Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 35187113 | Effect of Anti-Rheumatic Drugs on Cardiovascular Disease Events in Rheumatoid Arthritis. | 2021 | Rheumatoid arthritis (RA) is an autoimmune disease characterized by erosive arthritis, which can involve multiple systems. Patients with RA may have a variety of comorbidities, including cardiovascular disease (CVD), lung cancer, lymphoma, infection, osteoporosis, fatigue, depression, colon cancer, breast cancer, prostate cancer, and Alzheimer's disease. Among these comorbidities, the incidence of CVD, lung cancer, lymphoma, infection, and osteoporosis is higher. CVD is a serious complication of RA. The risk of CVD and associated mortality rate in patients with RA is high, and the treatment rate is low. In addition to traditional risk factors, such as age, sex, blood pressure, and diabetes, RA is also associated with inflammation. Furthermore, therapeutic drugs for RA, including non-steroidal anti-inflammatory drugs, glucocorticoids, and disease-modifying anti-rheumatic drugs, have beneficial or harmful effects on cardiovascular events in patients with RA. This article discusses the effects of therapeutic drugs for RA on cardiovascular events. | |
| 35308233 | Tofacitinib Decreases Autophagy of Fibroblast-Like Synoviocytes From Rheumatoid Arthritis | 2022 | The pathway of Janus tyrosine kinases (JAKs) has a central role in the pathogenesis of Rheumatoid Arthritis (RA) by regulating multiple immune functions and cytokine production. The JAK inhibitor tofacitinib is effective in RA patients not responding to methotrexate or TNF-inhibitors. Since hyperactive autophagy has been associated with impaired apoptosis of RA fibroblast-like synoviocytes (FLS), we aimed to investigate the role of tofacitinib in modulating autophagy and apoptosis in these cells. FLS isolated from RA biopsies were cultured with tofacitinib in presence of autophagy inducer rapamycin and in serum deprivation condition. Levels of autophagy, apoptosis, and citrullinated proteins were analyzed by western blot, flow cytometry, immunocytofluorescence, and Real-Time PCR. Rapamycin induced an increase in RA-FLS autophagy while the levels of autophagy marker LC3-II were reduced after in vitro treatment with tofacitinib. The analysis of autophagic flux by specific fluorescence dye confirmed the reduction of autophagy in RA FLS. The treatment with tofacitinib did not influence apoptosis of RA FLS. Modulation of the autophagic process by tofacitinib did not significantly change citrullination. The results of this study demonstrate that tofacitinib is able to modulate autophagy of FLS contributing to its effectiveness in RA patients. | |
| 35152867 | Rheumatologic Manifestations of Post SARS-CoV-2 Infection: A Case Series. | 2022 Feb 11 | BACKGROUND: It has been over a year since the first documented case of the COVID-19 virus was recorded. Since that time, our understanding of this virus has continually evolved, however, its wide-ranging effects are still unfolding. Similar to previously studied viral infections, severe acute respiratory syndrome-associated coronavirus-2 (SARS-CoV-2) has been shown to lead to a degree of autoimmunity in patients who are recovering from its effects. Due to its effects on the innate immune system such as the toll-like receptors and complement system, a varying degree of pro-inflammatory markers can become widespread in those who continue to recover from the virus. This case series offers a unique perspective on how COVID-19 has had dramatic effects on those already suffering from inflammatory rheumatic conditions such as rheumatoid arthritis, systemic lupus erythematosus, or fibromyalgia. As the ever-lasting effects of COVID-19 are still unfolding, this case series is one of few to discuss the development and changes of patients with rheumatic conditions. This study hopes to encourage larger studies to be done on the effects of COVID-19 on autoimmune conditions. CASE PRESENTATION: Seven patients were identified with new manifestations of rheumatic conditions, which included 3 cases of rheumatoid arthritis, 2 cases of polymyalgia rheumatica, 1 case of reactive arthritis, and 1 case of cutaneous lupus. Post-COVID syndrome was also diagnosed in 7 other patients. Rheumatoid arthritis patients presented with symptoms 4-5 weeks after being diagnosed with COVID-19. Symptoms of polyarticular joint pain, swelling, and morning stiffness were reported in this group. These patients were treated with disease-modifying anti-rheumatic drugs and experienced an improvement of symptoms on follow up. Two cases of