Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 9010054 | Clinical improvement and radiological deterioration in rheumatoid arthritis: evidence that | 1996 Dec | The contrast between clinical improvement and radiological deterioration in rheumatoid arthritis (RA) is striking. We characterized this relationship using serial disease activity measures and radiographs of hands and feet in 40 RA patients observed over 6 yr. All disease activity measures improved, including grip strength, Ritchie index (RI), haemoglobin and erythrocyte sedimentation rate (ESR) (all P < 0.0001). In contrast, articular erosion increased (P < 0.0001). Radiological change during the study correlated with RI (r = 0.49), haemoglobin (r = -0.56) and ESR (r = 0.53). Radiological status at review also correlated with these variables (r = 0.36, -0.44 and 0.36, respectively). Articular erosion continues in RA despite clinical improvement and is accelerated in those with evidence of continuing synovial inflammation, reflected in clinical and laboratory measures of disease activity. Since many therapies in RA suppress inflammation, but not erosion, these findings suggest that the pathogenesis of articular erosion may differ from that of synovial inflammation. | |
| 8230010 | Serum cytidine deaminase as a measure of disease activity in rheumatoid arthritis and syst | 1993 Aug | Serum cytidine deaminase (CD) as a marker of disease activity was assessed in 100 patients with rheumatoid arthritis (RA) and in 102 assessments of 85 patients with systemic lupus erythematosus (SLE). In RA CD levels correlated well with clinical assessment of disease activity, but were not influenced by varying dosages of ibuprofen as therapy. In SLE significant correlations were found between CD and anti-DNA antibody titers, as well as C3 complement levels. A subset of clinically active patients with SLE with elevated CD levels but normal anti-DNA titers was identified. Serum CD levels may be a clinically useful marker in RA and in certain subgroups of patients with SLE. | |
| 1334514 | Treatment of resistant rheumatoid arthritis with minocycline: an open study. | 1992 Oct | In a 48-week open trial, 18 patients with active rheumatoid arthritis (RA), resistant to second line agents, received 200 mg minocycline daily. Twelve patients completed 48 weeks of therapy. Statistically significant improvement was noted in almost all variables of disease activity. Three patients discontinued therapy because of lack of improvement, 2 patients because of side effects and one patient was lost to followup. Cytofluorographic analysis revealed a significant decrease in expression of a T cell activation antigen (gp 26). Our data suggest that minocycline could be a useful therapeutic agent in RA. | |
| 8546736 | Development and validation of the European League Against Rheumatism response criteria for | 1996 Jan | OBJECTIVE: To validate the European League Against Rheumatism (EULAR), the American College of Rheumatology (ACR), and the World Health Organization (WHO)/International League Against Rheumatism (ILAR) response criteria for rheumatoid arthritis (RA). METHODS: EULAR response criteria were developed combining change from baseline and level of disease activity attained during follow up. In a trial comparing hydroxychloroquine and sulfasalazine, we studied construct (radiographic progression), criterion (functional capacity), and discriminant validity. RESULTS: EULAR response criteria had good construct, criterion, and discriminant validity, ACR and WHO/ILAR criteria showed only good criterion validity. CONCLUSION: EULAR response criteria showed better construct and discriminant validity than did the ACR and the WHO/ILAR response criteria for RA. | |
| 1346498 | Linkage between rheumatoid arthritis susceptibility and the presence of HLA-DR4 and DR bet | 1992 Feb | OBJECTIVE: To analyze HLA-DR and DQ associations with rheumatoid arthritis (RA) in patients from southern China. METHODS: In 66 patients and 45 controls, restriction fragment length polymorphism studies were performed using DRB, DQA, and DQB probes, and DRB allele-specific typing of polymerase chain reaction-amplified DRB DNA: RESULTS: The frequency of HLA-DR4 was significantly increased among RA patients (42.4% versus 17.8%). Increased frequencies of the DQA3 allele (77.8% versus 48.9%) and the DQB1*0302 allele (71.0% versus 46.3%), which are in linkage disequilibrium with DR4, were also found. Oligonucleotide typing showed that the amino acid sequence LLEQRRAA, spanning amino acid positions 67-74 of the DR beta molecule, was found in 19 of 49 patients and 5 of 32 controls. The main DR4 allelic subtypes found in the population were DRB1*0404 and DRB1*0405, both of which carried the sequence. There was no difference in subtype distribution between patients and controls. CONCLUSION: Chinese RA patients have an increased frequency of HLA-DR4 alleles which possess the same DRB third allelic hypervariable sequence shown to be associated with susceptibility in Caucasian RA patients. | |
