Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3260093 | Evaluation of disease activity in rheumatic patients by leucocyte adhesiveness/aggregation | 1988 Jun | Previous work has shown that leucocyte adhesiveness/aggregation (LAA), as measured by the leukergy test, correlates well with disease severity in rheumatic patients. As LAA is probably a manifestation of the acute phase reaction various components of the acute phase reaction were measured in order to identify the best marker of disease activity. In addition to LAA, the following variables were measured in 79 patients with various rheumatic diseases and in 10 controls: white blood cell and platelet counts, erythrocyte sedimentation rate, haptoglobin, fibrinogen, C reactive protein, albumin, globulin, caeruloplasmin, alpha 1, alpha 2, beta, and gamma globulin, and haemoglobin concentrations. Patients were graded according to the state of their disease as mild, moderate, or severe. The extent of leucocyte adhesiveness/aggregation in peripheral blood proved to be the best laboratory variable for the grading of disease activity. Correct grading was obtained in 63% of the patients by means of the LAA, compared with 48% with C reactive protein, 41% with caeruloplasmin, 40% with haptoglobin, and 32% with haemoglobin. It is suggested that LAA of the peripheral blood during inflammation may be used as a reliable marker of disease severity. | |
| 2397628 | Microproteinuria as an index of initial renal lesion in patients with rheumatoid arthritis | 1990 Jul | Our investigation included 20 patients with rheumatoid arthritis and a negative routine (albustix) proteinuria test, and 20 healthy controls. The albustix test was compared with a method based on multifractional Cellogel RS electrophoresis of urinary proteins. The albustix test was found to be not reliable in patients with RA. Microproteinuria was in fact detected by the electrophoresis method in 12 out of 20 RA patients. Eleven patients showed glomerular type proteinuria (which was "selective" in 5 patients and "non-selective" in 6 patients), and 1 patient showed mixed type proteinuria. Electrophoresis failed to show microproteinuria in the controls. The high sensitivity, easy handling and low cost of multifractioned electrophoresis (which does not involve disturbing the patients) suggest its introduction as a routine test for all RA patients, thus achieving both accurate clinical assessment of proteinuria and a rational therapeutic approach. | |
| 2744575 | Monocyte-derived clastogenic factor in rheumatoid arthritis. | 1989 | Blood or lymphocyte cultures from patients with rheumatoid arthritis show increased chromosome breakage. This is due to the presence of a clastogenic factor (CF) inducing also chromosome damage in blood cultures of healthy persons. CF may be isolated not only from patients' plasma or synovial fluid, but also from the supernatant of blood or lymphocyte cultures. No CF was detectable, if the lymphocyte cultures were free of other contaminating blood cells. Addition of neutrophils did not considerably influence the production of CF, and platelets were without any effect. However, addition of increasing numbers of monocytes resulted in increasing clastogenic activity. Also monocytes in adherence, in absence of lymphocytes and without any chemical stimulant, produced CF. This indicates that monocytes are responsible for CF production. The protective effect of superoxide dismutase, as well against CF formation as against CF action on cells of normal subjects, suggests a role of the superoxide radical O2-. Inhibitors of arachidonic acid metabolism were only slightly anticlastogenic. | |
| 3816584 | [Surgical interventions in psoriatic arthritis]. | 1987 Mar 6 | As a general disease, psoriatic arthritis (which besides the skin and the joint can also affect internal organs) takes a special place amongst chronic polyarthritis conditions. It is characterized by combination of psoriasis with a seronegative polyarthritis affecting the spine and above all the joints in the hands and feet (frequently asymmetrically). The form and extent of the often painful joint and spinal involvement not uncommonly lead to an appreciable impairment of various functions and thus to a handicap for the patient. A series of different operations extending from synovectomy to arthrodesis and joint replacement improve the pain as well as functional restrictions. However, they also lead to new knowledge on the nature, etiology and development of this disease via photographic documentation of findings and investigation of the tissue obtained intraoperatively. In the years 1967 to 1984, 457 single operations were carried out in 80 patients with psoriatic arthritis. The results allow the conclusion that patients with psoriatic arthritis should be admitted to special hospitals for surgical treatment more frequently than was the practice up to now. | |
