Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
ID | PMID | Title | PublicationDate | abstract |
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2749791 | [The role of concomitant diseases in the etiology of chronic sialadenitis]. | 1989 Jan | Investigated were the concomitant diseases in 203 patients with chronic syaloadenitis and 143 control patients with various afflictions of maxillofacial region and intact salivary glands. The authors revealed that concomitant pathology in patients with chronic syaloadenitis was induced by the general premorbide background. Otherwise, it could create itself a background conducive to syaliadenitis. The respiratory and gastrointestinal pathology was prevalent in different patient groups. | |
3473625 | The gastrointestinal involvement in primary Sjögren's syndrome. | 1986 | Gastrointestinal manifestations in patients with primary Sjögren's syndrome (SS), which is an autoimmune exocrinopathy, include dysphagia, nausea, epigastric pain, dyspepsia and nutritional deficiencies. In this report, we are presenting the nature and incidence of esophageal, pancreatic and liver involvement in our primary SS patients. Esophageal motility was studied in 27 patients with primary SS and 25 normal age and sex matched volunteers. Esophageal dysfunction was detected in 11 of the 27 patients (40.71%). Individual analysis of the esophageal motility studies showed different patterns of esophageal dysfunction. These esophageal abnormalities did not correlate with the parotid flow rate, the degree of inflammatory infiltrate of the minor salivary glands, the extraglandular manifestations or the presence of autoantibodies. Sera from 25 patients with primary SS were studied for the total serum alpha-amylase activity and isoamylases. Sera from 81 normal age and sex matched volunteers were used as controls. None of these patients had abdominal pain or gastrointestinal symptoms at the time of blood collection. The presence of hyperamylasemia of P-type and S-type in 6/25 patients (24%) probably reflects a slow, subclinical, inflammatory process of the exocrine glands. Clinical and biochemical evaluation of the liver function was studied in 22 primary SS patients. One of them had abnormal liver function tests and another hepatomegaly and splenomegaly. Percutaneous liver biopsies in both revealed chronic active hepatitis. | |
3281609 | Pulmonary hypertension in primary Sjögren's syndrome. | 1988 Mar | The clinical course of a patient with pulmonary hypertension associated with Sjögren's syndrome is reported. The clinical features and outcome of this case are compared with those of two other reported cases in the Spanish and Japanese published work. Thus far, pulmonary hypertension has not been reported with primary Sjögren's syndrome in English publications. These three cases suggest that the development of pulmonary hypertension in primary Sjögren's syndrome is uncommon but should be included as part of the clinical spectrum. | |
3315499 | Molecular basis for the cross-reactive idiotypes on human anti-IgG autoantibodies (rheumat | 1987 | High titres of anti-IgG autoantibodies (rheumatoid factors, RF) are characteristic of patients with rheumatoid arthritis, Sjögren's syndrome, and mixed cryoglobulinaemia, and may contribute to immune complex formation and tissue damage. The monoclonal RFs from cryoglobulinaemia patients frequently display cross-reactive idiotypes. The genetic basis for the cross-reactive idiotypes on RF autoantibodies has not been determined. To clarify structural and genetic relationships among RFs from unrelated subjects, a series of anti-peptide antibodies have been generated that define primary sequence-dependent idiotypes on RF heavy and light chains. Multiple monoclonal and polyclonal RFs from unrelated individuals have been probed by Western blotting with the anti-idiotypic reagents. The results show that sequences in the kappa light chain variable region represent a common structural element among RF autoantibodies. This hypothesis is confirmed by the cloning and sequencing of the conserved germline variable region gene which encodes human RF kappa chains. | |
