Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
ID | PMID | Title | PublicationDate | abstract |
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8233232 | 99Tcm-labelled polyclonal human immunoglobulin G scintigraphy before and after intra-artic | 1993 Oct | The ability of 99Tcm-labelled polyclonal human immunoglobulin G (99Tcm-IgG) scintigraphy to monitor intra-individual variation in arthritis activity was studied in seven patients with rheumatoid arthritis (RA). These patients were treated with an intra-articular injection of 20 mg triamcinolone hexacetonide. The results of semiquantitative 99Tcm-IgG scintigraphy were compared with the degree of joint swelling and the histological changes observed in synovial biopsies before and 14 days after the injection. In all seven patients the local treatment resulted in a decreased arthritis activity of the treated knee as measured clinically or histologically. This decrease was parallelled, in all patients except one, by a lower uptake of 99Tcm-IgG after the injection when compared to uptake prior to treatment. This study shows that 99Tcm-IgG scintigraphy is able to reflect intra-individual variations in arthritis activity in patients with RA. | |
1410878 | [Constrictive pericarditis in severe seronegative rheumatoid polyarthritis]. | 1992 Jan | Constrictive pericarditis is a rare complication of rheumatoid arthritis, with 78 published cases. We report a new typical case where the pericardial disease was associated with a severe seronegative rheumatoid arthritis of 17 years duration. Constrictive pericarditis generally occurs in men (62.8% of all cases) aged 52.4 +/- 11.5 years. Its clinical features are identical with those of constrictive pericarditis due to other causes. Diagnosis rests on echocardiography and, chiefly, on right heart catheterization. The arthritis is seropositive in 85.7% of the cases, frequently nodular (75%) and advanced. There is no relation between its duration (mean: 9.6 +/- 7.4 years) and the occurrence of the pericardial pathology. The pericardial fluid has no specific abnormality. Histology shows fibrosis and a non-specific inflammatory cell infiltrate. Immunoglobulin and complement deposits in the walls of the pericardial vessels are detected by immunofluorescence. The only treatment is pericardiectomy; without it the disease is constantly lethal. | |
1302653 | Rheumatoid arthritis and its implications in temporomandibular disorders. | 1992 Jan | Rheumatoid arthritis is known to afflict the temporomandibular joint (TMJ) with common symptoms including pain during function, tenderness on palpation, stiffness, and crepitus. New evidence suggests that metalloproteinases may be responsible for tissue changes that occur in rheumatoid arthritis. These enzymes are collagenase, gelatinase, and proteoglycanase. Antiinflammatory drugs are the first line of management for pain and inflammation in rheumatoid arthritis. This paper, however, suggests that because increased joint load is believed to cause a greater expression of destructive metalloproteinase, it is appropriate to assess even the asymptomatic temporomandibular joint and the muscles of mastication for early objective signs of dysfunction or discomfort. Interceptive management, by the use of load-reducing appliance therapy, may enable reduction of the expression of destructive metalloproteinase within the joint, thereby reducing joint destruction. | |
7777832 | A prospective evaluation of antithyroid antibody prevalence in 100 patients with rheumatoi | 1995 | The prevalence of thyroid antibodies in 100 patients with rheumatoid arthritis in Northern Norway was studied. The serological data were compared with those from a major population survey in the same area. Compared to the prevalence in the normal population, the present study demonstrates that patients with rheumatoid arthritis have a higher prevalence of antibodies to both thyroid microsomal antigen and thyroglobulin. | |
7674291 | Spouse encouragement of self-reliance and other-reliance in rheumatoid arthritis couples. | 1995 Jun | Studying and helping couples burdened with a major life stressor such as rheumatoid arthritis (RA) can be enhanced by employing well-understood conceptual and empirical frameworks, in our research person/environment fit (P x E) models. We measured P x E effects in a sample of 62 rheumatoid arthritis (RA) patients with locus of control beliefs, age, and the health status of the subjects as the Person variables and their spouses' control encouragement as the Environment variable. As predicted, externals were most sensitive to their spouses' behavior. Health status and age moderated the effects of the subjects' control beliefs and spouses' control efforts. Control encouragement showed positive benefits, but only for the younger and healthier subjects; it was related to increased psychological distress for externals in poorer health. Although many models of therapy suggest the benefits of increasing personal control, these data suggest the necessity of employing a more complex model integrating both person and social environment variables in understanding mental health. | |
