Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3619387 | Christiansen replacement hemiarthroplasty in femoral neck fractures of the elderly. | 1987 | A total of 108 femoral neck fractures were operated on by Christiansen hemiarthroplasty. Primary mortality was 4.8%, but after an average of 61 months only one-third of the patients were alive. Sixteen of the 40 hips of the living patients showed a poor result as evaluated by the Harris score or subjective outcome. Only four hips were wholly satisfactory at follow-up. It appears that Christiansen hemiarthroplasty has no advantages over other hemiendoprosthetic devices. It is suggested that undisplaced or minimally displaced fractures should not be treated by hemiarthroplasty but by compression osteosynthesis. The problem of displaced fractures still remains open. It appears, however, that primary total hip arthroplasty should be performed in cases of rheumatoid arthritis or even initial osteoarthritis, if an endoprosthetic replacement is considered. | |
| 2732311 | [A study on lymphocyte subsets of peripheral blood and synovial fluid using monoclonal ant | 1989 Apr | Synovial fluid lymphocytes and paired peripheral blood lymphocytes from 29 patients with rheumatoid arthritis (RA) were analyzed using two-dimensional flow cytometry. The lymphocytes of peripheral blood from 20 normal subjects were served as control. In the RA patients, the composition of the lymphocyte population was different in the synovial fluid and peripheral blood. Compared with the peripheral blood, the synovial fluid contained higher populations of Ia+ (Leu 4 + Leu HLA-DR+) T cells, especially Leu 2a + Leu HLA-DR+ (activated suppressor/cytotoxic) T cells, and of Leu 2a + Leu 15- (cytotoxic T) cells and Leu 3a + Leu 8- (helper T) cells. Contrary, the synovial fluid contained lower populations of Leu 2a + Leu 15+ (suppressor T) cells and Leu 3a + Leu 8+ (inducer T) cells. Compared with the lymphocytes of the normal peripheral blood, the RA patients had an elevated ratio of helper T/suppressor T cells (Th/Ts) in both the synovial fluid and peripheral blood, incidentally the former group showed striking elevation. The ratio of Th/Ts in the synovial fluid showed considerable variation, with a significant inverse correlation with the disease activity (Lansbury index). These findings suggest that patients with rheumatoid arthritis show more specific changes in their synovial fluid lymphocytes than in their peripheral blood lymphocytes. | |
| 2203262 | Effects of sulindac and naproxen on prostaglandin excretion in patients with impaired rena | 1990 Sep | PURPOSE: The purpose of the current investigation was to study the influence of sulindac and naproxen on renal function and urinary excretion of the stable hydration product of prostacyclin, 6-keto-PGF1 alpha, in patients with arthritis and impaired renal function. PATIENTS AND METHODS: In a placebo-controlled, double-blind, cross-over design, the effects of 7 days of oral sulindac 200 mg twice a day were compared with naproxen 500 mg in the morning and 250 mg in the evening in 10 patients with polyarthritis and stable impaired renal function. Inulin and para-amino-hippurate sodium were used to calculate glomerular filtration rate and renal plasma flow. The excretion rate of 6-keto-PGF1 alpha was measured in urine collected overnight. After patients ingested drugs in the morning, urine was collected in fractions by spontaneous voiding. Venous blood samples were drawn repeatedly for assay of electrolytes, creatinine, proteins, hormones, and drugs. Grip strength and Ritchie articular index were recorded as indicators of symptomatic antiarthritic effectiveness. RESULTS: Naproxen decreased urine levels of 6-keto PGF1 alpha by 59% (p less than 0.01). Sulindac had no effect on renal prostaglandin excretion. Naproxen reduced the glomerular filtration rate and renal plasma flow by 18% (p less than 0.05) and 13% (p less than 0.05), respectively, while no significant change was observed during the sulindac treatment periods. Serum levels of creatinine and complement factor D were unaffected by either drug. Plasma renin activity decreased during naproxen and sulindac treatments by 38% (p less than 0.05) and 22% (p less than 0.05). No significant change in plasma aldosterone was observed during the two drug treatments, but urinary aldosterone declined significantly (p less than 0.05) by 34% with naproxen. Albuminuria decreased (p less than 0.05) during both naproxen (41%) and sulindac treatment (72%), while the albumin/creatinine clearance ratio decreased by 59% (p less than 0.05) only during treatment with sulindac. N-acetyl-beta-D-glucosaminidase in urine was not changed by either drug. Sulindac and naproxen had no discernible effects on base excess, excretion of water, sodium, or potassium, or on osmolal clearance. However, serum potassium increased slightly but significantly (p less than 0.01) during treatment with naproxen. Sulindac sulfide, the active metabolite of sulindac, could not be traced in the urine from any of the patients. Mean arterial blood pressure declined significantly (p less than 0.05) during sulindac treatment but did not change during treatment with naproxen. Both drugs produced equal clinical improvement as measured by grip strength and the Ritchie articular index. CONCLUSION: The results suggest that when sulindac and naproxen are given in clinical equipotent doses to patients with impaired renal function, sulindac does not affect renal prostaglandin synthesis or renal function, whereas naproxen induces suppression of renal prostaglandin synthesis and a further decrease in renal function. | |