| 2910598 | Early changes in gait and maximum knee torque following knee arthroplasty. | 1989 Jan | Fourteen knees in 11 individuals were studied before knee arthroplasty and at three and six months following surgery. Eleven of these knees were further evaluated at 12 months following surgery. At each evaluation, kinematic, electromyographic, and force plate data were gathered during level walking. Maximum knee extension and flexion torques were also determined. The greatest improvement in gait was noted in the first three postoperative months when velocity increased 13% and stride length increased 14%. After six months gait changes were negligible. Maximum knee torques in the osteoarthritic population were decreased at three months, then returned to preoperative levels at six months. In the rheumatoid population, maximum knee torques steadily increased up to six months following surgery. Gait abnormalities that persist at six months and beyond following knee arthroplasty appear to be most related to the presence of arthritis in joints other than in the operated knee(s). | |
| 3392058 | Treatment of the cervical spine in rheumatoid arthritis. | 1988 Jun | Of thirty-four selected patients who had rheumatoid arthritis and subluxations of the atlanto-axial and other joints of the cervical spine, eighteen were treated operatively and sixteen were treated non-operatively. Of the subluxations of the atlanto-axial joint, nineteen were anterior; four, posterior; and eleven, vertical. Additionally, subaxial subluxations were seen in three patients. At the time of treatment, the mean duration of the rheumatoid disease was 19.4 years and the mean duration of the disorders of the cervical spine was 4.5 years. After treatment the patients were followed for an average of 2.2 years (range, six months to six years). Of the thirty-four patients, two (both of whom were treated non-operatively) died of causes unrelated to the lesions of the cervical spine and were excluded from this study. Of the remaining thirty-two patients, eighteen were treated operatively and fourteen, non-operatively. The two groups were roughly comparable with respect to the lesions of the cervical spine, but more of the patients who were treated surgically showed evidence of compression of the cord as demonstrated by computed tomography and myelography. The thirty-two patients were not randomized in the two groups; therefore, comparison of the findings in these groups is not completely valid. Surgical treatment of the eighteen patients included an atlanto-axial fusion in thirteen and an occipitocervical fusion in five. In addition, two patients who had an occipitocervical fusion also had a subaxial laminectomy and posterior fusion. There was a superficial wound infection, which was treated successfully with short-term antibiotic therapy, in two patients. No patient died postoperatively. Occipital pain was relieved in twelve of the fifteen operatively treated patients who had pain, whereas pain was relieved in only one of the eight conservatively treated patients who had pain. At follow-up, neurological function was unchanged or improved in the operatively treated group but was slightly worse in the conservatively treated group. We concluded that fusion of an unstable rheumatoid cervical spine relieves pain and prevents progression of existing neural lessons without undue risk for the patient. | |
| 3616456 | [Teaching the patients with rheumatoid polyarthritis more about their disease]. | 1987 May | A meeting in a hospital environment gathers, during 4 full days, five patients with rheumatoid polyarthritis, of similar evolutive stage, strictly selected after a complete work-up and determination of a medical and surgical treatment. The meeting around the rheumatologist and the nurse, of the physical therapist, ergotherapist, orthesist, chiropodist, psychologist, and the social worker, permits to explain to the patients, already informed about his/her disease, rules of hygiene, savings, training and rehabilitation which will be useful. The experience of 30 patients is presented and proposed as a desirable model, which is the only way to improve the patient's formation, since the physician does not have enough time to devote to this formation. | |
