Search for: rheumatoid arthritis    methotrexate    autoimmune disease    biomarker    gene expression    GWAS    HLA genes    non-HLA genes   

ID PMID Title PublicationDate abstract
8774179 Determination of IgA- and IgM-rheumatoid factors in patients with rheumatoid arthritis wit 1996 Aug OBJECTIVE: To clarify the characteristics and pathogenesis of renal disorders in patients with rheumatoid arthritis (RA). METHODS: In this study, 143 patients with RA were included, from whom 43 with urinary abnormalities were biopsied. Serum rheumatoid factor (RF) concentrations of IgA and IgM isotypes were also measured in these patients by enzyme linked immunosorbent assay. RESULTS: Light microscopy of renal biopsy specimens showed minor glomerular abnormalities in six patients, mesangial proliferative glomerulonephritis (GN) in 21, membranous nephropathy in seven, renal amyloidosis in seven, and tubulointerstitial nephritis in two. Twelve patients with mesangial proliferative GN and one with minor glomerular abnormalities were found by immunofluorescence microscopy to have abnormalities consistent with IgA GN. Although the concentrations of IgA-RF in patients with IgA GN were slightly raised compared with those with glomerulopathy established by biopsy but not associated with IgA GN, the concentrations of IgA-RF were higher in patients with RA with vasculitis or interstitial pneumonia than those with RA complicated by IgA GN. CONCLUSIONS: Mesangial proliferative GN, including IgA GN, may be a frequent renal lesion in Japanese patients with RA. IgA-RF may play little pathogenetic part in the development of IgA GN in RA.
1471438 [Population epidemiologic evaluation of the Hannover Mobile Rheumatoid Health Service]. 1992 The aim of the study was the evaluation of a potential selection process for patients with rheumatoid arthritis (RA) referred to the Mobile Service for Rheumatics in Hannover (MSRH). The MSRH is the only referral center for patients with inflammatory rheumatic diseases in Hannover. A comparison of the health status was made between 58 individuals with RA identified in a population study, and 103 RA patients from the MSRH. The following disease parameters were less favorable in the clinical group: duration of morning stiffness, functional capacity, number of swollen joints, rheumatoid factor, ESR, disease activity, and classical RA according to the Rome-criteria. Only 22% of the individuals with RA identified in the population study have been referred to the MSRH. These patients more frequently had definite or classical RA (statistically not significant: p = 0.17, p = 0.11, respectively). It was shown that the clinical group comprised more severe RA cases. Thus, data from such patients may not be generalized for the entire group of RA cases in the population.
8145866 [Rapidly progressive aortic insufficiency in a female patient with rheumatoid arthritis]. 1994 Mar 19 In a 23-year-old woman with severe rheumatoid arthritis, a rapidly progressive aortic regurgitation (onset within 2 years) was observed. She had a high IgM rheumatoid factor titre and nailfold lesions. The differential diagnosis from infectious endocarditis was difficult. The patient's aortic valve was replaced with a St. Jude mechanical prosthesis. The aortic valve was tricuspid with thick sclerotic cusps and sterile ulcerations and vegetations on the left and right coronary cusps. Histopathologic examination showed hyaline degenerative changes and plasma cell infiltrates in the stroma of the cusps, associated with rheumatoid arthritis. In the literature, aortic regurgitation is associated with longstanding rheumatoid arthritis, subcutaneous nodules, a high IgM rheumatoid factor titre and (or) signs of vasculitis.
7932411 Anti-Ro(SSA) antibodies in patients with rheumatoid arthritis--a possible marker for gold 1994 Jun OBJECTIVE: To determine whether anti-Ro antibodies are associated with gold induced side effects. METHODS: A retrospective chart review of 208 patients with rheumatoid arthritis (RA) and examination of sera for the presence of anti-Ro antibodies by enzyme linked immunosorbent assay. RESULTS: Anti-Ro antibodies were detected in 44 (21%) of our patients with RA and their presence correlated with positive rheumatoid factor, antinuclear antibody, and secondary Sjögren's syndrome. Thirty-three out of 48 patients with gold induced side effects (69%) were anti-Ro positive in contrast to 11 patients (7.5%) with positive antibodies with no side effects (p < 0.001). Mucocutaneous reactions had the only significant correlation (p < 0.01) with the presence of anti-Ro antibodies. CONCLUSION: Patients with RA with anti-Ro antibodies are prone to develop mucocutaneous side effects to gold salts.
