Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 9010089 | MRI in assessment of the systemic manifestations of rheumatological disease. | 1996 Dec | Magnetic resonance imaging (MRI) has emerged as complementary imaging modality to conventional radiography. The same diagnostic rules that are used in the interpretation of the routine radiographs should be applied to the analysis of MR images with the macroscopic spread of the disease as a main diagnostic clue. MRI has been shown to be a sensitive tool in detecting early arthritic changes and erosions, inflammation in periarticular tendons and tendon sheaths, and in juxtaarticular bursae. MRI plays a pivotal role in diagnosis of arthritis of the craniocervical junction and its complications. It also has been used effectively to detect insufficiency fractures and osteonecrosis. MRI may be important in diagnosing early arthritis, in specifying the differential diagnosis of rheumatic disease, and in selecting subgroups of patients to provide tailored therapeutic regimens. | |
| 9213884 | [Patients with rheumatoid arthritis: study of the correlation between density of glucocort | 1996 Feb | BACKGROUND: The target cellular response to glucocorticoids is proportional to the concentrations or affinity of specific receptors to these substances. AIM: To look for a correlation between glucocorticoid receptor concentrations in synovial wall cells and the clinical response to steroidal treatment in patients with rheumatoid arthritis. PATIENTS AND METHODS: Twenty eight patients with rheumatoid arthritis were studied. Each subject was subjected to a synovial biopsy, in which a dry radioautographic technique for diffusible compounds was used. Patients were treated afterwards with three 500 mg intravenous pulses of methilprednisolone. RESULTS: A mean of 44.8% of synovial cells (range 30.1-62.8%) had binding sites for 3H dexamethasone. All patients had a significant clinical improvement after methylprednisolone. Multiple regression analysis did not show a correlation between clinical response and glucocorticoid receptor concentration. CONCLUSIONS: The lack of association between glucocorticoid receptor concentrations and clinical response could be due to the large steroid dose used, that saturated all available receptors. | |
| 8331164 | Anti-brain antibodies in the sera of rheumatoid arthritis patients: relation to disease ac | 1993 Jun | Auto-antibodies reactive with brain are known to occur in various immunological disorders. Their significance with respect to disease activity, neurological manifestations, or psychological status is, however, not known. In previous studies it was found that there were antibodies reactive with brain in the sera of patients with rheumatoid arthritis (RA). The present study sought to confirm and extend our previous findings and determine the significance of these antibodies with respect to disease activity. It also investigated a possible connection between psychological function in RA and these auto-antibodies. Sera drawn from 14 RA patients, at bi-weekly intervals over 3 months, showed the presence of antibodies against transmembrane proteins from murine brain. These antibodies correlated positively with rheumatoid factor and joint swelling. There was a trend toward a correlation between depression and daily mood scores and the number of antibodies reactive with brain. In addition, a correlation between cognitive coping styles in RA patients and auto-antibodies was found. There was also evidence for a sub-population of pathogenic antibodies. | |
| 1494705 | [Disability in rheumatoid arthritis: the predictive value of age and depression]. | 1992 Dec | Fifty rheumatoid patients were given the Health Assessment Questionnaire (HAQ) and the Arthritis Impact Measurement Scales (AIMS) in order to determine the contribution of clinical and demographic variables to the overall disability. Among the clinical variables, pain intensity and depression were carefully assessed along with the classic morning stiffness and the joint count and tenderness/Ritchie's index. Two main findings arose: age contributed on its own to the overall disability, while disease duration had no significant effects; joint count and tenderness (Ritchie's index) correlated in a highly significant manner with depression as derived from the AIMS subscale and the Zung Depression Inventory (ZDI). ZDI items were separated into a "somatic factor" and a "dysphoric factor", showing a clear-cut influence of the somatic factor on the disability score. Our results suggest that age of the patient, pain intensity and a depressive mood related to physical impairment are chief predictive factor of the overall disability in rheumatoid arthritis. | |
| 8368017 | [Follow-up of rheumatoid arthritis beginning in advanced age]. | 1993 May | Two cohorts of 125 patients each, with different onset of disease (group A = before the age of 55, group B = after the age of 54) were selected from a total of 1000 patients with definite rheumatoid arthritis (RA). Both groups were identical with regard to gender (women = 71%) and duration of disease (mean = 7 years). Mean age was in group A = 47, in group B = 68 years, respectively. When compared, in both samples no significant differences were found with regard to acuity of onset, to occurrence and duration of a period with nonspecific complaints prior to synovitis and to incidence of remissions and fever. However, in the elderly onset group progression of disease was significantly higher, the functional status poorer, dynamometer values lower, and the frequency of systemic signs higher. Furthermore, in the late onset group were more rarely reported regular exercise programs, other rehabilitative measures, treatment with gold preparations, and joint surgery. These features seem to indicate that age at onset has a modifying effect on disease expression in RA. One factor of influence, among others, is likely to be the generally decreased functional level in higher age. Late onset RA is not thought to be a separate entity of the disease. | |