| 3816097 | Methylprednisolone pulse therapy in conjunction with azathioprine in rheumatoid arthritis. | 1986 Dec | In the management of rheumatoid arthritis two potentially useful roles for methylprednisolone (MP) pulse therapy are presently recognised: in patients in whom second line drugs have not led to a satisfactory remission or have caused side effects, and in bridging the gap between the start and the delayed onset of effect of a slow-acting antirheumatic drug. Recently it was shown that MP-pulse therapy was effective in accelerating the response to sulphasalazine and D-penicillamine. Nineteen patients with a persistently active rheumatoid arthritis, who had failed to respond to at least two slow-acting antirheumatic drugs, were treated with MP-pulse therapy in conjunction with azathioprine. Twelve patients continued this treatment for 6 months and 8 for 12 months. MP-pulse therapy resulted in an immediate improvement in Ritchie articular index, grip strength, ESR and CRP. However, this improvement lasted less than six weeks. After 6 months some improvement due to the effect of azathioprine became apparent. Some rather serious side effects were noted. It is concluded that MP-pulse therapy has a (short lasting) beneficial effect in persistently active rheumatoid arthritis. However MP-pulse therapy is not suitable to bridge the gap between the introduction of azathioprine-treatment and the delayed response to this drug. | |
| 1988232 | Human cartilage is degraded by rheumatoid arthritis synovial fluid but not by recombinant | 1991 Jan | Rheumatoid arthritis (RA) synovial fluid (SF) stimulated significant loss of glycosaminoglycans (GAG) from normal and pathological human cartilage biopsies over 2 days as compared with normal human serum. By contrast, 15 RA SFs failed to degrade killed normal cartilage, and degraded killed RA cartilage less effectively than living RA cartilage. Four RA SFs were treated with neutralizing anti-cytokine antisera prior to incubation with normal cartilage. The degrading effects of two of the fluids were reversed by anti-interleukin-1 alpha (IL-1 alpha) while degradation by the third and fourth fluids were reversed by anti-interleukin-1 beta (IL-1 beta) and anti-tumour necrosis factor-alpha (TNF-alpha), respectively. However, recombinant human IL-1 alpha, IL-1 beta, TNF alpha or a combination of all three cytokines had no degrading effect in this 2-day culture system. It is concluded that RA SF degrades cartilage by a mechanism involving a synergistic interaction between cytokines and some other component of SF. | |
| 2258570 | Magnetic resonance imaging of pediatric foot and ankle disorders. | 1990 Sep | The authors present magnetic resonance imaging as an accurate modality that is available for evaluating lower extremity pediatric pathology. They examine various disorders, and review proper magnetic resonance techniques. Soft tissue, cartilaginous, and certain osseous abnormalities are inspected. | |
| 2201470 | Detection of transforming growth factor-beta in rheumatoid arthritis synovial tissue: lack | 1990 Aug | The presence of transforming growth factor-beta (TGF-beta) in inflammatory joint disease was investigated. Synovial fluid from patients with rheumatoid arthritis (RA) and patients with other non-autoimmune inflammatory joint diseases contained high levels of both active and latent TGF-beta. Levels of active TGF-beta did not correlate with drug regimen in either patient group or with the recovery period in the individuals with non-RA joint disease. Freshly isolated synovial cells from individuals with RA were shown by Northern blotting to express the mRNA for TGF-beta 1 and to secrete latent TGF-beta protein which could be neutralized by antibodies to TGF-beta 1 and TGF-beta 2. Lipopolysaccharide-stimulated peripheral blood mononuclear cells from normal donors produced interleukin-1 (IL-1) and tumour necrosis factor-alpha (TNF-alpha) which was inhibited by pretreatment of these cells with recombinant TGF-beta. Cytokine production was not inhibited if the addition of TGF-beta was used after the inducing stimulus, suggesting that in activated cells cytokine production cannot be inhibited. This was confirmed by the observation that neither TGF-beta 1 or TGF-beta 2 inhibited spontaneous IL-1 or TNF-alpha production by rheumatoid synovial mononuclear cells in culture. These findings show that despite the presence of active TGF-beta in RA synovial joints and the spontaneous production of latent (potentially active) TGF-beta by RA cells in culture, additional TGF-beta did not inhibit ongoing cytokine synthesis in vitro. This suggests that TGF-beta may not inhibit cytokine production in the rheumatoid joint although it cannot be ruled out that in vivo TGF-beta already has an immunosuppressive effect which cannot be further increased in vitro by exogenous protein. | |
