Browse

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

ID PMID Title PublicationDate abstract
32463710 Plasma acrolein level in rheumatoid arthritis increases independently of the disease chara 2021 Mar OBJECTIVE: This study aimed to clarify whether plasma acrolein level actually increases in rheumatoid arthritis (RA) patients, and to elucidate whether any relationship exists between the levels and the RA background variables. METHODS: Plasma levels of protein-conjugated acrolein (PC-Acro) in 84 patients (RA group) and 298 normal individuals (Control group) were measured by enzyme-linked immunosorbent assay procedures. The data were statistically analyzed with Wilcoxon rank-sum test, multiple logistic regression analyses and Spearman's rank correlation coefficient. RESULTS: The RA group showed significantly higher PC-Acro levels than the Control group (median [interquartile range]: 80.5 [63.2-105.2] and 65.9 [58.9-78.1] nmol/ml, respectively). Of background factors giving influence to PC-Acro level in the combination of the two groups, 'diagnosis of RA positive' indicated strong correlation to high PC-Acro level (odds ratio: 2.96; 95% confidence interval: 1.54-5.71). These increases of PC-Acro in the RA patients did not correlate to their disease duration and/or inflammatory variables: PC-Acro level could elevate even in early RA patients showing negative inflammatory findings. CONCLUSION: Plasma levels of PC-Acro increased with RA, but the levels did not correlate with RA background variables. This report provides the basis for further studies of early diagnosis of RA as well as its pathogenesis.
32827281 Rheumatoid lung nodules with "feeding-vessel" sign. 2021 Apr Rheumatoid arthritis is a systemic inflammatory disease which causes symmetric polyarthritis. Lungs are common site for extra-articular involvement. Rheumatoid lung nodules occur in about 32% of patients with rheumatoid arthritis. The appearance of a lung nodule, along with the blood vessel supplying it, is called "feeding-vessel" sign on computed tomography. It is most commonly seen in infections. However, it can also be present in metastases and pulmonary vasculitis. We describe a woman with long-standing rheumatoid arthritis with subcutaneous and pulmonary nodules. Computed tomography of the chest showed "feeding-vessel" sign. There was no evidence of infection, malignancy, or vasculitis. She was treated for rheumatoid lung nodulosis with rituximab with which she improved remarkably. To the best of our knowledge, "feeding-vessel" sign in rheumatoid lung nodules has never been reported before. This case highlights the fact that "feeding-vessel" sign is not specific for pulmonary infections. It can rarely be seen in rheumatoid lung nodulosis.
32920080 Recent trends, challenges and future outlook of transdermal drug delivery systems for rheu 2020 Nov 10 At present, several drug molecules have been used for the treatment of rheumatoid arthritis (RA). However, the utilization of these compounds through the oral and parenteral route is limited due to low bioavailability, rapid metabolism, poor absorption, first-pass effect, and serious adverse effects. A transdermal delivery system is an appealing option in this scenario, as it possesses the proficiency to overcome drawbacks associated with the oral and parenteral route. With the innovation of several enhancement strategies, many therapeutic agents have been administered transdermally, proposing an exceptional approach to treat RA. The present article provides an insight into the etiology and pathophysiology of RA. The challenges of the transdermal route and the strategies to improve those problems are described. The current advances in increasing the transdermal efficiency of the therapeutics against RA are discussed. Limitations and advantages regarding the state of the art transdermal delivery system and future outlook are also summarized.
32766528 Association between Rheumatoid Arthritis and Apical Periodontitis: A Cross-sectional Study 2020 OBJECTIVE: The present cross-sectional study aimed to investigate possible association between Rheumatoid Arthritis (RA) and Apical Periodontitis (AP). METHODS: In table one it is mentioned 48 patients diagnosed with RA were included in the experimental group. Another 48 healthy age- and gender-matched participants who reported no history of any systemic disease were selected to form the control group. All the patients were examined radiographically and clinically to diagnose the presence of AP. The following data was recorded for all patients; the number of teeth present, the number of teeth with AP, the number of patients with AP, the number of patients with root canal treated teeth (RCT) and the number of patients with RCT+AP. The chi-square test and logistic regression analysis were used to determine the possible association between RA and AP. RESULTS: A total of 1026 teeth were examined in the RA group and 45 of them was diagnosed as AP. In the control group, 1025 teeth were examined and 21 teeth were diagnosed as AP. It was found that the prevalence of teeth with AP (4.3%) was significantly higher in the RA group than the control (2%) (odds ratio [OR]=2.193, P=0.003). Logistic regression analysis showed that RA is significantly associated with AP. CONCLUSION: It can be concluded that patients with RA can be more prone to develop AP.