3682764 | Experimental arthropathy induced in rhesus monkeys (Macaca mulatta) by intradermal immuniz | 1987 Nov | Over a 6-month time course, polyarticular arthritis was induced in 7 male rhesus monkeys by 3 intradermal injections of bovine type II collagen emulsified in complete Freund's adjuvant, followed later by 2 intradermal injections of type II collagen in incomplete Freund's adjuvant. All animals exhibited delayed-type hypersensitivity to type II collagen by skin test and had serum anti-type II collagen titers of greater than 10,000 (at 1 month) and 20,000 to 160,000 (at 6 months) by enzyme-linked immunosorbent assay. Gross joint changes were observed in 6 of 7 monkeys, especially in the knee and elbow; synovial cell hyperplasia, increased vascularization and a focal mononuclear cell infiltrate were the most frequent findings. Chronic arthritis with destructive cartilage lesions was most prominent in the phalangeal joints of the hands (7 of 7 animals). Microscopically, these changes consisted of fibrosis of the synovium with increased vascularization, villous synovial membrane hyperplasia and focal mononuclear cell infiltration, as well as fibrous metaplasia of the articular cartilage adjacent to pannus formations. Also evident was a loss of safranin O staining intensity in the cartilage and loss of continuity of the articular surface. The 7 control monkeys (received Freund's adjuvant without collagen) were delayed-type hypersensitivity-negative, had no serum anti-type II collagen antibodies, and had grossly and microscopically normal joints. This primate model resembles collagen-induced arthritis seen in rodents and, to some degree, human rheumatoid arthritis. | |
2575493 | Pharmacokinetic analysis of cyclosporine in adjuvant arthritic rats. | 1989 Nov | Cyclosporine A (CsA) has been shown to be effective in patients with rheumatoid arthritis and to prevent the development and improve the symptoms of adjuvant-induced arthritis in rats. Since abnormal drug disposition has been reported in inflammatory conditions, we have evaluated the pharmacokinetics of CsA in this animal model of arthritis. We found a statistically significant decrease in the rate of disappearance of blood concentrations of CsA following iv administration to arthritic rats. The plasma half-life of CsA increased with a corresponding decrease in total body clearance. The volume of distribution remained unchanged. This abnormality in CsA kinetics was not observed in these animals until 10 days after adjuvant injection. The administration of CsA (15 mg/kg ip) twice daily to arthritic rats for 8 days produced a 39.8% and 49.5% inhibition of swelling in the right and left hindpaw, respectively. There was also a 63.5% decrease in the arthrogram score. Trough levels of CsA in arthritic animals were initially higher than in controls during this treatment but returned to control values after 8 days of dosing, suggesting reversal of abnormal disposition with improvement of the disease. The addition of indomethacin to the dosing regimen resulted in a significant increase in trough levels of CsA, indicating a drug interaction between these two compounds. Possible mechanisms responsible for these observations with CsA are discussed. | |
3358135 | Concentric joint space narrowing of the hip associated with hemosiderotic synovitis (HS) i | 1988 | Concentric joint space narrowing of the hip is an expected radiographic finding in cases of inflammatory arthritis such as rheumatoid arthritis or sepsis. However, similar joint space narrowing is associated with chronic hemorrhagic conditions that produce hemosiderotic synovitis. Hemosiderotic synovitis results from chronic intra-articular bleeding such as occurs in pigmented villonodular synovitis, generalized bleeding diathesis, synovial hemangioma, and chronic trauma. Five hips in five patients with concentric joint space narrowing not associated with inflammatory arthritis or with hemophilia were reviewed clinically, radiographically, and pathologically. All patients had a hemosiderotic synovitis. The definitive diagnosis of pigmented villonodular synovitis was made pathologically in two cases that demonstrated nodular areas of giant cell proliferation, collagen production, and lipid-laden histiocytes on histologic samples. | |
2169746 | Rheumatologic manifestations of human parvovirus B19 infection in adults. Initial two-year | 1990 Sep | During 1987 and 1988, we identified 9 adults at the Medical and Rheumatology Services of the University of Iowa Hospitals and Clinics who had a clinical diagnosis of fifth disease; 8 of the 9 had symptoms of joint involvement. Another 12 adults with serologic positivity for anti-parvovirus B19 IgM antibody presented with polyarthralgia/polyarthritis. Patients were usually found to be seronegative for rheumatoid factor, and none developed nodules or erosive disease. Many patients with chronic disease met criteria for a diagnosis of rheumatoid arthritis. A diagnosis of parvovirus B19 infection should be considered during the initial visit of patients with polyarthralgia/polyarthritis. | |
