Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1948778 | [Functions of the Rheumatism League Advisory Service in the care of patients with polyarth | 1991 Sep | A social worker at the Swiss League against Rheumatism describes her role as a mediator between arthritic patients and doctors and between arthritics and employers. She describes some of the hazards involved in taking the step from complete financial independence to being at the full mercy of the social insurance scheme. She also gives examples of her day to day work at the Rheumatism Advisory Centre. | |
| 2192055 | Reevaluating the therapeutic approach to rheumatoid arthritis: the "sawtooth" strategy. | 1990 May | A new therapeutic philosophy for management of rheumatoid arthritis (RA) is required, since the traditional "pyramidal" strategy has failed to measurably improve longterm outcome. This paper attempts a conceptual overview of the problem and suggests an available solution. The increased repertoire of potentially disease-modifying drugs (DMARD) allows a new creativity, and toxicity with these agents has been less than expected. Yet, clinical improvement observed initially with these agents over the first 10 to 20 months of treatment is eventually lost and accelerated increase in disability follows. Given these observations, a "sawtooth" strategy is proposed, with 6 principles: early DMARD use, continual serial DMARD use, regular quantitative monitoring of disability to detect insidious progression, setting a disability ceiling for the individual patient, sequential change in DMARD treatment when the ceiling is reached, and deployment of analgesics and NSAID as adjunctive rather than "first line" therapy. This strategy offers the potential for long-term disease modification with reasonable toxicity levels. | |
| 3734934 | Biochemistry and antigenicity of osteoarthritic and rheumatoid cartilage. | 1986 | The purpose of this study was to test whether cartilage serves as the source or repository of antigenic components active in the stimulation of inflammation in rheumatoid arthritis through an analysis of peripheral blood lymphocyte proliferation. Articular cartilage samples were obtained from patients with osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis undergoing joint replacement surgery. Each sample was homogenized and characterized biochemically with respect to the content of proteoglycan, collagen, and immunoglobulin. Proteoglycan content of rheumatoid cartilage was reduced by 71% when compared to osteoarthritic cartilage; the proteoglycan content of ankylosing spondylitis cartilage was reduced by 40% when compared to osteoarthritic cartilage. Immunoglobulins were detectable in all cartilage samples when analyzed by ELISA or end-plate titration. Lymphocyte proliferation, quantified by uptake of 3H-thymidine, was unaltered by addition of cartilage fragments, low (saline) and high salt extracts (2.0 M CaCl2), or cartilage residues. Both autologous and heterologous lymphocytes were tested against the cartilage samples with no difference in reactivity. Purified bovine articular proteoglycans and Type II collagen were also inactive. Although tetanus toxoid and phytohemagglutinin were effective stimulants of proliferation, lymphocytes from arthritis patients were suppressed relative to those of normal individuals. Analysis of arthritic articular cartilage by these techniques failed to demonstrate the presence of antigen(s) stimulating proliferation of peripheral blood lymphocytes. | |
| 3737479 | In situ evaluation of immunoglobulin synthesis of synovial plasma cells in rheumatoid arth | 1986 May | Synovial membranes of patients with osteoarthritis--a disease with unaltered immunoregulation--and rheumatoid arthritis were immunostained for the different immunoglobulin isotypes using the PAP-method and a two-layer alkaline phosphatase technique. Randomly selected plasma cells with positive immunostaining were measured by plug photometry. The average extinction of the single plasma cell is considered to be indicative of the immunoglobulin synthesis of the measured plasma cell and the isotype under study. When we compared both disease entities, patients with rheumatoid arthritis were characterized (i) by higher average extinction values for all Ig-isotypes except IgG (ii) by a higher rate of high producer plasma cells. From this data, we conclude that immunophotometry is a new in vivo method for discriminating two types of synovitis (i) one without increased Ig-synthesis at the single cell level and (ii) a second one with increased Ig-synthesis. | |
| 1965929 | [Leukocyte function in reactive arthritis]. | 1990 Jul | The authors studied ++chemotaxis, phagocytosis and the activity of intracellular enzymes of leukocytes in the peripheral blood of 90 patients with reactive arthritis as compared to 23 patients with rheumatoid arthritis and 28 healthy individuals. Disorders of all these parameters were noted. They correlated with the specific features of the clinical course of the disease and its activity. In case of reactive arthritis the persistence of the infection and immunopathological disorders underlying chronic synovitis are attributable to the condition of nonspecific resistance. | |