32370106 Current Understanding of an Emerging Role of HLA-DRB1 Gene in Rheumatoid Arthritis-From Re 2020 May 2 Rheumatoid arthritis (RA) is an autoimmune disease with an unclear pathogenic mechanism. However, it has been proven that the key underlying risk factor is a genetic predisposition. Association studies of the HLA-DRB1 gene clearly indicate its importance in RA morbidity. This review presents the current state of knowledge on the impact of HLA-DRB1 gene, functioning both as a component of the patient's genome and as an environmental risk factor. The impact of known HLA-DRB1 risk variants on the specific structure of the polymorphic HLA-DR molecule, and epitope binding affinity, is presented. The issues of the potential influence of HLA-DRB1 on the occurrence of non-articular disease manifestations and response to treatment are also discussed. A deeper understanding of the role of the HLA-DRB1 gene is essential to explore the complex nature of RA, which is a result of multiple contributing factors, including genetic, epigenetic and environmental factors. It also creates new opportunities to develop modern and personalized forms of therapy.
32668290 Rhupus: a systematic literature review. 2020 Sep "Rhupus" or "rhupus syndrome" is a poorly described and underdiagnosed disease in which features of both rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) appear in the same patient, most often sequentially. The SLE-related involvement is usually mild, dominated by hematological abnormalities and skin, serosal and renal involvement. The natural history of rhupus arthritis follows an RA-like pattern and can progress towards typical inflammatory erosions, deformations and disability. Despite the lack of consensus on the definition of rhupus and on its place in the spectrum of autoimmunity, a growing number of studies are pointing towards a true overlap between RA and SLE. However, the inclusion criteria employed in the literature during the last 4 decades are heterogeneous, making the already rare cohorts and case reports difficult to analyze. Because of this heterogeneity and due to the rarity of the disease, the prevalence, pathophysiology and natural history as well as the radiological and immunological profiles of rhupus are poorly described. Moreover, since there is no validated therapeutic strategy, treatment is based on clinicians' experience and on the results of a few studies. We herein present a systematic literature review to analyze the clinical and laboratory data of all reported rhupus patients and to provide up-to-date information about recent advances in the understanding of the pathophysiological mechanisms, diagnostic tools and treatment options.
31957665 Mindfulness interventions for rheumatoid arthritis: A systematic review and meta-analysis. 2020 May OBJECTIVES: To explore the effect of mindfulness interventions in improving outcomes for patients with rheumatoid arthritis. METHODS: Following the collective strategy of Cochrane Collaborative Group, the Cochrane Library, PubMed, EMBASE, Chinese Biomedical Literature Database, China National Knowledge Infrastructure, and Wanfang Database were searched from the establishment of databases to September 2019. Reference lists were searched for additional studies. Risk of bias was assessed using Revman 5.3. Disagreement was resolved by discussion. RESULTS: A total of 6 RCTs were included, including 337 patients. The results showed that the improvement of pain intensity in mindfulness group after intervention was better than that in the control group, and the difference was significant [WMD = 0.65, 95% CI (-1.11, - 0.18), P = 0.006]. There were significant differences in depression between the two groups [SMD = 0.47, 95% CI (- 0.86, - 0.07), P = 0.02]. The results showed that there were significant differences in DSA28 between the two groups [WMD = -0.29,95% CI (- 0.38, - 0.19), P ＜0.00001]. The results showed that there were no significant differences in anxiety and CPR between the two groups. CONCLUSION: mindfulness interventions can significantly improve pain intensity, depression, and symptoms in patients with rheumatoid arthritis compared with conventional therapy. But the result still needs to be confirmed by more high-quality, large-sample randomized controlled trials.
