Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1746015 | Serum level of interferon-gamma in autoimmune diseases. | 1991 Aug | Interferon-gamma is one of the cytokines which have various immunoregulatory functions. In the present study, the serum interferon-gamma level was determined in autoimmune diseases. It was increased in the active cases of systemic lupus erythematosus (SLE) and mixed connective tissue disease (MCTD). Since there was a positive correlation between the serum interferon-gamma level and the rate of peripheral mononuclear cells positive for HLA-DR antigen in systemic lupus erythematosus, circulating interferon-gamma might have a biological functions as suggested by many in vitro studies. In rheumatoid arthritis and Sjögren's syndrome, there was no correlation between the serum interferon-gamma level and the clinical findings. These data suggest that interferon-gamma might be associated with the pathogenesis of autoimmune diseases such as SLE and MCTD, and it can be one of the indices for their disease activity. | |
| 3464211 | Psychologic studies in fibrositis. | 1986 Sep 29 | During the past five years, there have been a number of controlled reports regarding the possible association of fibrositis with psychologic disorders. The results of these studies are quite different, which is not surprising in view of the differences in patient populations and study instruments used. We gave the Diagnostic Interview Schedule to 82 patients with fibrositis and to control subjects, and we found an association of depression with fibrositis. Depression was also more common in first-degree relatives of patients with fibrositis. However, in most instances, the depression antedated fibrositis by more than one year, indicating a possible psychobiologic association, rather than a casual one. | |
| 2340048 | Epidemiology of alpha 1-protease inhibitor deficiency. | 1990 Mar | Alpha 1-protease inhibitor can exist as over seventy different biochemical variants (the Pi system) which are inherited as autosomal codominant alleles. The majority of these variants are of no clinical significance. Epidemiologically, the most abundant are Pi types M, S and Z. Homozygotes of type Z have only 10 to 20% of the normal serum concentration of the inhibitor and have an increased risk of developing pulmonary emphysema. Cigarette smoking is the most important risk factor. A minority of Pi Z homozygotes (10 to 20%) develop a form of neonatal hepatitis and a proportion of these suffer from cirrhosis in adult life. Heterozygotes of Pi type SZ have about one third of the normal serum alpha 1-protease inhibitor concentration but this phenotype does not in itself appear to be a significant emphysema risk factor. Heterozygotes of Pi type MZ are thought to have a moderately increased risk of developing emphysema but only if they smoke; there is also evidence for an increased risk of cirrhosis among subjects of type MZ. No excessive risk appears to be attached to the MS phenotype. Cumulative survival curves have suggested that type Z homozygotes have a poor prognosis but such estimates are based on clinic or hospital patients who already have respiratory symptoms. Calculations based on population frequencies however, suggest that about 90% of the total number of type Z subjects are not accounted for in such surveys. Their whereabouts remains unclear at present; some will undoubtedly have died of liver or lung disease but it is possible that the majority escape and live undetected among the general population. | |
| 1747138 | Synovial fluid levels of complement SC5b-9 and fragment Bb are elevated in patients with r | 1991 Dec | To determine whether complement turnover in synovial fluids of patients with rheumatoid arthritis (RA) reflects activation by the classical or alternative pathway, we used novel immunoassays to measure products of complement activation (the membrane attack complex SC5b-9 and the cleavage fragments Bb and C4d). Mean synovial fluid levels of SC5b-9 were more than 8 times higher in RA than in crystal-induced arthritis (gout and pseudogout) and over 16 times higher than in degenerative joint disease (DJD). Similarly, Bb levels were more than 3 times higher in RA synovial fluids than in crystal-induced arthritis and over 7 times higher than in DJD. Levels of C4d did not differ among the groups. SC5b-9 levels correlated with synovial fluid C3 anaphylatoxin (C3a), Bb, and C4d levels (r = 0.81, 0.62, and 0.51, respectively). In patients with RA, synovial fluid SC5b-9 levels correlated with C3a and Bb (r = 0.6 and 0.56, respectively) but not with C4d. Therefore, novel assays for complement activation indicate that both classical and alternative pathways are involved in complement turnover and that the alternative pathway contributes more to complement activation in RA than in DJD or crystal-induced arthritis. | |
