Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 7488282 | Quantification of rheumatoid synovitis by magnetic resonance imaging. | 1995 Nov | OBJECTIVE: To develop a method for quantifying acute synovial inflammation in rheumatoid arthritis (RA), utilizing magnetic resonance imaging (MRI). METHODS: Gadolinium-diethylenetriamine pentaacetic acid-enhanced MRI was performed in 21 patients with knee synovitis. Changes in synovial membrane signal intensity were identified and quantified by line profile analysis. Multiple synovial biopsies were obtained by a blind biopsy technique, and standard clinical and laboratory measurements of disease activity were recorded. RESULTS: The rate of synovial membrane enhancement correlated with histologic features of acute inflammation (r = 0.63, P < 0.01), but not with clinical or laboratory assessments. CONCLUSION: Dynamic MRI is a valuable technique for assessing acute synovial inflammation in RA. | |
| 8102226 | Examination of HLA-DR4 as a severity marker for rheumatoid arthritis in Greek patients. | 1993 Jul | OBJECTIVES: Previous reports have shown that HLA-DR4 may be a severity marker for rheumatoid arthritis (RA) in patients of northern European origin. The aim of the present study was to investigate this relation in Greek patients with RA, as RA in Greece differs from the RA described previously on clinical, serological, and immunological grounds. METHODS: Eighty four patients were studied in whom HLA-DR typing was performed by restriction fragment length polymorphism and the subtypes of HLA-DR4 were determined by the polymerase chain reaction. The absence or presence of HLA-DR4 and its subtypes was correlated with the clinical and serological characteristics of the patients and with the side effects due to disease modifying drugs. RESULTS: Twenty one of the 84 (25%) patients with RA were DR4+. There was no difference between the DR4+ and DR4-patients with respect to duration of disease, severity of arthritis, functional grade, and joint erosion score. The DR4+ group were more likely to have side effects due to disease modifying drugs (43%) than DR4- patients (36%), but this difference was not statistically significant. DR4-patients had more extra-articular manifestations, including Sjögren's syndrome (47 v 19%). Analysis of the DR4 subtypes showed that Dw15 was the most common variant (9/21 patients; 43%). There was no statistical difference in the clinical manifestations among patients with different DR4 subtypes. The same was also true when the clinical picture was correlated with the 'shared RA epitope' (QKRAA/QRRAA/RRRAA), which is common to all HLA-DRB1 alleles positively associated with RA. CONCLUSIONS: These results suggest that HLA-DR4 is not a severity marker in Greek patients with RA and further indicate differences in the clinical expression of RA in Greece. | |
| 8882024 | Increased nitric oxide levels in patients with rheumatoid arthritis. | 1996 Feb | OBJECTIVES: We determined whether serum levels of nitric oxide (NO) correlate with disease activity of rheumatoid arthritis (RA) and inflammatory cytokines by measuring the serum and synovial fluid (SF) concentrations of NO in patients with RA and patients with osteoarthritis (OA) and healthy subjects. METHODS: The concentration of NO in each sample was determined by chemiluminescence. Cytokine levels were determined using sandwich enzyme-linked immunoassays. RESULTS: The mean serum concentration of NO was significantly higher in patients with RA (293.4 +/- 108.5 nM) compared with that of patients with OA (33.4 +/- 4.0, p < 0.01) and healthy subjects (35.9 +/- 4.5, p < 0.01). The mean SF concentration of NO (3218 +/- 73.7, p < 0.01) was significantly higher than that of serum in patients with RA. Furthermore, levels of serum NO, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha) were significantly higher in patients with RA with active disease compared to patients with inactive disease. Serum NO levels correlated significantly with the morning joint stiffness, the number of tender or swollen joints, and CRP. Furthermore, NO levels correlated significantly with serum TNF-alpha and IL-6 levels. CONCLUSIONS: Our results suggest that increased endogenous NO synthesis reflects abnormalities of immunoregulation in the joints of patients with RA. | |
