Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 3412795 | Patellofemoral problems following total knee arthroplasty. | 1988 Jul | We reviewed 350 knee arthroplasties performed between 1977 and 1984 for patellar problems. Seventeen knees with four types of patellofemoral complications were found. The diagnosis in both the group of 350 and the study group of 17 knees was evenly distributed between rheumatoid arthritis and osteoarthritis. The complication rate was 4.9%. Follow-up ranged from one to nine years post-complication. Two knees had two different complications, providing a total of 19 complications with five loosenings, three fractures of the patella, one fracture of the patellar component, and ten subluxations or dislocations. Sixteen revision surgical procedures were performed on 11 knees. Six knees were managed nonoperatively. In the four knees with multiple surgeries, one of the complications was patellar subluxation or dislocation. Only one patient was dissatisfied with his result; however, this included both knees. Patellar complications continue to be recognized as a frequent cause of problems after total knee arthroplasty. We recommend nonoperative management of patellar fractures, revision of implant with loosening or component fracture, and careful selection of realignment procedures. | |
| 3586090 | Tests for streptolysin-O antibodies in health and suspected streptococcal infections in Sa | 1987 Jun | 'Upper limits of normal' antistreptolysin-O (ASO) titres were determined in various age groups in Saudi Arabia using the conventional haemolysin and the newer, passive agglutination (Blue-ASO) tests. The upper limit of normal values were found to vary with age, being the highest (166 Todd units or 1:320) among the school age children. Serum samples from 744 patients with various clinical manifestations associated with streptococcal infections such as rheumatic fever, glomerulonephritis, tonsillitis, rheumatoid arthritis and polyarthritis were tested by both methods, with the geometric mean titres (GMT) being determined in each age group. In case of school age children with suspected rheumatic fever, and found positive by the tests, a GMT of 458 Todd units (1:1080) was obtained--much higher than the ASO levels detected in positives with glomerulonephritis or tonsillitis. Apart from its relative simplicity, rapidity and ease of performance, the Blue-ASO test was able to detect positivity in 15% of sera from patients of various age groups with suspected rheumatic fever, polyarthritis and tonsillitis who exhibited insignificant levels of ASO by the haemolysin test. | |
| 3612139 | Extensor mechanism complications following total knee arthroplasty. | 1987 | Extensor mechanism complications following 281 knee arthroplasties that included patellar resurfacing, performed by two surgeons in one hospital over a 6-year period, were reviewed. The mean follow-up period was 42 months. There were 28 (10%) extensor mechanism complications: 3 quadriceps tendon ruptures, 5 patellar fractures, 4 patellar tendon ruptures, 11 recurring patellar subluxations, 4 cases of patellar pain, and 1 malrotated patella. Nine (3%) required further surgery. Surgical technique may have contributed to the tendon ruptures; patellar fractures occurred mainly in patients who had rheumatoid arthritis. Patients with patellar subluxation had abnormal preoperative valgus deformities of their knees and presented with this subluxation problem an average of 4 months after surgery, but it appeared to cause them less discomfort with time. Patellar resurfacing as part of a knee arthroplasty procedure is recommended but should be performed with care to the integrity and vasculature of the extensor mechanism. | |
| 3811966 | Rapid HPLC-determination of ibuprofen and flurbiprofen in plasma for therapeutic drug cont | 1986 Nov | Ibuprofen has wide applications in the treatment of rheumatoid arthritis and osteoarthroses as an effective non-steroidal antiinflammatory drug. The drug is still being investigated regarding its possible ability to reduce myocardial infarct size. The more potent biphenyl propionic analogue, flurbiprofen, has recently been introduced. Both drugs are strong inhibitors of cyclooxygenase. The specific HPLC-method described requires plasma samples of 100 microliter which are deproteinized and simultaneously extracted with acetonitrile containing either of the drugs as internal standard. Aliquots of 25 microliter of this primary extract were directly injected on a mu Bondapack C18 column. For elution was used a mixture of 60% methanol and 40% 50 mM phosphate buffer adjusted to pH 4.6. The detection limit (at 214 nm) for both drugs corresponded to plasma concentrations of about 0.2 micrograms X ml-1. The applicability of the method was demonstrated in a pharmacokinetic ibuprofen experiment in an adult person. | |