| 1590060 | Locomotion status and costs in destructive rheumatoid arthritis. A comprehensive study of | 1992 Apr | Clinical manifestations (locomotion score) and annual costs were studied in a population-based cohort of 82 patients with rheumatoid arthritis fulfilling five to eight American Rheumatological Association's (ARA) criteria. The total costs were SEK 4.9 million: respectively 56 and 44 percent direct and indirect costs. The costs were correlated with total, as well as subjective and objective, locomotion scores, which assess separately impairment, disability, and handicap from the disease (WHO 1980). Patients below 65 years had higher costs-predominantly as an indirect cost due to loss of work-than older patients. Elderly rheumatoid arthritis (RA) patients had a low score and high costs for medical and social services' care, but they had no indirect costs. Patients with a low locomotion score had received previous hospital treatment averaging 89 days. The need of hospital treatment was strongly correlated with low locomotion score. The mean annual patient's costs were about SEK 60,000, but above this for younger patients. When compared with patients with a mild affliction (score 91-100), patients with moderate manifestations, i.e., with a score of 70-90, had five times higher costs, whereas those with severe manifestations, with a score below 50, had 20 times higher costs. | |
| 1575572 | Food intolerance in rheumatoid arthritis. II. Clinical and histological aspects. | 1992 Mar | Six patients with rheumatoid factor positive rheumatoid arthritis who had shown a marked symptomatic improvement during four weeks of hypoallergic, artificial diet were studied in greater detail. Placebo controlled rechallenges showed intolerance for specific foodstuffs in four patients. In three of these patients biopsies of both the synovial membrane and of the proximal small intestine were carried out before and during allergen free feeding. In two patients, both with raised serum IgE concentrations and specific IgE antibodies to certain foods, a marked reduction of mast cells in the synovial membrane and proximal small intestine was demonstrated. Although the number of food intolerant patients with RA remains limited and markers of allergic activity are scanty, our observations suggest an underlying immunoallergological mechanism. | |
| 8478874 | Criteria for clinically important changes in outcomes: development, scoring and evaluation | 1993 Mar | OBJECTIVE: To further the development of criteria for clinically important changes in outcomes seen in rheumatoid arthritis (RA) patients and trials. METHODS: Small group discussions and voting on specially designed profiles based on a 6 factor 2 level factorial design for changes seen in patients and trials. The purpose was to bring out the implicit opinions of participants on these issues, to complement the explicit opinions expressed in the OMERACT questionnaire. This took place at a conference of rheumatologists, methodologists, biostatisticians, regulatory, pharmaceutical and biotechnology industry personnel with an interest in therapies for patients with RA. Data from patients with RA and randomized clinical trials of second line drugs in patients with RA formed the basis to create 64 patient profiles and 64 trial profiles. The profiles contained information on changes in 6 measures: swollen joint count, tender joint count, pain, patient global assessment, physician global assessment and physical disability. The profiles were prepared on 4" x 5" cards and presented to the participants in packages of 64 in random order, in 2 different group sessions. Participants were assigned to 8 groups that contained a mix of all types of participants, with a majority of clinicians in each group. In the patient profile session, individual participants scored whether the profile represented important improvement. In the trial profile session, participants did likewise for important difference between the drugs. After structured discussion the group then voted: consensus was defined as agreement by at least 70% of the group. We decided that an