10163555 | Extracorporeal granulocytapheresis for cancer and rheumatoid arthritis. | 1996 Sep | In cancer and rheumatoid arthritis, granulocytosis is often observed and indicates the progress of disease. We developed a granulocytapheresis system to permit granulocyte reduction. Cellulose acetate was found to be a selective and effective adsorbent. In an in vivo study using an acetate bead column, 9.2 x 10(8) leukocytes were collected. Initially, granulocytapheresis was applied to terminal patients or those with stage IV cancer. Pain, cough and bloody sputum were reduced in spite of no decrease in tumor size. Granulocytapheresis appears to prevent inflammatory damage in or around the tumor site. This granulocyte reduction technique was also applied to patients with rheumatoid arthritis. The Lansbury index markedly improved after treatment. As cytokines and adhesion molecules might contribute to symptoms, granulocytapheresis may be useful in improving the "Quality of Life" in these diseases. | |
8970270 | Intrusiveness of rheumatoid arthritis on sexuality in male and female patients living with | 1996 Apr | OBJECTIVE: To determine whether physical disability, pain, depressive mood, and criticism by the spouse are differentially related to intrusiveness of rheumatoid arthritis (RA) on sexuality in male and female patients. METHODS: Physical and psychological aspects of health were assessed in 102 male and 118 female RA patients who were living with a spouse. Patients were classified into 3 levels of intrusiveness of RA on sexuality. The data were analyzed by means of analysis of covariance and multiple regression analysis. RESULTS: Greater intrusiveness of RA on sexuality was related to greater physical disability, pain, and depression in male and female RA patients. Female patients, compared with male patients, appeared to have lower levels of mobility and self-care. Male and female patients did not differ in their level of intrusiveness of RA on sexuality. CONCLUSION: Physical disability, pain, and, to a lesser extent, depression were found to contribute to intrusiveness of RA on sexuality. It is suggested that differences in sexual motivation between men and women might have been influential in the absence of gender differences in intrusiveness. | |
1622410 | Precision of the Larsen and the Sharp methods of assessing radiologic change in patients w | 1992 Jul | OBJECTIVE: To compare the sensitivity of Sharp's and Larsen's radiographic scoring methods for detecting change in rheumatoid arthritis (RA) over time. METHODS: Radiographs of the hands and wrists were taken at the beginning and at the end of a 2-year followup period, in 42 patients with active RA. Films were scored blindly using both scoring methods. Patients were under treatment with methotrexate (intramuscular injections). RESULTS: Radiographic evidence of progression or amelioration was detected in 25 patients by Larsen's method and in 35 patients by Sharp's method. The relative sensitivity to change over time was greater for Sharp's method (0.01 less than P less than 0.025). CONCLUSION: Sharp's radiographic scoring method seems to be more sensitive to change over time than is Larsen's method. The clinical importance of the change needs to be definitively established. | |
8975281 | [Pleural and pulmonary changes within the scope of rheumatoid arthritis]. | 1996 Aug | Pulmonary complications caused by rheumatoid arthritis are a clinically relevant aspect of this chronic arthropathy. Those complications can involve all parts of the thorax, including the lung parenchyma, the pleura, and the thoracic cage. The most common complications are necrobiotic nodules, pleural abnormalities, Caplan's syndrome, parenchymal fibrosis, bronchiolitis obliterans, and iatrogenic damage of lung the parenchyma. This article reviews pulmonary abnormalities induced by rheumatoid arthritis and their clinical and radiological findings. In addition, the role of different imaging modalities in the diagnostic work-up of pulmonary complications caused by rheumatoid arthritis is discussed. | |
