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

ID PMID Title PublicationDate abstract
3423621 Differential responses of old human cartilage explants to synovial- and mononuclear-cell f 1987 To investigate mechanisms of cartilage destruction that may apply to rheumatoid arthritis, young and old human, and young porcine, articular cartilage was cultured for 8 days and the effects on proteoglycan (PG) metabolism of normal synovium supernatant (NSS), rheumatoid synovial fluid (RFL), and blood mononuclear cell supernatant (MCF) were studied. The effects were chondrocyte-mediated. An inverse correlation was found between baseline net PG synthesis and the effect of NSS on PG synthesis. Responses of young (porcine and human) cartilage were similar. In young cartilage the three agents induced PG depletion by suppression of net PG synthesis. In old cartilage NSS and RFL induced PG depletion, whereas MCF did not. In cartilage of low baseline net PG synthesis, NSS and MCF stimulated both PG release and PG synthesis; NSS stimulated predominantly PG release, and MCF predominantly PG synthesis. In conclusion, young and old human cartilage differ in the quality of their in vitro response to potentially catabolic factors. This may be due to the difference in baseline net PG synthesis. Synovial extracts differ from mononuclear-cell supernatants in their effects on old cartilage. It is suggested that this is caused by the presence, in different relative amounts, of factors that influence either PG synthesis or PG release.
3474856 Clinical findings in the stomatognathic system for individuals with rheumatoid arthritis a 1987 Apr A group of 123 individuals with rheumatoid arthritis (RA group) and 28 individuals with osteoarthrosis (OA group) were compared with 52 individuals without general joint symptoms (C group). The individuals in the RA and OA groups constituted 35% and 14%, respectively, of all individuals with RA and OA at the Rheumatism Hospital in Strängnäs, Sweden, during the period of investigation. All individuals answered a questionnaire concerning subjective symptoms from the stomatognathic system and general joint symptoms and were given a clinical examination comprising the temporomandibular joint (TMJ), masticatory muscles, mandibular mobility, and occlusion. Most signs of disorder in the stomatognathic system were more frequent and more severe in the RA and OA groups than in the C group. The clinical signs were of a similar character in the RA and OA groups, but the individuals in the RA and OA groups had less occlusal support, more occlusal interferences, greater distance between RP and IP, and less vertical overbite than the C group. Anterior open bite was found with higher frequency and severity in the RA and OA groups than in the C group and was correlated to clinical dysfunction score and reduced maximum mouth opening capacity.
2060196 A method of ankle stabilization. 1991 Jul A simple method of ankle stabilization using a long trifin nail, inserted from below, is described. The method is particularly suitable in the elderly, when a short period of bed rest and early weight bearing is desirable. The procedure is contraindicated if subtalar joint motion is present and should be preserved.
2524277 Collagen arthritis in the rat is initiated by CD4+ T cells and can be amplified by iron. 1989 Jun The role of iron in arthritis was studied by administering ferric citrate (Fe-cit) to age-matched, female Sprague-Dawley rats immunized with chick type II collagen on Day 0. Rats received intravenously (iv) either Fe-cit (7.7 mg/kg body wt) or an identical concentration of sodium citrate on varying days after immunization. Transferrin saturation peaked (88-95%) 1 hr post-Fe-cit and returned to baseline values within 24 hr. Injection of Fe-cit on either Day 3 or Day 5, but not on Day 7 or Day 9, significantly (P less than 0.03) increased the incidence of arthritis. Synovium from the infrapatellar fat pad was harvested on Days 0-10 for analysis by immunocytochemistry. The inceptual morphologic change in the synovium following collagen immunization in rats not injected iv was an increase in the number of CD4+ and transferrin receptor+ mononuclear cells in perivascular regions; compared to Day 0 both cell types had increased two- to threefold by Day 3. On Day 7, an increase in CD8+ mononuclear cells occurred and the first polymorphonuclear leukocytes were noted. These alterations resulted in a peak in the CD4-CD8 ratio on Day 3, with a gradual decline thereafter. Although Fe-cit administration promoted the ingress of these mononuclear cells, it did not change the CD4-CD8 ratio significantly or recruit polymorphonuclear leukocytes into the joint tissue. Serum antibody titers to type II collagen, measured 20 days after immunization by an enzyme-linked immunosorbent assay, and delayed-type hypersensitivity to collagen, measured by a radiometric ear assay on Day 23, did not differ significantly between the groups. As well as showing that the initial intrasynovial event in collagen arthritis is perivascular infiltration by members of the CD4+ T cell subset displaying a phenotypic sign of activation, these findings demonstrate that iron administered at a critical time after immunization enhances the induction of collagen arthritis. The coincidence of this brief period of susceptibility with maximum CD4-CD8 ratios within the synovium and its occurrence prior to the stage of neutrophil infiltration are consistent with the possibility that the augmenting effect of iron is mediated by the inducer T cell subset.
