Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1930321 | A case of Sjögren's syndrome with repeatedly negative findings on lip biopsy. | 1991 Oct | We report a case of Sjögren's syndrome characterized by keratoconjunctivitis sicca, parotid swelling, reduced salivary flow, and abnormalities on nuclear scanning. Two labial gland biopsies showed complete atrophy. Biopsy of an enlarged submandibular gland revealed lymphoid follicles and glandular replacement consistent with the diagnosis of Sjögren's syndrome. This case supports the concept that a negative finding on labial biopsy does not rule out a diagnosis of Sjögren's syndrome. | |
| 1948450 | [A case of Sjögren's syndrome with malignant lymphoma]. | 1991 Jun | A case of a 62-year-old female with Sjögren's syndrome (SjS) who developed a malignant lymphoma (ML) is reported. The patient who became blind at 32 years of age due to retinitis, began to complain of sicca syndrome (dry eye and dry mouth) and polyarthralgia at 40 years of age. A rapidly progressive subcutaneous mass was noted in the right anterior chest wall at 62 years of age. The surgically resected mass was diagnosed histologically as ML, diffuse, large cell type. Immunohistological study was done. Almost all of the lymphocytes infiltrated around ductules of a small salivary gland biopsied 6 years earlier were B-cells (MB-1; +, Mx-Pan B; +, IgG k; +). Only a small number of them were evaluated as T-cells (UCHL-1; +). The ML tumor was studied as a B-cell lymphoma which did not produce immunoglobulins (MB-1; +, Mx-Pan B; +). The patient was treated with a CHOP-B protocol and radiation without exacerbation. In recent reports of this association, helper T-cells were dominant in the lymphocytes infiltrated in the salivary gland in the early stage when ML did not develop yet. In this case, B-cells were dominant in the small salivary gland in contrast to the former reports. It is interesting that there was a difference in the character of the infiltrating lymphocytes. | |
| 1914220 | Interactions of the salivary and gastrointestinal systems. II. Effects of salivary gland d | 1991 | Salivary gland dysfunction is uniformly detrimental to the oral cavity. Its effects on the GI tract have begun to be explored. Dry mouth is a common complaint among older adults, probably due to systemic disease and its therapy rather than the aging process per se. Evaluation of complaints of dry mouth should include medical history, sialometry and physical examination. Numerous medications can elicit drug-induced xerostomia. Patients who have received radiation therapy to the head and neck region often have permanent radiation-induced xerostomia, which has been linked to esophagitis. SS is an autoimmune systemic exocrinopathy resulting in irreversible salivary gland dysfunction. SS has numerous GI manifestations, including dysphagia, temporal defects of deglutition, esophageal dysmotility, gastritis, pancreatitis and liver disease. Management of salivary hypofunction is directed toward preserving the dentition and improving patient comfort. Drug-induced xerostomia is often correctable by altering the therapeutic modality. | |
| 2661072 | Criteria for the salivary component of Sjögren's syndrome. A review. | 1989 Mar | Sjögren's syndrome (SS) is characterized by the presence of least 2 components of the following three: keratoconjunctivitis sicca (KCS), xerostomia and another well-defined chronic inflammatory connective tissue disease (CTD). There is generally agreement that primary SS comprises the presence of KCS and xerostomia without the presence of a CTD, and that secondary SS occurs when a CTD is present together with KCS and/or xerostomia. However, there is disagreement as to the diagnostic criteria for the salivary component of SS (xerostomia). Assessment of this component by the presence of focal sialadenitis with a focus score on labial salivary gland biopsy is considered the most important single test. However, focal sialadenitis may occur in conditions other than SS. Therefore it is preferable to assess the salivary component with other tests as well, e.g. sialometry and salivary scintigraphy. It is demonstrated that the border between a normal and an abnormal test result may vary among investigators. Because the cause of SS is unknown, it is particularly important that international agreement on the diagnostic criteria is achieved. Investigators should state clearly in their publications how they have diagnosed SS. Patients suspected of having SS should be evaluated by a team of specialists in rheumatology, ophthalmology and odontology (oral medicine). | |