Polymyalgia Rheumatica were identified in patients that were previously diagnosed with COVID-19 six weeks prior. One patient had no significant past medical history and the other patient had a history of Rheumatoid Arthritis, which was well controlled. These patients experienced weakness and tenderness in the proximal joints with elevated levels of ESR and CRP. They were treated with prednisone and showed improvement. Reactive Arthritis was diagnosed in 1 patient who presented with swelling in both hands and wrists 1-2 after being diagnosed with COVID-19. This patient began to experience symptoms of Reactive Arthritis 1-2 days after resolution of initial COVID-19 symptoms and this persisted for 3 months. Patient was managed with methylprednisolone injections and NSAIDs, which improved her symptoms. Post-COVID syndrome was identified in 7 patients. All patients were female and had a history of well controlled fibromyalgia. Patients generally experienced fatigue, headaches, and memory fog, which had variable onset from a few days and up to 4 weeks after being diagnosed with COVID-19. One patient had a complete recovery of her symptoms at follow-up 3 months after the initial presentation. The other 6 patients continued to report symptoms of Post-COVID syndrome at follow up. Patients were managed with lifestyle modifications and their previous fibromyalgia treatment. CONCLUSION: While cases of COVID-19 continue to rise, complications of this disease are still being discovered. Those who initially recover from COVID-19 may experience new onset rheumatic conditions, worsening of previously diagnosed rheumatic conditions, or Post-COVID Syndrome. As we continue to learn more about the effects of COVID-19, the awareness of these manifestations will play a key role in the appropriate management of these patients. | |
| 35366780 | The Relationship Between FoxP3 and SOCs3 Gene Expressions and Disease Activity in Rheumato | 2022 Apr 1 | BACKGROUND: Immune dysregulation plays an important role in the pathogenesis of rheumatoid arthritis (RA). The CD4+CD25 high FoxP3+ subset of regulatory T cells plays an essential role in preventing autoimmunity and maintaining immune homeostasis. Negative regulation of JAK/STAT signaling is controlled by Suppressor of Cytokine Signaling (SOCs3) proteins. SOCs is produced at lower levels in RA. Our aim was to evaluate the expressional dysregulation of SOCs3 and FoxP3 genes in RA patients in relation to disease activity. SUBJECTS AND METHODS: We have recruited 90 patients with RA and 60 healthy controls in case control study. Whole blood samples were collected from RA patients and healthy subjects. The measurement of FoxP3 and SOCs3 gene expression was performed by real-time PCR (qPCR). RESULTS: Patients with RA had significant decreased expression levels of FoxP3 and SOCs3 genes in comparison with controls (P<0.001) in addition to the insignificance correlation of both genes with disease activity in RA patients. CONCLUSION: FoxP3 and SOCs3 genes showed a significant defects in rheumatoid arthritis patients with no significant difference in disease activity. | |
| 35611105 | Rheumatoid Arthritis Co-relation with Anti-CCP Antibodies with special reference to its Pr | 2022 Mar | OBJECTIVES: Rheumatoid Arthritis (RA) is a chronic inflammatory autoimmune disease. First-degree relatives (FDR) of patients with RA sharing genetic and environmental risk factors for RA may represent a pre-RA state. This study showed the clinical co-relation of RA with Anti-Cyclic citrullinated peptide (anti-CCP) antibody and prevalence of sero-positive anti-CCP antibody in asymptomatic first-degree relatives (AFDR) of rheumatoid arthritis patients. METHODS: Total 85 RA patients, 105 AFDR, and 105 healthy controls who belonged to the same geographical area having no family history of autoimmune diseases were enrolled in this cross-sectional study. RA patients were clinically examined, and DAS-28 was calculated. Anti-CCP was sent for RA patients, AFDR, and control group. Appropriate statistical tools were applied to find if any significant co-relation exists. RESULTS: DAS 28 co-related significantly with anti-CCP positivity (p≤0.01) but not with Rheumatoid Factor (RF). No significant co-relation was observed between anti-CCP and extra-articular manifestation (EAM) (p≥0.05). Seropositivity for anti-CCP antibody was detected in 22/105 (20.9%) AFDR and in 13/105 (12.3%) control group respectively. Anti-CCP antibody seropositivity was more prevalent in AFDR than in control group but the difference was not statistically significant (p = 0.1378). CONCLUSIONS: Anti-CCP should be preferred over RF as it correlated well with disease activity, but it does not guide well for the EAM. The higher sero-prevalence of Anti-CCP in AFDR may lead to higher risk of development of RA in near future. Thus, all AFDR should be screened so that we may follow up the positive cases for early detection and treatment of RA. | |