| 2283104 | [Carpal instability and secondary degenerative changes in lesions of the radio-carpal liga | 1990 Nov | Rotational subluxation of the scaphoid (RSS) and ulnar translocation of the carpus (UT) result from distinct lesions of the radiocarpal ligament complex. Trauma, rheumatoid arthritis, calcium pyrophosphate dihydrate crystal deposition (CPDD) and neurologic disease can lead to this ligament defect. The radiological features are identical despite different etiologies of the ligament failure. The secondary degenerative changes in RSS develop in three stages: starting with osteoarthritis at the styloid process, then progression of the degeneration into the mid-carpal joint from central towards ulnar. This mechanism is identical in posttraumatic, inflammatory, neurogenic or CPDD related instability. In cases with rheumatoid arthritis related instability, RSS and UT can be found simultaneously. The knowledge of these radiological features can be helpful in clarifying reasons for carpal changes and in determining the time of onset of the primary ligament failure. | |
| 2358816 | A functional and radiographic analysis of the total condylar knee arthroplasty. | 1990 Jun | Twenty-one knees in 14 patients were studied during walking, in clinical follow-up, and radiographically. The purpose was to examine the relationship between dynamic loading at the knee joint during level walking in the early postoperative period (1-2 years) and longer-term (4 years) prosthetic performance. Joint kinematics and kinetics were measured while patients were walking in the laboratory. The results were compared with an age-matched control group of healthy normal subjects. Patients were analyzed when grouped according to original diagnoses of rheumatoid or osteoarthritis. After total knee arthroplasty, patients with rheumatoid arthritis walked with a significantly lower magnitude peak adduction moment (force tending to thrust the knee into varus) about the knee than patients with osteoarthritis. The osteoarthritic group had an increased varus axial alignment when compared to the rheumatoid group. There was a strong correlation between postoperative varus alignment and the magnitude of the adduction moment. These results suggest that dynamic loading at the knee is greatly affected by static alignment of the joints in patients with total knee arthroplasty. In spite of the lower adduction moment during level walking and its associated effects on lower compressive loads at the knee, the patients with rheumatoid arthritis had a significantly higher radiolucency index. Thus, it appears that quality of bone stock may be a more important factor in determining prosthetic loosening than dynamic loading at the knee joint following total knee arthroplasty. | |
| 3572934 | Comparative toxicity of total lymphoid irradiation and immunosuppressive drug treated pati | 1987 Feb | Outcomes were compared between consecutive patients who had received either total lymphoid irradiation (TLI) or immunosuppressant treatment for intractable rheumatoid arthritis (RA). There were 33 TLI and 32 immunosuppressive recipients; all patients had failed standard therapy. Average followup from the start of therapy was 2.7 years for TLI and 5.9 years for immunosuppressive recipients. Final disability levels were the same in both groups; mortality was equal in both groups as well. There were more hospitalizations for infections in the TLI group and the infecting organisms tended to be staphylococcus or gram negative organisms. Apart from infections, there were more adverse effects reported in the immunosuppressive therapy group. | |
| 3503540 | Abnormal calcium metabolism caused by increased circulating 1,25-dihydroxyvitamin D in a p | 1986 Apr | A 35-year-old white male with rheumatoid arthritis who had developed hypercalcemia, hypercalciuria, and nephrolithiasis was found to be abnormally sensitive to vitamin D as a result of lack of regulation of circulating 1,25-dihydroxyvitamin D (1,25-(OH)2D). An increase in daily intake of vitamin D from 10 micrograms (400 units) per day to 50 micrograms (2000 units) per day produced an abnormal elevation in serum 1,25-(OH)2D, hypercalcemia, and hypercalciuria which were corrected by prednisone. Serum 25-hydroxyvitamin D initially was abnormally low, and increased with vitamin D to values which were in the low normal range. There were significant positive correlations between serum 1,25-(OH)2D (p less than .05) and serum calcium and between serum 1,25-(OH)2D and urinary calcium (p less than .05). Serum immunoreactive parathyroid hormone, initially in the lower range of normal, decreased further during hypercalcemia. A radiograph of the chest, gallium scan, and serum angiotensin-converting enzyme activity were normal. No granulomas or evidence of lymphoma were found in biopsies of the liver and of several lymph nodes. It is concluded that the abnormal calcium metabolism in this patient resulted from increased circulating 1,25-(OH)2D and that the defect in vitamin D metabolism was not related to sarcoidosis, other granulomatous disease, Hodgkin's disease, or lymphoma. The relationship, if any, of the abnormal metabolism of vitamin D and calcium to rheumatoid arthritis remains to be established. | |