| 3734575 | Differential diagnosis of acute dactylitis psoriatica. | 1986 Jun | A bulbous or "sausage-shaped" finger may represent a special type of psoriatic arthritis without any rheumatoid factor activity. Dactylitis psoriatica must be suspected in cases of arthralgias progressing along the phalanges of a finger associated with global soft tissue swelling. Acute dactylitis psoriatica is characterized by an intermittent course combined with psoriatic and partly extremely mild or masked skin and nail changes. X-rays findings are spicular protuberances at diaphyses in a "cloudy collar" image. Symptomatic treatment of dactylitis psoriatica consists of non-steroidal antirheumatic drugs or basic gold salt therapy. In the interval additional surgical treatment using arthro-plasties and arthrodeses is indicated in cases of joint destruction. Amputation of the affected finger is not to be considered as a mandatory causal therapy of dactylitis psoriatica. | |
| 3260727 | Spontaneous osteonecrosis of the tarsal navicular in adults: imaging findings. | 1988 Aug | We encountered five otherwise healthy adults with alterations of the tarsal navicular bone compatible with spontaneous osteonecrosis. Four women had bilateral involvement and one man had unilateral involvement. The patients were 23-71 years old. The disorder was initially described by Mueller and Weiss and should not be confused with Koehler disease (osteochondrosis of the tarsal navicular in children). This group of patients was compared with five other patients (29-74 years old) with similar radiographic and clinical changes in whom an underlying disease (rheumatoid arthritis, renal failure, trauma, and lupus erythematosus) associated with osteonecrosis was known. Routine radiography in both groups defined characteristic abnormalities of the navicular bone (decreased size, a comma-shaped configuration, increased radiodensity, fragmentation, and medial or medial and dorsal osseous protrusion). MR in three patients confirmed alterations consistent with osteonecrosis. Three of the patients without underlying disease had bilateral involvement on plain films, with flat feet and hindfoot valgus deformity, leading to local pain and deformity. In a fourth patient, bilateral distribution was documented by MR as marrow alterations. Although no certain pathogenic explanation for spontaneous osteonecrosis of the tarsal navicular is known, trauma and chronic stress changes caused by physiologic pressure on the medial longitudinal arch in hindfoot valgus and increased tension forces of the plantar aponeurosis during weight-bearing (in pes planus) may be important. Discrimination of primary from secondary osteonecrosis of the tarsal navicular bone is not possible by radiologic means alone, although bilateral distribution, particularly in women, favors the diagnosis of spontaneous disease. | |
| 3099556 | Unique properties of auranofin as a potential anti-rheumatic drug. | 1986 Oct | Gold salts, auranofin (AF), aurothiomalate (ATM) and aurothioglucose (ATG) displayed immunosuppressive action in a series of in vitro assays which mimic the cell-cell interactions thought to occur in rheumatoid arthritis. The gold salts inhibited phytohaemagglutinin (PHA)-induced thymidine incorporation and gamma-IF production by peripheral blood mononuclear cells, as well as IL-2-induced proliferation of PHA-blasts. The separate addition of IL-2 and gamma-IF partly reversed the anti-proliferative effects of ATM and ATG; however, the addition of IL-1 had no effect. ATM and ATG inhibited PHA-stimulated IL-1 production by mononuclear cells but not spontaneous or LPS-induced IL-1 production by adherent monocytes. It was concluded that ATM and ATG inhibited lymphocyte function and lymphocyte-amplification of macrophage function. The anti-proliferative effects of AF were partly reversed by IL-2 but not by gamma-IF or IL-1. AF inhibited PHA-stimulated IL-1 production by mononuclear cells as well as spontaneous and LPS-induced production by adherent cells. It appeared that AF inhibited lymphocyte and macrophage function directly. AF also displayed potential anti-inflammatory activity in that it inhibited PGE2 and collagenase production by proteolytically dispersed rheumatoid synovial cells. | |