| 35525528 | Investigation of the mechanism of Isobavachalcone in treating rheumatoid arthritis through | 2022 Aug 10 | ETHNOPHARMACOLOGY RELEVANCE: Isobavachalcone (IBC) is a natural chalcone compound widely distributed in traditional Chinese medicine Psoralea corylifolia L., and Tibetan medicine Abelmoschus manihot (L.) Medik. Etc.. Among them, Psoralea corylifolia has the effect of tonifying the kidney and strengthening Yang, and it is recorded in the Medicinal theory that it can be used in managing rheumatism and arthralgia. In addition, It has been included in many prescriptions in traditional Chinese medicine as the main herb for managing rheumatoid arthritis (RA). Similarly, Abelmoschus manihot is a common Tibetan medicinal herb and is a common medicinal material in Tibetan medicine and reported in ancient medicinal books such as Jing Zhu Ben Cao and Si Bu Yi Dian to possess the effect of Ganhuangshui and thus can be used in treating Huangshui diseases (such as RA). Previous research has demonstrated IBC to possess numerous biological activities, including anti-cancer, anti-inflammatory, antibacterial and immunomodulatory. Nevertheless, its efficacy and potential mechanism in treating rheumatoid arthritis are yet to be investigated. AIM OF THE STUDY: This study aimed at investigating the therapeutic efficacy and mechanism of IBC in treating RA through a combined strategy of network pharmacology, in vitro, and in vivo evaluation. MATERIALS AND METHODS: The Swiss Target Prediction and GeneCards databases were consulted to predict the potential targets of IBC and RA. Additionally, the potential targets for IBC in treating RA were predicted by consulting databases such as String, Cytoscape, MCODE, and Cytohubba. R software was utilized for enrichment analysis of GO and KEGG pathways, followed by in vitro experimentation using cell lines and in vivo experimentation using animals to explore the potential mechanism of IBC in RA treatment. RESULTS: By integrating the results of network pharmacological analysis, 17 genes were found to be strongly associated with RA, such as TNF, MAPK13, EGFR, PTGS2, MMP3, etc. The enrichment analysis indicated that IBC possessed tremendous therapeutic efficacy in managing RA through PI3K-AKT, rheumatoid arthritis, and TNF signaling pathways. The in vitro experimentation indicated that IBC inhibited the proliferation, migration, and invasion, and promoted apoptosis and inhibition of inflammation of MH7A cell lines stimulated with TNF-α. The IBC might also have an increasing effect on the intracellular ROS and reducing effect on the mitochondrial membrane potential. The western blotting results indicated that IBC markedly inhibited the expression of p-PI3K, p-AKT, p-JAK1, p-STAT3 and SOCS3 proteins in TNF-α stimulated MH7A cells. Furthermore, we found that IBC also significantly reduced paw swelling and arthritis severity in CIA model rats through in vivo animal studies. CONCLUSIONS: In short, this study explored the effect of IBC by combining network pharmacology prediction with in vitro and in vivo experimentation. The results indicated that IBC exerts its anti-rheumatoid arthritis effect by regulating cell proliferation and survival via PI3K/AKT and JAK/STAT signaling pathways. This may open a new horizon and provide a theoretical foundation for further development and utilization of IBC in RA management. | |
| 35598398 | Gentiopicroside attenuates collagen-induced arthritis in mice via modulating the CD147/p38 | 2022 May 19 | Gentiopicroside (GEN) is a secoiridoid glycosides isolated from a traditional Chinese medicine Gentiana macrophylla Pall.. It exhibits potential activities in the treatment of inflammatory diseases. Here, we investigated whether GEN had the anti-rheumatoid arthritic activities in a model of rheumatoid arthritis, and explored its molecular mechanism. In vivo, the male C57BL/6J mice were injected chicken type II collagen to induce the animal model (collagen-induced arthritis, CIA). In vitro, we performed the research in rheumatoid fibroblast-like synoviocytes (FLS). In our study, it was innovatively authenticated that GEN treatment could not only reduce synovitis and inhibit the proliferation of RA FLS, but also relieve cartilage damage in CIA