| 2670397 | Diclofenac sodium. | 1989 Aug | The pharmacology, pharmacokinetics, clinical efficacy, adverse effects, and dosage of diclofenac sodium are reviewed. Diclofenac, the first nonsteroidal anti-inflammatory agent (NSAID) to be approved that is a phenylacetic acid derivative, competes with arachidonic acid for binding to cyclo-oxygenase, resulting in decreased formation of prostaglandins. The drug has both analgesic and antipyretic activities. Diclofenac is efficiently absorbed from the gastrointestinal tract; peak plasma concentrations occur 1.5 to 2.0 hours after ingestion in fasting subjects. Even though diclofenac has a relatively short elimination half-life in plasma (1.5 hours), it persists in synovial fluid. The drug is metabolized in the liver and is eliminated by urinary and biliary excretion. In clinical trials, diclofenac was as effective as aspirin, diflunisal, indomethacin, sulindac, ibuprofen, ketoprofen, and naproxen in improving function and reducing pain in patients with rheumatoid arthritis. For treatment of osteoarthritis, diclofenac was equivalent in efficacy to aspirin, diflunisal, indomethacin, sulindac, ibuprofen, ketoprofen, naproxen, flurbiprofen, mefenamic acid, and piroxicam. Diclofenac was as effective as indomethacin or sulindac in treating ankylosing spondylitis. The most frequent adverse effects reported for diclofenac were gastrointestinal, but these effects were fewer and less serious than occurred with aspirin or indomethacin; in addition, diclofenac caused fewer central nervous system reactions than indomethacin. Diclofenac is administered in divided doses with meals. The recommended total daily dosage is 100 to 150 mg (osteoarthritis and ankylosing spondylitis) or 150 to 200 mg (rheumatoid arthritis). Diclofenac is effective, but no more so than other NSAIDs. It is structurally distinct and offers another choice in the treatment of rheumatological conditions. | |
| 3663951 | Erythropoietin titers in response to anemia or hypoxia. | 1987 | The normal response to anemic or hypoxic hypoxia is synthesis and release of erythropoietin in accord with the concept that erythropoietin production is controlled by a renal oxygen sensor. In this study, erythropoietin production, as predicted, was abrogated in patients with renal impairment (55 cases), but normal in nonuremic individuals. Specifically, patients with rheumatoid arthritis (34 cases), sickle cell anemia (25 cases), aregenerative anemia (27 cases), and aplastic anemia (13 cases) had erythropoietin titers overlapping with those observed in simple anemia (61 cases) at corresponding hematocrits. The response of polycythemic laboratory animals to hypoxia is more difficult to fit within the concept of an oxygen sensor responsive both to anemic and hypoxic hypoxia. If the polycythemia was induced by hypertransfusion, erythropoietin production in response to hypoxia was, as predicted, less than that observed in normal animals. If, however the polycythemia was induced by previous exposure to hypoxia, the animals responded to hypoxia as though they were not polycythemic. An explanation for this challenging observation may provide a clue as to the operation of the oxygen sensor. | |
| 2609062 | [Effect of 1-hour administration of dimethyl sulfoxide on the levels of prostaglandins, pr | 1989 Jul | The effect of dimethylsulfoxide (DMSO) on the level of prostaglandins (PGE and PGF2 alpha), the intensity of peroxide oxidation of lipids (POL), activity of beta-glucuronidase (BGU) prior to and 5 and 24 hours after application made to the patients' hands was studied by a double blind method in 20 patients with genuine rheumatoid arthritis (RA) against the background of therapy with nonsteroid antiphlogistic preparations. Of 20 patients 10 received one-hour application of a 50 per cent DMSO gel, 10 patients received placebo (glycerol instead of DMSO). The authors revealed a significant suppression of PS production against the background of an increased level of POL in four patients who had been given DMSO. The activity of BGU increased five hours after application of DMSO and in 24 hours returned to the initial levels. Changes in the levels of inflammation mediators proved to be statistically insignificant in the group of patients given placebo. Thus, one-hour application of DMSO produced a substantial effect on the system of mediators and their interrelationship in patients with RA. | |
| 3498031 | Partial characterization of the soluble mediator of leukocyte adherence inhibition. | 1987 Jun | The leukocyte adherence inhibition (LAI) test in arthritis is a model of cooperation between monocytes, T cells and polymorphonuclear cells (PMN). Mononuclear cells (MNC) from patients with rheumatoid arthritis in contact with aggregated IgG release within 60 min in the test tube a supernatant capable of inhibiting the adherence of PMN to glass (LAI activity). By protein labeling, fractionation and electroblotting, we showed that the supernatant LAI activity was located in the 14-20 kDa region of the gel and was actively secreted upon MNC stimulation. Under negative conditions, the factors with LAI activity were able to constitute larger complexes and their charge was heterogeneous. Their relationship to interleukin-1 (IL-1) is discussed, since the supernatant gave a positive response in the thymocyte proliferation assay; small amounts of IL-1 had the capacity to inhibit PMN adhesiveness and anti-IL-1 blocked this activity. | |
