Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 7940329 | [Rheumatoid arthritis and the intestinal microbiocenosis]. | 1994 | Intestinal microflora was investigated by fecal bacteriological examination in 175 patients with verified rheumatoid arthritis (RA). Intestinal dysbacteriosis of different stages was detected in 75% of the RA patients on nonsteroid antiinflammatory treatment. The frequency and severity of abnormal biocenosis in RA patients were significantly greater than in subjects with osteoarthritis deformans (p < 0.01) and bronchial asthma patients (p < 0.01). Dysbacteriosis severity increased with growing RA activity (between the groups with the activity stage I and III the difference was significant, p <( 0.05). After the fecal microorganisms inoculation it became evident that RA patients carry, as a rule, Clostridium perfringens. Seven RA patients diagnosed to have dysbacteriosis received adjuvant bactisubtil (dry culture of the strain Bacillus IP 5832). The addition of bactisubtil aggravated the patients' condition, in 4 patients, moreover, the microflora got worse. Explanations of the observations on the direct participation of the intestine in RA pathogenesis are suggested. | |
| 1464863 | Frequent induction of insulin autoantibodies by D-penicillamine in patients with rheumatoi | 1992 Oct | D-Penicillamine is a drug known to induce various immunological abnormalities. We used a competitive radiobinding assay, to evaluate the presence of insulin autoantibodies in 42 patients with rheumatoid arthritis (RA), under various treatment modalities. In 11/42 (26.2%) patients, the levels of insulin autoantibodies (range 59-1970 nU/ml) exceeded our upper limit of normal range (50 nU/ml). Nine of these 11 (81.8%) insulin autoantibodies positive patients had been treated with D-penicillamine. Out of 21 D-penicillamine treated patients, 9 (42.9%) were insulin autoantibodies positive (range 80 to 1970 nU/ml). An inverse correlation was found between the concentration of insulin autoantibodies and the time interval since the last drug administration, R = -0.58 (p < 0.05). No correlation was found between the autoantibodies levels and age, or duration of D-penicillamine treatment. In summary, elevated concentration of serum insulin autoantibodies are most probably induced by D-penicillamine therapy in patients with RA and tend to decrease after the drug withdrawal. | |
| 7794992 | Concordant and discrepant views of patients' physical functioning. | 1995 Jun | OBJECTIVE: Although considerable research has been done on patient-physician interaction, few studies have examined discrepancies between patients and physicians in their assessments of the patient's physical functioning. One recent study reports such discrepancies between rheumatologists and 41% of their rheumatoid arthritis patients. This article reports data replicating that study and examining the relationships between such discrepancies and a number of other variables. METHODS: This is a longitudinal study of 158 patients with rheumatoid arthritis who were interviewed 4 times over a 2-year period and who reported their levels of physical functioning on the Arthritis Impact Measurement Scales. At the time of the fourth interview, the rheumatologists rated each patient's physical functioning on the revised criteria published by the American College of Rheumatology. RESULTS: Rheumatologists' assessments of their patients' physical functioning were discrepant with the patient's assessment for 35% of these patients. Twenty-seven patients were rated as worse than they rated themselves and 28 were rated as better. There were no differences between the concordant and the two discrepant groups in demographic or health status characteristics. | |
| 7697962 | Comparison of microheterogeneity of alpha-1-acid-glycoprotein in serum and synovial fluid | 1994 Dec | Microheterogeneity of alpha-1-acid glycoprotein was studied using affinity immunoelectrophoresis with concanavalin A as a ligand in the samples of serum and synovial fluid obtained at the same time from 22 patients with rheumatoid arthritis. Individuals with intercurrent infection or other illnesses were excluded from the study. The results were expressed as reactivity coefficient (RC). Disease activity was evaluated by Mallya-Mace Activity Score, Lansbury Joint Index and laboratory tests. In most of the studied samples the glycosylation pattern was similar, composed of a nonreactive variant and 2 reactive (the first and the second) with Con A variants. In seven samples of synovial fluid an extra third peak representative of the strongly reactive one with Con A fraction was observed. It was the cause of the remarkable elevation of AGP-RC. Moreover, the level of IgM and IgA RF was higher in the synovial fluid derived from these patients--with the presence of the third peak in AFF-EP with Con A--than in those without the considered fraction. | |