modal. More importantly, we firstly demonstrated that GEN treatment lessened the pain behaviors of CIA mice. In vivo and in vitro experiments confirmed that CD147 was the main target of GEN in attenuating RA symptoms for the first time. Next, we identified the downstream signaling pathway of CD147, and proved that the anti-RA effects of GEN were mediated by down-regulating the expression of p38, IκBα and p65 in vivo and in vitro assays. In conclusion, the data of this manuscript suggested that GEN treatment attenuated synovitis and cartilage destruction in CIA mice; the inhibitory effects on MMP secretion and the anti-rheumatic effects of GEN might be regulated by the CD147/p38/ NF-κB pathway. Accordingly, we found that GEN has the potential therapeutic effects for RA. | |
| 35418478 | Deletion of activin A in mesenchymal but not myeloid cells ameliorates disease severity in | 2022 Apr 13 | OBJECTIVE: The aim of this study was to assess the extent and the mechanism by which activin A contributes to progressive joint destruction in experimental arthritis and which activin A-expressing cell type is important for disease progression. METHODS: Levels of activin A in synovial tissues were evaluated by immunohistochemistry, cell-specific expression and secretion by PCR and ELISA, respectively. Osteoclast (OC) formation was assessed by tartrat-resistant acid phosphatase (TRAP) staining and activity by resorption assay. Quantitative assessment of joint inflammation and bone destruction was performed by histological and micro-CT analysis. Immunoblotting was applied for evaluation of signalling pathways. RESULTS: In this study, we demonstrate that fibroblast-like synoviocytes (FLS) are the main producers of activin A in arthritic joints. Most significantly, we show for the first time that deficiency of activin A in arthritic FLS (ActβA(d/d) ColVI-Cre) but not in myeloid cells (ActβA(d/d) LysM-Cre) reduces OC development in vitro, indicating that activin A promotes osteoclastogenesis in a paracrine manner. Mechanistically, activin A enhanced OC formation and activity by promoting the interaction of activated Smad2 with NFATc1, the key transcription factor of osteoclastogenesis. Consistently, ActβA(d/d) LysM-Cre hTNFtg mice did not show reduced disease severity, whereas deficiency of activin A in ColVI-Cre-expressing cells such as FLS highly diminished joint destruction reflected by less inflammation and less bone destruction. CONCLUSIONS: The results highly suggest that FLS-derived activin A plays a crucial paracrine role in inflammatory joint destruction and may be a promising target for treating inflammatory disorders associated with OC formation and bone destruction like rheumatoid arthritis. | |
| 35628831 | Cardiovascular Disease Risk in Rheumatoid Arthritis Anno 2022. | 2022 May 11 | The risk for developing cardiovascular diseases (CVD) in rheumatoid arthritis (RA) patients is 1.5 times higher compared to the general population. This risk is partly due to the contribution of systemic inflammation in increased atherogenesis, while an increased prevalence of "traditional" cardiovascular risk factors, such as hypertension and dyslipidemia, is also attributed to nearly 50% of the total CVD risk. Most anti-rheumatic medication partly reduces this CVD risk, primarily by reducing inflammation. The increased risk is recognized by most guidelines, which advise consequent screening and multiplying calculated risk scores by 1.5. However, screening in daily clinical practice is poorly done, and RA patients often have undiagnosed and untreated risk factors. In conclusion, even nowadays, RA patients still have an increased risk of developing CVD. Advances in anti-inflammatory treatment partly mitigate this risk, but RA patients need mandatory screening for CV risk factors to turn their CVD risk towards that of the general population. | |
| 35371839 | Acute Pneumocystis jirovecii Pneumonia Due to Absolute Lymphopenia. | 2022 Mar | Pneumocystis pneumonia (PCP) is an opportunistic fungal infection associated with human immunodeficiency virus (HIV) infection as an acquired immunodeficiency syndrome (AIDS)-defining illness. The PCP incidence in patients with HIV has declined over the last few decades due to effective antiretroviral therapy and prophylaxis. The PCP incidence in HIV-negative patients has increased due to the increasing use of a wide array of immunosuppressants in cancer and autoimmune disease. PCP clinical course varies from patients with HIV in their clinical features, the severity of clinical presentation, and mortality. PCP in autoimmune diseases is rare, especially in rheumatoid arthritis (RA) in the United States of America (USA). Here, we describe an elderly Caucasian female with rheumatoid arthritis and left lung mucinous adenocarcinoma status post recent resection with no chemotherapy on a low dose of methotrexate (MTX) and prednisone presenting with acute hypoxic respiratory failure due to PCP from absolute lymphopenia. | |