| 3734024 | Prevalence of chronic disease and health practices in a retirement community. | 1986 | The prevalence of chronic disease based on a mailed questionnaire was estimated as part of a continuing epidemiological study of a retirement community. The prevalence of eight chronic diseases (high blood pressure, angina, myocardial infarction, stroke, diabetes, rheumatoid arthritis, glaucoma, and cancer) was determined across all age and sex groups. The relationships between these diseases and several health related life-style practices were assessed. A health index summarizing five practices (smoking, alcohol consumption, exercise, sleep and obesity) was clearly related to the prevalence of disease. | |
| 1867175 | Antineutrophil cytoplasmic autoantibody-associated diseases: a rheumatologist's perspectiv | 1991 Aug | Autoantibodies against neutrophil cytoplasmic antigens (ANCA) produce two major immunofluorescence (IF) patterns on ethanol-fixed granulocytes: the "classical" (centrally accentuated) C-ANCA, associated with Wegener's granulomatosis (WG), and P-ANCA (perinuclear), which mainly occur in renal vasculitis. Rheumatic manifestations are an important clinical finding in systemic vasculitis, often preceding a fulminant course and sometimes imitating various rheumatic disorders. We analyzed the incidence of ANCA in rheumatic patients and looked for the frequency of rheumatic symptoms in systemic vasculitis. In WG (n = 186), we found rheumatic symptoms in 55% (myalgia, 45%; arthritis, 21%); in 90%, rheumatic complaints were associated with active vasculitis. In 730 patients with various rheumatic conditions (eg, 268 rheumatoid arthritis, 130 systemic lupus erythematosis [SLE], 32 sharp-S, 50 ankylosing spondylitis, 43 systemic sclerosis) no C-ANCA were found. On the contrary, the P-ANCA pattern was seen in seven of 62 giant cell arteritis, five of 27 Felty's/Still's syndrome, and four of 130 SLE patients in addition to renal vasculitis (21/74). We demonstrated that 95% of C-ANCA-positive sera react with proteinase 3 (PR3 or myeloblastin). Using monoclonal antibodies, we showed that PR3 is expressed on the plasma membrane of neutrophil granulocytes and monocytes; thus, PR3 autoantigens are accessible for circulating antibodies. The detection of ANCA in sera from vasculitis and other rheumatic diseases is of immunodiagnostic value and provides new insight in the pathogenesis of systemic vasculitides. | |
| 3593436 | Bradykinin, a new potential mediator of inflammation-induced bone resorption. Studies of t | 1987 May | The effect of bradykinin and desArg9-bradykinin on bone was studied in cultures of calvarial bones taken from 6-7-day-old mice. Bradykinin, at and above a 3-nM concentration, caused a dose-dependent stimulation of bone mineral mobilization and matrix degradation. Bradykinin-stimulated resorption was inhibited by calcitonin, an increased concentration of phosphate in the culture medium, hydrocortisone, dexamethasone, indomethacin, meclofenamic acid, naproxen, and 5, 8, 11, 14-eicosatetraenoic acid. The results suggest that bradykinin stimulates osteoclast-mediated bone resorption by a process that is dependent on endogenous prostaglandin production. The stimulatory effect of bradykinin, but not of parathyroid hormone and prostaglandin E2, was potentiated by the angiotensin-converting enzyme inhibitor, BPP5a. Treatment with carboxypeptidase B did not affect the capacity of the peptide to stimulate 45Ca release. DesArg9-bradykinin (1 mumole/liter) stimulated 45Ca release to the same degree as did bradykinin. Bradykinin (3 microM) did not affect the degradation of cartilage proteoglycans, as assessed by the release of 35S-sulfate from prelabeled calf articular cartilage in organ culture. These findings suggest that generation of bradykinin in inflammatory lesions of rheumatoid arthritis and periodontitis may contribute to the bone resorptive process seen in the joints and alveolar bone; however, bradykinin does not directly activate chondrocytes into a catabolic state. | |