important improvement or difference was present in the profiles on which at least 6 of the 8 groups had achieved consensus. The changes in the profiles showing important improvement or difference can be used to suggest minimum criteria for each of the 6 measures. RESULTS: The lower quartile of the change present in the patient profiles with important improvement varied from 17% (swollen joints) to 49% (disability); the median of these quartiles was 36%. The lower quartile of the differences present in the trial profiles with important differences varied from 13% (tender joints) to 26% (physician global); the median of these quartiles was 18%. CONCLUSIONS: This approach has provided a beginning for less arbitrary definition of criteria for important change in patients and trials. It might be suggested that for patients, an improvement of at least 36% should be clinically important, while an active drug needs to be at least 18% better than placebo to be clinically important. | |
| 8147136 | [Costs and financial feasibility of long-term drug therapy of chronic polyarthritis]. | 1993 Nov | The annual costs of the most common basic therapies in Germany will be analyzed. The costs in Deutsche marks will be divided as drug charges, physician charges and laboratory expenses. There are significant price differences also in equipotent preparations. | |
| 8764910 | The lungs in rheumatoid arthritis--a clinical, radiographic and pulmonary function study. | 1996 Jul | OBJECTIVE: To determine the prevalence and spectrum of pulmonary abnormalities in patients with rheumatoid arthritis (RA) in a developing country. DESIGN: This was a prospective hospital-based survey of a randomly selected group of patients with RA who were seen in a rheumatic diseases unit. SETTING: Groote Schuur Hospital and Princess Alice Orthopaedic Hospital, Cape Town. PATIENTS: A group of 104 patients with RA were randomly selected from a total of 330 patients with RA who were seen in the rheumatic diseases unit. All the patients were interviewed and a clinical assessment, chest radiographs and pulmonary function tests were performed. RESULTS: Fifty-six patients (53.8%) had evidence of one or more current or previous pulmonary diseases: rheumatoid nodule in 1 (1%), bronchiectasis in 2 (1.9%), fibrosing alveolitis in 5 (4.8%), pneumonia in 5 (4.8%), asthma in 9 (8.7%), pleural disease in 17 (16.3%) and tuberculosis in 25 (24%). Excluding patients who were smokers or ex-smokers or who had coexistent pulmonary disease, there were 20 patients (19.2%) who had pulmonary abnormalities that could be attributed to RA: rheumatoid nodule in 1 (1%), fibrosing alveolitis in 5 (4.8%) (1 of whom also had pleural disease), pleural disease alone in 8 (7.7%), diffusion defect in 5 (4.8%) and airways obstruction in 1 (1%). CONCLUSION: This study provides clinical and lung function criteria that allow a clinically useful stratification of abnormalities in relation to a spectrum of common causes of pulmonary dysfunction that need to be distinguished from pulmonary abnormalities caused by RA. Pulmonary abnormalities are common and about 20% of RA patients may have an abnormality related to RA. | |
| 1284418 | [Contact radiotherapy of rheumatoid arthritis]. | 1992 | The authors have devised a method of contact radiotherapy with open radionuclides (198Au) to be used in the treatment of patients suffering from rheumatoid arthritis. Indications for therapy have been defined. In 360 patients suffering from rheumatoid arthritis, radioactive colloid gold was administered to the affected joints. The therapeutic effect was slow in development. The best clinical results were recorded at month 12. Considerable improvement was noticed in 70% of the patients, improvement in 20%, and in 10% of the patients, no therapeutic effect could be recorded. Good effect was ascertained in patients with X-ray Stage I and II disease (70%). | |
| 1613728 | Mechanisms of action of disease modifying antirheumatic drugs. | 1992 Jan | The relationship between the biologic activities of disease modifying antirheumatic drugs (DMARD) and their therapeutic effects are complex. Some DMARD are prodrugs, e.g., azathioprine; others may act in combination with endogenous substances, e.g., D-penicillamine and copper salts. Gold compounds, antimalarials, sulfasalazine, azathioprine and methotrexate affect various phagocytic cell functions. Most DMARD inhibit the immune responses of monocytes and of T and B lymphocytes. Gold, sulfasalazine, D-penicillamine also affect fibroblast and/or endothelial cell proliferation. Many DMARD inhibit responses to, or production of, cytokines. Several DMARD have overlapping biologic effects but differ in their therapeutic efficacy in individual patients for unknown reasons. | |
