Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
ID | PMID | Title | PublicationDate | abstract |
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1991212 | The prevalence of rheumatoid arthritis in the Sultanate of Oman. | 1991 Feb | One thousand nine hundred and twenty-five Omani adults aged 16 and over were studied in a house-to-house survey in representative areas of Oman. Seven cases (five female) are described who satisfied the 1987 ARA criteria for rheumatoid arthritis (RA), indicating a prevalence of 3.6 per thousand adults. Adjusted for the population structure, the prevalence was 8.4 per thousand adults. Complementary data are also presented on cases of RA ascertained by special screening clinics in rural health centres and by hospital rheumatology clinics. In all parts of the study, cases of RA were less often seropositive than in European populations which may account for the lower prevalence of erosive disease. | |
3423750 | IgM, IgG and IgA rheumatoid factors (antiglobulins) in early rheumatoid arthritis and thei | 1987 | An enzyme-linked immunosorbent assay was used to detect antiglobulins (rheumatoid factors, RF) of various classes in 33 patients with recently diagnosed rheumatoid arthritis and to follow their progress with 3-monthly checks for 1 year. For RF, IgA-RF and IgM-RF showed greater sensitivity than the latex test, either or both being positive in 76%. There was no correlation between any of the measures of RF and patient's clinical status as judged by articular index (AI), or serum CRP level. For individual patients, RF levels varied considerably between assessments. The best predictors of clinical status over 1 year were the initial AI and the latex test for RF. While class-specific measurement of RF is more sensitive than the latex test, the variation of individual classes of antiglobulins over time within individual patients makes them less helpful as predictors of disease progress. | |
2873861 | Selection of suitable patients for second-line therapy in rheumatoid arthritis. | 1986 Aug | Investigators studying second-line drugs often try to enroll 'ideal' patients with a high ESR, short disease duration and who have received no previous second-line therapy. In this paper we investigate the influence of gender, disease duration, previous second-line therapy, and initial ESR in 150 rheumatoid patients with clinically-active disease treated with sulphasalazine. Clinical improvement was seen in all subgroups and no difference in toxicity could be demonstrated. Haematological response was absent in patients with an initial low ESR although these patients improved clinically. Thus, patients with clinically-active disease suggesting a need for second-line drugs should benefit from sulphasalazine therapy irrespective of any of the above variables. The implications for clinical trial design regarding patients with low ESR, however, may be more complex. | |
2823951 | Silica exposure and rheumatoid arthritis: a follow up study of granite workers 1940-81. | 1987 Apr 18 | The incidence and prevalence of subjects awarded disability pensions and the prevalence of subjects receiving free medicines because of rheumatoid arthritis were studied in a Finnish cohort of 1026 granite workers hired between 1940 and 1971 and followed up until 31 December 1981. The incidence of awards of disability pensions because of rheumatoid arthritis during 1969-81, the prevalence of rheumatoid arthritis on 31 December 1981, and the prevalence of subjects receiving free medicines for rheumatoid arthritis at the end of 1981 were significantly higher among the granite workers than in the general male population of the same age. Retrospective analysis of the records of all patients with rheumatoid arthritis in the cohort showed a predominance of a severe, serologically positive and erosive form of rheumatoid arthritis, usually with an age at onset of 50 or over. The possible aetiological or pathophysiological role of granite dust in rheumatoid arthritis may be based on the effects of quartz on the immune system. | |
3125841 | One-year experience in patients treated with auranofin following completion of a parallel, | 1988 Jan | Following a 21-week double-blind trial that compared the effects of treatment with auranofin (AUR), gold sodium thiomalate, and placebo in 193 patients, 147 patients entered a 1-year, open-label study of treatment with AUR (6 mg/day). Results of this open-label study suggest that AUR has a long-term use profile similar to that of other slow-acting antirheumatic drugs. AUR appears to be capable of sustaining an initial response to gold sodium thiomalate. The withdrawal rate remains relatively high: Nearly half of the study patients had discontinued AUR by the end of 1 year. | |
2398252 | Esophageal involvement in secondary amyloidosis mimicking achalasia. | 1990 Aug | Amyloidosis is usually considered as a cause of motor disorders of the esophagus, including achalasia. However, most patients with amyloid in the esophagus are AL-type amyloid. We report what we believe is the fourth case of secondary amyloidosis (AA-type) resulting from rheumatoid arthritis. Clinically and radiologically the picture was that of achalasia. | |