| 8146772 | [The content of interleukin-1 beta in the blood serum of patients with systemic lupus eryt | 1993 | The enzyme immunoassay determined serum levels of interleukin-1 beta (IL-1 beta) in 35 patients with systemic lupus erythematosus (SLE) and 18 rheumatoid arthritis (RA) patients. In high activity of both SLE and RA as well as in the presence of fever, anemia, marked skin vasculitis IL-1 beta rose high, still higher levels being reported in patients with erosive joints compared to those in RA patients with initial stage of RA. Lower IL-1 beta content often marked nephropathy in both the diseases. Corticosteroids and cytostatics resulted in IL-1 beta fall which was also established in 9 SLE and 3 RA patients in parallel with inhibition of the process activity. | |
| 1590717 | Review of Swanson trapezium implants. | 1992 Jun | Sixteen Swanson trapezium silicone prostheses are reviewed retrospectively an average of 3 years after insertion. Fifteen were performed for osteo-arthritis and one for rheumatoid arthritis. Despite a very high patient satisfaction, 14 thumbs had residual functional compromise and caused pain when performing certain tasks. Three implants were completely dislocated and another four were significantly subluxed. One patient required implant removal. Intra-osseous cysts or significant bony erosion around the implant were present in five thumbs. It is concluded that there are early significant problems associated with this procedure which make it unsuitable for use in the osteo-arthritic thumb. | |
| 1643920 | Prediction of interstitial lung involvement in rheumatoid arthritis. The value of clinical | 1992 Aug | We initiated the present study to predict interstitial lung involvement in rheumatoid arthritis (RA) by means of logistic regression analysis of clinical data, lung function, chest roentgenogram, and serologic parameters. Fifty-eight nonsmoking patients with RA were randomized from the rheumatologic unit and sent for investigation to the pulmonary department. Bronchoalveolar lavage (BAL) was performed in the middle lobe and the BAL fluid was considered abnormal in case of increased cell count per milliliter and/or lymphocytosis and/or neutrophil granulocytosis; these findings or combinations thereof were found in 42 (72.4 percent) of 58 cases. The patients' data that had an impact on the normality of BAL were the sex (p = 0.001), vital capacity (p = 0.028), peripheral blood T-helper cells (OKT4+) (p = 0.025), DR(+)-lymphocytes (p = 0.002), and antinuclear antibodies (p = 0.025). By means of the logistic regression analysis, it was possible to reach high significance in the prediction of interstitial lung involvement, with a sensitivity of 92.9 percent and a specificity of 75.0 percent (p less than 10(-6)). The efficiency of prediction was 87.9 percent. From these results, we conclude that interstitial lung involvement in RA is predictable from laboratory findings that have been yielded by noninvasive diagnostic techniques. These data should be used in clinical routine monitoring and they may help to facilitate the assessment of whether bronchoscopy is indicated. | |
| 8012003 | [Rheumatoid arthritis of the hand. The initial results with 31-phosphorus MR spectroscopy] | 1994 Jun | The aim of this study was to demonstrate metabolic changes in the small joints of the hand due to rheumatoid arthritis by means of 31-phosphorus spectroscopy. Suitable measurements were developed and 11 normals and 12 patients were then examined during the course of treatment. Relative concentration of low energy phosphorus metabolites was increased in arthritic joints. The phospholipid quotient (phosphomonoester/phosphodiester) and the relationship of inorganic phosphate and beta-nucleoside triphosphate were significant factors during the course of individual treatments. | |
| 1483308 | Rheumatoid arthritis associated with high levels of immunoglobulin a: clinical and biologi | 1992 Nov | We measured the serum immunoglobulins in 191 patients with rheumatoid arthritis (RA) over an 8-month period, looking for a relationship between high IgA levels, disease activity, and clinical and biological features. Twenty-nine patients with a polyclonal hyperimmunoglobulin A (IgA) (15.2%) above 5 g/l constituted group A. A control group of 29 randomized RA patients with normal IgA levels was studied over the same period (group B). The mean serum IgA concentration was significantly elevated in group A: 6.6 +/- 1.8 g/l versus 2.8 +/- 0.9 g/l in group B (p < 0.01). In group A, microscopic haematuria occurred in 20.7% of the cases, as against 3.4% from group B (p < 0.05). Furthermore, the incidence of unilateral sacroiliitis and of arthritis of the distal interphalangeal joints was significantly increased in group A (41.4% and 34.5%, respectively) against 6.9% and 3.4% in group B (p < 0.01) and this correlated with a high IgA serum level (p < 0.01). On the other hand, neither disease activity nor the biological parameters of inflammation were influenced by the level of IgA. Patients with RA associated with high levels of IgA are characterized by a significant increase in the incidence of distal interphalangeal arthritis, unilateral sacroiliitis and microscopic haematuria. These clinical and biological features could define a distinct subgroup of patients with RA. | |