| 3597464 | Arthroplasty of the ipsilateral shoulder and elbow in patients who have rheumatoid arthrit | 1987 Jun | Over a ten-year period, arthroplasty of the ipsilateral shoulder and elbow was performed in thirty-five extremities of thirty-one patients who had advanced rheumatoid arthritis. The results of the procedures were retrospectively reviewed to determine the appropriate sequence of surgery and the functional results that were obtained. All patients were followed for a minimum of two years after the last arthroplasty. The elbow had been operated on first in twenty-one extremities and the shoulder had been operated on first in fourteen. The time-interval between arthroplasties was significantly longer (p less than 0.005) when the elbow had been operated on first (forty-five compared with 13.4 months). All motion of the elbow and elevation and external rotation of the shoulder improved significantly (p less than 0.005), similar to the improvement in motion that is noted when either joint is operated on alone. Also, there was a highly significant reduction in pain and improvement in function (both, p less than 0.001). Review of the roentgenograms of twenty-three patients demonstrated no humeral fractures or interference in the proper placement of the humeral component of the prosthesis either by the stem of the other prosthesis or by the methylmethacrylate. All of the arthroplasties of the shoulder that were performed as the second arthroplasty were done at least five months after the arthroplasty of the elbow, and no dislocations or subluxations of the components of the elbow prosthesis occurred.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 2595338 | Activity and severity of rheumatoid arthritis in Hannover/FRG and in one regional referral | 1989 | Between November 1984 and July 1988 a total of 8044 randomly selected German residents of the city of Hannover/FRG, aged 25 to 74, have been screened for rheumatic complaints by means of a postal questionnaire. An average 87% of the probands contacted returned completed questionnaires. Respondents with a "positive" questionnaire, i.e. suggestive of the existence of an inflammatory joint disease were invited for a rheumatological examination at the Hannover Medical School. 72% participated. 45 of a total of 1291 participants were identified as suffering from active or inactive, mostly rheumatoid arthritis. This yields a minimum prevalence of 0.56% (+/- 0.19%). The true prevalence is estimated to be 0.91% (99%-confidence interval 0.64-1.18). In 1985 and 1986 103 German RA sufferers aged 25 to 74, all citizens of Hannover, were referred to our outpatient rheumatology clinic for a first consultation. A comparison between the two groups revealed a higher disease activity in terms of "objective" criteria (joint swellings, ESR, rheumatoid factor) in the group of the referred patients as opposed to RA suffers from the community. Both groups were comparable in respect to "subjective" symptoms (morning stiffness, joint pain, pain intensity), functional capacity and degree of erosive joint lesions. The rheumatological outpatient clinic at the Hannover Medical School, providing the only specialized service in the region, actually covers less than 20% of all RA sufferers within the municipal area of Hannover and less than 50% of those with a "classical" RA according to the ARA-criteria. | |
| 1896787 | [Measurement of the functional capacity in rheumatoid polyarthritis: a French adaptation o | 1991 Jun | The ability in performing daily life activities, as assessed with self-administered questionnaire, measures the functional severity of rheumatoid arthritis (RA). The HAQ Disability Index, designed to explore RA, was translated by 3 francophone teams. Three anglophones gave a back-translation. The latters were compared with the original HAQ under the control of 2 bilingual individuals, allowing to the adjustment of the French version. The validity of this measurement tool was studied in a group of recent RA (n = 40, mean disease duration: 2.4 years), longstanding RA (n = 32, mean disease duration: 8.4 years) and controls (n = 59). The construct validity was assessed in a principal component analysis, which showed the contribution of each item of the questionnaire. The intra-subject reproducibility was satisfactory. The HAQ score correlated well with usual clinical and radiological parameters. It differed significantly in the groups, showing a high discriminant ability. A validated instrument for measuring functional ability in French RA patients is now available for the follow-up and therapeutic assessment. | |
