Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 2053913 | The progression of erosion and joint space narrowing scores in rheumatoid arthritis during | 1991 Jun | Erosions and cartilage destruction are nearly universal features in peripheral joints that have been chronically affected by rheumatoid arthritis. Scoring methods to measure the extent of these abnormalities in hands and wrists have been developed and have been thoroughly tested in several studies to establish their reproducibility. In this study, we utilized one of these scoring methods to examine the progression of radiologic damage as related to duration of disease. Two hundred ninety-two patients from 3 different participating centers in the Arthritis, Rheumatism, and Aging Medical Information System were included. Six hundred fifty films of the hands and wrists, obtained from 210 patients, were scored for erosions and joint space narrowing. The average annual rate of progression of the total radiologic score, which sums erosion and joint space abnormalities and has a maximum possible score of 314, was approximately 4 units per year over the first 25 years after onset; this progression was more rapid in the earlier years of disease and slightly slower in the later years. Data were insufficient to accurately determine the progression rate in disease of more than 25 years duration. | |
| 2962275 | Functional and phenotypical characterization of activated T cells from intra-articular sit | 1987 Dec | The presence of activated T lymphocytes bearing interleukin 2 (IL-2) receptors and HLA class II (Ia) antigens accompanied by impaired T cell functions such as a decreased mitogenic responsiveness are characteristic findings, especially in intra-articular sites in chronic inflammatory joint diseases. The objective of the present study was to further characterize these in vivo activated T cells by the investigation of IL-2 production and a possible T cell receptor modulation. IL-2 receptors were found to be expressed primarily in the CD4+ subset. The Ia+ subset expressing both DR and DQ antigens showed a weaker mitogen-induced response as compared to the Ia- fraction. A decreased mitogen-induced IL-2 production and a lower response to anti-CD3 monoclonal antibodies was observed with synovial T lymphocytes as compared to peripheral blood T cells. The density of the CD3 molecule, known to be closely associated with the T cell receptor, was significantly lower in intra-articular sites, while other T cell-specific surface molecules were expressed to a similar extent in both compartments. The decreased synovial T cell mitogenesis was not restored by the addition of lymphokines (IL-1 and IL-2) or blood monocytes, nor by removing CD8+ T cells. These data present further evidence for a significant T cell activation in intra-articular sites in chronic inflammatory joint diseases. The decreased expression of the CD3 glycoprotein suggests a modulation by so far unidentified antigen(s), which could also be responsible for the weak T cell response elicited by polyclonal mitogens. | |
| 2429362 | [Periungual capillaroscopy in rheumatoid arthritis. Prospective study of 80 cases]. | 1986 Jun | This study involved the screening for dermal microcirculatory abnormalities using periungueal capillaroscopy in a group of 80 cases of rheumatoid arthritis, so-defined in terms of ARA criteria. Excessive erythrocyte aggregation and/or pericapillary edema were detected in 74% of cases and were statistically correlated with ESR, reflecting an inflammatory syndrome. Capillary neogenesis, probably in reaction to subclinical cutaneous vascularity, was detected in 59% of cases (86% of subjects presenting extra-articular rheumatism). In 28% of cases this was accompanied by spontaneous hemorrhage, suggesting a progressive condition. Stigmata of cutaneous atrophy were present in 54% of subjects. These findings demonstrate the frequency of subclinical cutaneous damage in rheumatoid disease and suggest the possibility of the clinical usefulness of capillaroscopy, a non-invasive technic, in the follow-up of this disease. | |
| 3790424 | Distribution and biosynthesis of connective tissue components by synovial fibroblasts cult | 1986 Oct | Two main cell types, spindle-shaped and large flattened cells, were identified in fibroblast cultures from synovial tissue explants. Type I collagen and fibronectin were visualized by indirect immunofluorescence and the hyaluronic acid coat around the cells by the erythrocyte exclusion method. Collagen was detected as intracellular granules which varied greatly in their number with no correlation to the cell shape. Hyaluronic acid coat was seen only around the spindle-shaped cells, whereas the intercellular fibronectin was found throughout the cultures. Morphological alterations in synovial fibroblasts were detected when subjected to mononuclear cells isolated from peripheral blood. The fibroblast became thinner and branched and stellate cells with numerous extensions appeared. Hyaluronic acid synthetase activity increased by about 50% and was obviously related to the appearance of the stellate cells, whereas no evident change was detected in collagen synthesis. The stellate cells were full of collagen granules. The hyaluronic acid coat around these cells did not differ from that around normal spindle-shaped cells. Synovial fibroblasts cocultured with mononuclear cells lost the intercellular fibronectin network, but other main cell surface glycoproteins studied with the periodate-borohydride method and electrophoresis remained unaltered in spite of morphological alterations. | |