32803573 Sentinel joint scoring in rheumatoid arthritis: an individualized power Doppler assessment 2021 Mar OBJECTIVE: Musculoskeletal ultrasound quantifies the total synovial inflammatory burden in rheumatoid arthritis (RA) but is time consuming when scanning numerous joints. This study evaluated a novel patient-centered method for constructing a longitudinal ultrasound score in RA patients. METHODS: Fifty-four RA patients starting intravenous tocilizumab were evaluated with power Doppler ultrasound (PDUS) of 34 joints and DAS28-ESR was assessed at baseline and weeks 4, 12, 16, and 24. The sentinel joint score (SJS) was derived from the reduced subset of joints with PDUS ≥ 1 at baseline. Total PDUS (tPDUS) score and US7 were also calculated. Changes in tPDUS and SJS were correlated. Effect sizes were calculated for tPDUS, SJS, and US7. The proportion of "flipped" joints without baseline PDUS signal that later developed PDUS signal was estimated. RESULTS: At baseline, 1236/1829 joints scanned (67.5%) did not have PDUS signal. The proportion of "flipped" joints at 24 weeks was 5.6% for ≥ 1, 2.9% for ≥ 2, and 1.0% for = 3 PD. tPDUS and SJS scores were highly correlated (r = 0.91 to 0.97). Overall the effect sizes for tPDUS, SJS, and US7 increased over 24 weeks, where SJS was the highest (SJS 1.00 4-week, 1.07 12-week, 1.26 24-week) and tPDUS and US7 were comparable (tPDUS 0.32 4-week, 0.52 12-week, 0.84 24-week; US7 0.23 4-week, 0.52 12-week, 0.74 24-week). CONCLUSION: In RA patients starting a biologic, scanning only joints with baseline PDUS signal can substantially reduce the number of joints requiring follow-up scanning by 67.5% and improves feasibility. "Flipped" joints are infrequently seen after starting therapy. TRIAL REGISTRATION: ClinicalTrials.gov NCT01717859 Key messages • Only a small percent of joints develop power Doppler signal after baseline scanning. • Changes in the SJS correlate well with changes in clinical activity measured by DAS28-ESR over time. • The SJS effect size is higher than total PDUS and US7 scores, and may improve examination feasibility.
32990787 Sexual dysfunction and its determinants in women with rheumatoid arthritis. 2021 May OBJECTIVES: To evaluate sexual function in Tunisian women with rheumatoid arthritis (RA) and to examine factors that are predictors of female sexual dysfunction including sociocultural factors, disease activity, and psychological status. METHODS: We conducted a cross-sectional study including 71 women with a confirmed diagnosis of RA according to the 2010 American College of Rheumatology/European League against Rheumatism (ACR/EULAR) criteria. Clinical and sociodemographic characteristics were collected. The participants were asked to complete the Female Sexual Function Index (FSFI), which contains 19 questions, assessing six areas of female sexual function in the previous 4 weeks. Sexual dysfunction was defined as an FSFI score less than or equal to 26.55. The psychosocial status was evaluated by the Hospital Anxiety and Depression (HAD) scale. Prevalence of sexual dysfunction and predictors of sexual difficulties were assessed. RESULTS: The prevalence of female sexual dysfunction in women with RA was 49.3%. All areas were altered especially desire (2.92 ± 1.3), arousal (3.27 ± 1.5), and orgasm (3.77 ± 1.5). In univariate analysis, sexual dysfunction was correlated with the age of patients (p = 0.049), the age of partners (p = 0.013), pain (p = 0.001), number of night awakenings (p = 0.02), morning stiffness (p = 0.010), tender joints (p = 0.05), disease activity score (DAS28 ESR) (p = 0.043), fatigue (p = 0.028), and Health assessment questionnaire (HAQ) (p = 0.02). In multivariate analysis, the age of patients and pain were predictive factors of sexual dysfunction. By analyzing each area of the FSFI score, the age of patients was the independent variable associated with desire. Tender joints were associated with lubrication and the age of partners with arousal, orgasm, and satisfaction. CONCLUSION: Our study suggests that rheumatoid arthritis has a negative impact on patients' sexuality. Age of patients and partners, pain, and tender joints appear to be the main factors influencing sexual function.