8457219 Evidence suggesting that health education for self-management in patients with chronic art 1993 Apr OBJECTIVE: To determine the effects of the Arthritis Self-Management Program 4 years after participation in it. METHODS: Valid self-administered instruments were used to measure health status, psychological states, and health service utilization. RESULTS: Pain had declined a mean of 20% and visits to physicians 40%, while physical disability had increased 9%. Comparison groups did not show similar changes. Estimated 4-year savings were $648 per rheumatoid arthritis patient and $189 per osteoarthritis patient. CONCLUSION: Health education in chronic arthritis may add significant and sustained benefits to conventional therapy while reducing costs.
8216417 Biased T cell receptor V gene usage in rheumatoid arthritis. Oligoclonal expansion of T ce 1993 Sep OBJECTIVE: To analyze the T cell receptor (TCR) variable (V) region gene usage in the rheumatoid joint. METHODS: Monoclonal antibodies (MAb) were used to determine the prevalence of selected V elements on T cells in synovial fluid (SF) from rheumatoid arthritis (RA) patients and in peripheral blood (PB) from RA patients and normal controls. V alpha 2-positive PB and SF T cells from 1 patient were cloned by immediate limiting-dilution and analyzed by restriction mapping. RESULTS: In 9 of 14 RA patients, SF was enriched in at least 1 of the selected V elements, compared with PB. TCR genes of the V alpha 2 family were the most frequently overrepresented in the SF (4 patients). The expanded V alpha 2-positive cells were oligoclonal in SF but heterogeneic in PB. CONCLUSION: Our data showing biased and clonally restricted TCR elements in the rheumatoid joint indicate major histocompatibility complex-restricted antigen recognition, rather than a "superantigen," in the pathogenesis of RA.
7776717 Rheumatoid vasculitis manifesting as intra-abdominal hemorrhage. 1995 Jun Rheumatoid vasculitis, an extra-articular component of rheumatoid arthritis, causes a wide spectrum of manifestations that range from clinically insignificant to life-threatening disease. As a systemic necrotizing arteritis, rheumatoid vasculitis is usually characterized by end-organ ischemia. Herein we describe a patient with abdominal pain and syncope due to intra-abdominal hemorrhage from a ruptured aneurysm of the inferior pancreaticoduodenal artery in the setting of rheumatoid vasculitis. Although the intra-abdominal hemorrhage was the unusual manifestation of rheumatoid vasculitis in this patient, he had a history of prior extra-articular rheumatoid disease, including pulmonary fibrosis and Sjögren's syndrome with associated parotid lymphoproliferative disease. In patients with rheumatoid arthritis who have abdominal pain and an unexplained rapidly decreasing hemoglobin concentration, the diagnosis of intra-abdominal hemorrhage from a ruptured visceral aneurysm due to rheumatoid vasculitis should be considered, even in the absence of other indications of systemic vasculitis.