| 2075287 | [The lupus band test in the diagnosis of systemic lupus erythematosus: its decisive useful | 1990 Dec | The aim of this study was to evaluate an immunofluorescence skin test, the lupus band test (LBT), in comparison to other criteria as classified by the American Rheumatic Association for the diagnosis of systemic lupus erythematosus (SLE). Twenty patients with SLE and another 24 with different connective tissue diseases (rheumatoid arthritis 16, dermatomyositis 3, necrotizing vasculitis 5) were studied. Antinuclear antibodies (ANA) appeared very sensitive (100%) in the diagnosis of LES, though with a low specificity (63%). LBT was however both sensitive (80%) and specific (100%). Others ARA laboratory criteria (anti-dsDNA, anti-Sm, VDRL and hematological disorders) were also less sensitive and/or less specific than LBT. Most interestingly, LBT was positive in 7 SLE cases in which both dsDNA and Sm antibodies were negative. Thus, LBT appears a useful test in the diagnosis of SLE. In addition, it may be of critical value in certain subsets of patients in which the present ARA criteria may not suffice for diagnosis. | |
| 3238364 | Development of autoimmunity in MRL/lpr mice and the effects of drugs on this murine diseas | 1988 | MRL/lpr mice spontaneously develop a systemic Lupus erythematosus (SLE)-like disease with a wide range of clinical and serological characteristics that mimic not only human SLE but other autoimmune disorders. such as Sjögren's syndrome, and rheumatoid arthritis (RA). Unlike other murine SLE-like disorders, these mice have circulating rheumatoid factor (RF) and develop histological changes in their joints. Therapy of this disease with cyclophosphamide (CY), cyclosporin A, prednisolone, or leflunomide (HWA 486) resulted in very differing effects. Treating these mice with HWA 486 or cyclophosphamide (CY) resulted in a decrease in the amount of autoantibodies, and immune complex deposits on the glomeruli. HWA 486 therapy led to restoration of the depressed immune response of MRL/lpr mice. In the established disease, prednisolone (Pr), cyclosporin A (CSA), and HWA 486 could inhibit the proteinuria and return the urine-protein values to normal levels, but, unlike HWA 486, neither PR nor CSA could extend the longevity of these animals. The MRL/lpr mouse should prove to be very useful as a model for SLE, RA, and for discovering novel drugs to combat such disorders. | |
| 3502389 | Measurement of immune complexes with the liquid phase C1q binding assay: ten years experie | 1987 Dec | We describe our 10 years experience in assaying over 15,000 clinical specimens for immune complexes (IC) using the C1q binding assay. Normal ranges were initially established using a large panel of blood donor sera and precision of the assay was optimized by inclusion of heat aggregated IgG (HAGG) as standards. Nevertheless some variability was observed due to variation in C1q binding from batch to batch and with aging of this reagent. In an empirically selected 2 year period involving over 3,000 clinical specimens, 25% had elevated concentrations of IC. Of these the majority were from patients with rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), other connective tissue disorders, infective endocarditis (IE), diffuse interstitial lung disease (DILD) and vasculitis (VASC). In RA, IE and VASC, significant correlations were observed between concentrations of IC and rheumatoid factor (RF) and the addition of a purified monoclonal RF to normal serum caused increased C1q binding. Longitudinal studies in RA and IE demonstrated a striking decline in IC in response to effective treatment. We conclude that the measurement of IC provides little additional useful diagnostic information in those diseases associated with high levels of RF but appears more useful in disorders such as SLE, IE and DILD in which RF is absent or present in low concentration. Sequential monitoring of IC in RA and IE reflects response to treatment. | |