1948453 | [Upper gastrointestinal tract lesions in rheumatoid arthritis]. | 1991 Aug | We studied the upper gastrointestinal (GI) tract lesions by endoscopy, and evaluated the relationship between the lesions and clinical characteristics in 154 patients with rheumatoid arthritis (RA). Eighty-six (55.8%) had drug-induced ulcers and/or erosions, which were present mostly at the antrum as multiple lesions. A history of gastric ulcer, positive tests for fecal occult blood and progression of anemia were noticed more frequently in the patients with gastric ulcers and/or erosions, compared to those with normal mucosa. Indomethacin and prednisolone (15mg/day) were also used more frequently in the patients with gastric ulcers. Twelve patients showed amyloid depositions in the gastric mucosa, of which 8 patients had gastric ulcers and/or erosions. These results indicate that the incidence of GI tract lesions is significantly high in RA patients and that the endoscopic examination should be performed during the course of RA treatment. | |
2955515 | A minority of patients with rheumatoid arthritis show a dominant rearrangement of T-cell r | 1987 Jun | The clonality of T lymphocytes isolated from the synovial fluid and peripheral blood of patients with rheumatoid arthritis was investigated by restriction enzyme fragment mapping of the rearrangements of the beta chain gene of the T-cell antigen receptor. Three patients showed a dominant rearrangement amongst their synovial fluid T cells which was not seen in their peripheral blood T-cell population, suggesting the presence of a predominating T-cell clone. However, most of the patients examined (8 out of 11) demonstrated polyclonal T-cell populations in both their synovial fluid and peripheral blood. Of four synovial fluid T-cell lines investigated, one showed evidence of a dominant T-cell clone. | |
1834234 | Reconstitution of impaired autologous mixed lymphocyte reactivity in rheumatoid arthritis. | 1991 | We examined the ability of recombinant IL-2 to reconstitute the autologous mixed lymphocyte reaction (AMLR) defect in peripheral blood mononuclear cells (PBM) from patients with rheumatoid arthritis (RA). Our results revealed an ability to fully reconstitute RA AMLRs with pharmacologic concentrations (100 units/ml), but not physiologic concentrations (10 units/ml) of IL-2. Full reconstitution of RA AMLRs was achieved whether IL-2 was added as the initiation of culture or at 48 or 72 hours prior to termination of the cultures. Impaired IL-2 production was noted throughout the time course of the RA AMLRs. Neither an inhibitor of IL-1 nor IL-2 was detected in AMLR culture supernatants. Moreover, IL-1 in pharmacologic concentrations up to 50 units/ml failed to reconstitute impaired AMLR reactivity. In 2 patients whose AMLRs failed to reconstitute fully with 100 units/ml IL-2, addition of 10 units/ml IL-1 in combination with IL-2 fully reconstituted the AMLR defect. The results may suggest that defective IL-2 generation alone cannot fully account for impaired AMLR reactivity in RA patients. | |
3191939 | Plasma and synovial fluid meclofenamic acid concentrations in patients with rheumatoid art | 1988 | We have measured plasma and synovial fluid concentrations of meclofenamic acid at 2, 4, 8, and 12 h during steady-state administration (100 mg three times daily for 4-7 days). Paired plasma and synovial samples were obtained pre-treatment and at one of the above times in twelve patients with a diagnosis of rheumatoid arthritis. In addition, the extent of protein binding of meclofenamic acid was assessed in vitro in the pre-treatment plasma and synovial fluid specimens. Peak total concentrations of 1.73 and 0.86 micrograms.ml-1 were observed in plasma (at 2 h) and synovial fluid (at 4 h) respectively. The extent of protein binding was 99.7 and 99.6% (not significantly different) in plasma and synovial fluid respectively. The results of this study are compared to those from similar reported studies of other nonsteroidal anti-inflamatory compounds. | |
3482984 | Genetic analysis of families with multiple cases of rheumatoid arthritis. | 1986 Jun | We examined the inheritance of susceptibility to RA in families with multiple cases of RA, and studied existence of any linkage between the putative RA disease susceptibility locus and the HLA-DR locus. A pedigree analysis programme, PAP, was used for both analyses. Our investigation suggests that familial RA is the effect, in part, of an inherited autosomal dominant susceptibility gene with incomplete penetrance rather than that of a recessive gene. Linkage analysis indicates a tight linkage between the putative RA disease susceptibility locus and the HLA-DR locus under an autosomal dominant mode of inheritance. | |