8817749 Validation of the French version of the arthritis impact measurement scales 2 and comparis 1996 Jun Appropriate attention can be directed to quality of life indices in the evaluation of therapeutic interventions only if reliable, valid measurement tools with good sensitivity to change are available. The goal of this study was to validate the French version of the Arthritis Impact Measurement Scales 2 (AIMS2), called EMIR (Echelle de Mesure de l'Impact de la polyarthrite Rhumatoïde) and to compare it with the validated French version of the Nottingham Health Profile, called ISPN (Indicateur de Santé Perceptuelle de Nottingham). The French version of the AIMS2 (37 items, 12 dimensions) was obtained via several independent translations and back-translations, followed by selection of the most relevant items by a panel of experts and a preliminary evaluation in rheumatoid arthritis patients. The measurement properties of EMIR (reliability, validity and sensitivity to change) were investigated in a cohort of rheumatoid arthritis patients who were put under methotrexate therapy and followed up for six months. Reliability was evaluated by test-retest at a ten-day interval (intraclass coefficients of correlation). Principal component factorial analysis was used to study construct validity and Cronbach's alpha coefficients to study internal consistency. Convergent validity was evaluated based on correlations between the quality of life scores obtained in selected dimensions of the EMIR and a number of other parameters (number of painful/swollen joints, pain severity score on a visual analog scale, erythrocyte sedimentation rate). Sensitivity to change after three and six months was determined by calculating mean standardized response means. The EMIR and ISPN were compared based on scores and sensitivity to change for the dimensions that investigated the same concepts. One hundred twenty-seven rheumatoid arthritis patients scheduled for methotrexate therapy were entered into the study. Principal component analysis established that all dimensions of the EMIR were independent from one another, except the "walking and bending" dimension. Internal consistency was satisfactory for each of the 12 dimensions, with Cronbach's alpha coefficients ranging from 0.70 to 0.90. Most correlations between quality of life scores and clinical or laboratory parameters were significant, indicating satisfactory convergent validity. The reliability study also yielded satisfactory results, with intraclass coefficients ranging from 0.65 to 0.90. Sensitivity to change after three and six months was significant for 11 of the 12 dimensions (mean standardized responses, 0.30 to 0.77). Sensitivity to change was slightly better for the EMIR than for the ISPN. Analysis of scores demonstrated that these two instruments did not measure quality of life in exactly the same way but complemented each other.
8833047 Laboratory markers of disease activity. 1996 Mar Rheumatoid arthritis is associated with numerous abnormalities measurable in a laboratory. These are most commonly used to monitor disease but can also provide prognostic information; less frequently they are used to support a clinical diagnosis. In general, quantitative markers are used for monitoring early disease. By contrast, qualitative markers can provide prognostic information of particular relevance to early therapy. The markers with the best features for predication of radiological erosions are the MHC conserved epitope and rheumatoid factor. In established disease most of the quantitative measures indicate poor prognosis. Therefore, the choice of the best marker depends not only on the purpose for which it is desired, but also on the stage of disease.
8311542 Analysis of a T-cell receptor V beta segment implicated in susceptibility to rheumatoid ar 1993 Dec OBJECTIVES: The assessment of allelic polymorphism of the T cell receptor gene segment, TCRBV2S1, in rheumatoid arthritis. METHODS: A total of 136 patients with rheumatoid arthritis (RA) (ACR criteria) and 150 controls were TCRBV2S1 genotyped using a nested PCR amplification strategy followed by single-strand conformation polymorphism (SSCP) analysis. RESULTS: The SSCP typing method detected two previously unknown alleles of the TCRBV2S1 gene segment. The TCRBV2S1 allele, genotype and inferred phenotype frequencies were similar in the RA patients and controls. No differences were apparent after the RA patients had been partitioned according to their HLA-DR genotypes. CONCLUSIONS: SSCP analysis is a rapid and efficient method of typing T cell receptor germline polymorphisms. Allelic polymorphism of the T cell receptor variable segment, TCRBV2S1, does not influence susceptibility to RA.
8162478 Raynaud's phenomenon in rheumatoid arthritis. 1994 Feb The prevalence of Raynaud's phenomenon in RA was retrospectively reviewed in 411 consecutive RA patients and in a control group of 919 consecutive outpatients with OA. Raynaud's phenomenon was found in 19 (4.6%) of 411 RA patients and in 52 (5.6%) of 919 patients with OA: its prevalence was 4.3% (13 cases) in RA inpatients and 5.4% (six cases) in RA outpatients. Among the RA patients, the prevalence of Raynaud's phenomenon was 7.5% in men (7% of inpatients, 8.8% of outpatients) and 3.2% in women (3% of inpatients, 3.9% of outpatients) (P = N.S.). Conversely, the prevalence of Raynaud's phenomenon in patients with OA was higher in women (6.5%) than in men (2.9%) (P = 0.045). Our study indicates that the reported association between Raynaud's phenomenon and RA cannot be confirmed on the basis of a retrospective assessment of its prevalence.