2977039 [HLA-B27-negative sacroiliitis as a complication of inflammatory forms of acne: case repor 1988 Nov In this review, three patients with severe inflammatory acne accompanied by a distinct rheumatologic syndrome are discussed together with 44 similar cases reported in the literature. This syndrome, here referred to as "acne-associated arthritis (AAA)" usually involves male teenagers and twins. The most characteristic clinical findings relate to the axial skeleton as well as the sterno-costo-clavicular region. Although no association with HLA-B27 has been found, AAA shares a number of clinical, radiological and histomorphological features with seronegative spondylarthropathies. Furthermore, nosological connections seem to exist with a number of ill-defined "hyperostotic osteoarthropathies." Similar characteristics are known from other "pustulotic or neutrophilic dermatosis." The hypothesis of an infectious etiology of AAA has not been substantiated. Responses to systemic antibiotics are generally disappointing, whereas steroids have been shown to exhibit some therapeutic efficacy.
2655427 Subcutaneous phaeohyphomycosis of the finger caused by Exophiala spinifera. 1989 May A patient with severe rheumatoid arthritis treated with prednisone had a painless soft tissue nodule develop on the dorsal aspect of the ring finger. She denied any history of hand trauma, animal exposure, or systemic symptoms such as fever or malaise. Fungal cultures performed on an aseptically obtained aspirate of this lesion demonstrated dark, olive-black creamy colonies on Sabouraud's agar. Slide cultures made from mold colonies produced slender conidial forms with annellations and spine-like conidiophores, features characteristic of Exophiala spinifera. The lesion was surgically excised, and the patient was successfully treated with a course of oral itraconazole. This nodular lesion has not recurred at the time of this writing. Exophiala species are difficult to differentiate, and E. spinifera may be confused with Exophiala jeanselmei. A literature review will consider Exophiala species and clinical manifestations produced by these dematiaceous fungi.
3704525 [The contribution of computerized tomography to synovial pathology]. 1986 Feb The authors have developed a technique of CT arthroscan which, by the use of a gas or opaque contrast medium, is able to demonstrate the synovial structures of the knee, the shoulder and the hip. Among the essential indications, they include the demonstration of neoplasia of the synovium and the evaluation of the pannus in rheumatoid arthritis. Their secondary indications include the demonstration of fluid effusions in the hip, the precise evaluation of hyperostotic lesions in the same joint, the detection of ossification phenomena in the capsule of the inter-apophyseal joints in ankylosing spondylitis and, in some cases, following negative or doubtful arthrography for the detection of synovial plica. They also recall the usefulness or the arthroscan in the diagnosis of lesions of the labrum glenoidale.
3594005 Radioimmunoassay for IgG and IgM rheumatoid factors. 1986 The present paper describes two solid phase radioimmunoassays for detecting IgG and IgM rheumatoid factors (RF). Basically, serum rheumatoid factors were bound to rabbit IgG previously adsorbed to wells of flexible microtiter plates and quantitated after the addition of 125I-Fab anti-human gamma Fd for the IgG-RF assay or 125I-IgG anti-mu chain for the IgM-RF assay. The IgG and IgM rheumatoid factor assays were tested on 56 and 30 control sera, respectively. The upper normal limits for these assays were taken for cpm test serum/cpm control pool as 1.00 (0.76 + 0.24; X + 2SD) and 1.39 (0.73 + 0.66; X + 2SD) for IgG-RF and IgM-RF, respectively. When applied to sera of patients with rheumatoid arthritis, IgM-rheumatoid factor was detected in 15 of 15 (100%) patients, and IgG-rheumatoid factor in 15 of 17 (88%). The radioimmunoassay results for both rheumatoid factors were significantly higher for these patients than for the normal control sera (P less than 0.01).