| 8103802 | The role of helplessness in the response to disease modifying drugs in rheumatoid arthriti | 1993 Jul | Fifty patients with rheumatoid arthritis participated in an assessment of their helplessness before and after a 3-month disease modifying drug trial. A multidimensional approach measuring helplessness was used, assessing cognitive, affective, and behavioral components. Both before and after the drug trial, helplessness indices accounted for a highly significant amount of variation in self-reported pain and functional disability. Moreover, Time 1 helplessness predicted greater flare activity after the drug trial. Helplessness indices, however, did not correlate with joint examination measures within time periods, nor did they predict change in these measures over the drug trial. The importance of the role of helplessness in subjective and objective measures of clinical status in persons undergoing drug therapy is discussed. | |
| 8212920 | [Expanded anamnesis and psychodiagnostic classification of psychosomatic rheumatic patient | 1993 Jul | The author describes the information gained from anamnesis which points to a psychogenetic cause of rheumatic complaints. These symptoms are part of the diagnostically important criteria which must be supplemented still further by means of a personal discussion with the patient. A great deal depends on the skill of the physician in conducting these talks, with regard to obtaining relevant information on personal problems which may be underlying the disease patterns. Of course the possibility of a connection of the detected problems with the clinical picture should be given. | |
| 8474061 | Treatment of severe rheumatoid arthritis by anti-interleukin 6 monoclonal antibody. | 1993 Feb | Interleukin 6 (IL-6) appears to be a potential mediator of inflammation that may contribute to the pathogenesis of joint inflammation in RA. Anti-IL-6 monoclonal antibodies (Mab) may represent a new tool in RA treatment. Five patients with RA, after previous anti-CD4 therapy (B-F5) without antimouse immunization were included in our open pilot study. The anti-IL-6 Mab (B-E8, IgG1) was given intravenously (10 mg/day) for 10 consecutive days in hospital. No side effects were noted. Clinical and biological (C-reactive protein) improvement appeared during the treatment period. However improvement was transitory (mean: 2 months). Unexpectedly serum IL-6 levels increased in 4 patients with this treatment that seemed to have antiinflammatory effects. Further studies are required to evaluate the real benefit and the mode of action of this Mab. | |
| 8474059 | Quantitative microfocal radiography detects changes in erosion area in patients with early | 1993 Feb | Patients with early rheumatoid arthritis (RA) were randomly divided into those receiving gold early (n = 13) or 6 months later (n = 10). They were followed 6 monthly over 18 months. Mean erosion area in gold and delayed gold, measured from macroradiographs, was comparable at baseline and increased significantly over the first 6 months. In the second 6 months, gold showed no increase and delayed gold an insignificant increase. By the third 6 months both groups showed a decrease. On comparing the second 6 months of gold therapy in gold and delayed gold with a group of patients with RA of similar disease duration (n = 34) not receiving gold, a lower proportion (p < 0.005) had erosion area progression and a higher proportion (p < 0.001) erosion repair. | |
| 9010046 | The Michael Mason Prize Essay 1996. Role of adhesion mechanisms in the pathogenesis of chr | 1996 Dec | The hallmark of many rheumatic conditions, including rheumatoid arthritis (RA) and other seronegative inflammatory arthropathies (OIA), is a persistent inflammatory process that mainly affects synovial joints. Although the aetiology of the synovitis remains elusive, the pathogenesis is thought to be immune mediated. There are several reasons to believe that synovial T lymphocytes (S-TL) play a central role both as regulatory and effector cells in the initiation and perpetuation of the inflammatory process. In early studies, we demonstrated that the majority of S-TL are of the CD45RO 'memory' phenotype, while CD45RA 'naive' T cells are virtually absent. Various mechanisms can be responsible for such preferential