33426089 Gender Differences in Rheumatoid Arthritis: Interleukin-4 Plays an Important Role. 2020 INTRODUCTION: Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by symmetrical peripheral polyarthritis. A large number of studies have shown that RA is characterized by gender differences in clinical manifestations. The purpose of this study is to identify the key molecules of gender differences in patients with RA and to provide new molecular targets for personalized therapy. Material and Methods. The data from GSE55457 were downloaded from the comprehensive gene expression comprehensive database, and two groups (RA vs. No-RA groups, Male-RA vs. Female-RA groups) of differentially expressed genes (EDGs) were obtained by GEO2R. The GO function and KEGG pathway analyses of DEGs were carried out through the plug-in ClueGO in Cytoscape. Based on the STRING online, a protein-protein interaction (PPI) network was constructed. Hub genes were selected from CytoHubba. Through the intersection of the top 10 hub genes in two sets of EDGs, the key genes and related KEGG pathways were found. Quantitative Real-Time PCR and Western blotting analysis were performed for verification. RESULTS: 1230 DEGs were screened between RA and No-RA groups, and 306 DEGs were screened between male and female RA groups. The common key gene of the two groups is IL-4. Between RA group and No-RA group, interleukin-4 (IL-4) participates in cytokine-cytokine receptor interaction, Th1 and Th2 cell differentiation, Th17 cell differentiation, T cell receptor signaling pathway, etc. CONCLUSION: This study contributes to the molecular biological mechanism of gender differences in RA. IL-4 may have played an important role.
32706318 MicroRNA-340-5p suppressed rheumatoid arthritis synovial fibroblast proliferation and indu 2020 Sep Rheumatoid arthritis is a chronic systemic autoimmune disease. In this study, the role of microRNA-340-5p in rheumatoid arthritis was investigated. qRT-PCR was used to detect the expression of microRNA-340-5p in serums, synovial tissues, and fibroblast-like synoviocytes from patients and healthy participants. Cell proliferation rate, cell cycle and apoptotic cell numbers were measured by CCK-8 and flow cytometry assays. The expression of pro-inflammation factors was determined by ELISA. Our data showed that the expression of microRNA-340-5p was greatly suppressed in rheumatoid arthritis serums, synovial tissues and rheumatoid arthritis-fibroblast-like synoviocytes compared to that in healthy controls. Over-expression of microRNA-340-5p greatly suppressed cell proliferation, promoted cell apoptosis, and suppressed the expression of inflammation factors in rheumatoid arthritis fibroblast-like synoviocytes. Additionally, STAT3 was a target of microRNA-340-5. Overexpression of STAT3 could reverse the outcome of microRNA-340-5p on cell proliferation and apoptosis in rheumatoid arthritis fibroblast-like synoviocytes. The findings in our study demonstrated that microRNA-340-5p may serve as a potential target for therapeutic direction for patients with rheumatoid arthritis.
33039953 Role of glucose metabolism in aggressive phenotype of fibroblast-like synoviocytes: Latest 2020 Dec Glucose metabolism is considerably increased in inflamed joints of rheumatoid arthritis (RA) patients at early stages. Fibroblast-like synoviocytes (FLSs) activation and subsequent joint damage are linked with metabolic alterations, especially glucose metabolism. It has been shown that glucose metabolism is elevated in aggressive phenotype of FLS cells. In this regard, glycolytic blockers are able to reduce aggressiveness of the FLS cells resulting in decreased joint damage in various arthritis models. Besides, metabolic changes in immune and non-immune cells such as FLS can provide important targets for therapeutic intervention. Glycolytic enzymes such as hexokinase 2 (HK2), phosphofructo-2-kinase/fructose-2,6-bisphosphatase (PFKFB), and phosphoglycerate kinase (PGK) play essential roles in aggressive behavior of FLS cells. It has been documented that the HK2 enzyme is significantly upregulated in RA FLS cells, compared with osteoarthritis (OA) FLS cells. The HK2 is expressed in a few tissues and upregulated in the inflamed synovium of RA patients that makes it a potential target for RA treatment. Furthermore, HK2 has different roles in each cellular compartment, which offers another level of specificity and provides a specific target to reduce deleterious effects of inhibiting the enzyme in RA without affecting glycolysis in normal cells. Thus, targeting the HK2 enzyme might be an attractive potential selective target for arthritis therapy and safer than global glycolysis inhibition. Therefore, this review was aimed to summarize the current knowledge about glucose metabolism of FLS cells and suggest novel biomarkers, which are potential candidates for RA treatment.