3559598 Staged versus simultaneous bilateral total knee replacement. 1986 Bilateral total knee replacements were reviewed to determine whether any difference exists in the perioperative course between procedures done under one anesthetic (simultaneous) and those done under two anesthetics (staged). There were 29 staged and 18 simultaneous cases, therefore 76 separate procedures and 94 knees done. The total operative time, blood loss, and complications were similar between the two groups. However, the staged replacements had more than twice the hospital days (34.6 +/- 7.7 vs. 16.8 +/- 5.6, P less than .001) and 18% greater hospital bills. In fact, for a given patient, the hospital bill may be greater than 50% higher if a staged rather than simultaneous replacement is done. Therefore, simultaneous replacement is recommended for appropriate patients.
2893241 Impaired glucose handling in active rheumatoid arthritis: relationship to peripheral insul 1988 Feb Glucose metabolism was studied after an intravenous glucose loading in normal-weighted, previously untreated patients (n = 14) with active rheumatoid arthritis (RA). The patients displayed an enhanced insulin response and impaired glucose handling compared with healthy controls (P less than .001). The insulin sensitivity, measured as the glucose utilization rate during steady state of euglycemia (M) was significantly decreased (P less than .01) among the patients compared to the controls (5.5 +/- 1.9 mg/kg BW/min [mean +/- SD] and 7.2 +/- 1.2, respectively). The corresponding values for the metabolic clearance rate (MCR) were 5.8 +/- 0.6 mL/kg BW/min and 8.2 +/- 0.4, respectively (P less than .01). In the patient group the k value correlated with the peripheral insulin sensitivity (P less than .01), which, in turn, was inversely related to the acute phase reaction (P less than .05). During 1 week of potent anti-inflammatory treatment with corticosteroids (prednisolone 20 mg daily) the k value improved P less than .001), the insulin sensitivity tended to improve and the insulin response increased (P less than .001) after an intravenous glucose loading. Five patients who had a remission of their disease on sulphasalazine as antirheumatic therapy were reexamined. A normalization of the inflammatory activity as well as the glucose handling and insulin sensitivity was achieved. The data obtained indicate that impaired glucose handling in active RA is related to insulin resistance. The linkage between inflammatory indices and glucose metabolism might reflect a special consequence of inflammation, but the influence of nonspecific disease manifestations, ie, malnutrition, inactivity, and myopenia, has to be considered.
3765758 [Multicenter reticulohistiocytosis--histologic photoreport]. 1986 Aug 1 Histomorphologic features of multicentric reticulohistiocytosis are rarely seen in three predominant areas of one patient. Characteristic are infiltrates of eosinophilic histiocytes and multinuclear giant cells with opalescent appearance, fine vacuoles, and PAS-positive granules. In all three lesions, the histologic findings were identical. In the mucous membrane and the synovia, we found dilated vessels with thickened walls and edema of the tissue. In the synovia, size and number of the multinuclear giant cells are less pronounced.
3794231 Surgical management of the rheumatoid wrist--fusion or arthroplasty. 1986 Nov Forty-eight patients with 33 wrist fusions and 37 silicone wrist arthroplasties were reviewed and compared. Of those who had arthrodesis 97% showed a good or excellent result. Follow-up time averaged 82 months. All patients had a decrease in pain. Most patients had stronger wrists but complained of decreased dexterity. There were no pseudarthroses. The complication rate was 18%. Of patients in the arthroplasty group, 78% had a good or excellent result. Follow-up time averaged 51 months. Most patients in the arthroplasty group had improved dexterity and adequate wrist strength. Average flexion/extension was 32 degrees/29 degrees. The complication rate was 25%, which included four revisions. Of patients who had arthroplasties, 14% had bone resorption about the stem, and 11% of the patients with arthroplasties had x-ray evidence of settling. Factors that did not influence the result of the arthroplasty were patient age, duration of disease before surgery, finger extensor tendon rupture, preoperative motion, and hand dominance. Factors that were associated with failure and/or a fair result in arthroplasty patients were the use of ambulatory aids, the older and narrower prosthetic design, dislocated wrist preoperatively, and the chronic use of steroids.