8475349 | [Value of physiotherapy in chronic rheumatoid arthritis]. | 1993 Mar 30 | The main reasons for the importance of physiotherapy in treatment of rheumatoid arthritis are the biomechanical and neurophysiological factors, influencing not only joint function but also trophism. The dependence of the mechanical-structural differentiation of all parts of the joint from the regular practical usage, which is clinically obvious and can be pathophysiologically explained, enables us to use successfully all types of functional therapies. The treatment principle of calisthenics and ergotherapy must always again be derived from the therapy-relevant principles of joint physiology: the requirement of normal joint sensory; physiological instability; continuous activity for nutrition and structural differentiation; taking into consideration receptor sensitization during arthralgia; therapeutic usage of regeneration potency within its limits; and to avoid the unphysiological of an arthritis. The sketchy presentation of the hand's biomechanic lets us recognize easily the generation and prophylactics of the most important deformities: the so-called zig-zag deformities--button hole, swan neck, scoliosis of the hand, the subluxation, particularly those towards palmar, and the radial deviation of the carpus. In praxis we are searching for stabile joint positions, and we try to avoid lax joint positions to transmit force; also we are looking for early recognition of subluxations resp. deformities to train the joints, to fight reflex-dystrophic after-pain, the usage of orthotic devices, and finally treatment resp. prophylactics of contractures. Also part of physiotherapy are supporting and accompanying passive physiotherapeutic measures, therapeutic sport and handling of chronic states of pain. The sense and importance of all three supporting each other therapeutic concepts, will also be pointed out. | |
7791815 | The effect of glucocorticoids on joint destruction in rheumatoid arthritis. The Arthritis | 1995 Jul 20 | BACKGROUND: Oral glucocorticoids are widely used to treat patients with rheumatoid arthritis, but their effect on joint destruction, as assessed radiologically, is uncertain. METHODS: We conducted a randomized, double-blind trial comparing oral prednisolone (7.5 mg daily for two years) with placebo in 128 adults with active rheumatoid arthritis of less than two years' duration. Except for systemic corticosteroids, other treatments could be prescribed. The primary outcome variables were the progression of damage as seen on radiographs of the hand after one and two years, as measured by the Larsen index, and the appearance of erosions in hands that had no erosions at base line. The radiographs were viewed jointly by a radiologist and a rheumatologist who were unaware of the treatment assignment and the time point at which the films were obtained. RESULTS: The statistical analysis of radiologically detected changes was based on 106 patients for whom there were films obtained at base line and two years later. After two years, the Larsen scores increased by a mean of 0.72 unit in the prednisolone group, indicating very little change, and by 5.37 units in the placebo group, indicating substantial joint destruction (P = 0.004). Of the 212 hands of these patients, 147 (69.3 percent) had no erosions at the start of the study. At two years, 15 of the 68 such hands in the prednisolone group (22.1 percent) and 36 of the 79 such hands in the placebo group (45.6 percent) had acquired erosions (difference, 23.5 percentage points; 95 percent confidence interval, 5.9 to 40.7; P = 0.007). The patients in the prednisolone group had greater reductions than the patients in the placebo group in scores on an articular index and for pain and disability at 3 months; for pain at 6 months; and for disability at 6, 12, and 15 months (all P < 0.05). There was no difference between groups in standardized scores for the acute-phase response. The adverse events were typical of those encountered with antirheumatoid drugs. CONCLUSIONS: In patients with early, active rheumatoid arthritis, prednisolone (7.5 mg daily) given for two years in addition to other treatments substantially reduced the rate of radiologically detected progression of disease. | |