2068574 | Prolactin, immunoregulation, and autoimmune diseases. | 1991 Apr | Cells of the immune system synthesize prolactin and express mRNA and receptors for that hormone. Interleukin 1, interleukin 6, gamma interferon, tumor necrosis factor, platelet activator factor, and substance P participate in the release of prolactin. This hormone is involved in the pathogenesis of adjuvant arthritis and restores immunocompetence in experimental models. In vitro studies suggest that lymphocytes are an important target tissue for circulating prolactin. Prolactin antibodies inhibit lymphocyte proliferation. Prolactin is comitogenic with concanavalin A and induces interleukin 2 receptors on the surface of lymphocytes. Prolactin stimulates ornithine decarboxylase and activates protein kinase C, which are pivotal enzymes in the differentiation, proliferation, and function of lymphocytes. Cyclosporine A interferes with prolactin binding to its receptors on lymphocytes. Hyperprolactinemia has been found in patients with systemic lupus erythematosus. Fibromyalgia, rheumatoid arthritis, and low back pain patients present a hyperprolactinemic response to thyrotropin-releasing hormone. Experimental autoimmune uveitis, as well as patients with uveitis whether or not associated with spondyloarthropathies, and patients with psoriatic arthritis may respond to bromocriptine treatment. Suppression of circulating prolactin by bromocriptine appears to improve the immunosuppressive effect of cyclosporine A with significantly less toxicity. Prolactin may also be a new marker of rejection in heart-transplant patients. This body of evidence may have an impact in the study of rheumatic disorders, especially connective tissue diseases. A role for prolactin in autoimmune diseases remains to be demonstrated. | |
3204521 | Effect of tolmetin glycine amide (McN-4366), a prodrug of tolmetin sodium, on adjuvant art | 1988 Dec | The glycine amide of tolmetin sodium (TGA) functions as a prodrug and was demonstrated to be more potent than the parent compound as an inhibitor of developing and established adjuvant arthritis in the female Lewis rat. In contrast, the glycine amide of indomethacin was less potent than indomethacin. The superiority of TGA relative to tolmetin sodium in alleviating this condition was demonstrated by inhibition of paw swelling and reduction of the degenerative bone changes that are associated with the progression of this chronic animal model of rheumatoid arthritis in humans. These properties were not evident when equimolar mixtures of tolmetin sodium and glycine were administered concurrently. Pharmacokinetic analyses revealed that TGA was absorbed completely and hydrolyzed to tolmetin in the female adjuvant arthritic rat. The combined effects of absorption, distribution and hydrolysis of TGA produced lower peak plasma tolmetin levels than an equivalent dose of tolmetin sodium, but plasma concentrations were sustained for a longer period of time contributing to an apparent increase in potency. Furthermore, TGA displayed a decreased propensity to cause gastrointestinal irritation compared to tolmetin sodium. Several additional amino acid amides of tolmetin were similar to the glycine amide in exhibiting increased potency and reduced gastrointestinal toxicity in comparison to equivalent doses of tolmetin sodium. | |
3139562 | Antiarthritic synergism of combined oral and parenteral chrysotherapy. I. Studies in adjuv | 1988 Aug | In comparative clinical studies of auranofin (AF, oral gold) and parenteral gold in the treatment of rheumatoid arthritis, no difference in efficacy was detected. Since the pharmacologic profiles of these compounds are different, we studied their combined effect on adjuvant arthritis (AA). The effect of AF alone and combined with gold sodium thiomalate (GTM) or gold sodium thiosulfate (GTS) on the excretion of urinary hydroxyproline (UHP) and urinary calcium (UCa), and the articular index of arthritic rats was followed during five weeks of treatment. The excretion of UHP and UCa was significantly inhibited (P less than 0.005) in rats treated with AF combined with GTM or GTS as compared with animals treated with the individual gold compounds. However, the articular index only decreased significantly (P less than 0.02) in the group of rats treated with AF + GTS. The present studies open the possibility that combined treatment with oral and injectable gold provide a new approach for chrysotherapy with an increased antiarthritic potency. | |