1895259 Rheumatoid arthritis in Israeli Jews: shared sequences in the third hypervariable region o 1991 Jun Rheumatoid arthritis (RA) is known to be associated with class II HLA antigens in most populations, but recent studies in Israeli Jewish patients showed no significant differences in either DR4 or DR1 between patients and controls. In a previous DR4 subset study we found DR4-Dw15 to be associated with susceptibility (RR = 9.2) but this allele occurred in only 12% of the patients. We analyzed all DRB1 genes, using the polymerase chain reaction (PCR) and hybridization with allele specific oligonucleotides, in 49 Jewish patients with RA and 40 normal Jewish controls. Six DRB1 alleles that are similar to the prototype DR4-Dw4 (DRB1*0401) appeared to contribute to the risk for developing RA. In addition to DR4-Dw15 (DRB1*0405) 2 other alleles having substitutions in codons 71 only (DR1-Dw1/DRB1*0101, DR4-Dw14.2/DRB1*0408) or in codons 70 and 71 (DRw10/DRB1*1001) gave highly significant relative risks. Together, this group, with valine in position 85, and glycine in codon 86, gave a relative risk of 11.0 (p = 0.0002). Two other alleles with the same sequence in the third hypervariable region (amino acids 67-74) but with valine in codon 86 (DR4-Dw14.1/DRB1*0404) or alanine in 85 and valine in 86 (DR1-Dw20, DRB1*0102) gave a combined risk of 3.6 (p = 0.049). Altogether these 7 alleles with similar sequences in the third hypervariable region accounted for 55.6% of the patients, with an overall relative risk of 8.6 (p = 0.00002). Our results in this population indicate that shared epitopes in the third hypervariable region of DRB1 alleles also play a role in susceptibility to RA.(ABSTRACT TRUNCATED AT 250 WORDS)
3273869 Controlled-release ketoprofen in rheumatoid arthritis and osteoarthritis: comparison of tw 1988 Thirty-one hospital outpatients in Thailand, 14 with rheumatoid arthritis and 17 with osteoarthritis, received 100 mg (15 patients) or 200 mg (16 patients) of controlled-release ketoprofen daily for 12 weeks. At the start of treatment, at day 42, and at day 84 (end of treatment) the patients were assessed for pain, duration and severity of morning stiffness, duration of daytime inactivity needed to produce stiffness, the duration of that stiffness, and overall clinical state. Blood and urine samples were taken to monitor hematological, renal, and carbohydrate function. On all clinical measures the patients improved during the study to a highly significant extent in both treatment groups, with no significant between-group differences. No ketoprofen-induced side effects were reported. No clinically important changes in laboratory variables were found. It is concluded that controlled-release ketoprofen is effective and well-tolerated in the treatment of the symptoms of arthritis in Thailand. On the basis of this study, there appears to be no advantage in increasing the dose above 100 mg daily.
1858444 [Validation of electronic by conventional pain diaries]. 1991 A new type of electronic pain diary was validated in an open, randomized, crossover study. The main target variables were the comparison of the correctly realized pain assessment entries as well as the recording of the number of adverse events. Selected for the study were 20 patients, who were either hospitalized, partially-hospitalized or treated on an out-patient basis, with painful spondylogenic spinal syndrome or osteoarthritis of the trunk-proximal large joints. The patients were randomly-assigned to the two groups. The first group initially received the conventional diary and thereafter the electronic diary; the sequence was reversed for the second group. The drug therapy consisted of the NSAID, Ibuprofen, at an individually-adjusted dosage. Additional therapeutic measures were carried out by all the patients. The electronic pain diary proved to be equivalent to the conventional diary with regard to adherence of the pain assessment entry times. At a defined equivalence range of +/- 20%, the statistical comparison showed that the limits were never exceeded. The equivalence test of Anderson-Hauck showed a significance level of p less than 0.0001. The minimum equivalence range was +/- 2%. It therefore follows, that the conventional method of data recording can indeed be fully replaced by the electronic method. Comparing the individual data of the 16 patients, from whom entries with both the electronic as well as the conventional pain diaries were submitted, a clear tendency for increased entries on adverse events in the electronic diary (C.D. 6.4 +/- 10.5/E.D. 36.4 +/- 44.1) was demonstrated. No significant difference, however, was shown for the number of patients making data entries on adverse events in the electronic pain diary compared to those patients, who made their entries on adverse events in the conventional diary. According to the data from the physicians and patients, the Ibuprofen treatment results in an improvement in 90%/75% of cases, respectively. Likewise, the functional impairment of the affected joints as well as the swelling decreased markedly. The advantages of the electronic data recording system, i.e. closely-meshed controls can be carried out, transcriptional errors are minimized, data can be processed on-line, no possibility to subsequently change an entry, stand in contrast to the feature that there is no possibility to make free-style entries. The employment of the electronic system in the recording of individual data and subjective data represents a substantial improvement with regard to the quantity and quality of the data.