| 1979344 | Treatment of drug-induced agranulocytosis with recombinant GM-CSF. | 1990 Nov | A 53-year male patient, treated for rheumatoid arthritis with sulphasalazine, developed a total agranulocytosis. When this state had prevailed for at least 10 d no bone marrow granulocyte progenitor cells were detectable. Intravenous GM-CSF treatment was initiated 5 d later, and the patient recovered within the next 6 d. GM-CSF treatment for severe agranulocytosis deserves further investigation. | |
| 3681068 | [Effects of pathological synovial fluids on the metabolism of chondrocytes]. | 1987 Jun | The purpose of this study was to clarify the mechanism of joint destruction in rheumatoid arthritis and osteoarthritis by observing the effects of the pathological synovial fluids on proteoglycan (PG) and collagen metabolism of chondrocytes. When chondrocytes from chick embryo were cultured with pathological synovial fluids, especially RA synovial fluid, biosynthesis of both proteoglycan and collagen of chondrocytes were found to increase in proportion to the amounts of pathological synovial fluids applied to the culture medium. Chondrocytes began to synthesize PG of small molecular size, approximately 70,000 in addition to PG of normal molecular size. It is noteworthy that the PG of small molecular size shows a shortening of the glycosaminoglycan link and core protein on undersulfation. These findings indicate that pathological synovial fluids disturb the biochemical regulation of the articular cartilage matrix by altering both PG and collagen metabolisms of chondrocytes. | |
| 2354871 | Antibodies from patients with rheumatoid arthritis and juvenile chronic arthritis analyzed | 1990 | Antihistone antibodies were detected in the sera of a randomly selected group of patients with rheumatoid arthritis (RA) and juvenile chronic arthritis (JCA) by an enzyme-linked immunosorbent assay (ELISA) with the five individual histones and by immunoblotting. In ELISA, the overall frequency of antihistone antibodies in RA and JCA was 51 and 44%, respectively. Antibodies present in these serum samples were further studied by ELISA by means of 17 core histone synthetic peptides. The fragment 1-21 of H3 was recognized by 60% of RA sera and by 62% of JCA sera. In addition, at least four terminal or internal peptides of H3 and H4 were recognized by more than a third of JCA sera, while only two of these peptides reacted with 20% of RA sera. Many of the sera that did not show any reactivity with the whole histone reacted with various histone peptides. This finding demonstrates the usefulness of synthetic peptides for identifying autoantibodies. | |
| 2363030 | Reproducibility of isokinetic muscle strength measurements in normal and arthritic individ | 1990 | The serial reproducibility of an individual's isokinetic torque was assessed in order to establish a reliable baseline value for future comparison. Thirty-two controls and twenty arthritic patients were tested for their peak isokinetic torque on knee flexion and extension and hip flexion at three velocities on five occasions, at fortnightly intervals. The first test was found to provide a reliable baseline for controls and subjects who could generate a peak torque of 54 Newton meters (Nm) or more. The second test was found to be more representative of the series for groups containing weaker subjects. Variation related to torque: for subjects who generate a peak torque of 54 Nm or more, a range of +/- 20% accommodates the variability of 95% of tests. We conclude that a +/- 20% range applied to either the first or second test, depending on the nature of the group to be studied, serves as a representative baseline value. | |
| 2787225 | Osteocalcin and bone mineral content in rheumatoid arthritis. | 1989 Mar | Abnormal bone metabolism was reported in rheumatoid arthritis (RA). In order to evaluate the interest of serum osteocalcin, also called bone GLA-protein (BGP), to assess bone metabolism in RA, we studied 20 postmenopausal RA out-patients and 20 matched controls. Nine patients were treated with low-dose corticosteroids (C+) for at least one year (less than 10 mg/day, prednisolone equivalent), the remaining 11 (C-) received non-steroidal anti-inflammatory drugs (NSAID). The distal and proximal forearm bone mineral content (BMC) was measured by single photon absorptiometry, the vertebral BMC was measured by dual photon absorptiometry. A trend to low BGP was observed in the C+ group. The lowest values were observed in patients with vertebral fractures. Compared with controls, both RA groups had similar low significant BMC at the forearm sites. At the vertebral sites, the bone mineral content decrease observed in the two groups, was more marked in the C+ group. From our results, BGP did not appear as a useful index of osteoporosis in RA, except in some patients with vertebral fractures, treated with low-dose corticosteroids. | |