| 8877919 | Comparison of standard and alternative health assessment questionnaire scoring procedures | 1996 Sep | OBJECTIVE: To compare statistical properties of data from the Health Assessment Questionnaire (HAQ) with those from an alternative version (AHAQ) that used a different scoring system for the item categories and disability index. Comparisons included descriptive statistics, correlations, and inferential statistics to determine whether the AHAQ would be a more sensitive measure of change in functional status. METHODS: The subjects were 107 adults diagnosed with rheumatoid arthritis and hospitalized for exacerbations in their arthritis or arthritis related joint surgery. Disability was assessed upon admission to hospital and at one year followup with the HAQ. AHAQ scores were generated for the item categories making up the disability index by taking the mean of the item scores in a category instead of the worst item score; the disability index was the mean of the alternative category scores. RESULTS: The standard method of scoring the HAQ was found to generate greater variance on category scores, lower correlations between category scores and the total disability index, and lower correlations between first and 2nd administrations of the instrument, compared to the AHAQ. HAQ disability index scores also correlated slightly lower than those of AHAQ to scores from the HAQ pain scales, and to scores from 2 other measures of functional disability. In addition, the AHAQ was found to be more powerful in detecting functional changes at one year followup. CONCLUSION: Because of its statistical properties the AHAQ scoring method may be preferable to the HAQ method when the instrument is used for documenting change in functional outcomes. | |
| 8334719 | Psychological and educational interventions to reduce arthritis disability. | 1993 Jun | The extent of disability attributable to arthritis is briefly summarized and the World Health Organization's (WHO) classification scheme for progression from pathology to disability described. The types of outcomes that have been examined in evaluations of psychological and educational interventions aimed at preventing arthritis disability are described and classified according to the WHO scheme where appropriate. Next, the most common components included in psychological and educational interventions for arthritis are reviewed. These are (1) providing general information, (2) teaching illness self-management skills, (3) training in biofeedback, (4) applying cognitive-behavioural techniques, (5) using other psychotherapeutic techniques, and (6) enhancing social support. This is followed by a discussion of issues pertinent to assessing the efficacy of various intervention components, citing specific examples of intervention research. Finally, the conclusion that certain types of psychological interventions appear to be effective in mitigating arthritis disability is drawn and the contribution of social science theory to intervention efficacy acknowledged. | |
| 7968721 | Plasma thiols, copper and rheumatoid arthritis. | 1994 Jul | A means by which methotrexate diminishes the overproduction of leukotriene B4 by neutrophils from rheumatoid arthritic patients is described. It is postulated that neutrophil intracellular reduced glutathione is decreased by increased cellular copper, which results in leukotriene B4 overproduction. In the arthritic patient it is proposed that there is an inappropriate amount of a copper donor form of ceruloplasmin which contains a reduced copper that was formed during ceruloplasmin's oxidation of plasma cysteine. Oxidation of increased amounts of plasma homocysteine, present during methotrexate administration, restores ceruloplasmin's redox state leading to decreased copper transport into cells. | |
| 10999058 | American Rheumatism Association 1958 and 1987 revised criteria for rheumatoid arthritis--h | 1996 Feb | The American Rheumatism Association (ARA) criteria for rheumatoid arthritis (RA) were evaluated in 52 newly referred consecutive, clinically diagnosed cases of RA. The 1958 and 1987 criteria were highly correlated (r = 0.795). By the 1958 criteria, 48 cases (92.3%) had classical/definite RA while 40 cases (76.9%) satisfied the 1987 criteria traditional format. By the 1987 classification tree 50 cases (96.2%) belonged to the first three RA subsets while 2 cases (3.8%) belonged to the non-RA subsets. Comparing the clinicians opinion of the outcome with the statistical modelling of variables based on ARA criteria, we conclude that the clinicians opinion of the outcome is reflected by a combination of morning stiffness duration, number of swollen joints, erosion score on hand radiographs and erythrocyte sedimentation rate. We conclude that evaluation of ARA 1958 and 1987 criteria in individual cases has both diagnostic and prognostic significance. We propose a short questionnaire based on ARA criteria, for use in hospital out patient clinic for diagnosis of RA. | |