2060197 | Wolf blade plate ankle arthrodesis. | 1991 Jul | Fifteen patients, each of whom had a Wolf blade plate ankle arthrodesis, were followed for a mean of 56 months. The mean age at the time of operation was 46.7 years. The preoperative diagnosis was posttraumatic arthritis in 16 cases and one each of degenerative arthritis, rheumatoid arthritis, and avascular necrosis of the talus. Eighteen of the 19 cases fused for a fusion rate of 94.7%. The average fusion position was 2.9 degrees of plantar flexion and 5 degrees of valgus. All patients whose ankle fused were satisfied with their results. The average Mazur postoperative score was 75 (range, 33-91). Five patients had delayed wound healing. The Wolf blade plate is a simple and easy method to fuse the ankle. Minimal dissection is required and a fusion rate of 95% is obtainable. | |
2781875 | [Familial Mediterranean fever--an important differential diagnosis in systemic juvenile ch | 1989 May | Familial Mediterranean Fever (FMF), characterized by recurring episodes of fever, serositis, arthritis, skin changes and complicated by amyloidosis in 30%-60% of cases frequently begins in childhood. Systemic juvenile rheumatoid arthritis (systemic JRA, Still's disease) is the most important differential diagnosis. In our series of 10 patients the mean age of onset was 4.9 +/- 2.2 years (range 2-9 years). The mean time period elapsed before the diagnosis was established was 4.1 +/- 2.7 years (range 1.5-10 years). Three of our 10 patients already had developed renal amyloidosis at the time of diagnosis. Essential criteria for differential diagnosis against systemic JRA were positive family history for FMF (4/10), ethnic background (9/10 of Turkish decent), typical erysipeloid skin rashes (4/10), attacks of abdominal pain accompanied by fever (10/10) and the characteristic pattern of recurrent episodes lasting only a few days each (a patient's diary monitoring the attacks may be helpful). In problematic cases the metaraminol provocative test can be helpful. If an elevated plasma dopamine beta-hydroxylase activity appears to be a specific finding in FMF patients, this may well open up new avenues in the early diagnosis of the disease. Since amyloidosis can be prevented by prophylactic long lasting treatment with colchicine, a timely diagnosis of FMF is the physician's challenge. | |
3822680 | Bone scintigraphy in the evaluation of children with obscure skeletal pain. | 1987 Apr | A retrospective analysis of bone scans of 381 children with unexplained skeletal pain was made. Of these, findings are reported on 358 for whom there were sufficient clinical data. The bone scan results suggested trauma as the cause of pain in 43 patients, inflammatory disease in 73 patients, and neoplasia in ten patients. There was only one false-positive bone scan. Normal findings were obtained from 227 patients, in whom no significant skeletal disease was detected on follow-up, except for juvenile rheumatoid arthritis in 23 patients. Bone scintigraphy is, therefore, an important, noninvasive diagnostic test for evaluating children with obscure bone or joint pain. We recommend that this test be performed early in the evaluation of these children to arrive at the diagnosis expeditiously and with minimal patient discomfort and morbidity. | |
2487717 | Improving compliance with prednisone therapy in pediatric patients with rheumatic disease. | 1989 Dec | Compliance with regimens for pediatric rheumatic diseases is often poor, and few studies have evaluated strategies for improving compliance. This study utilized relatively simple behavioral and educational strategies to improve compliance with prednisone for three patients with pediatric rheumatic diseases (systemic lupus erthematosus and dermatomyositis). These strategies were implemented in a pediatric rheumatology setting and resulted in improved compliance that was maintained at 6- and 12-month follow-up. During baseline, patients were found to be overmedicating as well as undermedicating. This study is a systematic replication of an earlier study that demonstrated that behavioral and educational strategies can improve compliance with medications for juvenile rheumatoid arthritis. It also raises the possibility of overmedicating as a compliance problem to be managed. | |