| 8484689 | Prevalence of rheumatoid arthritis and rheumatoid factor in women: evidence for a secular | 1993 Apr | OBJECTIVE: To determine the current prevalence of rheumatoid arthritis (RA) and rheumatoid factor positivity in the United Kingdom middle aged female population and to compare this with previous estimates to assess whether the disease is becoming less prevalent. METHODS: A cross sectional prevalence study was undertaken. All women aged 45-64 from the age and sex register of a large 11,000 general practitioner group practice in Chingford, East London were contacted and responders examined clinically and radiographically for the presence of RA by a single observer. Blood was also taken for rheumatoid factor testing (sheep cell agglutination test (SCAT), latex, and IgG). The prevalence in non-attenders was assessed from general practitioner and local hospital records. A diagnosis of definite or classical RA according to 1958 American Rheumatism Association criteria was used, and seropositivity was defined by a SCAT rheumatoid factor of 1/32 or more. RESULTS: From the 1003 women examined (response rate of 78.8%), 12 women had definite RA (1.2%, 95% confidence interval 0.6 to 1.8). Of these, 7/12 had definite erosive changes on radiography and 3/12 had a positive SCAT (> 1/32). Three cases of RA were also found in the 284 non-responders (prevalence 1.1%) by case-finding techniques. The rate of SCAT positivity in the whole study group was 0.5%. The rates of RA and SCAT positivity currently found in this group were less than those obtained in previous surveys. In the only previous large scale United Kingdom survey, performed in the north of England between 1958 and 1960, 406 women aged 45-64 were examined and 10 cases of definite RA were found, a prevalence of 2.5%. In the patients with RA 68% had erosions and 63% positive SCAT. The population SCAT positive rate in this and other surveys sampled between 1954 and 1961 was in the range of 4-5%, since when there has been a progressive decline according to a number of other studies. CONCLUSIONS: The prevalence of RA and rheumatoid factor in middle aged women is lower than previously believed and supports a variety of other data which indicate that RA is declining in incidence and severity. | |
| 8172744 | Assessment at CT of the rheumatoid shoulder with surgical correlation. | 1994 Mar | Eleven shoulders in 10 patients with rheumatoid arthritis were examined by conventional radiography and CT prior to cup hemiarthroplasty of the humeral head and the results were compared with the surgical findings. There was good agreement between preoperative CT and surgical findings. Humeral head cavities and erosions, with cortical boundaries, could be seen more accurately at CT than at conventional radiography. The HU of their contents corresponded to those of soft tissue, being granulomatous in nature at surgery. In 8 humeral heads CT disclosed large areas of fatty degeneration of bone marrow with HU between -10 HU and -76 HU that were not visible on the conventional radiographs. These "fatty cysts" had no cortical boundaries, unlike inflammatory granulomas, but both lesions may influence the surgical approach to hemiarthroplasty. | |
| 8159940 | Involvement of connections between the brainstem and the sympathetic ganglia in the pathog | 1993 Dec | The central connections between the superior cervical ganglion of the sympathetic trunk and the brainstem were investigated in five rats by trans-synaptic transport of lectin-conjugated horse-radish peroxidase. After injection of this tracer into the superior cervical ganglion, labelled cells were seen in both the ventral and dorsal parts of the medullary reticular formation. The neurons were found mainly on the same side as the injection site. Besides retrograde labelling, there was an antegrade termination within the nucleus of the solitary tract. We hypothesise that a nervous mechanism is involved in the pathogenesis of rheumatoid arthritis, and that a supraspinal input to the sympathetic ganglia might influence this mechanism. | |
| 8191073 | [Monoclonal antibodies and rheumatoid polyarthritis]. | 1993 | Monoclonal antibodies allow to foresee selective immunotherapy in rheumatoid arthritis (RA). Several molecules implicated in the immunopathogenesis of the disease represent the targets (antigens) of monoclonal antibodies already used in man: T cell antigens, T cell activation antigens, adhesion molecules, cytokines. The first open studies gave promising results. However complementary investigations are requested to confirm the clinical efficacy and to precise the real place of these biologic agents in the strategy of treatment of RA or auto-immune diseases. | |