3342293 | Functional outcome in rheumatoid arthritis. | 1988 | The ability to carry out daily activities depends on an individual's physical and psychological make up, and the environment and society in which he or she lives. Thus, rheumatoid arthritis produces functional impairment that is not simply related to the severity of the disease process. Two-thirds of patients are concerned more with potential loss of function than with discomfort. There is, therefore, a need to assess disability separately from inflammatory activity. The principles of disability measurement concern assessment of performance of everyday activities. Global measures or the performance of one or more specific activities can be used to assess aspects of mobility and manual dexterity. Activities can be related to social life and employment and can include assessment of psychological as well as physical disability. Many different tools are available and can be divided into: 1. Measures depending on clinical judgement. 2. Measures based on observed patient performance. 3. Measures depending on patients' opinions. In addition, a variety of health status measures have been described that include disability as one of a number of parameters aimed to assess the overall impact of the disease on the patient. Evaluation of these tools has been patchy. Full assessment using measurement theory (validity, simplicity, reliability and sensitivity) has not been undertaken for any index. However, the Health Assessment Questionnaire (HAQ) Disability Index and the Arthritis Impact Measurement Scales (AIMS) have both been tested fairly extensively in North America. The choice of a particular measurement tool depends on: 1. The context in which it will be used.(ABSTRACT TRUNCATED AT 250 WORDS) | |
3098194 | Early and late changes in sulphydryl group and copper protein concentrations and activitie | 1986 Oct | Superoxide dismutase activity (SOD), plasma and lysate thiol concentrations (PSH and LSH), and caeruloplasmin oxidase activity (CP) reflect the underlying reduction-oxidation imbalance associated with rheumatoid arthritis (RA), and are believed to be involved in the protection of the cell against free radical activity. The early and late changes in these parameters have been observed and compared with standard clinical and biochemical assessments of disease activity in 90 patients with active RA, randomly assigned to receive either sodium aurothiomalate, auranofin, or auranofin placebo. An index based on clinical criteria was used to identify patients as responders or non-responders after 24 weeks of therapy. In the first six weeks of treatment a change in SOD activity and LSH concentration in a direction away from controls was followed by a return towards control levels in responders only. This suggests that in RA evidence of clinical improvement induced by gold drugs is preceded by an initial biochemical response in an inflammatory direction. The extracellular parameters PSH and CP did not show the same early response, but PSH levels in responders showed a slower change towards normal values, though at no time were values obtained that might suggest a complete remission. Thus the intracellular parameters appear to reflect an early effect of the drugs on cells which may possibly be of use in predicting the outcome of therapy, whereas the extracellular parameters provide confirmatory evidence for an eventual improvement. | |
2139302 | Possible role of microbial IgG Fc-binding proteins in rheumatoid arthritis. | 1990 Jan | IgG Fc binding substances (receptors) are widespread among pathogenic microorganisms. The receptors from Staphylococcus aureus, streptococci of group A, C and G as well as Herpes-infected cells bind to the interface between the CH2 and CH3 domains i.e. to His 435, Tyr 436 and possibly also His 433 and/or 310. Most rheumatoid factors (RF) from patients with rheumatoid arthritis show a similar binding pattern. Hence, it has been shown that antibodies to microbial IgG Fc receptors (S. aureus and group A streptococci type M15) and RF are idiotypic-anti-idiotypic antibody "partners" i.e. that RF are the "internal images" of microbial IgG Fc binding proteins. Group A streptococci possessing IgG Fc receptors elicit higher titres of RF when injected in rabbits as compared to group A streptococci without IgG Fc receptors. The streptococcal IgG Fc receptors exhibit a diversity of preferences for subclasses of human IgG, some of them showing allotype preferences. Such allotypes are also recognized by certain RF. IgG RF are able to self-associate thereby forming immune complexes which can activate the complement cascade as well as stimulate release of prostaglandins and (probably) interleukin-1. Since these factors have been assigned an important pathogenic role in rheumatoid arthritis, self-aggregating IgG RF, proposed to be induced by microbial IgG Fc receptors might be an important pathogenic factor in rheumatoid arthritis because rheumatoid arthritis is the only known condition where synthesis of RF takes place in the synovia. | |
3716511 | [Effectiveness of plasma exchange therapy in patients with rheumatoid arthritis and system | 1986 Mar 15 | For the advantage of the therapeutic plasma exchange in the active rheumatoid arthritis there exist at present contradictory opinions. Three patients with rheumatoid arthritis and systemic manifestation as well as high activity of the disease, in whom the conventional therapy with antirheumatic drugs showed only little effectiveness and which was stopped due to severe side effects, respectively, underwent 6 plasma exchange treatments within 14 days. The subjective condition as well as standardized clinical and laboratory-chemical activity parameters quickly ameliorated. A positive therapeutic effect was to be proved still after 6 to 12 months. In 2 patients a proposed synovectomy could be renounced. The reasonable indication for the plasma exchange will be given when there is an acute immunological reaction which can be shortened by a rapid reduction of pathogenic protein fractions before irreversible morphological injuries occur. | |