| 8508554 | The Italian version of the Functional Disability Index of the Health Assessment Questionna | 1993 Mar | A working group of ten rheumatology institutes (UNIREUM) was formed in Italy to promote multicenter therapeutic studies on rheumatoid arthritis. The Functional Disability Index (FDI) of the Health Assessment Questionnaire (HAQ) was chosen as a measure of disability. This paper reports the results of a multicenter study to validate an Italian translation of the instrument and to assess its reliability and validity. Two questions were modified to achieve cross-cultural equivalence. Back-translation into English showed agreement with the American instrument. Reproducibility was high: the test-retest correlation coefficient was 0.989 and ranged from 0.81 to 0.99 for the centers taken separately. Validity was confirmed by a correlation coefficient of 0.95 between the patient self-attributed and the physician-attributed FDI scores. We conclude that our Italian version of the HAQ FDI is a reliable and valid self-administered instrument. | |
| 7481585 | Plasma viscosity in the monitoring of therapy in rheumatoid arthritis patients. | 1995 | Plasma viscosity (PV) was compared with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP) and clinical measures in the monitoring of parenteral gold therapy in a longitudinal study of 40 consecutive rheumatoid arthritis (RA) patients. Significant correlations with the combined clinical variables were only found for differences in PV and not for the other laboratory tests. PV but not ESR or CRP discriminated significantly between active and inactive disease. The sensitivity and specificity for PV above the normal range as a sign of disease activity was 89% and 73%, respectively, which was superior compared with ESR and CRP. The advantages of PV over CRP and ESR justify wider use of this test and warrant further studies of PV in the monitoring of other therapies in RA patients. | |
| 8110041 | [A study of neuropeptides and cytokines in sera from patients with rheumatoid arthritis]. | 1993 Dec | Neuropeptides and cytokines are known as substances which produce various effects on local disease sites. Many studies of these substances role in rheumatoid arthritis (RA) have been carried out in connection with synovial effusion and synovium, but very few in connection with sera. We studied the substances in sera from patients with RA, hypothesizing that the serum levels should reflect the degree of RA activity. We selected nine neuropeptides and cytokines, and measured their serum levels in twenty-five RA patients. For comparison, ten healthy persons were also studied. The results showed that low levels of CRF, ACTH and cortisol, and the high levels of SP, IL-6 and TNF-alpha in sera from the patients with RA compared with those from healthy persons. IL-6 and TNF-alpha correlated with RA activity indexes. We conclude that some neuropeptides and cytokines should act actively on RA through the circulatory blood. The measurement of serum neuropeptides and cytokines in patients with RA is a useful indicator of the degree of RA activity. | |
| 8478847 | A comparison of the sensitivity to change of several health status instruments in rheumato | 1993 Mar | We carried out a study to compare the sensitivity to change of disease specific compared with more generic health status instruments in relation to rheumatoid arthritis (RA). A sample of 102 patients was recruited and assessed by means of 4 health status instruments and standard rheumatological measures on 3 occasions separated by 3 monthly intervals. Sensitivity to change for mobility, activities of daily living, household, pain, emotions and social dimensions were calculated. For some dimensions disease specific health status instruments performed less well. However overall there was no evidence of consistent differences between the 2 approaches. We conclude that generic instruments have a role in the assessment of RA. | |
| 7575695 | Reduction of synovial inflammation after anti-CD4 monoclonal antibody treatment in early r | 1995 Oct | OBJECTIVE: To study the effect of chimeric anti-CD4 monoclonal antibody (MAb) therapy on synovial inflammation, in order to interpret the clinical experience with anti-CD4 treatment. METHODS: The immunohistologic features of synovial biopsy specimens before and 4 weeks after anti-CD4 MAb (cM-T412) therapy were studied in patients with rheumatoid arthritis. The patients received intravenous doses of either placebo (n = 1) or 10 mg (n = 4), 25 mg (n = 2), or 50 mg (n = 1) of cM-T412 daily for 5 consecutive days. RESULTS: Although the patients did not experience clinical improvement, significant decreases in the number of circulating CD4+ cells, the degree of synovial inflammatory infiltration, and the mean scores for expression of adhesion molecules were found in the 7 patients 4 weeks after receiving cM-T412. The scores for infiltration with CD4+ and other inflammatory cells were particularly reduced following treatment with either 25 mg or 50 mg cM-T412. Cytokines, such as interleukin-1 beta and tumor necrosis factor alpha, could still be detected in the synovial tissue after treatment. CONCLUSION: The decline in the numbers of inflammatory cells and adhesion molecules in synovial tissue after CD4+ cell depletion supports the view that CD4+ T cells orchestrate local cellular infiltration. The lack of clinical effect of anti-CD4 therapy might be explained by an insufficient decrease in the number of synovial CD4+ cells and by the persistence of cytokines. Determination of whether more adequate dosing would lead to a clinical improvement must await further study. | |