| 1383168 | Are we seeking the correct targets for therapeutic intervention? | 1992 | In this plenary symposium paper, the authors review the physiological development of rheumatoid arthritis, the rationale for the manipulation of the eicosanoid pathway, the inhibition of tissue destruction, and angiogenesis. They proceed to discuss immunotherapy under the headings of intercellular adhesion, the induction of tolerance, and novel immunomodulatory agents. They conclude that the palliative treatment of the acute aspect of inflammation will continue by necessity into the foreseeable future. Whilst the selectivity and tolerability of existing and novel modulators of the acute inflammatory response are being improved, the alleviation of joint destruction in the long-term rheumatoid patient will depend on the manipulation of those mechanisms involved in the maintenance of the chronic inflammatory process. The ultimate goal for the therapy of the future, namely remission, can now be pursued with good reason for success, with the application of modern molecular biological techniques which will increase not only our understanding of autoimmunity, but also our ability to manipulate the immune system with profound selectivity. Central to the realization of these goals are the long-term chronic models of inflammatory joint disease, such as granuloma-cartilage implants and polyarticular and monoarticular arthritides, which will be essential for the assessment of the therapeutic promise of these exciting new developments. | |
| 1586256 | Intra-articular rheumatoid nodules and triggering of the knee joint. | 1992 Apr | Rheumatoid nodules are a common extra-articular manifestation in rheumatoid arthritis. Intra-articular localisation of these nodules is rare and may produce clinical symptoms. Seven patients with walking problems due to an intra-articular rheumatoid nodule, which became entrapped on the ridge of the tibial plateau of the knee joint resulting in a phenomenon referred to as trigger knee, are described. After excision of the nodules all symptoms completely disappeared. | |
| 1570479 | Disease manifestations in patients with isolated elevation of IgA rheumatoid factor. | 1992 | In this retrospective study a comparison was made between the disease manifestations in patients with isolated elevation of IgA rheumatoid factor (RF) and patients with elevation of IgM RF. Of the 28 patients with isolated elevation of IgA RF, 14 (50%) had rheumatoid arthritis (RA) and 9 (32%) miscellaneous other inflammatory rheumatic disorders. It was found that 61% of these 23 rheumatic patients had disease manifestations from mucous membranes or secretory organs compared to 18% in the IgM RF positive group (p = 0.020). Patients with RA and an isolated elevation of IgA RF had more often mucosal or secretory symptoms than RA patients with elevation of IgM RF. We suggest that IgA RF may be a marker for activation of the mucosal or secretory immune system. The relationship between IgA RF and non-articular symptoms is discussed. | |
| 8052925 | [The comparison of clinical features between early rheumatoid arthritis and established rh | 1994 Jun | Clinical features between 69 early RA patients (within a year duration) and 79 established RA patients (more than 3 years duration) were compared retrospectively. There were no significant differences about frequencies of morning stiffness (68.2% vs 54.4%) and rheumatoid nodules (20.2% vs 15.2%) between early RA and established RA. There were also no significant differences between two groups about elevation of ESR (92.8% vs 97.4%), positivity of CRP (97.1% vs 94.9%) and rheumatoid factor (RF) (82.6% vs 93.7%), and Lansbury activity index (AI) (mean 68.8% vs 78.8%). After hospitalization and treatment, all clinical indices (ESR, CRP, RF, AI) improved significantly in both groups. There, however, were clinically more "marked improvement" (39.1% vs 16.4%) and "remission" (8.7% vs none) in early RA group. We conclude that by hospitalization and treatment, clinical improvement can be expected in both early and established RA, but to secure satisfactory improvement, early detection and intervention of RA would be recommended. | |
| 1450805 | The evolution of a case of overlap syndrome with systemic sclerosis, rheumatoid arthritis | 1992 Nov | An unusual case of overlap syndrome which evolved over a 12-year period is described. The patient initially presented with limited cutaneous systemic sclerosis. She then developed seropositive erosive rheumatoid arthritis and subsequently vasculitis with positive lupus serology. There was no evidence that she had mixed or undifferentiated connective tissue disease, and antibody to ribonuclearprotein was negative. This unusual combination of connective tissue disorders in one patient is reported and the literature is reviewed. | |