8217218 | The synovium of transgenic arthritic mice expressing human tumor necrosis factor contains | 1993 | We have recently reported that nerve growth factor (NGF) increases in the synovium of patients affected by rheumatoid arthritis and in the synovium of pharmacologically-induced arthritis in animal models. In the present study, we demonstrate that arthritic transgenic mice which carry and express the human TNF gene (Tg197) also express elevated levels of NGF, and that subcutaneous injection of NGF-antibodies attenuates the loss of body weight caused by the development of disease in these mice. Along with our previous findings, which show an increase in the level of NGF during the acute phase of other autoimmune diseases, these results suggest a role of NGF in these pathologies. The functional significance of NGF in rheumatoid arthritis (RA) is currently under study. | |
7860508 | Effect of D-penicillamine on lymphocyte subsets: correlation with clinical response in rhe | 1994 Mar | We studied the effects of D-penicillamine (DP) on the clinical response, immunoinflammatory parameters and the lymphocyte subsets in 46 patients with rheumatoid arthritis (RA). Patients were evaluated before the start of the drug and then at 3 and 9 months during the follow up. 38 of 46 (82.6%) patients could continue DP treatment for over 9 months, while in 8 the drug was withdrawn due to adverse effects. Improvement in the various disease activity indices of more than 50% (responders) was seen in 25 of 38 (65.8%) patients. Responders showed a significant decrease in the serum IgA and IgM at 9 months, and in IgM only at 3 months. The serum levels of C3 and C4 did not show any significant change. Serum levels of C-reactive protein and rheumatoid factor (RF) showed a significant decrease at 3 and 9 months. A significant decrease in CD3+ and CD4+ lymphocytes along with a fall in CD4+/CD8+ lymphocyte ratio was also seen in responders at 3 and 9 months, compared to the baseline. Our results suggest that DP may have immunomodulatory action in RA. | |
8894643 | Maternal exposure to paternal HLA does not explain the postpartum increase in rheumatoid a | 1996 | The postpartum period, particularly after the first pregnancy, represents a time of increased risk for the development of rheumatoid arthritis (RA). The present study was undertaken to investigate whether this increase in risk may be due to maternal exposure to fetally inherited paternal HLA-DR antigens that were either 1) similar to their own or 2) had an increased likelihood of being one of the two specific types, HLA-DR1 and DR4, implicated in the etiology of RA. We recruited 94 families where the mother had developed RA within 12 months of a pregnancy, and HLA typed the mother, father, and relevant child of each family. Mothers were not more likely to share HLA-DR genes with their partners than would be expected, and children whose parents shared one HLA-DR gene were not more likely to inherit the shared gene from their father as opposed to the non-shared gene. Further, those children whose fathers were heterozygous for HLA-DR1 or DR4 were not more likely to inherit these genes as opposed to the non-DR1/DR4 gene. In conclusion, maternal exposure during pregnancy to either fetally inherited paternal HLA-DR1 and DR4 genes or to paternal DR genes similar to their own does not appear to contribute to postpartum maternal susceptibility of RA. | |
1476010 | The coexistence of mutilating rheumatoid arthritis, progressive systemic sclerosis and pol | 1992 Sep | A 41-year-old patient with mutilating rheumatoid arthritis and progressive systemic sclerosis, who developed a chronic myeloproliferative disorder polycythemia vera was observed. Some of the pathogenetic aspects of this case with special respect to the function abnormalities of peripheral blood polymorphonuclear cells are analyzed. | |
1638165 | Repeated melting of corneal grafts in a patient with rheumatoid arthritis and Sjögren's s | 1992 Jan | We present a case of corneal melting in a patient with severe rheumatoid arthritis and Sjögren's syndrome. The melting appeared in the area of a bacterial corneal ulcer that healed after treatment with antibiotics. No signs of scleritis were present. Repeated melting of two corneal grafts was seen after surgery. | |