8923380 Exacerbation of rheumatoid arthritis after termination of chemotherapy for breast carcinom 1996 Nov Three women with breast carcinoma were treated with combination chemotherapy, including cyclophosphamide, 5-fluorouracil, and methotrexate, after mastectomy. Within two months of termination of chemotherapy, all 3 patients developed florid synovitis. Two patients had prior clinical manifestations consistent with rheumatoid arthritis; one patient had no antecedent history of arthritis. We suggest that this presentation may represent exacerbation of mild or subclinical rheumatoid arthritis as a consequence of withdrawal of methotrexate therapy.
7551577 Inflammatory and infectious processes of the cervical spine. 1995 Aug This article discusses infectious and inflammatory processes of the cervical spine. Major emphasis is placed on infectious discitis/osteomyelitis and epidural abscess, particularly the epidemiologic, bacteriologic, pathophysiologic, and clinical aspects, as well as the major role played by magnetic resonance imaging and other imaging modalities used in the detection and diagnosis of these processes.
7923884 Evaluation of a model for post-partum arthritis and the role of oestrogen in prevention of 1994 Oct Sixty-eight percent of female MRL-lpr mice developed a post-partum exacerbation of their mild spontaneous arthritis within 30 days of parturition. The flare became evident between 5 and 15 days after delivery. Histologically it was characterized by a significant increase of subsynovial inflammation and synovial hyperplasia without changes in the level of cartilage and bone erosion. Immunohistologically, marked subsynovial and frequent synovial staining of MHC class II bearing cells was noted, along with the sporadic presence of CD3, CD4, and CD43 receptor-bearing cells in the subsynovium. Injection of physiological levels (0.08 mg/kg) of estradiol on days 2, 3, 9, 15 and 20 post-partum delayed and reduced the flare to 23% of the animals. Administration of pharmacological amounts (0.4 mg/kg per day for 2 weeks following Freund's complete adjuvant injection) prevented adjuvant-enhanced arthritis, reducing the incidence from 67% to the baseline 21% level. Deleterious changes in the underlying systemic lupus erythematosus (SLE), as demonstrated by proteinuria and mortality rate increases, were elicited only by the employed pharmacological amounts of estradiol. These results indicate that the MRL-lpr mice might serve as a model for post-partum flare of arthritis in SLE and rheumatoid arthritis by providing an approach to study the complexity of the effects of pregnancy on autoimmune diseases, and to obtain further evidence for the involvement of oestrogen in arthritis.
8805856 Muscle fiber changes of the vastus medialis in rheumatoid patients. 1996 Jun To study the pathology of muscle atrophy in rheumatoid arthritis (RA), we examined the vastus medialis in rheumatoid patients histologically. The relationship of the findings to their ambulatory ability and long-term steroid therapy was investigated. The muscles of the RA patients were also compared with those of patients with osteoarthritis (OA). Specimens of the vastus medialis were collected from 29 knees of 23 patients with RA and 16 knees of 13 patients with OA during total knee arthroplasty. Muscle fibers were classified according to their type, and the ratio between the area of single type I and type II fibers as well as the ratio between the total area of these fibers was calculated. The total area of type II fibers in the RA group was significantly greater than in the OA group (P < 0.05). In the RA group, the mean proportion of the type II fibers relative to the total muscle fiber area tended to increase with the decline of ambulatory ability, while there was no such increase in the OA group. The proportion of type II fibers was increased significantly in RA patients on long-term steroid therapy when compared to those without therapy. In the ratio of the area of a single fiber, there was no clear relationship to ambulatory ability and long-term steroid therapy. It is considered that muscle atrophy in RA is not solely disuse atrophy, but also has a close relationship to steroid therapy and the pathology of the disease itself.