| 30285402 | Viral Arthritis. | 2022 Jan | Acute-onset polyarticular arthritis is the most common presentation of viral arthritis. The most common viruses causing arthritis and/or arthralgias are parvovirus, the alphaviruses, hepatitis B, hepatitis C, Epstein-Barr virus (EBV), and tropical viruses, such as Zika and chikungunya (CHIKV). The diagnosis can be difficult to confirm but should be considered in all patients presenting with acute-onset polyarticular symptoms. Although viruses cause only a small proportion of all cases of acute arthritis, differentiation of virally mediated arthritis from primary rheumatological disease is important. Low-titer autoantibodies, such as rheumatoid factor and antinuclear antibody, can occur in the context of acute viral arthritis. Overall, viral arthritis is milder than osteoarthritis or rheumatoid arthritis. Most patients respond to NSAIDs, and antiviral treatment is rarely needed. | |
| 35357421 | Effectiveness of sequential biologic and targeted disease modifying anti-rheumatic drugs f | 2022 Mar 31 | OBJECTIVES: Whether patients with rheumatoid arthritis (RA) benefit from repeated trials of biologic or targeted synthetic DMARDs (b/tsDMARDs) after three or more attempts is unknown. We aimed to describe treatment outcomes in each line of b/tsDMARD therapy. METHODS: Using data from the British Society for Rheumatology Biologics Register for RA from 2001 to 2020, change to a new b/tsDMARD (except biosimilar switches) was defined as a new line of therapy. Treatment outcomes were compared across lines of therapy, including DAS28 remission (≤2.6), low disease activity (LDA, ≤3.2) at 6 months, and median time to drug discontinuation. Multiple imputation was used for missing data. RESULTS: 22 934 individuals starting a first b/tsDMARD were included (mean age 56 years, 76% female), among whom 10 823 commenced a second-line drug, 5,056 third, 2,128 fourth, 767 fifth and 292 sixth. Most (71%) had sufficient data for DAS28-derived outcome analyses. TNF inhibitors were the commonest first-line drug, but choice of subsequent-line drugs changed over time. Seventeen percent achieved DAS28 remission following first-line, 13% second and 8% to13% with third through sixth. LDA was achieved in 29% of first-line, 23% second, 17-22% through to the sixth. Patients stayed on first-line therapy for a median of 2.6 years, ranging from 1.0-1.4 years for lines two to six. CONCLUSION: Many patients will eventually benefit after repeated trials of b/tsDMARD. Further research to improve treatment selection are needed to prevent prolonged trial and error approaches in some patients. | |
| 35543293 | A review of the totality of evidence in the development of ABP 798, a rituximab biosimilar | 2022 May 11 | ABP 798 (RIABNIâ„¢) is a biosimilar to rituximab reference product (RP), a monoclonal antibody that targets CD20. Approval of ABP 798 was based on the totality of evidence generated using a stepwise approach which began by showing that it is structurally and functionally similar to rituximab RP. This analytical assessment was followed by a demonstration of pharmacokinetic/pharmacodynamic similarity in patients with rheumatoid arthritis. Comparative clinical efficacy and safety of ABP 798 with rituximab RP was demonstrated as a final step in patients with non-Hodgkin lymphoma and in those with rheumatoid arthritis. Overall, the totality of evidence supported the conclusion that ABP 798 is highly similar to rituximab RP and provided scientific justification for extrapolation to other approved indications of rituximab RP. | |