| 3190040 | Cyclosporin A in severe, treatment-refractory rheumatoid arthritis. A randomized study. | 1988 Dec 1 | STUDY OBJECTIVE: To assess the efficacy and toxicity of cyclosporin A in patients with severe, treatment-refractory rheumatoid arthritis. DESIGN: Prospective randomized, double-blind 6-month trial. PATIENTS: Thirty-one patients who had classic seropositive rheumatoid arthritis with active synovitis unresponsive to conventional therapy. INTERVENTIONS: Patients were randomly assigned to high-dose (10 mg/kg body weight.d) or low-dose (1 mg/kg.d) cyclosporin A therapy. A reduction in the dose was permitted for adverse side effects. After 6 months of therapy, patients who showed clinically relevant improvement, defined as a 40% or greater reduction in their total joint activity score, were given the option to continue receiving the therapy for an additional 6 months. MEASUREMENTS AND MAIN RESULTS: At 6 months, clinically relevant improvement occurred in 10 of 15 patients (95% CI, 38 to 88) receiving high-dose therapy and in 4 of 16 patients (CI, 7 to 52) receiving low-dose therapy (P = 0.02). Statistically significant improvements in individual measures were shown only in the high-dose group. Improvements were noted in the number of tender joints (-18.8; CI, -24.5 to -13.1) and swollen joints (-12.1; CI, -15.4 to -8.6), as well as in physician's global scores (-1.5; CI, -2.1 to -0.9) and patient's global scores (-1.1; CI, -1.9 to -0.5). Improvement in disease activity was maintained through 12 months in the high-dose group. The clinical responses to cyclosporin A were most evident in patients with depressed in-vitro proliferative responses of peripheral blood mononuclear lymphocytes to soluble recall antigens. Toxicities, such as fatigue, gastrointestinal and neurologic complaints, and hypertrichosis were frequent but often reversible with a reduction in the dose. Nephrotoxicity, with a 20% increase in the serum creatinine level, was seen in 27 of 31 patients (CI, 71 to 97). CONCLUSIONS: Cyclosporin A is an effective therapy for severe, treatment-refractory rheumatoid arthritis. Side effects, particularly nephrotoxicity, are common. | |
| 2780060 | Reliability and validity of the evaluation of pain in patients with total knee replacement | 1989 Jul | Ninety-two knees in 46 patients were evaluated with regard to pain: in 51 of these knees, implantation of a hinged endoprosthesis had been performed. The reliability and validity of 2 pain evaluation methods were assessed: the knee-pain questionnaire method (standard version including 10 questions and modified version including 14 questions) and the visual analogue scale method (standard version without numbering and 0-10 scale). The visual analogue scale--standard version and 0-10 scale--turned out to be more reliable than the questionnaires. The 0-10 scale was the most valid when compared to the patients' own opinions regarding pain. | |
| 2298612 | Shared molecular markers of genetic predisposition to seropositive rheumatoid arthritis. | 1990 Feb | Rheumatoid arthritis is associated with the human class II major histocompatibility complex antigens known as HLA-DR4. HLA-DR4 can be subdivided by cellular typing into five subtypes: Dw4, Dw10, Dw13, Dw14, and Dw15. By traditional serologic methods, 60-80% of rheumatoid arthritis patients type HLA-DR4 compared to approximately 20% of the general population. It has been demonstrated, using a panel of four alloreactive T-cell clones, each of which recognized HLA-DR4, Dw14 homozygous typing cells, that cells from all of a group of 23 rheumatoid arthritis patients could be recognized by one or more of these clones regardless of the patients' serologic typing. As the expressed polymorphism of the DR molecule is accounted for by the beta 1 gene, this gene was amplified, using the polymerase chain reaction, and sequenced. Seven patients whose cells were recognized by one of the DR4, DW14-specific T-cell clones, T431, were analyzed. All of these patients shared a common sequence in the third hypervariable region of the DR beta 1 chain gene. The sequence identified is the one normally associated with DR4, Dw14 and DR1. Patients and DR4-positive controls whose cells did not stimulate this clone did not share this sequence. These results suggest that this hypervariable region might be an important contribution to a restriction site for the putative causative agent(s) in rheumatoid arthritis. | |