| 8448631 | Cytokines and anti-cytokines. | 1993 Mar | The cause of RA is unknown but there are several hypotheses: an autoimmune mechanism; a superantigen-driven disease; an infection with an unusual pathogen (e.g. lentivirus); and a non-specific infectious stimulus acting on a particular genetic background. Whatever the cause(s) of RA, it would appear that cytokines are very important mediators of the pathology. Genetic polymorphisms with Mendelian inheritance have been characterized in regulatory regions of cytokines such as IL-1, TNF and related genes. It is possible, therefore, that whatever the initiating stimulus might be, the possession of different cytokine alleles may confer greater or lesser risk of developing a progressive disease. | |
| 1294738 | Severity of disability and duration of disease in rheumatoid arthritis. | 1992 Dec | A longitudinal sample of patients with rheumatoid arthritis (RA) from Santa Clara County, CA was analyzed. Severity was measured with the Disability Index from the Health Assessment Questionnaire (HAQ). First, 6 cohorts were created of women and men with 0 to 10, > 10 to 20, and > 20 years of duration of illness in 1981. Experiences of the 6 cohorts were studied from 1981 to 1989. For both sexes, and both samples which alternately included and excluded the deceased, persons with > 20 years of duration experienced faster deterioration than those with < 20 years. Second, multiple regression models were estimated which treated the Disability Index as the dependent variable. In the regression models, the Disability Index worsened more quickly for women than men, for persons with few rather than many years of education, and for older than younger persons. Regression models which excluded an intercept term suggested a unique "S" shaped curve that described the Disability Index and duration relation. | |
| 8779787 | [Roentgenological and histomorphological studies of the knee joint in rheumatoid arthritis | 1996 Jun | In order to study the disease process of rheumatoid arthritis in the knee joint, clinical and roentgenological analysis as well as histomorphological study of the proximal tibia taken at total knee arthroplasty procedure were carried out. The natural course of eight patients who had been followed 12.7 years on an average were studied in respect to range of motion, swelling, pain, instability of the knee joints along with radiographical appearance of the knee joints and other locations such as hand, spine and other major joints. There were two extreme types: one which led to obvious joint instability and one which ended up with joint contracture. The majority of the cases, however, fell between the two types. These three groups well corresponded to the three types proposed earlier by Katsube: unstable, stiff and standard types, respectively. For the roentgenological analysis, 148 knees of 80 preoperative patients were also subjected. The findings included osteoporosis, abnormal femoro-tibial angle, osteophyte formation, bone destruction with or without osteosclerosis. There were apparent bone destruction and a tendency toward valgus demormity in the unstable type, whereas apparent osteoporosis and little osteosclerosis of the tibial plateau were found in the stiff type. In the standard type, there were osteophyte formation and osteosclerosis of the tibial plateau as usually seen in osteoarthritic knees. For the histomorphological study, 30 patients were given tetracycline hydrochloride preoperatively for tetracycline labeling and total of 38 knees were thus examined. The specific findings in the unstable type included severe pannus formation and bone absorption, and those in the stiff type were severe osteoporosis with articular cartilage degeneration and decreased mineralization. No specific findings were observed in the standard type. | |
| 8927885 | [Therapy of rheumatoid arthritis (chronic polyarthritis)]. | 1996 Sep 10 | A continuous and systematic monitoring of disease activity provides the basis for the therapeutic management of rheumatoid arthritis patients. This helps to individually tailor medication and to correctly time physiotherapy, ergotherapy, surgery, and rehabilitative measures. NSAID are the drugs of choice for symptomatic therapy. The dosage is adjusted to the circadian rhythm of the patient's complaints. Systemic glucocorticoids are very efficacious to control inflammation; however, caution is required in their long-term usage. Preventive measures to limit bone loss are mandatory. Disease-modifying antirheumatic drugs (DMARD) are prescribed early, at the time of diagnosis. The choice of sulfasalazine, antimalaric drugs, methotrexate or parenteral gold is based on the clinical presentation, the degree of systemic inflammation and on prognostic parameters. Treatment with DMARD has to be continued for years. If complete remission is achieved, lasting for at least six months, the dosage can be gradually reduced and finally stopped. At late stages of disease, residual joint pain is often due to secondary osteoarthritis. | |