| 3493039 | Plasmapheresis in rheumatic diseases. | 1986 | Apheresis is an innovative, expensive method for treating serious complications of refractory rheumatic disease and may be useful in selected cases. Technologic improvements which will increase our ability to remove plasma fractions and/or lymphocyte subsets are the object of study and may alter the current indications for performing apheresis, as well as increasing our basic knowledge of the disease process. | |
| 2343002 | Collagenous colitis with protracted course and fatal evolution. Report of a case. | 1990 Apr | We report the case of a female patient who suffered from collagenous colitis for 13 years, the complications of which may have contributed to her death. The disease was associated with seropositive rheumatoid arthritis and Sjögren's syndrome. Cases of collagenous colitis with a course leading to death have not been reported in the literature, to the best of our knowledge. | |
| 3241041 | Long-term results after tenosynovectomy to treat the rheumatoid hand. | 1988 Sep | To be effective as a prophylactic procedure, tenosynovectomy to treat rheumatoid hand has to be done before there is significant tendon damage. Tenosynovectomy is usually considered to prevent subsequent tendon rupture and recurrent tenosynovitis. We reviewed the results of all tenosynovectomies done at the Dartmouth-Hitchcock Medical Center from 1968 to 1983. One hundred seventy-three procedures were done for 125 patients. Fifty percent of patients who had prophylactic tenosynovectomy demonstrated tendon invasion. Examination at a mean of 70 months after 129 procedures showed extensor tendon failure in 1 patient of 44 who had normal tendons, 1 of 42 with invaded tendons, and in 3 of 43 who had ruptured tendons at the time of original surgery. Seven patients had recurrent tenosynovitis. | |
| 3621847 | Vasculitis of the gall bladder in rheumatoid arthritis and systemic lupus erythematosus. | 1987 Jun | Three cases of acute cholecystitis due to vasculitis of the gall bladder are described; one in a patient with rheumatoid arthritis, and two in association with systemic lupus erythematosus. | |
| 2387814 | Early beneficial effects of low dose oral methotrexate in rheumatoid arthritis. | 1990 May | The effect of low dose methotrexate pulse therapy was studied in 21 patients with active rheumatoid arthritis. Three doses of oral methotrexate 2.5 mg at 12 hourly intervals weekly was administered to all the patients. Patients were followed up for clinical, radiological and serological evaluation. Significant reduction in the number of painful and swollen joints, decrease in the duration of morning stiffness, fall in the erythrocyte sedimentation rate, and improvement in global assessment were seen in 15 patients (71.4%) by the end of 16 weeks. Five patients (23.8%) complained of minor gastric discomfort. None of the patients discontinued the treatment because of any side effect. | |
| 2092955 | [Analysis of knee arthroscopic findings in rheumatic diseases]. | 1990 Dec | 46 patients with knee joint arthritis were subjected to arthroscopic examination. The results were analyzed and its clinical significance was discussed. The postoperative diagnoses were rheumatoid arthritis in 19 cases, Sjögren syndrome in one, seronegative spondyloarthropathy in 4, gouty arthritis in one, tuberculous arthritis in one, pigmented villous nodular synovitis in two, undefined synovitis in 5, osteoarthritis in 8 and nonsynovitis conditions in 5. The most important indication of arthroscopic examination is for differential diagnosis of arthritis of unknown cause, such as rheumatoid arthritis with single knee joint involvement, osteoarthritis with symmetric large and small joints involvement as well as crystal induced arthritis. These conditions showed under arthroscope their special features in synovium both grossly, microscopically and immuno-pathologically. The synovial damage as observed through arthroscopic examination correlated to certain extent with the X-ray film changes of the knee joint, but direct visualization with the former is better than indirect imaging with the latter. | |
| 3659618 | Sarcoidosis and amyloidosis. Is the association causal or co-incidental? | 1987 Sep | During 1950-83, 52,371 autopsies were done at the Los Angeles County Hospital; 503 cases showing amyloidosis, seven of these also had sarcoidosis, and three also had rheumatoid arthritis. These associations could be coincidental or it is just possible that there is a causal aetiological relationship. It is hoped that other workers will review their material, and, in particular, to assess whether there is an increased incidence of amyloidosis in sarcoidosis. | |