| 1719105 | Concentrations of neuropeptides substance P, neurokinin A, calcitonin gene-related peptide | 1991 Aug | Arthroscopy was performed on 18 patients (19 joints) with temporomandibular joint arthropathy. Arthroscopic investigation revealed that 12 patients had disk derangement, including 3 patients with rheumatoid arthritis. Six patients had osteoarthrosis, including one patient with rheumatoid arthritis. Synovial fluid content of substance P-like immunoreactivity (SP-LI), neurokinin A (NKA-LI), calcitonin gene-related peptide (CGRP-LI), neuropeptide Y (NPY-LI) and vasoactive intestinal polypeptide (VIP-LI) were analysed using radioimmunoassay technique. All peptides analysed were found, although in various concentrations, in the different joints. There were no significant differences in concentrations of the peptides in the synovial fluid between patients in the various groups. No significant correlation was found between clinical symptoms and signs, arthroscopic findings, or use of analgesic/anti-inflammatory medication versus concentrations of peptides in the synovial fluid. In comparison with earlier findings in the knee joint significantly higher concentrations of SP-LI, CGRP-LI and NPY-LI were found in the TMJ. | |
| 2765009 | Increased expression of HLA-DQ antigens by interstitial cells and endothelium in the synov | 1989 Aug | We investigated cellular phenotypes and expression of class II major histocompatibility complex antigens on endothelium and cellular infiltrates in synovium from patients with rheumatoid arthritis (RA) or reactive arthritis, using an indirect immunoperoxidase technique. The RA specimens showed synovial lining layer hypertrophy and several focal accumulations of lymphocytes, both of which were absent in the reactive arthritis synovium. The percentage of cells expressing monocyte/macrophage markers was significantly higher in RA specimens. The percentages of cells expressing B and T cell markers were similar in both diseases. There was no significant difference in the expression of HLA-DR or DP by endothelium in the 2 diseases, but a marked increase in expression of HLA-DQ by endothelium was observed in the RA synovium versus that from patients with reactive arthritis. This overexpression of HLA-DQ was also seen in the interstitial cells of RA patients compared with reactive arthritis patients. In the reactive arthritis synovium, a significant population of cells (30%) was noted to be HLA-DR positive, and negative for macrophage and lymphocyte markers. Some of these cells had a dendritic morphology. The coexpression of HLA-DQ and HLA-DR may play an important role in antigen presentation and disease chronicity in RA. | |
| 2612115 | Measurement of pain threshold in patients with rheumatoid arthritis, osteoarthritis, ankyl | 1989 Dec | Pain threshold was measured using a pressure algometer in 126 subjects, of whom 54 were females and 72 males. These subjects included 18 males and 18 females with rheumatoid arthritis, 18 males and 18 females with osteoarthritis, 18 males with ankylosing spondylitis, and 18 male and 18 female healthy control volunteers. Six points were studied on each side of the body: 2 cm above the eyebrow on the forehead, lateral aspect of the arm at the insertion of the deltoid muscle, midpoint of the ulna, hypothenar eminence in the palm, midpoint of the quadriceps muscle, and midpoint of the antero-medial aspect of the tibia. None of these points corresponded to the "trigger" points in fibromyalgia. The pain threshold was statistically significantly higher in patients with ankylosing spondylitis than in patients with osteoarthritis, and these in turn were statistically higher than in the normal subjects. Patients with rheumatoid arthritis had significantly lower pain thresholds than the normal subjects. No laterality in pain threshold was identified, but females had in general a lower pain threshold. | |
| 1788550 | Felty's and pseudo-Felty's syndromes. | 1991 Dec | Felty's syndrome, consisting of rheumatoid arthritis, leukopenia, and splenomegaly, has been recognized as a distinct clinical entity for more than 60 years. Clinical and laboratory manifestations of the condition are reviewed. The major sources of morbidity and mortality remain recurrent local and systemic infections. Immunogenetic analysis shows a strong association with HLA-DR4, in addition to DQ beta 3b and C4B null allele. Potential mechanisms of neutropenia are contrasted, including impaired granulopoiesis and neutrophil-immune complex interactions. Lithium carbonate and splenectomy may have a role in the treatment of fulminant disease. Maintenance therapy should be directed at control of the underlying inflammatory arthropathy. A syndrome of proliferation of large granular lymphocytes and neutropenia, associated with rheumatoid arthritis in 23% to 39% of cases, has been described recently. Cases of "pseudo-Felty's" syndrome are often confused with traditional Felty's syndrome, which has twice the prevalence. The clinical and laboratory distinctions between these two conditions are elaborated. | |