accumulation. In this dissertation, I will present a number of studies, carried out over several years, investigating the relative role of adhesion and migration in the pathogenesis of the CD45RO accumulation in inflamed tissues. Since the first step in lymphocyte extravasation is adhesion to endothelium, the ability of purified CD45RO vs CD45RA T cells to adhere to human umbilical vein endothelial cells (HUVEC) in vitro was analysed. Second, to examine the migration process itself, an in vivo model of cell migration into suction-induced skin blisters raised over delayed-type hypersensitivity reactions was developed. Third, the role of tissue-specific homing mechanisms in the regulation of T-cell migration into different inflammatory sites was investigated. Finally, the adhesion of T cells to extracellular matrix (ECM) components, as a mechanism for preferential cell retention in inflamed tissues, was examined. These studies demonstrate that the critical mechanisms leading to CD45RO lymphocyte accumulation in chronic inflammatory foci include (a) an increased adhesion to endothelium, (b) an increased migratory capacity and (c) an increased adhesion to ECM components. I also present evidence to suggest that besides these general mechanisms, organ-specific homing may be of relevance in determining the selective accumulation of distinct CD45RO T cells in different inflamed tissues. | |
| 8162474 | High resolution computed tomography of the lungs in patients with rheumatoid arthritis and | 1994 Feb | We performed high resolution computed tomography (HRCT) on the lungs of 20 patients with RA and clinical and radiological evidence of interstitial lung disease (ILD). A case control group of patients with RA but without evidence of ILD were similarly studied and all patients underwent detailed pulmonary function testing. Clinical findings, drug therapy, smoking status, the presence/absence of SS and disease activity were also assessed. HRCT showed a range of abnormalities among patients thought to have ILD. Interstitial fibrosis was confirmed in 16 but was frequently associated with emphysema. Ground glass opacification was present in seven, while basal honey-combing was also evident in seven patients. Both these features were present in two patients with ILD. Bronchiectasis was identified in six patients and was the predominant finding in two patients previously thought to have ILD. Among the control patients, HRCT was normal in only five. Clinically unsuspected ILD was present in four patients, while a further four had bronchiectasis. Pleural disease was identified in seven controls. Pulmonary function tests were generally poor predictors of HRCT findings, although a reduced residual volume (RV) [> 1 S.D.] was 83% specific for the presence of ILD and a raised RV [> 1 S.D.] was 64% specific for emphysema. Smoking did not correlate with the presence of either ILD or emphysema and there were no correlations between disease activity and HRCT findings. RA patients with evidence of ILD have abnormalities on HRCT which cannot be confidently predicted on any other non-invasive test.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 1455379 | [Factors that determine the high blood viscosity syndrome in rheumatoid arthritis patients | 1992 | High blood viscosity is a syndrome that may be attributed to a group of the most important disorders of microcirculation under different pathological conditions of the body. The given syndrome manifests itself by disorders of red blood cell deformability (RBCD), high plasma and whole blood viscosity. 32 patients with a verified diagnosis of rheumatoid arthritis (RA) were examined, showing varying activity and systemic manifestations. There was a significant decrease of RBCD from 82.0 + 4.5% in patients with grade I activity to 33.0 + 15.0% in patients with grade III activity (p < 0.01). At the same time plasma viscosity remained practically unchanged. Whole blood viscosity rose with RA activity enhancement: in grade I, it was 1.87 + 0.60 relative units, in grade II, it was 2.80 + 0.80 relative units, in grade III, it constituted 5.30 + 3.70 relative units (p < 0.02). It is assumed that RBCD disturbance is one of the most leading signs in the development of high blood viscosity in RA patients. | |