| 3668553 | Knee arthroplasty in rheumatoid arthritis. Four- to six-year follow-up study. | 1987 | A consecutive series of total condylar knee arthroplasties in patients with rheumatoid or related arthritis, with a 4-6-year follow-up period, was studied. Eighty-seven percent had an excellent or good overall result (score of 70 or more on the HSS knee rating scale). The median total score increased from 45 points before operation to 83 after operation. Sixteen complications, mostly minor, occurred in 14 patients. There were no early infections. Two prostheses were removed for deep infection, after 3 and 5 years. One patient had patellectomy for avascular necrosis. The crude prosthesis survival rate was 97%. Tibial radiolucencies were noted in 76% of cases; in 29% they were significant (2 mm or more in one or more of three zones). Two tibial components (2%) were believed to be mechanically loose, but no revisions for mechanical loosening were done. The presence of radiolucencies did not signify an inferior clinical result. | |
| 3060616 | Pathophysiologic factors affecting the pharmacokinetics of nonsteroidal antiinflammatory d | 1988 Oct | The nonsteroidal antiinflammatory drugs are a group of compounds mainly used in the treatment of rheumatologic disorders. Although these agents differ among themselves in their pharmacokinetic properties of absorption, distribution and elimination, they do have some common characteristics, such as high plasma protein binding, small distribution volume, and low plasma clearance. Rheumatoid arthritis, renal and hepatic disease, and old age can potentially affect the disposition of these agents. Unfortunately, no generalizations can be made and, therefore, the effect of these disease states should be carefully studied for each individual agent. A better understanding of the pathophysiologic factors affecting the pharmacokinetics of these agents will improve their efficacy and safety. | |
| 3531722 | Foot pressure measurement: a review of clinical findings. | 1986 Oct | In this review, a description of what is known about plantar pressure distribution in standing and in gait is followed by sections on clinical findings. Two major clinical areas are treated extensively, namely the diabetic foot and the foot in rheumatoid arthritis. Other applications, including the assessment of surgical procedures for orthopaedic corrections are also included. A large variety of different techniques for foot pressure measurement have been used; interpretation of the results has to be made on the basis of a firm understanding of the technique employed. Often, quantitative results from different pieces of apparatus are difficult to compare, indicating a need for accurate calibration and a standardized presentation. An up-to-date summary of pressure measurement systems reported over the past five years is included. | |
| 1916874 | [Renal involvement in rheumatic (systemic) diseases: new diagnostic possibilities]. | 1991 Jun | Patients (pts) with rheumatoid arthritis (RA) may develop structural damage and functional deterioration of the kidney, where interstitial fibrosis and mesangioproliferative glomerulitis are seen most frequently. Compared to controls 80 pts with RA under various therapeutical regimes and 23 pts with SLE excreted immunoreactive membrane proteins of the proximal tubule at an increased rate. 30 out of 76 pts, but all with SLE, revealed a pathological pattern of proteinuria in SDS-PAGE. | |
| 1676256 | Enumeration of IgA producing cells by the enzyme linked immunospot (ELISPOT) technique to | 1991 Jun | Numbers of IgA producing cells in peripheral blood were determined by the enzyme linked immunospot (ELISPOT) technique in 15 patients with inflammatory arthritides receiving sulphasalazine treatment. The numbers of IgA producing cells decreased significantly after the first three weeks of treatment. In 11 of the patients this decrease persisted, whereas a subsequent increase was seen in the four others; in two of these latter patients this increase coincided with a temporary withdrawal of the sulphasalazine treatment. A reduction of serum concentrations of IgA and haptoglobin was seen after three months' treatment. Eleven of the patients had a subjective improvement in their joint disease during the first three months of treatment. Analysis of circulating cells committed for IgA secretion may constitute one way of assessing gut associated immunity indirectly, and the present data suggest that sulphasalazine has a rapid effect on lymphocytes possibly originating from the gut and that such an effect precedes improvement in laboratory parameters and clinical symptoms in arthritic diseases. |