| 35356392 | Tocilizumab-Associated Small Bowel Perforation in a Young Patient With Rheumatoid Arthriti | 2022 Mar | Tocilizumab is a recombinant humanized monoclonal antibody directed against the interleukin-6 (IL-6) receptor, which has been used for the treatment of rheumatoid arthritis (RA). A range of side effects have been associated with tocilizumab, with gastrointestinal perforation (GIP) being described as a rare but potentially life-threatening complication that deserves considerable attention. The authors report a case of a young male patient with a history of challenging RA who encountered a lower GIP that was associated with tocilizumab therapy. The occurrence of tocilizumab-induced GIP in this reported patient had initially posed a diagnostic dilemma, as its clinical presentation mimicked other autoimmune inflammatory and infectious diseases that are commonly associated with RA. Physicians should be aware of GIPs as a serious adverse event of tocilizumab use despite being a rare phenomenon, particularly in the era of the global pandemic of coronavirus disease 2019 (COVID-19), when this novel drug has been authorized for the management of selected patients with severe COVID-19 infection. Therefore, early recognition and timely management of GIPs would minimize potential morbidities associated with critically ill COVID-19 patients. | |
| 35646974 | Interstitial Lung Disease in Rheumatoid Arthritis: A Practical Review. | 2022 | Rheumatoid arthritis (RA) is a systemic inflammatory disease, which primarily causes symmetric polyarthritis. An extrarticolar involvement is common, and the commonly involved organ is lungs. Although cardiac disease is responsible for most RA-related deaths, pulmonary disease is also a major contributor, accounting for ~10-20% of all mortality. Pulmonary disease is a common (60-80% of patients with RA) extra-articular complication of RA. Optimal screening, diagnostic, and treatment strategies of pulmonary disease remain uncertain, which have been the focus of an ongoing investigation. Clinicians should regularly assess patients with RA for the signs and symptoms of pulmonary disease and, reciprocally, consider RA and other connective tissue diseases when evaluating a patient with pulmonary disease of an unknown etiology. RA directly affects all anatomic compartments of the thorax, including the lung parenchyma, large and small airways, pleura, and less commonly vessels. In addition, pulmonary infection and drug-induced lung disease associated with immunosuppressive agents used for the treatment of RA may occur. | |
| 35416963 | In rheumatoid arthritis patients, total IgA1 and IgA2 levels are elevated: Implications fo | 2022 Apr 13 | OBJECTIVE: Mucosal initiated immune responses may be involved in the pathophysiology of rheumatoid arthritis (RA). The most abundant immunoglobulin at mucosal surfaces is IgA, of which two subclasses exist: IgA1 and IgA2. IgA2 is mainly present at mucosal sites and has been ascribed pro-inflammatory properties. As IgA subclasses might provide insights into mucosal involvement and pro-inflammatory mechanisms, we investigated IgA responses in sera of RA patients. METHODS: In two cohorts of RA patients, the EAC and IMPROVED, total IgA1 and IgA2 were measured by ELISA. Furthermore, IgA subclass levels of rheumatoid factor (RF) and anti-citrullinated protein antibodies (anti-CCP2) were determined. The association of these IgA subclass levels with CRP and smoking was investigated. RESULTS: Total IgA1 and IgA2 were increased in RA patients compared with healthy donors in both cohorts. This increase was more pronounced in seropositive RA vs seronegative RA. For RF and anti-CCP2, both IgA1 and IgA2 could be detected. No strong associations were found between IgA subclasses (total, RF and anti-CCP2) and CRP. In smoking RA patients, a trend towards a selective increase in total IgA2 and RF IgA1 and IgA2 was observed. CONCLUSION: RA patients have raised IgA1 and IgA2 levels. No shift towards IgA2 was observed, indicating that the increase in total IgA is not due to translocation of mucosal IgA into the bloodstream. However, mucosal inflammation might play are role, given the association between smoking and total IgA2 levels. Despite its pro-inflammatory properties, IgA2 does not associate strongly with pro-inflammatory markers in RA patients. | |
| 35156345 | [Refractory pneumonia : when evoke an Adult-Onset Still's Disease ? Case report and revi | 2022 Feb 9 | Adult-Onset Still's Disease (AOSD) is an inflammatory systemic disease, including fever, arthralgia and rash. The disease can also cause organic involvement, and lead to serious complications. We report the case of a patient who presented a pulmonary form of AOSD, initially diagnosed and treated as pneumonia. Marked hyperferritinemia oriented us to the right diagnosis. In this article, we proceed to a review of literature to look for a better comprehension of physiopathology of pulmonary involvement in AOSD, and to withhold some practical advice in the diagnostic procedure. | |