| 1464862 | Effect of low doses of deflazacort vs prednisone on bone mineral content in premenopausal | 1992 Oct | Longterm administration of steroid drugs, particularly prednisone, is known to induce osteoporosis, as well as bone growth inhibition and delayed fracture union. Recently deflazacort, an oxazoline prednisone derivative, has been developed to reduce such deleterious effects. We carried out a comparative study in premenopausal patients with rheumatoid arthritis (RA). Sixteen cases whose mean age was 36.5 years and mean disease duration 29 months, all fulfilling ARA criteria, were evaluated in a randomized, double blind trial. Visually identical deflazacort or prednisone capsules were given and patients were instructed to maintain an adequate calcium intake. Laboratory tests focussed on bone mineral density in lumbar spine, femoral neck and Ward's triangle and whole body mineral content. Differences between baseline and 12-month values were processed statistically. Persistent synovitis control proved similar for both drugs and features suggestive of Cushing's syndrome were only found in the prednisone group. The difference in whole body bone mineral content between the deflazacort and prednisone groups just failed to reach statistical significance. In the deflazacort group, the difference between the nonsignificant bone mineral density increase at the femoral neck and the significant decrease in the prednisone group proved statistically significant. Ward's triangle was the most sensitive area to bone mineral density changes in patients receiving prednisone, with a highly significant intergroup difference (p < 0.01). We believe this is the first study on corticosteroid induced osteoporosis, as evaluated by whole body mineral content measurements in premenopausal patients with short term RA, showing that deflazacort is a promising alternative in cases severe enough to require steroid therapy. | |
| 8318971 | A new incisional approach to the rheumatoid foot. | 1993 Mar | The authors introduce a new incisional approach to surgery of the rheumatoid foot. Advantages and disadvantages are presented. Historical comparisons are discussed, along with refinement of techniques for pan metatarsal head resection. | |
| 8417910 | Rheumatoid nodules in the trachea. | 1993 Jan | We describe the first case of endotracheal rheumatoid nodules in a 45-year-old Chinese man with rheumatoid arthritis. He developed exacerbation of polyarthritis, new subcutaneous nodules and fibrosing alveolitis. At bronchoscopy, four whitish nodules were detected at the tracheal wall, and biopsy showed fibrinoid necrosis, palisaded inflammatory cell infiltrate and vasculitis, consistent with rheumatoid nodules. Both tracheal and subcutaneous nodules regressed with orally administered prednisone. | |
| 8728664 | Soft versus hard resting hand splints in rheumatoid arthritis: pain relief, preference, an | 1996 May | OBJECTIVES: This study compared soft versus hard resting hand splints on pain and hand function in 39 persons with rheumatoid arthritis. Splint preference was also evaluated to determine its effects on splint wear compliance. METHOD: A repeated measures research design was used to compare the two experimental conditions, wearing a soft splint versus a hard splint on the dominant hand for 28 days at night only, and an unsplinted control period of 28 days. RESULTS: Arthritis pain was considerably less during both splinted periods when compared with the pretest. Subjects identified fewer joints as being painful during the soft splint condition than during the unsplinted condition. There were no significant differences among conditions on hand function measures. Splint preference was 57% for the soft splint, 33% for the hard splint, and 10% for no splint. Splint wear compliance was significantly better with the soft splint (82%) than with the hard splint (67%). CONCLUSION: The findings indicate that resting hand splints are effective for pain relief and that persons with rheumatoid arthritis are more likely to prefer and comply with soft splint use for this purpose. Individualized splint prescription that focuses on client comfort and preference may enhance splint wear compliance. | |
| 8356410 | The recognition of rheumatoid arthritis in the eighteenth century. The contribution of Lin | 1993 | Linné and Boissier de la Croix de Sauvages, two botanists and physicians of the mideighteenth century, proposed systems for the classification of diseases. Their medical works have been examined for passages suggestive of rheumatoid arthritis (RA). References to gouty arthritis dominated in Linné's works. Sauvages described chronic joint diseases with affection of small and large joints which might have been RA. William Musgrave described similar cases in 1703. In a single passage in Linné's works such cases are also described. The conclusion is that RA probably has existed throughout the eighteenth century, and that its supposed emergence around the year 1800 is not well-founded. |