Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
3313662 What's happened to catabolin? 1987 Unlike other areas of research into arthritis, it is pleasing to record independent work leading to convergence of ideas instead of divergence and increasing complexity. Catabolin is now identified with interleukin-1, although there is case for the retention of the original name to describe its chondrocyte-stimulating function with subsequent matrix degradation. In 10 years, catabolin/interleukin-1 research has yielded much information about cellular interactions within the arthritic joint and has provided a probe with which the intricacies of matrix metabolism are being unravelled. In future, there are prospects of characterizing the naturally occurring inhibitors and developing new compounds which influence the actions of catabolin/IL-1 to the benefit of the patient with arthritis.
2781422 Nutritional assessment in rheumatoid arthritis. 1989 Sep 16 The nutritional status was assessed in a group of 220 patients with rheumatoid arthritis from three communities (coloured 89 patients, white 88 and black 43). The triceps skinfold (TSF) thickness, upper arm muscle circumference (UAMC), body mass index (BMI) and percentage of ideal body weight (% IBW) were measured and the serum albumin value determined. The mean age of the coloured patients was 49.8 years, white 57.7 years and black 44.8 years. Forty-five patients (20.5%) had a reduction of one or more anthropometric measurements (TSF, UAMC and/or %IBW) and a further 6 patients (2.7%) had a reduction of the serum albumin value alone. These 51 patients were considered to be malnourished and had a higher mean erythrocyte sedimentation rate and more severe functional disability than the remainder of the patients. The prevalence of malnutrition was lower if diagnosed only on abnormality of the TSF, UAMC and %IBW, since 25 patients (11.4%) had a reduction of only one measurement, 12 (5.5%) had a reduction of 2 and 8 (3.6%) had a reduction of all three measurements. Obesity (BMI greater than 30) was noted in 10.5% and there were no differences in the functional disability, disease activity and use of steroid therapy in the obese patients compared with the rest of the patients.
3486448 [HLA system and complications of the treatment of rheumatoid polyarthritis with D-penicill 1986 Jan The data of the literature concerning the relationship between complications of D-penicillamine treatment and the HLA system are discussed. This relationship particularly concerns the renal complications which are associated with HLA antigens B8 and DR3, although this relation is not sufficiently strong to be used in practice in the indications for treatment with D-penicillamine.
2787645 Autoreactive T cells in rheumatic disease (1). Analysis of growth frequencies and autoreac 1989 Feb A limiting dilution system was established in order to estimate frequencies of interleukin-2 (IL-2)-responsive, autoreactive and alloreactive T cells in samples of peripheral blood (PBL) and synovial fluid lymphocytes (SFL), from patients with rheumatoid arthritis (RA) and lyme disease, as well as from healthy donors and a patient with osteoarthrosis. The frequencies of IL-2-dependent T-cell colony formation were significantly higher in patients with RA and lyme disease (median: 1/287) as compared to controls (median: 1/1,313) indicating a preactivation of T cells in these patients in vivo. Autoreactivity was measured by the proliferative response of T-cell lines to autologous irradiated PBL as stimulating cells. The frequencies of autoreactive T cells in blood were significantly higher in patients (median: 1/2,615) as compared to controls (median: 1/19,607). There was no significant difference in autoreactive T-cell frequencies between the patients' SFL (median: 1/3,185) and PBL (median: 1/2,615). In every case the frequency of alloreactive T cells exceeded the frequency of autoreactive T cells. Most autoreactive T-cell lines were also alloreactive and were shown to be MHC Class II-restricted. There is evidence of a down regulation of autoreactive T cells by suppressor cells in peripheral blood in two cases with elevated autoreactive T-cell frequencies (one RA patient and one control patient suffering from a viral infection). In contrast, no suppression of autoreactive T cells was observed in the RA patients' SFL or in PBL and SFL from patients with lyme disease. These results suggest that the chronic inflammation observed in RA and lyme disease may be supported by an elevated number of autoreactive T cells in the absence of suppressive mechanisms.
3372573 Posterior interosseous nerve palsy in rheumatoid arthritis. 1988 May Bilateral posterior interosseous nerve palsy in a rheumatoid patient is described. Six previous case reports and our experience indicate that steroid injection into the elbow may not produce lasting recovery and may lead to unacceptable delay before surgical decompression. An anterolateral approach for division of the arcade of Frohse is effective in cases with diffuse synovitis; where there is a local cystic swelling a posterolateral approach provides better access. Good recovery of nerve function can be expected after early operation.
