Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8358964 | HLA-DPA1 and HLA-DPB1 in rheumatoid arthritis and its subsets. | 1993 Jun | The aim of this study was to examine the relationship between HLA-DP and susceptibility to articular and extra-articular features (Felty's syndrome and vasculitis) of rheumatoid arthritis (RA). The possible association of DP types with severity of articular disease was also analysed. No statistically significant associations were observed between HLA-DP alleles and articular or extra-articular features of RA, or to the severity of the arthritis when p was corrected for the number of alleles tested. | |
| 7492221 | Urinary nitrate excretion is increased in patients with rheumatoid arthritis and reduced b | 1995 Oct | OBJECTIVES: To determine daily production of nitric oxide (NO) measured as urinary nitrate excretion, and the effect of prednisolone in patients with rheumatoid arthritis (RA). METHODS: Twenty four hour urinary nitrate was measured by gas chromatography in 10 patients with RA, before and two to four weeks after commencement of prednisolone 0.5 mg/kg body weight, and in 18 healthy controls. RESULTS: Before the start of prednisolone treatment the urinary nitrate excretion in patients with RA was 2.7-fold greater (p < 0.001) than that in healthy volunteers. After prednisolone it decreased significantly, by 28%, at which time inflammatory activity (as indicated by C reactive protein, erythrocyte sedimentation rate, joint count, and early morning stiffness) was also reduced considerably. Despite this decrease, the urinary nitrate excretion in patients with RA remained twice that in the control group (p < 0.05). CONCLUSIONS: Our data suggest that the endogenous production of NO is enhanced in patients with RA. Furthermore, the results indicate that, in parallel with suppression of inflammation, this increased NO synthesis could be reduced by prednisolone treatment. | |
| 8258230 | Tissue plasminogen activator, plasminogen activator inhibitor-1 and von Willebrand factor | 1993 Sep | Tissue plasminogen activator (tPA), plasminogen activator inhibitor-1 (PAI-1) and von Willebrand factor (vWF), all of endothelial origin and active in the haemostasis, were analysed in 74 patients with rheumatoid arthritis. The concentrations were related to extra-articular disease and to the incidence of thromboembolic events (TE) registered in a 2-year follow-up period. Patients with extra-articular disease had a significant increase in PAI-1 activity and reduced tPA release in the venous occlusion test. von Willebrand factor, PAI-1 and also haptoglobin and triglycerides were significantly increased in the group of patients who later suffered from TE. In a multiple regression model, in which cholesterol, triglycerides and lipoprotein (a) showed significant association with TE, vWF had the strongest additive explanatory value. No distinct acute phase pattern of PAI-1 was found in any patient subgroup. | |
| 8465574 | [Polyarthritis in the elderly]. | 1993 Jan | Ten to thirty-three per cent of all cases of rheumatoid arthritis (RA) develop after sixty years of age. Late-onset RA patients are more likely to be male, to have faster onset of symptoms, to experience shoulder and hip disease initially, and to have higher erythrocyte sedimentation rates; they are less likely to develop rheumatoid nodules, extraarticular manifestations, positive serologic tests, or unfavorable outcomes. There are roughly three patterns of late-onset RA: a classical form which resembles typical adult-onset RA; a limited, fairly mild form in which Gougerot-Sjögren syndrome often coexists; and a form in which the shoulders and hips are involved first. The latter form, whose early stage closely resembles polymyalgia rheumatica (PMR), accounts for approximately 25% of cases, is very specific of elderly patients, and is difficult to differentiate from PMR. RS3PE (Remitting Seronegative Symmetrical Synovitis with Pitting Edema) is a different entity from RA. | |
| 1572917 | Reconstruction of the rheumatoid thumb. | 1992 Feb | Most rheumatoid patients will present with one or more thumb deformities at some stage of their clinical history. The goal of treatment is restoration and maintenance of stable and painless motion. Treatment is based on the type and stage of the deformity. The boutonniere thumb is the most common deformity. Metacarpophalangeal arthrodesis is preferred for isolated metacarpophalangeal involvement. For advanced cases in a low-demand patient, metacarpophalangeal arthroplasty with interphalangeal arthrodesis is performed. In the higher demand hand with an uninvolved carpometacarpal joint, arthrodesis of both metacarpophalangeal and interphalangeal joints may be considered. The less common swan neck is approached by treating the carpometacarpal joint with a hemiarthroplasty or a total resection with capsulodesis or arthrodesis of the metacarpophalangeal joint. Adduction contracture is treated by Z-plasty of the skin of the first web space and release of the adductor aponeurosis. Gamekeeper's deformity is treated with reconstruction of the ulnar collateral ligament. Arthrodesis is recommended for those patients with articular erosion of the metacarpophalangeal joint. Flexor pollicis longus and extensor pollicis longus tendon ruptures are common in rheumatoid patients. Extensor pollicis longus ruptures are usually treated with EIP transfer or observation. Flexor pollicis longus ruptures are more disabling and usually require a tendon transfer, tendon graft, or an interphalangeal joint fusion in patients with radiographic destruction of that joint. | |