8846652 Cyclosporine in rheumatoid arthritis: an overview. 1995 Sep All the studies so far performed indicate that Cyclosporine (CyA) treatment i RA is effective and one study indicates that it can also slow down radiological progression. But it is also clear that CyA induced nephrotoxicity is so far the main problem. However, nephrotoxicity can be minimised by lowering the CyA dosage and by ensuring that RA patients subjected to CyA therapy have a normal kidney function and no history of hypertension. I believe that CyA alone or in combination with other drugs will find its place in the treatment of RA and other autoimmune diseases in the near future.
7839071 An 8-year follow-up study of pulmonary function in patients with rheumatoid arthritis. 1994 To evaluate longitudinal alterations in pulmonary function, 63 patients suffering from rheumatoid arthritis (RA) with previously reported reduced pulmonary diffusing capacity were re-examined in an 8-year follow-up study. Cross-sectional examination revealed normal values for vital capacity (VC), forced expiratory volume in 1 s (FEV1) and diffusing capacity per litre alveolar volume (KCO). Total diffusing capacity (DLCO; P < 0.0001), maximal expiratory flow at 75% of expired VC (MEF75; P < 0.0001) and MEF50 (P < 0.01) were decreased. Longitudinal evaluation revealed unchanged MEF50, MEF75 and FEV1, whereas increases in DLCO (P < 0.0001) and KCO (P < 0.0001) and a decrease in VC (P < 0.05) were found. The longitudinal changes in diffusing capacity were unrelated to patient age, disease duration, disease activity in the study period or pulmonary function at the first examination. Thus, in patients suffering from RA, the most prominent functional pulmonary abnormality, decreased diffusing capacity, appeared to improve in the course of time, despite a slight decrease in VC and continued articular disease activity.
7586980 Osteoporosis in rheumatoid arthritis: effect of disease activity. 1995 Jul In addition to juxtaarticular osteoporosis, which appears to reflect predominantly local disease mechanisms, more generalized bone loss can occur in rheumatoid arthritis (RA). The aim of this study was to compare bone mineral density (BMD) of the lumbar spine and proximal femur in RA patients versus controls and evaluate the influence of disease related determinants. Twenty-seven patients with RA and twenty healthy subjects were included in this study. BMD was significantly reduced in RA patients compared with the control group. BMD was correlated with duration of disease, health assessment questionnaire scores, hand grip strength and erythrocyte sedimentation rate. These results support the hypothesis that BMD may be affected by RA related determinants.
1608144 Rheumatoid arthritis-like deformities in an early 16th-century painting of the Flemish-Dut 1992 Jul 8 Hand deformities resembling those of rheumatoid arthritis have been depicted in a painting by an anonymous artist of the Flemish-Dutch School, mid-15th to early 16th century. The painting is presently in the Escorial Museum near Madrid, Spain. This observation, like other earlier observations of rheumatoid deformities in paintings of the Middle Ages, suggests that rheumatoid arthritis is not a modern disease; it had, indeed, appeared several centuries before Landré-Beauvais' description in 1800.
7701524 Thrombomodulin levels in the plasma and joint fluid from patients with rheumatoid arthriti 1993 Dec The hemostatic mechanism is thought to contribute to the inflammatory process of rheumatoid arthritis (RA). Thrombomodulin (TM), an inhibitor of blood coagulation, is synthesized by various cells which are recognized in the inflammatory lesions of RA. To elucidate a possible relation of TM with the process of RA, therefore, we measured soluble forms of TM in the plasma and joint fluid (JF) from RA patients by a recently developed sandwich enzyme immunoassay using monoclonal antibodies. TM levels in the plasma and JF were not significantly elevated in RA patients, although TM levels in plasma were positively correlated with those in JF. The plasma TM levels were related to renal functions (serum creatinine levels), but the levels showed no connection with systemic inflammatory indices of RA such as erythrocyte sedimentation rates, serum C-reactive protein levels and Lansbury's activity index. In the JF, TM levels were not correlated with the numbers of neutrophils or monocytes/macrophages associated with articular inflammations. Our results indicate that TM levels in the plasma and JF do not reflect systemic and articular inflammations of RA, and suggest that TM molecules in JF are mainly recruited from circulating TM.