31782615 Relationship between polymorphisms in -572G/C interleukin 6 promoter gene polymorphisms (r 2020 Jan AIMS: This meta-analysis was aimed to investigate the association between -572G/C interleukin (IL)-6 gene polymorphism and occurrence risk of rheumatoid arthritis (RA). METHODS: Literature search was conducted in PubMed, Embase, Springer and Google Scholar up to November 2018. The pooled odds ratios (ORs) and 95% confidence interval (CI) were calculated by Revman 5.3. RESULTS: A total of six case-control studies were included in this meta-analysis. In the allele model (G vs C), homozygous gene model (GG vs CC), recessive gene model (GG vs GC + CC), and dominant gene model (GG + GC vs CC), the pooled estimate indicated there was significant association between -572G/C IL-6 gene polymorphism and risk of RA. However, no significant statistical results were found in meta-analyses of heterozygote gene models. CONCLUSIONS: The -572G/C IL-6 gene polymorphism is associated with the risk of RA. The GG genotype may be the main contributor in increasing susceptibility to RA.
32776721 Predicting Imaging Remission in Rheumatoid Arthritis: a Case-control Ultrasound Study. 2020 Aug 10 BACKGROUND: To elucidate the achievement rates of imaging remission and to examine the characteristics associated with imaging remission status among patients with rheumatoid arthritis (RA) who have attained clinical remission. METHODS: Ninety-seven patients with RA patients who had attained clinical remission, defined by DAS28-ESR < 2.6 were enrolled. Power Doppler ultrasonography (PDUS) was performed on 16 joints and 2 tendons, including the first to third metacarpophalangeal, second and third proximal interphalangeal, radiocarpal (RC), second and third metatarsophalangeal joints, and extensor carpi ulnaris tendons. They were graded based on a dichotomous assessment. The clinical and laboratory data of patients who had attained imaging remission were compared to those of patients who had attained only clinical remission. RESULTS: The imaging remission rate was 51.5% in patients who had attained clinical remission. Forty-seven patients (48.5%) were PDUS positive. Power Doppler was detected most frequently in the right RC joint (n = 40). PDUS positive patients had higher evaluator global assessment (EGA) scores (P < 0.001) than PDUS negative patients. PDUS positive patients also had higher clinical disease activity index and simplified clinical disease activity index scores than PDUS negative patients. Patients who had attained imaging remission had lower pain scores and used nonsteroidal anti-inflammatory drugs less frequently. Patients who had attained imaging remission had higher rheumatoid factor (RF) and anti-cyclic citrullinated peptide levels. A low EGA score was found to be a predictor of imaging remission achievement among patients who had attained clinical remission. CONCLUSION: Only 51.5% of the patients with RA who had attained clinical remission were also in imaging remission. Patients who had attained imaging remission had lower EGA scores and higher RF levels than patients who had attained only clinical remission.
32858756 [Prevalence of Rheumatoid Arthritis in Germany: Analysis of Longitudinal Data of Statutory 2021 May BACKGROUND: Rheumatoid arthritis (RA) is a progressive chronic inflammatory systemic autoimmune disease with destructive joint changes. Data on prevalence in adult patients are only available to a limited extent in Germany. METHODOLOGY: Anonymised diagnosis and prescription data for 2008-2013 were evaluated at patient level for approximately 2.3 million insured adults (total data set; status 2013) and approx. 1.2 million insured adults (smaller data set with additional information such as treatment by a specialist; status 2013) from 7 different statutory health insurance companies. RA was diagnosed if the code M05 (seropositive chronic polyarthritis) or M06 (other chronic polyarthritis) was present (diagnosis group M0[5,6]) and if the patient was either an outpatient at least twice (in 2 different quarters) or at least once an inpatient within a calendar year (according to the BVA criteria, inpatient diagnoses were thus classified as more reliable). The data were extrapolated to the SHI-insured and total population in Germany for 2013. RESULTS: The prevalence of RA in the total data set was 1.26% on average over all years (2008-2013). More than 90% of the diagnosis was based on the diagnosis code M06. In 88% of the cases, the classification was based exclusively on outpatient diagnoses. Taking into account a diagnosis by a specialist based on a smaller data set containing this additional information to determine a "reliable" RA diagnosis, the average RA rate for 2011-2013 was about 0.99%. Related to the diagnosis group M0[5,6] in the total data set, the prevalence of RA in 2013 was about 1.8% of women and about 0.8% of men. Only about 40% of diagnosed patients were treated with DMARDs. CONCLUSIONS: The prevalence estimates for RA derived from the larger data set correspond to those of previous surveys with partially different methodological approaches. Based on the analysis of the health insurance data presented, the prevalence of diagnosed RA in adults in Germany is 1.26%, which is within the range of 0.81-1.62% that can be found in the literature. This represents about 721,000 adult SHI-insured persons. The low rate of DMARD prescriptions may indicate inadequate care of these patients.