| 2662478 | Recent developments in the understanding of the pharmacokinetics and mechanism of action o | 1989 | Because of the binding of chloroquine to various tissue components and the lysosomotropism of chloroquine, its pharmacokinetics exhibit large apparent volumes of distribution, partial recoveries in urine, and persistence of low blood levels. These complexities have been reinvestigated with modern, highly sensitive methods for the determination of the drug and its major metabolite, desethylchloroquine, which reaches blood levels of about one-third those of the parent drug and constitutes about one-fifth of the 56% of drug accounted for by urinary recovery. Bioavailability is essentially complete, apparent volumes of distribution range up to 800 L/kg, and the pharmacokinetic data are generally accomodated by three compartment models. Half-lives for the terminal component are 1 to 2 months, but the terminal phases may be of minor importance in effectiveness. Dose dependence, i.e. nonlinearity in the relationship of dose and area under the plasma curve, apparently is not a factor. Some of the most recent studies, designed to provide a rationale for safer parenteral administration, have made possible computer-generated optimal infusion regimens. Revised schedules of loading and maintenance oral doses for antimalarial therapy have resulted from other pharmacokinetic studies. The in vitro antimalarial potencies of the two optical enantiomers of chloroquine are identical, but recent data suggest stereospecific differences in metabolic rates and renal secretion mechanisms. The marked uptake of chloroquine into the acidic food vacuoles of parasites resident in erythrocytes is assumed to underlie its antimalarial action, but mechanisms other than the previously assumed alkalization of the vacuole, possibly inhibition of phospholipid metabolism, now seem more likely to inhibit parasite function. Mild immunosuppression with inhibition of the elaboration of rheumatoid factor and acute phase reactants is a likely mechanism for the beneficial effects of chloroquine in rheumatoid arthritis. Blockade of interleukin-1 release could lead to these effects and is one of the few instances in which the low chloroquine levels attainable in human serum can be shown to affect immunological reactions. | |
| 3323030 | Identification of the site on IgG Fc for interaction with streptococci of groups A, C and | 1987 Dec | The interaction between living groups A, C and G streptococci and IgG Fc was studied using human IgG, IgG Fc and IgG Fc-intermediate (Fci) fragments, chemically modified human IgG and fragment D of staphylococcal protein A (SPA). Diethylpyrocarbonate modification of His or N-acetylimidazole modification of Tyr of human IgG resulted in the loss of its capacity to inhibit the binding of radiolabelled human IgG Fc to the group A streptococci types M1 and M55, and to the group C strain SC-1, indicating that the amino acids His and Tyr are involved in the binding. Lys seems not to participate in the binding of IgG to these bacteria, however, since reductive methylation of Lys did not reduce its inhibitory capacity. Fragment D of SPA also inhibited the binding of radiolabelled human IgG Fc to strains M1, M55 and SC-1. We have previously shown that these bacteria do not bind to IgG fragments consisting of only the C gamma 2 or C gamma 3 domains. On the basis of these results, and the known relative positions in space of the His and Tyr residues on IgG Fc, it is speculated whether streptococci with IgG Fc receptors, like SPA and rheumatoid factors, interact with IgG in the interface between the C gamma 2 and C gamma 3 domains and involve His 435 and one or more of Tyr 436, His 433 and His 310. The similarities in binding sites on IgG for RFs and these bacterial Fc binding proteins suggest structural similarities between them that may be relevant to the production of rheumatoid factors in rheumatoid arthritis. | |
| 2150740 | Modulation of extracellular matrix metabolism in rabbit articular chondrocytes and human r | 1990 Nov | Cultures of human rheumatoid synovial cells and rabbit articular chondrocytes were exposed to various concentrations of Etodolac (from 0.01 to 10 micrograms/ml) in presence or absence of 500 pg/ml (5 U/ml) human recombinant Interleukin-1 beta (IL-1 beta). Incubation of chondrocytes with Etodolac for 24 h did not alter collagen biosynthesis. In contrast, 1 micrograms/ml Etodolac caused a 20% increase of collagen production in synoviocytes. Addition of Etodolac in combination with IL-1 could partially suppress the inhibitory effect exerted by the cytokine on both cell types. Four-day exposure of chondrocytes to 0.1 and 1 micrograms/ml Etodolac led to an increased accumulation of collagen in the cell layer compartment. However, this treatment could not prevent the inhibitory effect of IL-1 on this collagen fraction. Treatment of synoviocytes for eight days with the same concentrations of Etodolac did not modify their collagen production but suppressed totally the inhibitory effect of IL-1. These data show that Etodolac is able to augment chondrocyte metabolism during a long term treatment. Moreover, under certain conditions, this drug can reduce or even suppress the IL-1-induced inhibition of collagen biosynthesis, a process that may take a part in the connective tissue alterations associated with osteoarticular diseases such as rheumatoid arthritis and osteoarthritis. | |