| 3548731 | Mast cell numbers in rheumatoid synovial tissues. Correlations with quantitative measures | 1987 Feb | Synovial biopsy specimens from 20 patients with rheumatoid arthritis were subjected to quantitative analysis for several parameters of inflammation and for enumeration of synovial tissue mast cells. Strong positive correlations were found between numbers of mast cells per cubic millimeter of synovial tissue and the following synovial tissue parameters: inflammatory index (a quantification of lymphocytic infiltration), Leu-3a grade (T helper/inducer lymphocytes), Leu-1 grade (T lymphocyte), and plasma cell grade. A strong negative correlation was found between the synovial mast cell count and the extent of sublining layer fibrin deposition. Correlations between synovial mast cell count and Leu-2a grade, ratio of Leu-3a grade:Leu-2a grade, OKM1 grade, HLA-DR grade, and lining layer thickness grade did not reach statistical significance. In addition, we obtained synovial specimens from 6 of the patients both before and after long-term therapy with oral methotrexate and from 3 of the patients before, and 1 week after, an intraarticular injection of steroid. The 3 patients who had an intraarticular steroid injection showed a 67-96% decrease in the number of synovial tissue mast cells; there was no significant change in the number of synovial mast cells in the tissues of the 6 patients who received oral methotrexate. These observations are the first documentation of a quantitative relationship between the number of mast cells and the number and phenotypic profile of infiltrating lymphocytes in an inflamed tissue, which in this case, is human synovium. Our findings suggest that mast cells are involved in the pathologic interactions in rheumatoid arthritis and might play a role in the early phases of exacerbations of disease activity. | |
| 2843316 | Radiosynoviorthesis of the knee: a doubleblind trial of 1 versus 5 mCi Gold-198. | 1988 Jun | Since the minimal effective dosage for radiosynovectomy is not known, we have performed a doubleblind controlled trial of 1 mCi vs. 5 mCi 198Au in 60 knees of 46 patients with persistent rheumatoid synovitis. The therapeutic effect was assessed with a clinical score, 99mTc pertechnetate uptake measurements and plain X-rays. With regard to clinical parameters no statistical differences between the two groups were found, but results indicate a trend towards a better outcome in patients treated with 5 mCi. 99mTc uptake improved significantly in patients treated with the higher dose and not in the low dose group. Weighing ease of treatment and risk of side effects against the small difference in effectiveness, we conclude that the use of less than 5 mCi of 198Au may be justified. During the study the injection technique was changed, enabling a comparison of two methods. Leakage to lymph nodes and liver decreased when the needle was flushed with normal saline after administration of the radiocolloid. | |
| 1767643 | Ankle arthrodesis in rheumatoid arthritis. 30 cases followed for 5 years. | 1991 Dec | We have reviewed the results of 30 ankle arthrodeses performed on 26 patients with rheumatoid arthritis. This procedure was associated with a high morbidity, with wound breakdown and infection occurring in 12 cases. Eighteen ankles had fused, six had pain-free fibrous union, and six required further surgery for nonunion. Clinical evaluation, at an average follow-up of 5 years, was based on a modified ankle-grading system with good or excellent results in 14, fair results in nine, and poor in two. Only 4 patients had some residual pain in the ankle, and so, despite the high complication rate, arthrodesis is an effective method of treating the painful, rheumatoid ankle. | |
| 3416536 | Synovial fluid osmolality in osteoarthritis and rheumatoid arthritis. | 1988 Oct | The osmolality of synovial fluid aspirated from the knees of 15 rheumatoid and 15 osteoarthritic patients was observed concurrently with the same measurement on blood serum. The group averages were compared to a group of 13 with identical apparati. Synovial fluid osmolality in rheumatoid arthritics (280 +/- 7.7 mmol/kg) was significantly different from that in osteoarthritics (297 +/- 16.9 mmol/kg), and both group averages were significantly different from normal (404 +/- 57 mmol/kg). Blood serum osmolality also differed between the normal and the two arthritic groups. The potential application of vapor pressure osmometry techniques in the diagnosis and management of joint disease is discussed. | |
| 2952146 | Computed tomography of humeral head cup arthroplasties. A preliminary report. | 1987 Jan | Computed tomography (CT) was employed to evaluate resurfacing metal cup arthroplasties, in shoulders affected by rheumatoid arthritis. Reconstruction of the information obtained, with the high frequency filter, resulted in an image of the cement and skeletal structures inside the cup. This new application of CT may prove valuable in assessing the complications and results of cup arthroplasties. | |