32745151 Cardiovascular risk in persons at risk of developing rheumatoid arthritis. 2020 BACKGROUND: Rheumatoid arthritis (RA) is associated with an increased cardiovascular disease (CVD) risk which may start even before diagnosis. To explore this CVD risk prior to RA, we determined multiple risk factors and two 10-year clinical risk scores in a cohort of individuals at-risk of RA. We also analyzed associations with arthritis development and autoantibody status and compared a subset of at-risk individuals to an age and sex matched seronegative control group. METHODS: In a cohort of 555 consecutive arthralgia patients positive for rheumatoid factor (RF) and / or anti-citrullinated protein antibody (ACPA) we retrospectively identified patients with preclinical arthritis (i.e. those who developed arthritis), and non-arthritis patients (those without arthritis development during maximum 5 years follow up). Demographics, CVD risk factors and the 10-year cardiovascular risk according to the SCORE and QRISK3 system were determined at baseline. RESULTS: Preclinical arthritis patients (n = 188) had a higher heart rate (68 vs 63 bpm, p = 0.048) and lower cholesterol (5.2 mmol/l vs 5.5, p = 0.006), HDL (1.0 mmol/l vs 1.1, p0.003) and ApoB (0.85 g/l vs 0.91, p = 0.011) compared to non-arthritis patients (n = 367). Lipid levels were associated with ACPA status in both the preclinical arthritis and non-arthritis group. Ten-year CVD risk scores did not differ between preclinical arthritis and non-arthritis patients, in total, 7% (SCORE) and 8% (QRISK3) of seropositive arthralgia patients were classified as high risk. Seropositive at-risk patients (n = 71) had higher total cholesterol (5.4 vs 4.9, p<0.001), TC/HDL ratio (4.0 vs 3.0, p<0.001), triglycerides (1.4 vs 1.0, p = 0.001), ApoB (1.0 vs 0.9, p = 0.019) and 10-year risk scores (median SCORE 1.0 vs 0.0, p = 0.030 and median QRISK3 4.4 vs 3.1, p<0.001) compared to seronegative controls. CONCLUSION: Our results suggest that lipid changes commence prior to RA diagnosis and that ACPAs might play a role.
32438423 The Central Role of Acute Phase Proteins in Rheumatoid Arthritis: Involvement in Disease A 2020 Jun Rheumatoid arthritis (RA) is an autoimmune disease of complex etiopathogenic origin and traditionally characterized by chronic synovitis and articular erosions. Furthermore, there is strong evidence that infectious agents, including those that become dormant within the host, play a major role in much of the etiology of RA and its hallmark of inflammation. A combination of genetic predisposition, environmental exposure, and presence of infectious agents may therefore lead to a loss of immune tolerance to citrullinated proteins, which present as self-antigens to the human immune system. This results in generation of highly RA-specific autoantibodies, known as anti-citrullinated protein antibodies (ACPAs). Protein citrullination occurs via posttranslational deamination of arginine residues by peptidylarginine deiminase enzymes, which have confirmed sources of both endogenous and infectious origins. A recognized plasma protein target of citrullination and RA autoantibody generation is fibrin and its soluble precursor fibrinogen, both key components of hemostasis and acute phase reaction. Increased titers of ACPAs that accompany rapid progression to clinical RA disease have been shown to drive a variety of proinflammatory processes, and therefore results in aberrant fibrin clot formation and increased cardiovascular risk. However, the full extent to which hemostasis is affected in RA remains controversial, owing to the differential impact that citrullinated fibrin(ogen) and concurrent systemic inflammation may have on resulting hemostatic outcome. This review highlights key events in initiation of autoimmune-driven inflammatory events, including the role of bacterial infectious agents, which subsequently result in clinical RA disease and associated secondary cardiovascular disease risk, with specific focus on plasma proteins that are heavily involved throughout the immunopathological progression process.