| 1744528 | The use of long-acting drugs in the treatment of rheumatoid arthritis. | 1991 Sep | Experience to date strongly indicates that long-acting drugs currently used in treatment of rheumatoid arthritis are very potent antiinflammatory agents which act in most cases by completely unknown mechanisms. All of them have built in but recognizable toxicity which can usually be prevented by appropriate monitoring. Although most of them offer relatively short term (up to 3 years) benefits, with the probable exception of methotrexate, nonetheless they can offer for a period of time improved function and relief of pain for many individuals. Thus, even though they do not dramatically affect the long-range outcome of the disease, they continue to offer useful benefit for patients with rheumatoid arthritis who are not responding to conservative therapy. Some of the long-acting agents are only slightly more toxic than the widely nonsteroidal antiinflammatory drugs which do have a definite risk of serious upper gastrointestinal bleeding. Currently the use of combinations as well as the continued introduction of new drugs in this class, offer hope that greater benefit than we can currently provide is within reach over the next few years. | |
| 3382446 | A model of health status for rheumatoid arthritis. A factor analysis of the Arthritis Impa | 1988 Jun | Health status is a key aspect of quality of life that may be addressed and affected by health care. The measurement of this construct requires the identification of unique and relevant components of health status that can be operationally defined by specific scales or scale groupings. We explored the components of health status that are operationalized by the Arthritis Impact Measurement Scales (AIMS). Prior testing has shown that the AIMS measures delineate at least 3 components of health status: Physical Function, Psychological Status, and Pain. This 3-component model, however, can be theoretically and empirically restrictive. Using AIMS responses from a rheumatoid arthritis (RA) patient population, our investigation, through factor analyses, identifies 5 components of health status in this chronic disease: Lower Extremity Function, Upper Extremity Function, Affect, Symptom, and Social Interaction. It is proposed that these intuitively reasonable and measurable components constitute the core of the health status construct for individuals with RA. These 5 components could also prove central to the assessment of health status in other rheumatic diseases. Future studies of health status in RA should include tested measures to assess these 5 components. | |
| 3828664 | Assessment of stiffness in rheumatology: the use of rating scales. | 1987 Apr | A study of 100 patients with rheumatoid arthritis has shown good correlation amongst three rating scales when used for measuring severity of morning stiffness and severity of stiffness present at the time of interview. Duration of morning stiffness was found to correlate only moderately well with severity of morning stiffness and poorly with severity of stiffness present at the time of interview. Investigation of the patients' definitions of stiffness, with and without the aid of a list of descriptive words, indicated an inter-relationship of pain and limited movement in the majority. This linking of the two symptoms under the term 'stiffness' may explain why some objective methods of measurement do not appear to reflect the subjective stiffness of which patients complain. | |
| 3064523 | [Chronic polyarthritis in advanced age]. | 1988 | Approximately a quarter of polyarthritis in the elderly is beginning with a single- or oligo-articular attack of big joints. The first attack of the shoulder joints is noticed especially in men. Most of the patients with rheumatoid arthritis in the elderly have a gradually progressive course. There is often showed a very high blood sedimentation rate (BSR); rheumatoid factor is rare. Generally there is a strongly marked osteoporosis. The success of therapy with disease modifying agents is comparable with that of younger patients with rheumatoid arthritis, but there is a smaller tolerance to gold and D-penicillamine. In some non-steroidal anti-rheumatic drugs a lower dosage is recommended. | |
| 2379345 | ELISA determined IgM and IgA rheumatoid factors in seronegative rheumatoid and psoriatic a | 1990 May | Previous studies have strongly suggested an association between rheumatoid factors (RF's), particularly IgA-RF, and the presence of erosions in rheumatoid arthritis (RA). The present study was aimed at studying this association in seronegative erosive arthritides. Forty-eight patients with seronegative arthritis were evaluated for the presence of IgM- and IgA-RFs using an enzyme linked immunosorbent assay (ELISA). Twenty-nine had seronegative RA and nineteen had psoriatic arthritis (PA). Twelve (41%) seronegative RA patients were found to be seropositive for IgM- or IgA-RF. Only 1 (7%) patient with PSA was positive for IgA-RF alone. Fifteen (51%) of the RA patients and eight (42%) of the PSA patients had erosive disease. A significant correlation between IgA-RF alone and erosive disease was found only in the seronegative RA patient (p less than 0.02). We conclude that in PSA patients there appears to be no need to define isotype specific RFs. On the other hand, our findings indicate that an early detection of IgA-RF can have clinical importance in seronegative rheumatoid arthritis, as it may constitute an indication for the timely institution of disease-modifying drugs in these patients. | |