| 8833051 | Combination therapy in rheumatoid arthritis: metaanalysis. | 1996 Mar | Metaanalysis is a systematic review that applies scientific strategies for limiting bias to the assembly, critical appraisal, and synthesis of all relevant articles on a specific topic. I review the methodologic issues relevant to the assessment of combination therapy in rheumatoid arthritis (RA). Only one metaanalysis of combination therapy in RA has been published; this combined results from trials of different agents. For forthcoming metaanalyses of combination therapy involving the same agents, individual studies being designed must be standardized to the fullest extent and agreed upon endpoints, such as the WHO/ILAR/ACR endpoints, must be included. The study should also follow the guidelines for metaanalysis adopted by the Cochrane Collaboration. | |
| 8737725 | HSP70-1 promoter region alleles and susceptibility to rheumatoid arthritis. | 1996 Mar | The distribution of HSP70-1 promoter alleles was studied in 90 adult Caucasian RA patients (65 European and 25 Asian Indian) and 113 normal control (60 European and 53 Asian Indian). The HSP70-1 promoter alleles were defined by oligonucleotide typing of polymerase chain (PCR)-amplified genomic DNA. The prevalence of HSP70-1 promoter allele "B" was significantly (p < 0.0004, pc < 0.0012; RR = 5.1) higher in RA patients (22.2%) compared to normal controls (5.3%). It is likely therefore that HSP70-1 promoter allele B is associated with susceptibility to RA. | |
| 8164201 | Histologic changes in rheumatoid synovitis induced by naproxen and methotrexate. | 1993 Sep | OBJECTIVE: To study the changes in rheumatoid synovitis induced by the nonsteroidal antiinflammatory drug (NSAID), naproxen, and methotrexate (MTX). METHODS: Twelve patients were treated with naproxen, and 11 with MTX and a clinical activity index was measured before and after treatment. A synovial biopsy was taken, on entry into the study and after 73 +/- 43 days in the NSAID group and 145 +/- 35 in the MTX group. Synovial cells bearing CD3, CD4, CD8, CD19, LeuM5 (CD11c), HLA-DR, HLA-DP and CD25 antigens were measured by stereology. RESULTS: Patients treated with MTX showed a reduction in the number of CD3+ (p = 0.01), CD4+ (p = 0.007) and HLA-DR+ (p = 0.01) cells with an improvement in the activity index (p = 0.001). The patients treated with naproxen did not show changes in the activity index or in the synovial infiltrate. CONCLUSION: Our findings support the theory that clinical improvement in rheumatoid synovitis is associated with a significant decrease in the number of T cells infiltrating the synovial membrane. | |
| 7488283 | Peripheral neuropathy with necrotizing vasculitis in rheumatoid arthritis. A clinicopathol | 1995 Nov | OBJECTIVE: To examine the clinicopathologic features of the noncompressive neuropathies in rheumatoid arthritis (RA). METHODS: We studied 32 patients with RA and peripheral neuropathy whose nerve and/or muscle biopsy specimens exhibited necrotizing vasculitis. Morphologic analysis of nerve specimens included light and electron microscopy studies and teased fiber preparation. Survival was evaluated, and the prognostic values of clinical, biologic, and pathologic features were assessed by Cox proportional hazards model. A prognostic assessment based on the significant variables was devised to estimate the probability of survival of any individual patient. RESULTS: Epi- and/or perineurial vasculitis was observed with the same frequency in the 17 patients with sensory and motor deficit and the 15 patients with sensory neuropathies and was associated with axonal degeneration of an average of 77.7% of the nerve fibers. The mean followup was 7.2 years, and the overall survival rate at 5 years was 57%. A full prolonged remission of the vasculitis was observed in 53% of the patients; relapse occurred in 25%. The factors correlated with mortality, in decreasing order of significance, were clinical cutaneous vasculitis (P = 0.0003), neuropathy affecting 3 or 4 limbs (P = 0.03), and depressed level of C4 (P < 0.05). The prognostic assessment indicated a wide range of 5-year probabilities of survival, from < 1% to 93%. CONCLUSION: Necrotizing vasculitis is responsible for the different patterns of noncompressive neuropathies in RA, including mononeuritis multiplex and distal symmetric sensory or sensorimotor neuropathy. Cutaneous vasculitis, multifocal neuropathy, and depressed C4 level were the 3 independent variables which best predicted mortality. We propose a prognostic assessment according to these variables, to stratify patients to receive more aggressive or less aggressive therapy. | |