| 3188659 | [Physician consultation and use of drugs for rheumatic symptoms]. | 1988 | Between May 1986 and November 1987 we asked 4037 randomly sampled 25-74 year old german residents at Hannover (FRG) by a mailed questionnaire for back, neck and joint pain, for joint swelling and morning stiffness. Further we asked for the consultation of a physician during the past 12 months and for the use of drugs during the past 7 days because of rheumatoid complaints. 3426 members of the sample (85%) returned the questionnaire. 1828 (53%) reported at least one symptom "today" (= "the day you fill out this questionnaire"). The highest rate of persons suffering from complaints of the locomotor system was found among middle-aged women, with the maximum of 74% in the age group 50-54 years. For the illness behavior-physician consultation, use of drugs-the extent of complaints was of decisive importance. Sex was without, age of very low influence. The rate of those who reported the consultation of a physician and/or the use of drugs was increasing with the amount of positive answers to the questions on rheumatoid complaints. Nevertheless, of those who had answered in the affirmative all questions on complaints, 10% had denied the question on physician consultation. 41% had denied the question on the use of analgetic/antirheumatic drugs. | |
| 1871514 | [Adult oligoarthritis with antinuclear factors. A new syndrome, relations with juvenile ol | 1991 Jan | We report an original form of chronic inflammatory arthritis in 14 young adults, mainly females: an oligoarthritis with antinuclear antibodies. A first group of 10 patients, 9 females and one male, over 17 year-old, mean age 25, presented with monoarthritis or oligoarthritis of the knees, and less frequently of the wrist or elbow. Arthritis was chronic, recurrent, not destructive nor incapacitating. Rheumatoid factor was absent, and the only biologic abnormality was positive ANA at a significant rate. No patient was typed for HLA DR5. No other clinical or biological symptom appeared during a mean follow-up period of 5.5 years (6 mo-30 yrs). The patients have been totally free of any ocular symptoms. The benignity of the disease and its good prognosis must be underlined. Another group of 4 adult women had a similar inflammatory disease, which started during childhood: the biological and clinical spectrum was found quite similar in both groups, except for uveitis which occurred only in the later. Most subsets of juvenile arthritis have counterpart in adulthood, except for the pauciarticular subset with AAN. The cases herein described could fill the gap, the only difference with the juvenile onset form being the absence of uveitis. Thus, even if our observations of oligoarthritis with ANA in young women are the equivalent of the pauciarticular form in young girls, ocular involvement remains specific of childhood. | |
| 1928088 | Recombinant human erythropoietin therapy in the surgical setting and applications in oncol | 1991 Oct | The development of recombinant human erythropoietin (Epo), along with a sensitive and reproducible assay for plasma Epo, has resulted in new potential applications for the treatment of medical and surgical anemias. A series of studies have defined a role for Epo therapy in the perisurgical setting to include the facilitation of autologous blood procurement and to facilitate postoperative erythropoiesis in order to minimize homologous blood transfusion requirements. Other possible applications of Epo therapy include the treatment of medical illnesses. Clinical trials to date have demonstrated that Epo therapy can correct the anemias of renal insufficiency, of rheumatoid arthritis, and of acquired immunodeficiency syndrome (AIDS) patients undergoing antiviral therapy. Clinical trials investigating the application of Epo therapy in the oncologic setting are in progress. These developments herald a new age in transfusion medicine, which includes the use of pharmacologic therapies in blood conservation strategies. | |