1973396 Treatment of non-steroidal anti-inflammatory drug induced enteropathy. 1990 Jul Non-steroidal anti-inflammatory drug induced small intestinal inflammation may have an adverse effect on the joints of patients with rheumatoid arthritis. We therefore assessed small intestinal and joint inflammation in patients with rheumatoid arthritis before and after three to nine months' treatment with sulphasalazine (n = 40) and other second line drugs (n = 20), while keeping the dosage of non-steroidal anti-inflammatory drug at the same level. Sulphasalazine significantly decreased the mean (SD) faecal excretion of 111indium labelled leucocytes from 2.39 (2.22)% to 1.33 (1.13)% (normal less than 1%, p less than 0.01) and improved the joint inflammation as assessed by a variety of parameters. There was no significant correlation between the effects of sulphasalazine treatment on the intestine and the joints. Treatment with other second line drugs had no significant effect on the faecal excretion of 111indium (1.58 (1.04)% and 1.86 (1.51)%, respectively) but improved joint inflammation significantly. The lack of correlation between the intestinal and joint inflammation and their response to treatment suggests that the two are not causally related.
3539573 Pirprofen. A review of its pharmacodynamic and pharmacokinetic properties, and therapeutic 1986 Dec Pirprofen is a non-steroidal anti-inflammatory drug, related structurally to drugs such as ibuprofen, ketoprofen and naproxen. Published clinical trials indicate that pirprofen 600 to 1200 mg/day as 2 or 3 divided doses is a suitable alternative to usual therapeutic dosages of aspirin, flurbiprofen, ibuprofen, indomethacin, ketoprofen, naproxen, piroxicam and sulindac in the treatment of rheumatoid arthritis, osteoarthritis, ankylosing spondylitis, musculoskeletal disorders and non-articular rheumatism. More studies are required to evaluate its potential relative to other commonly used drugs in the treatment of gout, juvenile rheumatoid arthritis and dysmenorrhoea. In patients with acute postsurgical, trauma or cancer pain, single oral or intramuscular doses of pirprofen 200 to 400mg provide equivalent analgesic activity to usual therapeutic doses of aspirin, diflunisal, ketoprofen, noramidopyrine, paracetamol and pentazocine. As with other non-steroidal anti-inflammatory drugs, gastrointestinal complaints are the most frequently reported side effects. At equivalent analgesic or anti-inflammatory dosages, pirprofen probably causes fewer side effects than aspirin and appears to be as well tolerated as the other agents with which it has been compared. Long term tolerability, particularly compared with some of the newer, purportedly less gastrotoxic agents or formulations, needs to be investigated further. Pirprofen does not appear likely to offer any particular advantage with respect to efficacy and tolerability over other non-steroidal anti-inflammatory drugs, except aspirin. However, as no one agent is the most suitable drug for all patients requiring such therapy, pirprofen may be considered along with other drugs of this type in the therapy of arthritic conditions and acute pain states.
3564728 [Tubulointerstitial nephritis]. 1986 A concept of the pathogenesis of tubular interstitial nephritis (TIN) is presented, based on histologic, immunohistologic and electromicroscopic investigations on 61 patients with glomerulonephritis, lupus erythematodes and rheumatoid arthritis. The pathogenic model is a hypersensitivity reaction which leads to alterations in the tubular basement membrane (TBM) and results in changes in the TBM and secondary damage to stroma, vessels and tubular cells. The findings change depending on the stage, reflecting the transition from an acute to a chronic process. In acute TIN which is generally a drug allergy, the dominant characteristic of the inflammatory process allows the reaction to be categorized in edematous (72%), cellular (23%) and tubular necrotic (5%) types. The cellular types show 4 subdivisions: plasma cellular, eosinophil-granulocytic, lymphohistiocytic and granulomatous. Chronic TIN is in particular characterized through the destruction of the TBM, dystrophy and atrophy of the tubules as well as their degeneration, lymphohistiocytic infiltrates and sclerotic stroma reactions. A distinction is made between cellular destructive and atrophic-sclerotic types. At view of the etiology and pathogenesis a distinction should be made between an infectious and non-infectious TIN and further by the character of the immunoreaction, into a primary and secondary form. If there glomerular changes are present and there is evidence of an immune phenomenon in the glomeruli and TBM we recommend the use of the term glomerulo-tubulo-interstitial nephritis.