| 1629822 | Extraarticular manifestations of rheumatoid arthritis and HLA antigens in northern Italy. | 1992 Feb | We performed retrospective analysis of 141 Northern Italian patients with rheumatoid arthritis (RA). This series represents all the patients seen as in and/or outpatients at the rheumatologic unit of Reggio Emilia Hospital during a 2 year period (1987-88). We observed a low frequency of nodules (16%) and vasculitis (2.1%). Thus, RA seems to be milder in our population compared to Caucasian patients with RA originating from North America or England. We observed a weak association with DR4 (RR = 2.4) in the total group of patients with RA. A low frequency of DR4 was observed in patients and controls (29 vs 14.5%, p = 0.001). When compared with controls the frequency of DR4 was significantly higher in seropositive (p = 0.001), but not in seronegative patients. We found that DR4 was significantly associated with nodules (RR = 6.4), with extraarticular features (EAF) (RR = 4) and with erosions (RR = 3) compared with controls. The subgroups with nodules and EAF had a DR4 frequency (respectively, of 52 and 40%) which was significantly higher than that observed in remaining patients (respectively, 25 and 24%). No significant difference was observed in the DR4 frequency between the patients with erosions and those without (34 vs 18%). Thus, DR4 in our population seems to be predominantly associated with a subgroup of patients characterized by seropositivity and EAF. | |
| 7570211 | [The validity and reliability of a Japanese version of Arthritis Impact Measurement Scales | 1995 Jun | A Japanese version of Arthritis Impact Measurement Scales (Japanese-AIMS) was developed after the original AIMS Version 2 (AIMS 2). We then conducted a Quality of Life measurement of 691 patients with Rheumatoid Arthritis (RA) with this newly developed questionnaire. Based on the data collected, the validity and reliability of the Japanese-AIMS was examined. The validity of the Japanese-AIMS, which was assessed by the examination of internal consistency among items and through factor analysis, was almost comparable with that of the original AIMS 2. QOL scales were also validated using internal standards based on the subject's responses to other items in the questionnaire. The test-retest reliability, which was the correlation of scale scores between two tests administered 4-5 weeks apart, was slightly lower than the original one. We conclude that the validity and reliability of the Japanese AIMS were comparable with those of the original one, though there could be possibly improved by the minor revision of phrasing. The large scale QOL measurement study with RA patients is under way, using the Japanese-AIMS with minor revision. | |
| 8326357 | Record linkage to conduct an epidemiologic study on the association of rheumatoid arthriti | 1993 Jul | The objective of this effort was to assess the utility of the large automated database in Saskatchewan as a resource for pharmacoepidemiologic studies. To this end a study was undertaken to test the hypothesis that rheumatoid arthritis (RA) increases the risk of cancer, especially lymphoma. This was done by performing a retrospective cohort study based on record linkage data from Saskatchewan Health. From hospital discharge diagnoses in the hospital file an exposed group (RA) and two comparison groups matched to the RA group by age and sex were identified: (1) the RA group consisted of people with a discharge diagnosis of rheumatoid arthritis; (2) the osteoarthritis (OA) group consisted of people with OA discharge diagnoses; and (3) a comparison (CN) group consisted of hospitalized people with no discharge diagnoses of arthritis. Drug exposures were determined by linkage with the Prescription Drug File, cancer outcomes were determined by linkage with the Cancer Foundation file, and length of eligibility in the health plan and demographics information were determined by linkage with the registration file. The data were checked for quality of linkages across files and consistency with study definitions. Of 13,333 identified subjects, 2.8% were excluded because of apparent incorrect assignment to study group or age group or because of ineligibility in health plan during the study period. In order to decrease the possibility of misclassification of exposure (rheumatoid arthritis), hospital discharge diagnoses were used to exclude subjects with any inflammatory rheumatic diseases (IRD) from the CN (7.8%) and OA (8.3%) groups and subjects with IRD other than rheumatoid arthritis (4.6%) from the RA