| 3329109 | Efficacy and tolerability of tenoxicam--an overview. | 1987 | One-hundred and thirty-three clinical studies have been conducted with tenoxicam in patients with rheumatoid arthritis, osteoarthrosis, extra-articular rheumatism, ankylosing spondylitis and acute gouty arthritis. Its efficacy has been demonstrated in double-blind comparative studies against placebo, and dose-finding studies have found the optimal dose to be 20 mg. Most trials comparing tenoxicam with another NSAID have used piroxicam, an earlier oxicam derivative which also has a long half-life. In general, efficacy was similar in both drugs with a trend in favour of tenoxicam. The tolerability of tenoxicam has also been studied in detail. In short-term studies 11% of patients receiving 20 mg tenoxicam and 18% on 40 mg tenoxicam experienced side-effects (p less than 0.01), as did 20% treated with 20 mg piroxicam (p less than 0.01 against 20 mg tenoxicam). In long-term studies clinical tolerability of 20 mg tenoxicam was found to be superior to that of 20 mg piroxicam. The types of side-effects encountered were mainly gastrointestinal disturbances, followed in frequency by skin rashes. However, all side-effects were generally mild and reversible. The efficacy of tenoxicam is clearly established and its tolerability is acceptable with a 20 mg dose. Tenoxicam thus seems a promising drug and a useful addition to the therapeutic armamentarium. | |
| 1723371 | The use of antidepressants in the treatment of chronic pain. A review of the current evide | 1991 Nov | In the last 30 years antidepressant drugs have been used increasingly in the treatment of patients with chronic pain. This article reviews the results of some 40 placebo-controlled studies. It is difficult to make comparisons between the various studies because they often differ in terms of pain conditions, patient selection, antidepressant drug used, dosages, trial design, etc. However, in spite of this heterogeneity and other methodological problems it is clear that a wide range of pain conditions are responsive to antidepressant drug treatment, in particular: headache, migraine, facial pain, neurogenic pain, fibrositis, and probably arthritis and rheumatoid arthritis. More data need to be gathered in cancer pain, and in other conditions such as low back pain for which no, or very limited, effect has been shown. The beneficial effects of antidepressant drugs is in most cases of a mild to moderate degree, some time lag is necessary before it is completely manifest, and it tends to persist over time if drug treatment is continued in the long term. Strong evidence of efficacy is not evident for all the antidepressants, and there are probably significant differences in this respect between various drugs. The effect of a drug on pain does not seem necessarily to be related to its effect on mood. Further studies are needed to clarify this topic, and it will be necessary to examine specific pain conditions, compare different antidepressants, with reference to each other and to placebo, further investigate the role of drug plasma concentrations and control for the presence of concomitant psychiatric disturbances and for organic lesions responsible for the pain symptomatology. | |
| 1993047 | Interleukin-1 induced gene expression of neutrophil activating protein (interleukin-8) and | 1991 Jan 31 | We report here that human synovial cells stimulated by interleukin-1 alpha and interleukin-1 beta express mRNA for both IL-8 (neutrophil chemotactic peptide) and monocyte chemotactic protein. IL-1 stimulated synovial cells from both osteoarthritis and rheumatoid arthritis patients exhibited similar mRNA expression of interleukin-8 and monocyte chemotactic protein. A capacity to produce factors selectively chemotactic for neutrophils, lymphocytes and monocytes provides a mechanism whereby synovial cells can facilitate inflammatory arthritis. | |