| 2740804 | [Tolerability and therapeutic maintenance of tiopronin, new basic treatment of rheumatoid | 1989 Apr 30 | A long-term survey of 268 patients.--Tiopronin (Acadione) is a new long-term treatment of rheumatoid arthritis. To define the tolerance and the therapeutic maintenance, the data for 268 patients with rheumatoid arthritis who started a treatment with Tiopronine from January 1979 to December 1986 have been reviewed in December 1987. Tiopronin was started after a mean duration of rheumatoid arthritis of 14.1 +/- 8.2 years, at a mean daily dosage of 1.2 +/- 0.2 grammes. The efficacy of tiopronin was considered very good or good in 67 p. cent of the patients. Adverses effects led to stop the treatment in 27.7 p. cent of the patients: these adverses effects were similar to those observed with D-Penicillamine, but no crossed intolerance was noticed between tiopronin and D-Penicillamine. At the 72nd month of follow-up, tiopronin remained effective and well-tolerated in 40 p. cent of the patients. The efficacy and the high rate of prolonged therapeutic maintenance make tiopronin a new major long-term treatment of rheumatoid arthritis. | |
| 2839121 | Demonstration of impaired T cell regulation of Epstein-Barr virus stimulated B lymphocytes | 1988 May | Lymphocytes from patients with rheumatoid arthritis (RA) show an abnormal response after stimulation with Epstein-Barr virus (EBV), a potent B cell mitogen. In vitro IgM production from EBV stimulated lymphocytes was measured over a 21 day period. In keeping with previous studies, RA lymphocytes showed increasing IgM production between 14 and 21 days, whereas IgM production decreased during this period in normal lymphocytes (p less than 0.001). Experiments on 12 HLA identical, RA discordant sibling pairs were also undertaken. B enriched and T enriched lymphocyte populations were obtained and recombined in both an autologous and homologous manner. The abnormality in IgM production in patients with RA was shown to reside in the RA T cell population (p less than 0.005), and RA B cells combined with normal T cells behaved similarly to autologous cultures of normal B and T cells. The study shows that impaired immunoregulation of EBV stimulated B cells in RA is secondary to a functional defect in RA T cells, but no difference in the concentration of T suppressor/cytotoxic cells could be found between the disease discordant siblings. The abnormality in immunoregulation appears to be secondary to RA, rather than a product of genes encoded within the major histocompatibility complex (MHC) region, as defined by HLA-DR, A, B, and C typing. | |
| 2029111 | Influence of methotrexate and azathioprine on radiologic progression in rheumatoid arthrit | 1991 Jun 15 | OBJECTIVE: To compare the effects of azathioprine and methotrexate on progression of radiologic damage in patients with rheumatoid arthritis. DESIGN: Double-blind, randomized 48-week trial. PATIENTS: Sixty-four patients with active rheumatoid arthritis who either have not responded to or who have reacted with side effects to at least parenteral gold and D-penicillamine. INTERVENTIONS: Either azathioprine, 100 mg daily, or methotrexate, 7.5 mg weekly, was administered orally. Depending on the clinical effect after 8 weeks, the dosage was increased to either azathioprine, 150 mg, or methotrexate, 15 mg. The dosages for nonsteroidal anti-inflammatory drugs and prednisone were held stable. MEASUREMENTS: Clinical and laboratory assessments were done by the same physician every 4 weeks for the first 24 weeks and every 8 weeks thereafter. Radiographs of hands, wrists, and feet obtained at baseline and after 24 and 48 weeks were scored by one rheumatologist blinded to medication and clinical findings. MAIN RESULTS: Initial radiologic scores were comparable in both groups and correlated with disease duration (r = 0.38). An intention-to-treat analysis after 24 and 48 weeks showed significantly fewer new erosions in the methotrexate group compared with the azathioprine group (difference, 2.0 [95% CI, 0.2 to 3.9] and 3.5 [CI, 1.3 to 5.8], respectively). The change in total joint score was also significantly less pronounced in the methotrexate group compared with the azathioprine group after 24 weeks (difference, 2.8 [CI, 0.2 to 5.2]) and after 48 weeks (difference, 3.9 [CI, 0.3 to 7.4]). Radiologic stabilization after 48 weeks was present in 10% of the azathioprine group compared with 29% of the methotrexate group. CONCLUSIONS: Patients with rheumatoid arthritis treated with low-dose methotrexate showed significantly less radiologic progression than patients treated with azathioprine. This result suggests that methotrexate therapy is clinically superior in these patients. | |
| 3827347 | Rheumatoid blood decreases the adherence of polymorphonuclear cells (PMNs) to cultured end | 1987 Feb | Rheumatoid sera and plasma inhibited the adherence of normal blood polymorphonuclear cells (PMNs) to cultured porcine endothelium. This inhibition of adhesion was not seen when PMNs were treated with the plasma or serum from normal subjects or patients with other inflammatory arthropathies. The abrogation of PMN adherence was directly related to the levels of circulating immune complexes and was not dependent upon the type of anti-inflammatory therapy that the patients were receiving nor on any of the recorded clinical parameters. A similar inhibition of adhesion was seen with heat induced aggregated human IgG (HAGG) provided that serum was present in the culture medium. In view of these results we propose that circulating immune complexes in RA may have a significant role in controlling the interaction of PMNs with vascular endothelium and in perpetuating the entry of these cells into the synovial fluid of the inflamed joints. |