| 8122200 | [Drug therapy of rheumatoid arthritis. Recommendations to specialists and general practiti | 1994 Jan 20 | We report from a workshop on pharmacological treatment for rheumatoid arthritis, arranged by the Swedish Medical Product Agency in October 1991. The purpose was to reach consensus and make recommendations concerning treatment with corticosteroids and anti-rheumatic drugs. It was recommended to start treatment with anti-rheumatic drugs as soon as the diagnosis of an active rheumatoid arthritis was established. The selection of drugs for the individual patient should be determined both by patient and drug factors. The therapy requires close monitoring, a co-operative task for the specialist and general practitioner. Use of anti-rheumatic drugs during pregnancy and lactation was not recommended, except for sulphasalazine. | |
| 9004134 | Unexpected HLA haplotype sharing in dizygotic twin pairs discordant for rheumatoid arthrit | 1996 Dec | Dizygotic twins are generally believed to be no more genetically similar than sibs born from separate pregnancies. In the present study, a panel of 93 dizygotic twin pairs discordant for rheumatoid arthritis were typed for HLA-A, -B, -Cw, and -DR antigens. HLA haplotype sharing identical by descent between the twins showed a trend towards increased sharing of both HLA haplotypes; this increased sharing was statistically significant when the female/female twin pairs were considered separately. In contrast, the pattern of HLA haplotype sharing in sib pairs (n = 128) was consistent with a 1:2:1 ratio of 2, 1, or 0 haplotypes shared. An analysis of 16 normal dizygotic twin pairs was consistent with these results raising the possibility that dizygotic twins in general are genetically more similar at the HLA complex than sibs born from separate pregnancies. | |
| 8187438 | Coexistence of ochronosis and rheumatoid arthritis. | 1994 Mar | We describe a 64-year-old female patient with ochronosis and rheumatoid arthritis. Magnetic resonance imaging of the spinal column disclosed the destruction of vertebral disks, and a bony bridging in Th12 to L2. In addition, we observed joint space narrowing in the wrists as well as among the carpal bones, positive rheumatoid factor and the presence of rheumatoid nodules, in which the histological findings were compatible with those of rheumatoid arthritis. The co-existence of these two diseases has not yet been previously reported. Pre-existing ochronotic arthropathy might have masked the manifestation of rheumatoid arthritis and made the diagnosis of rheumatoid arthritis rather difficult. | |
| 7799334 | Increased type I collagen degradation in early rheumatoid arthritis. | 1994 Sep | OBJECTIVE: To evaluate the serum concentration of the mature, crosslinked carboxy terminal telopeptide of type I collagen (ICTP) in patients with early onset rheumatoid arthritis (RA) and to assess its correlation with clinically relevant features of the disease. METHODS: The serum ICTP concentration was measured in 99 adult patients with RA with a duration of disease less than one year. The main clinical outcome measures were joint count, modified Lansbury index, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), Larsen index and number of erosions in peripheral joints. RESULTS: There was a strong positive correlation (p < 0.001) between the serum ICTP concentration and the Lansbury joint index and a weaker but still significant correlation (p < 0.01) between the serum ICTP concentration and the number of eroded hand and foot joints. CONCLUSION: Serum ICTP may have value as a marker of tissue destruction in patients with early RA. | |
| 1307351 | Methotrexate: clinical and immunological effects in refractory rheumatoid arthritis. | 1992 Oct | Thirty five patients with refractory rheumatoid arthritis were given 7.5 mg of methotrexate (Mtx) every week. Eleven patients had to discontinue treatment either because of adverse effects or unresponsiveness. Twenty four patients showed clinical response and significant improvement in ESR and they continued Mtx for a mean of 25.24 months. Seven patients achieved clinical remission as defined by ARA criteria. Immunological parameeters including IgG, IgM, IgA, lymphocyte subsets (CD3+, CD4+, CD8+ and B), C3 and C4 however, did not show any change during this treatment in any of the groups upto 6 months. There was a significant fall in the erythrocyte sedimentation rate (ESR), c-reactive protein (CRP) and rheumatoid factor (RF) levels in responders only. | |
| 8275584 | Severity of rheumatoid arthritis, function and quality of life: sub-group comparisons. | 1993 Sep | The main purpose of this study was to explore whether people with more severe rheumatoid arthritis, as diagnosed by increasing functional disability, also exhibit a poorer quality of life, being more negatively affected by the disease, than individuals with less severe rheumatoid arthritis. A cross-sectional survey was carried out on 169 females and 53 males with rheumatoid arthritis (RA). Functional status was measured according to the Stanford Health Assessment Questionnaire (HAQ), overall ill-health was assessed by the Sickness Impact Profile (SIP) and the quality of life assessment was performed using a generic quality of life assessment package (QLsc). The severity of RA, as measured by HAQ, correlated both with changes due to disease and the quality of life status, and with SIP. The intrusion of the disease appeared to be greatest within the physical life domain, followed by the psychological and social domains. Correlations between the physical, psychological and social life domains were high. Although the relationship between the various life domains is complex, the present study confirms a significant relation between physical and psycho-social dysfunction. |