| 35356811 | High prevalence of undiagnosed impaired glucose tolerance in patients with rheumatoid arth | 2022 | OBJECTIVES: Although the risk of diabetes mellitus has been recognised in rheumatoid arthritis, undiagnosed dysglycaemia remained under-reported. The study aimed to determine the prevalence and associated factors of dysglycaemia among patients with rheumatoid arthritis, utilising the oral glucose tolerance test. METHODS: This cross-sectional study involved patients with rheumatoid arthritis, aged ⩾30 years. Following an oral glucose tolerance test, they were divided into two: dysglycaemia and normoglycaemia. Demographic and laboratory parameters were compared using logistic regression analyses. RESULTS: There were 35.5% (55/155) patients with dysglycaemia (including 25.8% impaired glucose tolerance, 7.1% diabetes mellitus and 1.9% with both impaired fasting glucose and impaired glucose tolerance). Patients with dysglycaemia were heavier (65.5 ± 12.3 versus 60.7 ± 10.6 kg, p = 0.01), had wider waist (89.0 ± 12.5 versus 83.1 ± 9.6 cm, p < 0.01), lower high-density lipoprotein cholesterol (1.4 ± 0.3 versus 1.5 ± 0.4 mmol/L, p = 0.02), higher triglyceride (1.3 (0.9-1.8) versus 0.9 (0.8-1.2) mmol/L, p < 0.01) and intercellular adhesion molecule-1 (361.79 (290.38-481.84) versus 315.92 (251.45-407.93) ng/mL, p = 0.01). History of smoking (odds ratio: 5.70, confidence interval: 1.27-25.7), elevated triglyceride (odds ratio: 2.87, confidence interval: 1.33-6.22) and intercellular adhesion molecule-1 (odds ratio: 1.003, confidence interval: 1.001-1.006) were significantly associated with dysglycaemia. CONCLUSIONS: Prevalence of undiagnosed dysglycaemia, particularly impaired glucose tolerance, was high in these patients with rheumatoid arthritis, using a 75-g oral glucose tolerance test, which was not associated with disease activity or corticosteroid use. Those with high triglyceride, history of smoking and elevated intercellular adhesion molecule-1 were the two significant predictors for dysglycaemia in our patients with rheumatoid arthritis. Oral glucose tolerance test could be an important laboratory investigation for dysglycaemia in these high-risk patients. | |
| 35123568 | Effectiveness and safety of aerobic exercise for rheumatoid arthritis: a systematic review | 2022 Feb 5 | BACKGROUND: Rheumatoid arthritis (RA) can cause severe physical impairment and a reduced quality of life, and there is limited evidence for any effective intervention. Aerobic exercise may be beneficial for improving symptoms. Therefore, the purpose of this meta-analysis was to evaluate the effectiveness and safety of aerobic exercise for rheumatoid arthritis patients. METHODS: PubMed, The Cochrane Library, Web of Science, EMBASE, CNKI, WanFang Data and VIP databases were searched. Randomized controlled trials of the effectiveness and safety of aerobic exercise for rheumatoid arthritis were included. Risks of bias were assessed by two independent reviewers using the methods described in the RevMan 5.3, GRADEpro and the Cochrane Handbook. Meta-analyses were performed to investigate the effects of aerobic exercise on rheumatoid arthritis. RESULTS: A total of 13 RCTs were included, including 967 rheumatoid arthritis patients. The Meta-analysis results showed that aerobic exercise can improve functional ability [MD = - 0.25, 95% CI (- 0.38, - 0.11), P = 0.0002], relieve pain [SMD = - 0.46, 95% CI (- 0.90, - 0.01), P = 0.04], increase aerobic capacity [MD = 2.41, 95% CI (1.36, 3.45), P < 0.00001] and improve the Sit to Stand test score[MD = 1.60, 95% CI (0.07, 3.13), P = 0.04] with statistically significant differences. CONCLUSION: Generally, aerobic exercise is beneficial and safe for RA patients and has a certain alleviating effect on the disease, such as functional ability improvement, pain relief and aerobic capacity increase. Limited by the quantity and quality of the included studies, future research with higher-quality studies needs to be conducted to verify the above conclusions. TRIAL REGISTRATION: PROPERO registration number: CRD42021242953. | |
| 35438290 | Adult Onset Still's Disease. | 2022 Mar | Adult onset Still's disease (AOSD) is a rare systemic inflammatory disorder of unknown aetiology, characterised by daily spiking high fevers accompanied by rash, arthritis, and systemic manifestations. There are no specific diagnostic tests for AOSD. To establish the diagnosis of AOSD one should require the fulfilment of proposed major and minor criteria as well as exclusion of other diseases. This report described a 35-year-old female who was presented with fever, pruritus, arthritis, sore throat, leukocytosis and hyperferritinemia. She was diagnosed to have AOSD based on Yamuguchi et al.5 criteria after the exclusion of other possible conditions. |