| 2169747 | Lysis of fibrillar collagen by neutrophils in synovial fluid. A role for surface-bound imm | 1990 Sep | Synovial fluids (SF) contain inhibitors capable of neutralizing the activity of proteases secreted by inflammatory cells and fibroblasts. To further define a potential role for SF polymorphonuclear neutrophils (PMN) in mediating joint destruction, peripheral blood PMN were suspended in SF and incubated with reconstituted collagen fibrils. Incubation of PMN-SF mixtures with collagen fibrils precoated with monomeric IgG resulted in significant lysis of the underlying fibrils relative to that seen with uncoated fibrils. Augmented fibril lysis by PMN-SF mixtures in which the PMN were activated with fluid-phase ligands such as phorbol myristate acetate or heat-aggregated IgG was not seen. Lysis of IgG-coated fibrils by PMN-SF was inhibited in the presence of EDTA or sodium azide. PMN-mediated resorption of fibrillar collagen occurred despite the presence of protease inhibitors in the SF at a concentration capable of neutralizing human neutrophil collagenase. These results suggest that the focal release and activation of human neutrophil collagenase during PMN stimulation by tissue-bound immunoglobulins may mediate the resorption of joint tissue collagens in rheumatoid arthritis, even in the presence of protease inhibitors. | |
| 2423433 | [Therapy of rheumatic diseases with inosiplex]. | 1986 May | 27 patients (13 rheumatoid arthritis, RA; 4 systemic lupus erythematosus, SLE; 5 systemic sclerosis, PSS; 5 undifferentiated connective tissue disease, UCTD) were treated with inosiplex for more than 23 months (7.7 +/- 1.3). Clinical improvement was impressive by the end of the first month of therapy in 7 patients with moderate active RA (p less than 0.01), and 5 of these patients treated for more than 8 months continued to do well (p less than 0.05). In contrast, patients with very active RA did not show any clear-cut improvement. In the other diseases studied, 5 patients responded rapidly (reduction in arthritis, improvement of pulmonary involvement). A concomitant rise in the T4/T8- (helper-/suppressor-) cell ratio with increased numbers of T4+-cells was observed in patients with RA and PSS. Our data suggest that some patients with rheumatic diseases may benefit from long-term treatment with inosiplex. | |
| 1900690 | Restricted diversity of the variable region nucleotide sequences of the heavy and light ch | 1991 Mar | The complete nucleotide sequences of the variable region genes of the heavy and light polypeptide chains of a human monoclonal rheumatoid factor (RF) produced from a human-mouse heterohybridoma were determined. The antibody, designated YES8c, contained V kappa III, J kappa 2, VH1, JH4, and a D gene segment of 9 amino acids. The nucleotide sequences and the deduced amino acid sequences of the light chain variable region were remarkably homologous (97-98%) to previously described RF of the Wa idiotypic family (PAY, GLO, CUR, FLO, and GAR) and to that of a V kappa III germline gene (Humkv325). The YES8c heavy chain variable region gene was most closely related to the VH1 gene of the restricted human fetal repertoire, designated 51p1, and also to 3 rearranged VH1 genes that were recently isolated from patients with chronic lymphocytic leukemia. These results suggest that variable region genes of RFs are highly conserved and that YES8c VH, as well as V kappa, may be identical to heavy and light chains expressed during early B cell development. | |
| 2053920 | Acute familial myositis with a common autoimmune response. | 1991 Jun | In 1986, we diagnosed and treated 4 patients, all members of 1 rural family, who presented simultaneously with a polymyositis-like syndrome, anticytoplasmic antibodies (on HEp-2 cells), and precipitating antibodies of anti-Jo-1 and anti-PM-Scl specificities. Serum samples from these patients reacted by immunodiffusion against serum from a rodent that had been caught in the patients' house. The precipitin line showed complete immunologic identity with anti-Jo-1. To study the specificity of this serum-serum reaction, 2 mice (Mus musculus) and 1 rat (Rattus rattus) from the neighboring areas of the patients' house were caught and killed. Sections of the liver, kidney, spleen, and skeletal muscle were processed for histopathologic examination and for direct and indirect immunofluorescence studies of the patients' sera. The rodents' sera were tested by immunodiffusion against serum samples from 25 patients with systemic lupus erythematosus, 11 with rheumatoid arthritis, 6 with mixed connective tissue disease, and 11 with various other rheumatic diseases, as well as 16 healthy controls. A serum-serum precipitin reaction was noted between the rodents' sera and sera from 2 of the patients with polymyositis-like syndrome. A distinct, but weaker, reaction was found with 2 lupus patients' sera (8%), and with 1 healthy control serum (6%). The rodents' sera were antinuclear antibody positive by indirect immunofluorescence on HEp-2 cells. These results, suggest that some rodents could be carriers of an as-yet-unknown transmissible agent that, in susceptible individuals, induces clinical and serologic manifestations similar to those of polymyositis. | |