| 2672136 | Methotrexate therapy in the treatment of rheumatoid arthritis. | 1989 Aug | MTX has been demonstrated to be one of the most effective agents in current use for the treatment of patients with active RA who have failed other approaches. Therapy must be individualized to achieve an optimal efficacy/toxicity profile. The drug is a potent steroid-sparing agent which is a factor of marked significance in this patient group. Although cellular activity is well described, many unanswered questions about its absorption, target cell population, and mechanism of action remain. More information is needed about the true incidence of long-term toxicities to be able to better address the all important issue of when to use MTX in the treatment of RA. Research efforts, including studies of immunologic parameters over time, are needed to achieve a better understanding of the drug's mechanism of action. Lastly, the reasons for the plateau in clinical response to MTX should be explored to devise strategies to enhance and sustain the effects of this already potent drug. | |
| 3529884 | A study to determine the clinical relevance of the pharmacokinetic interaction between asp | 1986 Jun | Interaction studies in the rat and healthy human volunteers have shown that protein binding of diclofenac is reduced by the addition of salicylic acid causing an increased free drug level of diclofenac. The diclofenac area under curve (AUC) is also reduced by approximately one-third in the presence of salicylate. We have performed a crossover comparison of soluble aspirin, diclofenac and the two drugs in combination in patients with rheumatoid arthritis to determine whether this had clinical relevance. 36 patients entered the study. There was a high dropout rate on aspirin alone but analysis of completors (22 patients) showed diclofenac either alone or in combination to be superior to aspirin alone on two of the five clinical parameters measured. There was no significant difference between disclofenac and aspirin + diclofenac. We thus found no clinical manifestations of the pharmacokinetic interaction. | |
| 2029152 | Drug treatment of progressive rheumatoid arthritis. | 1991 Jan | The drug treatment of progressive rheumatoid arthritis (RA) is discussed with emphasis on second line agents used both singly and in combination. NSAIDS play a supportive role in the management of RA. Low dose prednisolone is acceptably safe and effective in long term use whereas pulsed steroids and intra-articular use is reserved for short term control of disease. Antimalarials are rarely valuable as sole agents in progressive arthritis. The use of sulphasalazine, gold thiomalate, d-penicillamine, auranofin, methotrexate, azathioprine and cyclophosphamide in rheumatoid arthritis and their place in the therapeutic strategy are discussed. The reported use of combination chemotherapy has not shown the expected additive benefits although azathioprine, methotrexate and hydroxychloroquine combination may prove to be better than single agents. Recently cyclosporine and gamma interferon have not been shown to be highly efficacious. Of the new therapies monoclonal antibodies to CD4 and CD5 positive lymphocytes are showing promise of marked efficacy in the short term. Sustained control of synovitis appears to improve the long term outcome but better strategies and better drugs are needed. | |
| 2406712 | Osteoarthritis. Differentiation from rheumatoid arthritis, causes of pain, treatment. | 1990 Feb 15 | Osteoarthritis affects a majority of the elderly population in one form or another. It must be differentiated from rheumatoid arthritis because treatment of the two diseases is quite different. Once the diagnosis of osteoarthritis has been established, treatment should include a combination of physical, medicinal, psychological, and surgical measures to improve the patient's quality of life. The future may bring new approaches to interrupt pathogenetic factors in the disease. | |
| 3781074 | Cloning of cells from synovial membrane for the investigation of rheumatoid arthritis. | 1986 | In an attempt to make well-defined cell culture systems, a method has been developed to produce clones of cells obtained from the synovial fluid of patients with rheumatoid arthritis and patients with HLA B-27 associated arthritis. A preliminary characterization of the cloned cells based on morphologic appearance, avidity for Sudan black B, phagocytosis of latex particles and E-rosette formation is here described. |