| 3055878 | Immunomodulators. | 1988 | A new era is emerging in the therapy of rheumatic disease involving the use of biologically based immunomodulators. Cytokines, such as the interleukins and interferons, are proteins produced by activated lymphoid cells which can now be synthesised by genetic engineering techniques. These agents have already been used to correct "immune deficiencies" in patients with neoplastic and inflammatory disease e.g. gamma-interferon in rheumatoid arthritis (RA). Monoclonal antibodies (mca) targeted against lymphocyte cell surface receptors or against autoantibodies have been successfully applied in human lymphoid malignancies, organ transplantation and in animal models of arthritis. Potential problems in man include the development of allergic reactions to mouse proteins and of antibody resistance. Although in its infancy, immunomodulation represents an exciting approach to the treatment of rheumatic disease. | |
| 2487715 | Family stress and coping in rheumatoid arthritis. | 1989 Dec | Stress and coping were examined in a sample of 30 rheumatoid arthritis (RA) patients and their 30 spouses. Two components of stress were measured: concerns and help needs. Results showed a significant agreement between patients and spouses on total concerns. The area of greatest concern for both groups was wondering about the future. The only help need that showed a significant difference between groups was diet and nutrition. Need for information about RA was the greatest need cited by both groups. Patients used significantly more coping strategies than spouses in dealing with RA-related stressors. Overall, cognitive restructuring was used most often by both groups. The study suggests that RA patients and spouses have similar concerns and help needs, and that while families may have lived with the RA for an extended period of time, health professionals should continuously assess concerns about the future and information needs in these families. The study results also suggest that spouses may need assistance in the use of effective coping strategies. | |
| 2800390 | [Errors in the evaluation of osteoarticular symptoms]. | 1989 Aug | The authors describe two patients with osteoarticular symptoms. In the first patient they were treated as rheumatic disease, and only after treatment had failed, a neoplastic aetiology was considered. In the second patient the authors considered the articular complaints from the beginning a paraneoplastic syndrome and only the subsequent course of the disease revealed that they were mistaken. It was rheumatoid arthritis with an atypical Caplan syndrome. | |
| 2756689 | [The prevention of chrysotherapy complications in patients with rheumatoid arthritis]. | 1989 Apr | To prevent side-effects of chrysotherapy for rheumatoid arthritis the authors recommend a treatment scheme under corticosteroid protection. The proposed method was used in 56 patients with rheumatoid arthritis. Side-effects manifested in allergic eruptions were noted in 3 patients (5.35%) while in the control group of 34 patients who were treated by chrysotherapy according to the routine method complications were observed in 9 patients (26.47%). | |
| 3578338 | Kaposi's sarcoma in rheumatoid arthritis. | 1987 May | Cutaneous Kaposi's sarcoma developed eight months after initiation of prednisone treatment in a 58-year-old man with systemic rheumatoid disease (rheumatoid arthritis, Felty's syndrome, rheumatoid vasculitis, and myositis). This patient did not have the acquired immune deficiency syndrome. Review of the literature suggests that the onset of his Kaposi's sarcoma may have been related to immunosuppressive therapy with corticosteroids. | |
| 2702836 | Methodology and overt and hidden bias in reports of 196 double-blind trials of nonsteroida | 1989 Mar | Important design aspects were decreasingly reported in NSAID trials over the years, whereas the quality of statistical analysis improved. In half of the trials, the effect variables in the methods and results sections were not the same, and the interpretation of the erythrocyte sedimentation rate in the reports seemed to depend on whether a significant difference was found. Statistically significant results appeared in 93 reports (47%). In 73 trials they favored only the new drug, and in 8 only the active control. All 39 trials with a significant difference in side effects favored the new drug. Choice of dose, multiple comparisons, wrong calculation, subgroup and within-groups analyses, wrong sampling units (in 63% of trials for effect variables, in 23% for side effects), change in measurement scale before analysis, baseline difference, and selective reporting of significant results were some of the verified or possible causes for the large proportion of results that favored the new drug. Doubtful or invalid statements were found in 76% of the conclusions or abstracts. Bias consistently favored the new drug in 81 trials, and the control in only one trial. It is not obvious how a reliable meta-analysis could be done in these trials. | |