1991218 | Immunogenetic heterogeneity in rheumatoid disease as illustrated by different MHC associat | 1991 Feb | Genetic variants at DRB1 (Dw subtypes), DQB, and C4 loci were compared in rheumatoid disease subjects with or without the extra-articular feature of Felty's syndrome or major vasculitis. DR4 positive subjects with rheumatoid arthritis alone showed no preferential associations with DQB or Dw variants or with C4 null alleles. Felty's subjects showed associations with the DQB encoded DQw7 allele and with the C4B null allele but no preferential associations with any Dw subtype of DR4. By contrast DR4 +ve rheumatoid-vasculitic subjects showed associations with the Dw14 as well as with DQw7 and the C4A null allele. These different MHC associations in different clinical disease subsets show that rheumatoid disease is immunogenetically heterogeneous and suggest that MHC genes outside the DRB1 locus may also influence susceptibility or modify expression of the rheumatoid disease process. | |
3335576 | Total knee arthroplasty in young adults who have rheumatoid arthritis. | 1988 Jan | At the Mayo Clinic, between 1978 and 1982, forty-four total knee arthroplasties were performed with cement in twenty-six adults who had rheumatoid arthritis. The age at operation ranged from nineteen to thirty-nine years old. The twenty-six patients were followed for two to eight years (average, five years). At the time of final follow-up, thirty-nine knees were free of pain and five were mildly painful during weight-bearing. The Hospital for Special Surgery knee score improved from a mean of 52 points preoperatively to 84 points postoperatively. There were twenty-four excellent, fourteen good, six fair, and no poor results. Radiographic analysis revealed an incomplete radiolucent line that was more than one millimeter in width adjacent to five tibial and four femoral components in eight knees (18 per cent). The positions of the components had not changed. Postoperatively, there was one transient peroneal palsy and two knees required patellar resurfacing. No revisions were performed for loosening of a prosthesis. We concluded that use of a cemented total knee prosthesis in a patient who has rheumatoid arthritis and is less than forty years old provides a satisfactory result and that the component will not loosen after an average of five years. | |
3807438 | Auranofin-associated colitis and eosinophilia. | 1987 Feb | Gold compounds, often used in the treatment of rheumatoid arthritis, have been associated with gastrointestinal disturbances in some patients. Use of auranofin, an oral gold preparation, in a 50-year-old woman with rheumatoid arthritis resulted in diarrhea, abdominal tenderness, nausea, and vomiting, which persisted despite discontinuation of auranofin therapy. The presumptive diagnosis was gold-induced colitis and eosinophilia. Administration of cromolyn sodium provided relief. Although this complication may be rare, evolving bowel symptoms in patients receiving auranofin demand prompt attention. | |
3958445 | Failure of silicone rubber wrist arthroplasty in rheumatoid arthritis. | 1986 Mar | Of 71 silicone rubber wrist arthroplasties performed between 1976 and 1983, 20% were found to have fractured, and an additional 5% required revision for deformity and pain. In most cases, no specific cause for the failure could be identified. However, excessive wrist motion, overuse, and inadequate surgical technique appear to be contributory. Prosthetic fracture is associated with increasing wrist pain, instability, and deformity with decreasing strength and function. Twelve of 14 fractured prostheses required revision. Eleven of these were revised with another silicone rubber implant, and two of these have refractured. Based on this review, we have narrowed our indications for silicone rubber wrist arthroplasty and now give greater consideration to alternative methods of treatment. | |
2044570 | Measurement of synovial inflammation in rheumatoid arthritis with technetium 99m labelled | 1991 | The ability of technetium 99m labelled nonspecific, polyclonal human immunoglobulin G (99mTc-IgG) scintigraphy to depict and quantify synovial inflammation was studied in patients with rheumatoid arthritis (RA). Eight patients with clinically active synovitis were injected with 350 MBq 99mTc-IgG, and imaging took place 4 h later. This resulted in excellent images of inflamed synovium. Significant correlations were observed between individual joint uptake on the scan and scores for joint pain (n = 316, p less than 0.001), joint swelling (n = 300, p less than 0.001) or the average of pain and swelling (n = 300, p less than 0.001). These results suggest that 99mTc-IgG scintigraphy may provide an objective, non-invasive test to detect and measure synovitis. |