| 2390122 | The synovium-cartilage junction of the normal human knee. Implications for joint destructi | 1990 Aug | The immunohistology of the synovium-cartilage junction was studied in 8 normal human knees, using monoclonal antibodies. In all joints at the junction with synovium, a vascular, wedge-shaped tongue of tissue was found to cover the cartilage surface. This marginal tissue overlying cartilage was in continuity with and was immunohistochemically similar to the adjacent synovial tissue, and contained cells possessing class II HLA antigens and antigens present on macrophages and type B synoviocytes. Periosteal tissue adjacent to the synovium-cartilage junction contained not only macrophages and other class II-positive cells, but also cells and matrix that stained with monoclonal antibodies specific for articular cartilage (keratan sulfate and type II collagen). This study demonstrates the presence of immunocompetent cells in tissue overlying the cartilage surface and adjacent to bone in normal human joints. It is likely that pannus in chronic inflammatory rheumatic disease develops by the recruitment of inflammatory cells augmenting this normal marginal tissue. Furthermore, overgrowth of tissue onto the cartilage surface may not be necessary in the pathogenesis of joint destruction in rheumatoid arthritis. In addition, our findings suggest that cells in the periosteum, rather than those in the marginal synovium, may be involved in attempted "repair" mechanisms, such as osteophyte formation. | |
| 2664086 | Autogenous bone grafting for severe angular deformity in total knee arthroplasty. | 1989 | Fourteen patients with severe angular knee deformities (range, 30 degrees varus to 35 degrees valgus) had total knee arthroplasty using autogenous bone graft to the tibia. Twelve knees had osteoarthritis, one rheumatoid arthritis, and one gouty arthritis. The preoperative knee motion averaged -5 degrees of extension to 80 degrees of flexion and the average motion arc was 70 degrees. All tibial defects were greater than 25% of the tibial component support surface and more than 10 mm deep. Twelve knees were reconstructed with Insall-Burstein posterior stabilized total condylar knee implants and two knees, with severe preoperative ligamentous instability, with the constrained Total Condylar III implant. Postoperative rehabilitation was routine, and weight bearing was begun, on average, on the third postoperative day. The follow-up period averaged 4.1 years (range, 2-7.3 years). Radiographic analysis revealed no change in knee or component alignment compared with immediate postoperative position. All grafts consolidated without evidence of collapse, resorption, or prosthetic subsidence. All patients had good or excellent clinical results (Hospital for Special Surgery Knee Rating Scale). The average postoperative arc of motion was 90 degrees. There were no infections and no need for implant removal. The technique developed by the senior author (T.P.S.) utilizes bone resected from the distal femur during knee arthroplasty. An oblique planar cancellous surface is created on the recipient side, and coaptation of cancellous distal femoral graft surface to this recipient bed is ensured by vitallium screw fixation. The proximal tibia is reconstituted by the graft, and subchondral femoral bone after shaping of the graft forms the tibial periphery. | |