| 1974834 | Lack of association between DQ A and DX A polymorphisms with rheumatoid arthritis and Felt | 1990 Mar | DQ A and DX A RFLPs were studied in DR4-positive rheumatoid arthritis, Felty's syndrome, and in DR4-positive control subjects, and in the light of the previously documented association between Felty's syndrome and the DQ B 3.1 allele (3b RFLP). In these DR4-positive subjects there were no preferential associations between DQ A or DX A polymorphisms and rheumatoid arthritis or Felty's syndrome and no evidence for unusual DQ A-B haplotypic associations in Felty's or rheumatoid subjects. | |
| 2323127 | Posterior interosseous nerve syndrome associated with rheumatoid synovial cysts of the elb | 1990 May | Three rheumatoid arthritis patients developed synovial cysts of the elbow joint and an acute compression neuropathy of the posterior interosseous nerve. All patients had weakness of the finger extensors; in one the extensor tendons were explored before the exact diagnosis was made. Intraarticular steroid injections were effective in one patient. In the other two patients surgical decompression of the radial nerve and elbow synovectomy with radial head resection were curative. Although relatively rare, the diagnosis of an antecubital cyst must be considered when complications such as a nerve compression syndrome are present. | |
| 1842119 | [Active rheumatoid arthritis: effect of dietary supplementation with omega-3 oils. A contr | 1991 Mar | We evaluated the effect of dietary supplementation with eicosapentaenoic acid in 8 patients with active rheumatoid arthritis. An appropriate placebo was given in a randomized double blind fashion to 8 control subjects. After 12 weeks of therapy a significant improvement in prehensile function was detected in patients receiving active treatment, other clinical parameters remaining unchanged. No significant side effects were detected. A larger trial may help define a possible therapeutic role for omega-3 fatty acids in patients with rheumatoid arthritis. | |
| 2789456 | [Hyaluronic acid and N-terminal procollagen-III-peptide in the urine in inflammatory and d | 1989 May | In a cross-sectional study of 130 patients (main diagnosis: rheumatoid arthritis, n = 41, osteoarthritis, n = 39; ankylosing spondylitis, n = 28) we measured the concentrations of hyaluronan (HA) and the N-terminal propeptide of type-III collagen (NP III P) in urine and evaluated the relationship with their serum levels. Increased HA levels in serum correlated with increased urinary excretion (r = 0.69 for patients with active rheumatoid arthritis). Only patients with rheumatoid arthritis showed significantly elevated HA concentrations in urine (mean = 1,493 micrograms/mmol creatinine). Because of relatively wide fluctuations in urinary HA in normals (mean = 944, standard deviation 818 micrograms/mmol creatinine) and only modest differences between groups, the diagnostic accuracy of urinary HA measurements is inferior to serum determinations. NP III P showed no significant differences between patients and controls (means 10.5 to 15 micrograms/mmol creatinine). Obviously, renal excretion is of minor importance in the metabolism of HA and NP III P. The possible diagnostic usefulness of determinations of these parameters in serum is not enhanced by measurements in urine. | |
| 3117157 | Acquired haemophilia and rheumatoid arthritis. | 1987 Oct | Four patients with classical rheumatoid arthritis who developed acquired haemophilia are described. They developed a spontaneous bleeding diathesis and diagnosis was based on low or absent Factor VIII levels and the presence of a circulating anticoagulant directed against Factor VIII. The course is variable and cyclophosphamide together with control of the underlying rheumatoid arthritis are recommended as treatment. | |
| 2800387 | [Long-term observation of patients with isolated seropositivity for rheumatoid factor in t | 1989 Aug | A group of 40 subjects (33 women and 7 men) assembled in the course of several years comprised clinical and ambulatory patients. The main characteristic of the group was isolated seropositivity of rheumatoid factors assessed by the latex fixation test with titres of 1:320 and more in apparently healthy subjects. The mean age of the subjects at the beginning of the investigation was 39 years. They were followed up for 2-18 years, on average for 7.8 years. Regular clinical, biochemical and immunological check-up examinations were made after 1-2 year intervals. The latex fixation test was made in a test tube. The most serious manifestation was