gait in patients who have rheumatoid	1991 Feb	To investigate the cause of valgus deformity of the hindfoot in patients who have rheumatoid arthritis and to characterize the effects of the deformity on gait, two groups of patients were evaluated clinically, radiographically, and with gait analysis in the laboratory. Group 1 consisted of seven patients who had seropositive rheumatoid arthritis and normal alignment of the feet and Group 2, of ten patients who had rheumatoid arthritis and valgus deformity of the hindfoot. In Group 2, the disease was of longer duration and the feet were more painful than in Group 1. There was no evidence of muscular imbalance, equinus contracture, valgus deformity of the tibiotalar joint, or isolated deficiency of the tibialis posterior (such as weakness, tenosynovitis, or rupture of the tendon) that could have contributed to the development of the valgus deformity. In the patients who had valgus deformity, quantitated electromyography demonstrated that the intensity and duration of activity of the tibialis posterior was significantly increased, apparently in an effort to support the collapsing longitudinal arch of the foot. Gait studies revealed decreases in velocity, stride length, and single-limb-support time, as well as delayed heel-rise in both groups, but the decreases were more marked in the patients who had valgus deformity. The results of this study suggest that valgus deformity of the hindfoot in rheumatoid patients results from exaggerated pronation forces on the weakened and inflamed subtalar joint. These forces are caused by alterations in gait secondary to symmetrical muscular weakness and the effort of the patient to minimize pain in the feet. Radiographs also suggested an association between the valgus deformity of the feet and valgus deformity of the knees in patients who have rheumatoid arthritis.