| 1748067 | [The selection of spongiosa donors for a bone bank]. | 1991 Dec 13 | A prospective trial was carried out in 156 unselected patients (41 men, mean age 67.5 years, 115 women, mean age 71.4 years) who had undergone total hip joint replacement because of degenerative or inflammatory arthritis or fracture of the neck of the femur. The excised femoral heads were subjected to three-stage bone bank screening so as to ascertain how many of them would pass the clinical, biochemical and microbiological exclusion criteria. Only 26 out of 156 femoral heads (17%) proved to be acceptable for the bone bank. Ninety patients (58%) were excluded on clinical grounds such as old age (over 80 years), malignant neoplasms, rheumatoid arthritis, previous intraarticular injections or long-term steroid medication. Positive hepatitis serology excluded 19%, and raised preoperative neopterin concentration excluded 25%, though three months postoperatively this was confirmed in only 2%. Routine neopterin assay seems to be a useful step towards improved bone bank screening, since neopterin concentration is clearly increased in recent virus infections such as HIV. Bacterial contamination was of no practical importance. Because of the low proportion of femoral heads passed as suitable for the bone bank, the existing exclusion criteria will have to be critically scrutinized, and alternative procedures for harvesting bone safe for transplantation (freeze drying, autoclaving, irradiation) will have to be employed. | |
| 11188591 | The effects of chronic illness on the spouse. Social resources as stress buffers. | 1991 Jun | This study examined the effects of rheumatoid arthritis (RA) on spouses' psychological well-being and the role of social resources in enhancing adaptation in the face of illness-related stress. Spouses of 42 patients with RA completed a mailed questionnaire assessing marital adjustment, social support received from the person with RA and from the close social network, and depressive symptoms. Illness-related stress was assessed using rheumatologists' assessments of patients' disease severity and patients' self-reports of depressive symptoms. Social resources within and outside the marriage were related to spouses' well-being through different pathways. Marital adjustment had a direct effect on well-being, such that greater marital adjustment was related to lower depression. In contrast, support from the social network operated in a stress-buffering fashion: When the patient's illness was more severe, spouses with greater network support experienced fewer depressive symptoms. Implications of these findings for psychosocial interventions are discussed. | |
| 3562353 | Wrist arthroplasty: a retrospective study. | 1987 Feb | A retrospective study was conducted to evaluate the long-term effectiveness of wrist arthroplasties in patients with various arthritic conditions. A total of 39 wrist arthroplasties were performed in 29 patients (average age, 52.5 years) by the orthopedic staff at Tulane University School of Medicine. Rheumatoid arthritis was the major presenting diagnosis in 84.6% of these operative cases and pain was the most common indication for surgery (79.5%). Postoperative relief of pain was reported in all of the cases reviewed, with an average follow up period of 51.2 months (range, 12 to 118 months). A group of 15 patients who were examined clinically had an average grip strength of 19.2 lb (range, 6 lb to 45 lb). Pinch measurements averaged 1.9 lb and arc of motion averaged 59.5 degrees (range, 20 degrees to 100 degrees) for these patients. Postoperative complications included dislocation (3 cases), fracture of the prosthesis (2 cases), and infection (2 cases). No complications were observed in 32 (82.1%) of the 39 cases reviewed. This retrospective study revealed that at an average follow up period of 51.2 months, pain relief was excellent and patient acceptance was good, with 94.9% of the wrists having been improved by the procedure. The majority (82.1%) of the cases were free of complication. It is concluded from this study that wrist arthroplasty is a viable alternative to wrist arthrodesis. | |
| 2492198 | Characterization of two immunoglobulin VH genes that are homologous to human rheumatoid fa | 1989 Jan | We isolated a VH1 germline gene (Humhv1263) that is closely related to the heavy chains of 2 human rheumatoid factors (RF), Bor and Kas. We also found that the 783 rearranged VH1 gene is actually 91-93% homologous to Bor and Kas, and it differs from a VH1 complementary DNA (51P1) by only a single base. Thus, 783 is likely to be the unmutated form of a germline VH gene that may encode the heavy chains of RF Bor and Kas and several other human monoclonal RF. |