32893286 Subclinical atherosclerosis in rheumatoid arthritis patients of the Gulf Cooperated Counci 2020 Sep OBJECTIVES: To assess the existence of subclinical atherosclerosis in the Gulf Cooperation Council (GCC) rheumatoid arthritis (RA) patients in comparison to age, gender and cardiovascular disease (CVD) risk factors matched controls. Methods: A cross-sectional study, 100 RA patients and 150 age, gender and CVD risk factors matched controls were recruited between June 2019 and December 2019. Detailed history, physical examination, and ultrasound examination of the carotid arteries for the carotid intima-media thickness (cIMT) and for the presence of atheroma, had been carried out. Differences between RA and controls carotid structural changes were carried out using t-test and Chi-test. RESULTS: Patients with RA showed more sub-clinical atherosclerosis with thicker cIMT at 0.60±1.4 versus 0.56±0.09 mm, (p=0.03). cIMT is a surrogate marker for the presence of atherosclerosis and a predictor for the cardiovascular disease progression.  Rheumatoid arthritis patients had more carotid atherosclerotic plaque; 21 (21%) patients versus 6 (4%) healthy controls (p less than 0.001). Conclusion: Subclinical atherosclerosis is more prevalent among RA patients of the GCC than the control participants.
33059295 Rheumatoid arthritis-related lung disease detected on clinical chest computed tomography i 2020 Dec OBJECTIVE: We aimed to determine the real-world prevalence and investigate risk factors for rheumatoid arthritis (RA)-related lung disease on chest computed tomography (CT) imaging. We also investigated the impact of RA-related lung disease on mortality. METHODS: We studied chest CT imaging abnormalities among RA patients. We determined the presence and type of abnormalities using the chest CT imaging radiologic report. RA-related lung disease was defined as interstitial lung disease (ILD), bronchiectasis, or pleural disease. We examined whether demographics and RA characteristics were associated with RA-related lung disease using logistic regression. RA-related lung disease and mortality was described using survival curves and Cox regression. RESULTS: We analyzed 190 patients who had chest CT imaging performed for clinical indications. Mean age was 64.2 years (SD 11.8), 80.0% were female, and 75.3% were seropositive. RA-related lung disease was detected in 54 patients (28.4%); 30 (15.8%) had ILD, 27 (14.2%) had bronchiectasis, and 18 (9.5%) had pleural disease. RA-related lung disease was reported in both seropositive and seronegative RA (28.7% vs. 27.7%, p = 1.00). Male sex (OR 2.62, 95%CI 1.17-5.88) and current methotrexate use (OR 2.73, 95%CI 1.27-5.61 vs. not current) were associated with RA-related lung disease. Twenty-four (44.4%) patients with RA-related lung disease died during mean 7.0 years of follow-up. RA-related lung disease had HR of 5.35 (95%CI 0.72-39.9) for mortality compared to normal chest CT. CONCLUSIONS: In this real-world study, RA-related lung disease was commonly detected on chest CT imaging regardless of RA serostatus. RA-related lung disease had high mortality, emphasizing the importance in close monitoring of these patients.
31611592 Folyl polyglutamate synthethase (FPGS) gene polymorphisms may influence methotrexate adver 2020 Apr The aim of the study was to look for the association of FPGS 2752 G > A (rs1544105), FPGS 1994 A > G (rs10106), and GGH 452 C > T (rs 11545078), GGH -401C > T (rs 3758149) gene polymorphisms with methotrexate (MTX) treatment response and MTX-induced adverse events in South Indian Tamil patients with rheumatoid arthritis (RA). Further the influence of these gene polymorphisms on MTX polyglutamate levels was analyzed. A total of 330 patients with RA were investigated. FPGS gene polymorphisms were analyzed by TaqMan 5'nuclease assay and GGH gene polymorphisms were analyzed by PCR-RFLP. Methotrexate polyglutamates (nmol/L of packed erythrocytes) were measured by liquid chromatography mass spectrometry (LCMS/MS) method. We found that the heterozygous genotype of FPGS rs1544105 [p = 0.02, OR 1.93, 95% CI (1.15-3.35)] and FPGS rs10106 AG genotype [p = 0.01, OR 2.11, 95% CI (1.20-3.71)] were associated with MTX adverse events. FPGS rs1544105 and GGH -401C > T SNPs influenced the polyglutamate levels. None of the investigated SNPs seems to be associated with MTX treatment outcome.