| 3951265 | Health outcomes for a chronic disease in prepaid group practice and fee for service settin | 1986 Mar | The authors compare health care use and outcomes of a panel of persons with rheumatoid arthritis receiving health care in prepaid group practice and fee-for-service settings. In 1982, they randomly sampled one half of all 114 board-certified or eligible rheumatologists in Northern California. Those who participated provided the names of all patients with rheumatoid arthritis presenting during a 1-month period; 812 of these patients (97% of those listed) were interviewed. In 1984, 745 of them (92% of the baseline cohort) were interviewed; 569 receive care in fee-for-service settings and 176 in prepaid group practice. As in the baseline survey year, the prepaid patients received similar amounts and kinds of health care as their fee-for-service counterparts. The prepaid and fee-for-service patients achieved similar outcomes, as measured by symptoms of illness, functional status, and work disability. The fee-for-service patients reported poorer overall health status. The authors conclude, after 2 years of follow-up study, that patients in prepaid group practice receive similar medical care inputs and achieve outcomes at least as good as those in fee-for-service. | |
| 1966978 | Serum albumin metabolism in rheumatic diseases: relationship to corticosteroids and peptic | 1990 Jan | Serum albumin concentrations and albumin metabolism were assessed in 150 patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) and healthy subjects. Hypoalbuminemia was more marked in RA patients than in SLE patients. There was no correlation in RA patients between albumin levels and either disease activity or glucocorticosteroid administration; however, hypoalbuminemia in RA patients significantly correlated with juxta-articular erosions or with the incidence of peptic ulcer. The incidence of peptic ulcer was higher in RA patients with the combination of hypoalbuminemia and corticoid therapy, and reduced by the injection of anabolic steroid. In contrast, anabolic steroid did not improve hypoalbuminemia and bony erosions in the patients. The fractional catabolic rate of albumin was similarly elevated in both RA and SLE, while the absolute catabolic rate was increased to a greater extent in SLE patients. This explains the differences in serum albumin concentration between the patients with RA and SLE. | |
| 3361538 | Collagen antibodies in juvenile arthritis and adult rheumatoid arthritis: differences in l | 1988 Feb | Antibodies to both native and denatured type II collagen were measured in the serum of 63 patients with juvenile onset arthritis (JA) and in 67 patients with adult onset rheumatoid arthritis (RA). Levels of antibodies in the 2 groups were compared with antibody levels in 30 healthy adult controls, and in 20 children with nonrheumatic diseases. Antibodies to denatured and native collagen were increased in RA but not in JA. There was no apparent difference between the collagen antibody levels in any of the 3 subgroups of JA, pauciarticular, polyarticular or systemic onset disease. Antibodies to denatured collagen were not type specific, and reacted similarly with type I and type II collagens, but antibodies to native collagen were much more specific, and most reacted more strongly on type II collagen than on type I collagen. Our results, unlike those in previous reports, imply that antibodies to collagen are infrequent in JA and hence cannot be implicated in the pathogenesis of that disease, which is in contrast to adult onset RA. | |
| 3409598 | Strength function after elbow arthroplasty. | 1988 Sep | A prospective study of elbow strength after total elbow joint arthroplasty was conducted in 27 patients (31 procedures). In this overall group, flexion strength improved 92%, pronation, 63%, and supination, 69%. Grip strength improved 35%, but there was no mean improvement in extension strength among these patients. After 27 procedures for rheumatoid arthritis, the average strength improvement of all five functions was 71% compared to a 25% improvement in four patients with nonrheumatoid involvement. Placement of the prosthetic axis of rotation proximal or anterior to the normal axis was associated with consistently poorer strength. The sample was too small to distinguish performance among prosthetic types, but the triceps-sparing approach showed consistently better strength in extension (averaging 20%) than did the other exposures. |