group. To decrease selection bias, those who had cancer within 1 year of enrollment (to exclude those in hospital because of symptoms of undiagnosed cancer) were excluded. Because RA subjects hospitalized by a rheumatologist were most likely to have valid rheumatoid arthritis diagnoses, each analysis was run twice: once with the entire RA group (N = 1210) and once with those in the RA group who were rheumatologist-hospitalized (N = 646). Logistic regression of incidence was used to control for age, sex, and use of individual disease-modifying anti-rheumatoid drugs (DMARDs). For the rheumatologist-hospitalized RA group compared to the CN group, a significant 4-fold greater risk for lymphoma/myeloma was detected when DMARD use was not controlled for, and a 3.4-fold increase in risk was detected even when use of individual DMARDs was controlled for.(ABSTRACT TRUNCATED AT 400 WORDS) | |
| 1525024 | Rheumatoid arthritis in pregnancy. | 1992 Jul 29 | For many women with rheumatoid arthritis, pregnancy can bring a welcome, temporary relief from symptoms. The baby's birth, however, can end the remission and coping with the infant and the return of difficulties associated with the disease can cause particular problems. In this article, the author highlights potential difficulties both before and after the birth of the baby, including the complexities of drug therapy during pregnancy, and offers practical advice to assist in their resolution. | |
| 7937028 | [Consequences of early-stage rheumatoid arthritis]. | 1994 | The consequences of early rheumatoid arthritis were studied in a series of patients treated at University Hospital, Lund, during the period 1985-1989. Mean disease duration at enrollment was 12 months. Most of the patients have now been followed prospectively for five years, during which time disease activity and pain have increased markedly. Ability to perform the activities of daily living (ADL) was well maintained, and the level of psychological distress fairly low. Radiographic changes in the hands and feet increased markedly, hand deformity being a common sign of severe disease; and only about ten per cent of the patients remained non-erosive. Another subgroup of ten per cent of the patients manifested rapidly progressive disease, resulting in destruction of larger joints, particularly hip joints, necessitating joint replacement in one or both hips. Eighteen per cent of the patients were in remission at 5-year follow-up. At 2-year follow-up, there was a high (37 per cent) prevalence of work disability, most patients who had had to stop work having done so in the first year. Physically demanding work and difficulties in performing ADL at presentation were the best predictors of subsequent work disability. The disease had a pronounced effect on life style, ability to cope with shopping, housework, leisure activities and social activities being adversely affected in more than half the patients. | |
| 7534494 | Expression of CD5 and CD23 on B cells of patients with rheumatoid arthritis, systemic lupu | 1994 Jul | CD5+ and CD23+ lymphocytes were determined in peripheral blood of patients with rheumatoid arthritis (RA) (n = 56), systemic lupus erythematosus (SLE) (n = 20) and primary Sjögren's syndrome (pSS) (n = 21). No definite correlation between the numbers of CD5+ or CD23+ cells and most of the parameters of disease activity was found. A significant correlation (r = 0.59, p = 0.005) between rheumatoid factor levels and numbers of CD23+ cells was found in RA patients not taking disease modifying agents. For SLE and pSS no signification associations with autoantibody production were found. In conclusion, although CD5+ and CD23+ B cells might be important in the pathogenesis of autoimmune diseases, determination of these subsets in peripheral blood of RA, SLE or pSS patients provides no clear useful clinical information for the individual patient. | |
| 8275586 | The effect of D-penicillamine on lung function parameters (diffusion capacity) in rheumato | 1993 Sep | Sequential lung function tests were performed on 28 rheumatoid arthritis (RA) patients who were treated with D-penicillamine (total of 101 treatment years) and on 42 control RA patients who were not treated or who were treated with NSAIDs, chloroquine, gold salts, corticosteroids, salazopyrine or methotrexate. A decline in lung function parameters was found in both groups, although it was only significant for the carbon monoxide diffusing capacity corrected for lung volume (DLCO/VL). This decrease in DLCO/VL was less pronounced in the D-penicillamine group (mean -6.9%) than in the control group (mean -11.3%). This difference could not be attributed to smoking, which was more frequent in the control group. When reviewing only the patients with an initial DLCO/VL < 80% of the predicted value and having, with some exceptions, chest X-ray abnormalities, we even observed an amelioration in the mean DLCO/VL in the D-penicillamine group, in contrast with a deterioration in the control group (+5.1% versus -5.6%). |