2590315 | Genetic epidemiology of Greenland. | 1989 Oct | The Inuit (Eskimo) gene pool is in many respects similar to that of East Asian populations. Some polymorphisms imply frequent occurrence of disorders comparatively rare in Western Europe (e.g. lactose and sucrose malabsorptions). Low frequencies of alleles for slow isoniazid acetylation and sparteine/debrisoquine oxidation indicate slow elimination of a multitude of drugs. Autoimmune disorders (e.g. rheumatoid arthritis, insulin dependent diabetes mellitus, Graves' disease and psoriasis) are rare, possibly explained by the associations of these disorders with HLA-alleles rare in Inuit (e.g. HLA-B8). Correspondingly high incidence of reactive arthritis may be explained by a frequent HLA-B27 allele. Prevalence of disorders due to instability of mesenchymal tissues (e.g. spondylolisthesis, osteoarthrosis, hernia, heart block) are still in want of a biochemical explanation. Attention is drawn to the urgency of genetic studies in the Arctic because of the accelerating hybridization of Inuit in all circumpolar areas. | |
3105633 | The consultant's role in continuing medical education of general practitioners: the case o | 1987 Jan 10 | Consultant rheumatologists were surveyed by questionnaire about their contribution to the continuing education of general practitioners, and 84% (203/243) replied. Altogether 157 respondents had participated in some form of teaching, 147 in collective teaching sessions such as lectures and 99 in the teaching of small groups. Arthritis comprised 44% of the rheumatological topics taught; there was a noticeable lack of teaching on problems commonly encountered in general practice, such as soft tissue rheumatism and injury and back pain, and on clinical skills including examination and injection of joints. Eighty eight respondents made comments and suggestions. The favoured educational strategies were small group teaching, apprenticeship schemes, and interchange between general practitioners and consultants about shared cases. This contrasts with what was typically done--namely, formal lectures on rheumatoid arthritis in postgraduate medical centres. These findings raise questions about the continuing education of consultants themselves as well as about the consultants' role in teaching others. | |
2456909 | [2 cases of Whipple's disease with different outcomes]. | 1988 Aug 5 | A 45-year-old man developed migratory arthritis and fever, at first believed to be caused by rheumatoid arthritis. Whipple's disease was eventually diagnosed after a malabsorption syndrome had occurred and biopsies been taken from the distal duodenum and jejunum. The patient was cured after several months on tetracycline. In a second case, a 73-year-old woman, malabsorption of six months' duration resulting from Whipple's disease had brought about such deterioration that after hospitalisation she died despite a correct diagnosis and an appropriate treatment. | |
3780105 | Immune pathology in polyarticular osteoarthritis. | 1986 Dec | Although osteoarthritis (OA) generally is considered a disorder of mechanical origin, the common occurrence of chronic mononuclear cell infiltrates in the synovium in conjunction with immunofluorescent evidence for immune-reactant products in cartilage of surgical case specimens (knees, hips, and peripheral joints) has suggested the local involvement of immune processes in the arthritis. Further, the findings of polyarthropathy in the majority of these cases have indicated the propensity for a systemic disorder. Wide variations were noted in both synovial and cartilage immune changes, quite different to those found in rheumatoid arthritis, along with the frequent asymptomatology of the many joints involved. These features, with and without other causative factors, suggest that immune reactions of local and/or systemic origin occur at times in a population at risk for joint degradation. | |
3759516 | [Examples for possible tumor induction by immunosuppressive and cytostatic drugs (case stu | 1986 Aug | The problems of immunosuppressive and cancer therapy are discussed based on five case reports. In each case neoplasms were observed, which appear to have been caused by the previous treatment. A tumor is particularly tragic when it follows immunosuppression for chronic inflammatory disease (eg. uveitis, rheumatoid arthritis). |