1699542 Specificity of antibodies to type II collagen in rheumatoid arthritis. 1990 Oct To reassess the role of autoantibodies to type II collagen in the pathogenesis of diseases, we studied antibodies from patients with rheumatoid arthritis (RA) and from patients with relapsing polychondritis for species specificity and collagen type specificity, using an improved enzyme-linked immunosorbent assay. Antibodies were found in the sera of 15% of the RA patients and 50% of the relapsing polychondritis patients, as well as in the cartilage of 69% of the RA patients examined. Reaction with both homologous and heterologous type II collagens was common. Analysis of 19 selected RA sera revealed that autoantibodies were generally associated with specific antibodies to some species of heterologous type II collagen. In contrast, antibodies found in 4% of the non-RA controls were specific for either bovine or chick type II collagen. These findings indicate that autoantibody formation in RA and relapsing polychondritis may occur as a result of an immune response to heterologous type II collagen. However, since RA and relapsing polychondritis patient sera differed in their reactivity with the cyanogen bromide-digested peptides, it is possible that the clinical manifestation of collagen autoimmunity might be influenced by the epitope specificity of the antibodies.
1837861 [Surgical possibilities in orthopedic rheumatology]. 1991 Aug Surgery has been a mainstay in the treatment of rheumatic conditions. Basically, its effect is limited to the site involved. Reconstruction of a damaged component of the locomotor system, however, may also relieve other components, and thus improve their function. Usually the prescribed drug treatment and physiotherapy must be continued, although the rehabilitation of individual, particularly severely affected joints may result in reduced drug intake. Surgery is indicated in the early stages, when isolated joint inflammations remain unchanged for more than half a year in spite of intensive physical and drug treatment. Best results have been achieved with preventive procedures (synovectomy, tenosynovectomy) carried out before joint alterations become evident in the x-ray. These procedures can also be performed in advanced stages, usually together with reconstructive measures. These patients, however, must expect some discomfort to remain, because of the irreversible joint damage already incurred. The operations selected for advanced cases include corrective osteotomies, resection arthroplasties and arthrodeses. To date, satisfactory long-term results of allo-arthroplastic joint replacements are only assured in terms of hip and, with reservations, knee prostheses.
3234952 [Long-term results of finger joint endoprostheses of the "St. Georg" model]. 1988 Nov Long-term results of 100 cemented finger joint replacements (endoprosthesis) of the "St. Georg" design are presented. Good reduction in pain and swelling was noted. There was only a little improvement in motion of the replaced metacarpophalangeal joint, but more in the proximal interphalangeal joint; the latter decreasing from radial to ulnar. Approximately one half of the preoperative ulnar deviation was corrected. Mechanical failures occurred in approximately 30% of the implants. Without changing the design, this demanding technique cannot be recommended routinely.
3236302 The varied clinical manifestations of iliopsoas bursitis. 1988 Nov Iliopsoas bursitis is often overlooked as the cause of symptoms involving the inguinal area and lower extremity. We report 8 patients with iliopsoas bursitis. All had either osteoarthritis or rheumatoid arthritis of the hip but only 3 had significant hip pain. Patients presented with an inguinal mass and hip pain (2); unilateral leg swelling (2); inguinal mass and unilateral leg swelling (1); hip pain (1); pelvic mass with bladder compression (1); and no symptoms (1). The diagnosis was entertained initially in only 2 patients. Computed tomography was useful in establishing the diagnosis.
1697425 Lack of natural antibodies in rheumatic diseases. 1990 The prevalence and Ig class of natural antibodies in the sera of healthy individuals and of patients with rheumatic diseases were studied. The presence, even in high concentrations, of natural antibodies in normals was confirmed. In the rheumatic diseases tested, however, a discordance in the levels and Ig class of anti-actin, anti-myosin and anti-ssDNA antibodies was noted. IgM anti-actin antibodies occur infrequently, whereas IgM anti-myosin and anti-ssDNA are increased in these diseases. IgG anti-actin antibodies are increased in the sera of patients with RA, but not in patients with SLE, polymyositis or mixed connective tissue disease (MCTD). IgG anti-myosin as well as anti-ssDNA antibodies were increased in patients with RA and SLE, but not in patients with polymyositis or MCTD. These findings suggest that these natural antibodies are unlike the multispecific autoantibodies produced by lymphocytes from the CD5+ B cell lineage and that they may have undergone affinity maturation. Perhaps natural antibodies are a feature of health rather than of disease.