1896782 [Treatment of rheumatoid polyarthritis with methotrexate]. 1991 Jun This retrospective study involved 60 patients (7 men, 53 women) with rheumatoid arthritis (RA) and given methotrexate between 1985 and 1990. The mean time that RA had been present was 12 years and more than half of the patients had received more than 3 types of general treatment in the past. The mean total duration of MTX was 17.3 months, with a total dose of 790 mg. The efficacy of MTX was confirmed by a significant improvement in clinical and laboratory parameters. Treatment was withdrawn permanently in 21 cases (35% of patients). Adverse reactions, responsible for two thirds of treatment withdrawals (14/21) occurred in most instances during the first year of treatment. Hepatic toxicity was commonest. Two cases of aplasia were reported as well as 3 cases of pneumonitis, one fatal. These involved two cases of secondary infection and one of pneumonitis directly imputable to MTX. Withdrawals for inefficacy were rare, occurring in less than 10 p. cent of patients. Treatment continuation rates were 77 p. cent at 1 year, 66 p. cent at 18 months, 55 p. cent at 2 years, 42 p. cent at 3 years and 32 p. cent at 4 years. MTX is effective treatment for RA but is not free of adverse reactions, sometimes potentially fatal. Prolonged monitoring is necessary because of the sometimes delayed onset of adverse reactions.
2264719 Girdlestone operation. An acceptable alternative in the case of unreconstructable hip arth 1990 Between 1970 and 1984, 1250 total hip arthroplasties using methylmethacrylate bone cement were performed at the Department of Surgery, University of Turku, Finland. Girdlestone arthroplasty was performed in nine women and one man in ten cases of failed arthroplasty. In general, the results were evaluated as good. The patients were satisfied, and they had no pain or only slight or occasional pain on weight bearing. Nine of ten patients could walk, two of them without any walking aids. In conclusion, the Girdlestone operation can offer an acceptable functional result when reconstruction of the hip joint is not possible.
3794235 Matched distal ulnar resection. 1986 Nov Painful disorders of the distal radioulnar joint severely limit the work capability of the hand. Until recently, the standard treatment for this problem has been transverse resection of the distal ulna, as originally proposed by Darrach. A technique for a "matched" resection arthroplasty of the distal ulna, leaving the ulnar shaft--styloid axis along with the triangular fibrocartilage complex and the distal ulnar ligamentous attachments intact, has been used since 1967. This procedure resects the distal ulna in a long, smooth, convex curve, matching the opposing surface of the concave radial metaphysis in three dimensions. Forty-four wrists were followed for an average of 6.5 years and showed that the procedure is reliable and relieves pain while retaining a more normal ulnocarpal, radioulnar, and radiocarpal alignment, with painless pronation averaging 80.5 degrees and supination of 88.5 degrees.
3529375 Low-dose methotrexate in rheumatoid arthritis: effect and tolerance. An open trial and a d 1986 Weekly low-dose Mtx may be considered the preferred drug for the treatment of patients with severe, progressive RA resistant to conventional therapy. The drug is sufficiently safe, provided contra-indications are considered and treatment is carefully supervised. Controlled long-term prospective studies are needed in order to determine whether the drug demonstrably retards progression of the erosions, and to guard against untoward long-term adverse reactions.
3490009 [Autoimmune changes in various rheumatic diseases]. 1986 A combined clinicoimmunologic investigation of 895 patients was conducted, of them 518 had rheumatic fever, 68 rheumatoid arthritis, 35 systemic scleroderma and 12 systemic lupus erythematosus. The immune status of the patients was evaluated by the results of the rosette-formation method, the reaction of lymphocyte blasttransformation, the reaction of leucocyte migration inhibition using purified cardial and other tissue antigens. The weakening of rosette-forming function of lymphocytes, a decrease in a mitogenic response to PHA, dysimmunoglobulinemia, imbalance in antibody production, particularly hyperproduction of cardial antibodies in rheumatic fever were observed as was marked delayed-type hypersensitivity to tissue antigens, more frequently to purified cardial antigens--to myocardial cell membranes and myosin. It indicates the involvement of the autoimmune mechanisms in the development of the disease.
3437969 A new method of occipitocervical fusion using internal fixation. 1987 Dec We describe a method for decompression and fusion of the occipitocervical junction in cases of atlantoaxial subluxation. Use of an implanted steel rectangle provides immediate rigid internal fixation, permitting early mobilization with minimal external support.