1348942 | Role of glutathione peroxidase in rheumatoid arthritis: analysis of enzyme activity and DN | 1992 Apr | Aberrant expression of the antioxidant enzyme glutathione peroxidase (GPx) could contribute to the etiology of rheumatoid arthritis (RA). However, previous enzyme activity studies examining this relationship were inconclusive. Indirect evidence for this relationship derives from the known efficacy of gold therapy in RA, since gold compounds specifically inhibit GPx. The hypothesis that variants of GPx are associated with RA was examined by two approaches: enzyme activity analysis and restriction fragment length polymorphism (RFLP) association analysis. No significant difference was found in whole blood GPx activity between 28 RA patients and 36 controls. GPx activity appeared to be independent of sex, race, or type of drug treatment. However, a statistically significant difference was found with respect to treatment responsiveness. RA patients classified as good responders to gold therapy, but who were no longer taking gold, had a significantly higher GPx activity compared to both the controls and good responders currently on gold therapy. Aberrantly high GPx activity could contribute to RA by generating excess oxidized glutathione, a potent collagenase activator. Gold therapy would reduce GPx activity to normal levels. The restriction enzyme Pvu II in conjunction with a GPx gene probe identified a useful RFLP (Al, 22 kbp; A2, 15 kbp) with allelic frequencies of A1 and A2 equal to 0.11 and 0.89, respectively, in the control population. No statistically significant association, however, could be demonstrated between this allelic variant of the GPx gene and RA. | |
8546724 | The coexistence of systemic sclerosis and rheumatoid arthritis in five patients. Clinical | 1996 Jan | To elucidate the clinical characteristics and pathogenesis of scleroderma-rheumatoid arthritis (SSc-RA) overlap syndrome, we analyzed the clinical features of 5 patients with SSc-RA overlap. Their HLA phenotypes and genotypes were also determined. Generalized skin sclerosis, severe seropositive polyarthritis, pulmonary fibrosis, anti-topoisomerase I antibodies, and HLA-DR4,53;DQA1*0301;DBQ1*04 haplotype were observed in all of the patients. Similar clinical features were recognized in most of the 10 cases reported previously. Our case studies indicate that SSc-RA overlap may be a distinct entity. | |
1458289 | A longitudinal study of pulmonary function in patients with rheumatoid arthritis treated w | 1992 Dec | Sixty-two patients with classical or definite RA who were considered suitable for disease-modifying drug therapy were entered into a prospective longitudinal study to determine the long-term effects of commonly used drugs such as gold, D-penicillamine and azathioprine on pulmonary function. Each patient had an assessment of pulmonary function, including spirometry, static lung volumes and diffusion tests, before starting drug therapy and at 6-monthly intervals during treatment. In those patients where drug therapy was discontinued, pulmonary functions were performed at withdrawal and 1 year later. Forty-six per cent of the patients in the 'gold group' and 21% in the 'penicillamine group' had developed a restrictive defect after 2 years. There was a significant reduction in vital capacity and transfer factor for carbon monoxide (P < 0.001) in both groups. A significant improvement in pulmonary function was found in the gold-treated patients (P < 0.05) a year after treatment was discontinued. This study shows that a significant proportion of rheumatoid patients on second-line drugs such as gold and penicillamine develop chronic progressive pulmonary damage indistinguishable from fibrosing alveolitis or 'rheumatoid lung'. Its recognition is important as the condition is asymptomatic, slowly progressive and appears to be reversible on withdrawal of the drug therapy in the majority of the patients. | |
7918727 | Joint protection behavior in patients with rheumatoid arthritis following an education pro | 1994 Mar | PURPOSE: Joint protection (JP) education is a common feature in rheumatoid arthritis (RA) treatment programs. However, no objective studies have been published demonstrating patients' behavior changes following such education. This study evaluated whether RA patients' hand movement patterns altered following a JP education program. METHODS: An assessment procedure was constructed to assess application of four JP principles related to altering patterns of hand use during common everyday activities (making a hot drink and snack meal). RESULTS: Eleven RA patients were assessed. There was no significant behavioral change at 6 weeks post-JP education (t = 10; P > 0.1). In contrast, follow-up interviews of self-perceived JP behavior showed all subjects considered JP relevant for them and seven believed they had changed to using these techniques. CONCLUSIONS: This suggests education led to attitudinal change but that behavioral change requires longer and more targeted input than is currently normally provided. |