the development of rheumatoid arthritis in 7 subjects (6 women and 1 man). In two of them it was preceded by palindromic rheumatism. Two women have abortive manifestations of systemic lupus erythematosus. Seven developed, mostly repeatedly, tendovaginitis in the region of the flexors of the fingers and abductors of the thumb. Seven subjects suffered from polyarthritis of the hands. None of the subjects suffered from cirrhosis or monoclonal gammapathy. In the course of the investigation the titres of rheumatoid factors had a declining trend even to negative values. In 23 they became negative or had titres of 1:40. The high incidence of rheumatoid arthritis in 17% apparently healthy subjects with isolated seropositivity of rheumatoid factors emphasizes the importance of dispensarization of these subjects in a rheumatological surgery and of careful long-term follow up. Early administration of line 2 antirheumatic drugs could prevent a possible fatal course of rheumatoid arthritis. | |
| 3330697 | Rheumatoid arthritis: inheritance and association with other autoimmune diseases. | 1986 Jun | This paper reviews the significance of the associations between rheumatoid arthritis (RA) and both diabetes mellitus and autoimmune thyroid disorders (ATD). All three disorders are thought to result from an interaction between genetic susceptibility and environmental factors. There is a probable real but not dramatic aggregation of insulin-dependent diabetes mellitus (IDDM) in the families of RA probands and a significant aggregation of ATD in both first- and second-degree relatives of RA probands. HLA-linked genes predispose to all three disorders while genes linked to Gm have been implicated in predisposition to RA and ATD. Within the HLA region two or more genes may predispose independently to RA; one of these genes is in linkage disequilibrium with HLA-DR4 and a second is in linkage disequilibrium with DR1 and 3. The familial aggregation of RA and IDDM is at least partially attributable to a single gene linked to HLA-DR4 predisposing to both disorders. By contrast, although 'DR4 negative RA' seems more frequent in sibships containing members with ATD, the familial aggregation of RA and ATD cannot be accounted for by a single gene linked to HLA predisposing to both disorders. Neither can this familial aggregation be accounted for by a single gene linked to Gm predisposing to RA and ATD so that any genetic predisposition common to both disorders is likely to involve at least a third locus which is still to be defined. A simple model with an interaction between at least three independent genetic loci and genetic heterogeneity is proposed to account for the known facts concerning the genetic susceptibility to RA. | |
| 1968293 | Heterogeneity of HLA-DR4 in Greeks including a unique DR4-DQw2 association. | 1990 Jan | It has been shown that Greek RA patients do not show an increased frequency of HLA-DR4 compared with Greek controls. As only the Dw4 and Dw14 subtypes of DR4 are implicated in RA, we have characterised DR4-positive Greek RA patients and controls using serology, MLC typing and RFLP analysis to see whether the distribution of DR4 subtypes or other HLA antigens associated with DR4 could account for these findings. In the 10 patients and 12 controls studied, Dw10 was common, being present in almost half the controls. Dw4 was not detected in the controls, but was present in three of the RA patients, indicating that there may be some relationship between Dw4 and RA in this population; Dw13 and Dw14 were also found, Dw15 was not detected. Eight of the subjects did not type as any of the HLA-D antigens mentioned. Three controls had unusual DR4-DQ associations, two having DR4-DQw2 and one possessing DR4-DQw4. Analysis of the TaqI DRB RFLP of the subjects showed that one control did not have the 6.1 kb band characteristic of DR4s. All these results indicate that DR4 is a heterogeneous antigen in this population and that several as yet undescribed variants of DR4 may be present. | |
| 2180405 | Low-dose methotrexate compared with auranofin in adult rheumatoid arthritis. A thirty-six- | 1990 Mar | Weekly treatment with low-dose oral methotrexate (MTX) was compared with daily auranofin (AUR) treatment in a 36-week double-blind, randomized, multicenter study of 281 patients with active, adult-onset rheumatoid arthritis. Both treatment groups showed significant improvement by the usual measures of clinical efficacy. The response with MTX occurred earlier and was consistently greater than that with AUR. An intent-to-treat analysis showed significantly greater improvement (P less than 0.01) with MTX for painful and swollen joint counts and physician and patient global assessments of disease activity. Adverse reactions were reported more frequently in the AUR group, and more AUR-treated patients were withdrawn from the study because of toxicity. MTX was thus more effective and better tolerated than AUR in this study. |