2587073 [Injuries of the menisci in patients with deforming gonarthrosis]. 1989 Aug The authors present their observations concerning the difficulties in the diagnosis of the injuries of the menisci of the knee joint associated with deforming arthrosis which have quite a number of similar clinical signs with injuries of the menisci. The importance of an arthroscopic study of the meniscus of the knee joint is demonstrated for revealing the lesion as well as a possibility of solution to the problem of partial meniscectomy. The expediency of such tactics is confirmed by the results of the treatment of 28 patients, in 10 of whom lesions of the inner menisci were revealed and partial meniscectomies were performed. The remaining 18 patients were given sanation of the joint cavity. The results of the treatment with a follow-up period up to 5 years were evaluated as good.
2452607 Reaction of antibodies to rheumatoid arthritis nuclear antigen with a synthetic peptide co 1988 Apr Antibodies to rheumatoid arthritis nuclear antigen (RANA) are detected by immunodiffusion (ID) and immunofluorescence (IF), though reports of the identity of the antigen(s) have been conflicting. In this study it is shown conclusively that ID and IF anti-RANA react with epitopes on Epstein-Barr nuclear antigen 1 (EBNA-1) and that the major epitope detected by immunofluorescence is represented by a synthetic peptide, P62, corresponding to part of EBNA-1. In an enzyme linked immunosorbent assay (ELISA) anti-P62 antibodies in 35 rheumatoid arthritis sera were threefold higher than those of 35 age and sex matched controls, with the highest levels occurring in young patients with active joint disease.
3951809 Hyperviscosity retinopathy secondary to polyclonal gammopathy in a patient with rheumatoid 1986 Jan A patient with rheumatoid arthritis developed retinal venous stasis as part of a hyperviscosity syndrome secondary to a polyclonal gammopathy. Ocular findings included bilateral retinal venous dilation, disc hyperemia, optociliary venous collaterals, and left macular edema. This clinical picture improved following systemic corticosteroid therapy. Although occasional cases of rheumatoid polyclonal gammopathy causing hyperviscosity have been described in the rheumatology literature, this case represents the first detailed ophthalmological documentation of this occurrence.
2809654 Muscle function of the lower extremities in rheumatoid arthritis and osteoarthrosis. A des 1989 Thirty-six patients with rheumatoid arthritis (RA), 30 patients with cox- or gonarthrosis (OA), and a control group of 40 patients with diabetes mellitus (DM) were studied with the aim of analyzing and comparing patient experienced muscular problems of muscle-strength analyzing and comparing patient experienced muscular problems of muscle-strength, endurance and balance/coordination with muscle function as assessed by standardized tests. The results indicated that patient-experienced problems of muscle function of the lower extremities were frequent in both the RA and the OA groups (about 80%) compared to the DM group (10%). Multivariate analyses of variance (MANOVAs) on experienced and tested muscle strength, endurance and balance/coordination, revealed a significant RA-OA difference (p less than 0.05). Separate analyses of variance (ANOVAs) indicated OA patients to show decreased tested endurance compared with the RA group. There was no significant RA-OA difference as to pain. Results provide evidence for considering muscle function of the lower extremities in therapeutic programs for RA and OA within primary health care.
2465767 A longitudinal study of anticollagen antibodies in patients with rheumatoid arthritis. 1989 Feb Antibodies to native and denatured collagens (types I, II, IX, and XI) were measured in sequential serum samples collected over 1.5-8.7 years (median 4.3) from 15 patients with rheumatoid arthritis. Eleven patients were seropositive and 4 were seronegative. Disease duration ranged from 3 years to 25 years before the first sample was tested. The patients showed a selective and varying response to collagens, even after disease had been present for a long time. Changes in the levels of antibody to one collagen type were not necessarily linked to changes in the levels of antibody to other collagens. Only some patients showed a strong correlation between C-reactive protein levels (a measure of disease activity) and antibodies to individual collagens. These findings suggest that rheumatoid arthritis patients produce antibodies to a wide variety of epitopes on these collagen molecules, as a result of different antigenic epitopes being exposed by cartilage degradation at different times throughout the disease.
2555505 High titer of antibody to the Epstein-Barr virus membrane antigen in sera from patients wi 1989 Aug Sera from patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) contained more antibody to the Epstein-Barr virus membrane antigen (EBV MA) than sera from healthy controls. Since antibody titer to EBV MA closely correlates with viral neutralization, it was inferred that these patients were frequently exposed to infectious EBV, producing high titers of neutralizing antibody.