| 1588732 | [Cytokines and chemical mediators in rheumatoid arthritis]. | 1992 Mar | Multiple chemical mediators are constitutively produced from rheumatoid synovium resulting in joint destruction. These include arachidonic acids metabolites such as prostaglandins and leukotrienes, vasoactive amines, kinins, endothelins, complement fragments, reactive oxygens, neutral proteinases and cytokines. Among cytokines, interleukin-1 (IL-1), IL-6, IL-8, tumor necrosis factor (TNF), platelet-derived growth factor (PDGF), GM-CSF, M-CSF are known to be constitutively produced from inflammatory synovium. Most of these cytokines are mainly produced from synovial cells which are recruited and/or proliferated in the synovium. The mechanism of inducing or aggravating joint destruction with these cytokines and other chemical mediators is discussed. | |
| 8101408 | [The status of various indicators of the protease inhibitor system in blood and synovial f | 1993 May | Elastase-like activity, alpha 1-inhibitor of proteinases and acid stable antitryptic activity were studied in blood of 26 patients and in synovial fluid of 11 patients with rheumatoid arthritis during acute stage of the disease and after treatment with salase pyridasine and orthophene. The higher values of the elastase-like activity were detected in synovial fluid as compared with that of blood. In blood of these patients, hyperproduction of alpha 1-inhibitor of proteinases and acid stable inhibitors was observed, while deficiency of these substances occurred in synovial fluid. Distinct decrease in the patterns of the blood protease-inhibitory system studied simultaneously with clear positive clinical effect were observed after treatment with salase pyridasine together with orthophene; estimation of these patterns may be used in the evaluation of the therapy. | |
| 8065879 | [Preoperative evaluation of tendons in the hands of patients with rheumatoid arthritis by | 1994 Jun 25 | The findings of ultrasonography (US) of 52 tendons of the hands of 14 patients with chronic rheumatoid arthritis (RA) were compared with operative findings obtained subsequently. US showed tenosynovitis as expansion of a hypoechoic area around the tendon. US also enabled pattern classification based on shape, internal echo and border features of the scanned tendon, differentiation of acute and progressive stages among acute inflammation, invasion of tenosynovitis, degeneration, and rupture of the tendon to be made, and the progression of tendon lesions could be ascertained. It was found that in inflammation the tendon was significantly thickened, and in degeneration, the tendon was thinned. By dynamic US scanning, disturbances of tendon movement due to tendon rupture and adhesion to surrounding structures could be detected and differentiated. It was found in this study that preoperative US of the hand of RA patients is very useful for early diagnosis and for the selection of treatment including operative methods. | |
| 7932415 | Neurotransmitter status and remission of rheumatoid arthritis in pregnancy. | 1994 Jun | Hormonal, immunological and neural factors contribute, but none exclusively, to the remission of rheumatoid arthritis (RA) in pregnant women. It is proposed (1) that a reset of neurotransmitter status early in pregnancy (associated with enhanced dopaminergic (DA) activity and subtly modified norepinephrinergic-DA functional interrelationships, and altered cholinergic function) initiates and maintains specific changes in immunological responses and in the endocrine system; that these changes collectively impose an alternative order of efficient physiological function and metabolism which is inimical to the progress of RA and promotes remission and, as reported, also prevents onset of the disease in normal pregnancy; (2) that pregnancy converges the ANS profile of Caucasians on the profile normally observed in nonpregnant Africans and is accompanied by the emergence of resemblances in certain aspects of metabolism; (3) that the reported low incidence of RA in non-pregnant Africans and suppression of onset and remission of the disease in pregnant Caucasians underline the proposed major influence of a specific neurotransmitter profile in determining the risk for and course of RA. |