| 1932705 | Inhibition of T cell activation by blockade of MHC class II molecules. | 1991 Jul | Autoimmune diseases result from the activation of self-reactive T cells induced by autoantigens or by foreign antigens cross-reactive with an autoantigen. A striking characteristic of autoimmune diseases is the increased frequency of certain HLA alleles in affected individuals. Moreover, as demonstrated for example in rheumatoid arthritis and insulin-dependent diabetes mellitus, class II alleles positively associated with autoimmune diseases share amino acid residues in the hypervariable HLA regions involved in peptide binding. Therefore, it is likely that disease-associated HLA class II molecules have the capacity to bind the autoantigen and present it to T cells, thereby inducing and maintaining, under appropriate conditions, the autoimmune disease. The data reviewed here demonstrate MHC-selective inhibition of antigen-induced T cell responses in vivo by parenterally administered soluble, MHC-binding peptide competitors, under conditions in which the competitor is not immunogenic. This suggests the feasibility of a therapeutic approach based on MHC blockade in the treatment of HLA-linked autoimmune diseases. | |
| 2014745 | Joint disorders and walking disability in Sweden by the year 2000. Epidemiologic studies o | 1991 | The prevalence of joint complaints with walking disability, as well as clinically diagnosed hip and knee diseases, in Sweden in the year 2000 was calculated from data from a population survey that we made in a Swedish community (Atvidaberg) in 1986. The population was representative of that of the whole country. Among all 5,259 persons aged 45 years and older, 35 percent reported long-lasting joint complaints. The prevalence of clinically diagnosed degenerative joint disease was 14 percent, that of extraarticular disease 12 percent, inflammatory joint disease 2.4 percent, arthralgia 1.4 percent, and collagenoses 0.5 percent. From the official estimations of the Swedish 8.5 million population as to age classes and sex by the year 2000, joint complaints can be foreseen in 1.2 million inhabitants, representing a total increase of 0.16 million persons. The number of patients with destructive rheumatoid arthritis can be estimated at 58,000 in the year 2000. | |
| 1909140 | New insights into the immunopathology of tuberculosis. | 1991 | Tuberculosis is characterised by fever, weight loss and necrosis in both lesions and tuberculin skin test sites (Koch phenomenon), although the antigens of Mycobacterium tuberculosis are not directly toxic to the tissues. The tissue damage appears to be due to several interacting factors. First, M. tuberculosis induces an immunoregulatory disorder of which a raised percentage of agalactosyl IgG is a marker. This is seen also in rheumatoid arthritis and Crohn's disease and is associated with tissue-damaging inflammation. Subsequently, several properties of M. tuberculosis exacerbate this disorder by triggering cytokine release, and rendering tissues sensitive to the toxicity of tumor necrosis factor (TNF). Moreover, M. tuberculosis, but not bacillus Calmette-Guérin or several Mycobacterium avium strains, produces a factor which increases the toxicity of TNF for individual cells. Thus, M. tuberculosis may distort the normal protective role of TNF so that this cytokine becomes toxic to the host. The immunoregulatory disorder associated with agalactosyl IgG appears to be susceptible to immunotherapy, so novel types of treatment for the immunopathological component of tuberculosis are being explored. | |
| 2116582 | Economic assessments in randomized controlled trials. | 1990 Aug 6 | When comparing costs and benefits of different medical strategies, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis may be used. Both direct and indirect costs and benefits must be considered. Integrating survival with a measure of quality of life such as a health status index permits calculation of quality of life adjusted years of survival (QALYS). In any trial where it is expected that a more expensive treatment is the most effective, a full economic assessment should be made. Examples are provided from the use of verapamil and propranolol in hypertension, naftidrofuryl in stroke and auranofin in the treatment of rheumatoid arthritis. |