| 8546738 | Percentage of anti-CD4 monoclonal antibody-coated lymphocytes in the rheumatoid joint is a | 1996 Jan | OBJECTIVE: We assessed the effect of a daily dosing schedule of the chimeric anti-CD4 monoclonal antibody (MAb), cM-T412, in rheumatoid arthritis (RA) patients, and compared lymphocyte changes in the peripheral blood (PB) and synovial fluid (SF) of these patients. METHODS: Twelve patients received 50 mg/day of cM-T412 for 5 days, followed by a maintenance treatment of 50 mg/week for 5 weeks (6 patients), or a retreatment course of 50 mg/day for 5 days after 5 weeks (6 patients). Paired PB and SF samples were obtained during treatment for analysis. RESULTS: Changes in lymphocyte count and coating with the MAb in PB did not reflect changes in the SF. After 5 daily treatments, the percentage of cM-T412-coated CD4+ lymphocytes in SF correlated with the degree of clinical improvement seen in patients at 2 weeks after the initiation of therapy (r = 0.75, P < 0.05). CONCLUSION: These results demonstrate the importance of antibody dosage and treatment regimen in determining clinical benefit. Our findings suggest that the percentage of cM-T412-coated CD4+ lymphocytes in SF may be a predictor of clinical outcome. | |
| 7913501 | Effect of sulfasalazine on B cell hyperactivity in patients with rheumatoid arthritis. | 1994 Apr | OBJECTIVE: We investigated the in vitro immunomodulatory effects of sulfasalazine on B cells in rheumatoid arthritis (RA). METHODS: Reversed hemolytic plaque assay and 3H-thymidine incorporation were measured. RESULTS: B cells from patients with RA showed hyperactivity to stimulation by Staphylococcus aureus Cowan I. Sulfasalazine significantly inhibited this B cell hyperactivity in a dose dependent manner. The kinetic study and a decrease in 3H-thymidine incorporation on Day 3 indicate that sulfasalazine inhibited the early phase (0-48 h) of B cell proliferation in these patients. Sulfapyridine also inhibited B cell hyperactivity in these patients, but 5-aminosalicylic acid and N-acetylsulfapyridin had no significant effect. CONCLUSION: Sulfasalazine exhibited a direct immunosuppressive effect on B cell hyperactivity in patients with RA, which may be responsible for its therapeutic effectiveness in this disorder. | |
| 8882051 | C1 inhibitor deficiency in a patient with rheumatoid arthritis--increased risk of adverse | 1996 Feb | We report the coincidence of hereditary angioedema and rheumatoid arthritis in a male patient and in his father. During treatment with D-penicillamine the patient developed a transient lupus-like disorder with glomerulonephritis that resolved when D-penicillamine was discontinued. He later was diagnosed with malignant lymphoma. Impaired classical complement pathway function could have contributed to development of the drug reaction. | |
| 8324961 | Methotrexate: anti-inflammatory or immunosuppressive? | 1993 Mar | Low dose methotrexate (MTX) is an effective drug for rheumatoid arthritis, suppressing joint inflammation and even radiographic progression of joint disease. Some disease-specific side effects suggest an immunomodulatory effect of the drug. However, most data currently available suggest a mechanism of action at the level of the non-specific efferent arc of the immuno-inflammatory process rather than on T cells. | |
| 7936610 | [Causes of death as well as complications in rheumatoid arthritis]. | 1994 Sep 11 | The frequency of basic diseases, complications, causes of death and associated illnesses were studied on non selected autopsy material of 161 patients with rheumatoid arthritis died at the National Institute of Rheumatology in 1970-1992. The authors determined the incidence of severe complications such as systemic vasculitis, generalized secondary amyloidosis, generalized septic infection and miliary epithelioid granulomatosis (probably miliary tuberculosis). In 122 cases (75.8%) the RA, while in the remaining 39 (24.2%) cases other basic disease was the underlying cause of death. Vasculitis was observed in 36 cases (22.4%), amyloidosis in 34 (21.1%), sepsis in 22 (13.7%), and miliary tuberculosis in 6 (3.7%) out of 161 RA patients. Vasculitis led to death in 19 (11.8%), amyloidosis in 17 (10.6%), sepsis in 22 (13.7%) cases. However, none of the miliary tuberculosis was direct cause of death. In 76 cases (47.2%) rheumatoid arthritis was not complicated by vasculitis, amyloidosis, sepsis or military tuberculosis and in 85 cases (52.8%) one or more of these complications existed in the necropsy material of 161 RA patients. In 74 patients (46%) only one complication and in 11 (6.8%) more than one from the mentioned complication existed simultaneously in the same patients. Vasculitis was detected clinically in 7 patients (relative frequency: 19.4%), amyloidosis in 8 (relative frequency: 23.5%), sepsis in 10 (relative frequency: 45.4%), however none of the 6 mT was detected clinically. Out of 98 complications in 85 Rheumatoid patients only 25 were recognized clinically (25.5%). | |
| 7505480 | Prospect for an additional laboratory criterion for rheumatoid arthritis. | 1993 | The aim of the study was to establish the benefit of an additional hypothetical laboratory criterion for rheumatoid arthritis (RA), comprising positivity for antikeratin antibody (AKA) and/or antiperinuclear factor (APF). The tests were applied to a series of 308 hospital patients with various recent-onset inflammatory joint diseases who were followed for 3 years. The performance of APF and AKA was compared with rheumatoid factor (RF). The most sensitive (.72) but the least specific (.86) test for RA was the latex test. The most specific (.96) but the least sensitive (.33) test was AKA. Waaler-Rose and APF were intermediate. AKA and/or APF positive patients had significantly more erosions than patients negative for these autoantibodies. Despite the impressive performance characteristics of APF and AKA, the actual classification impact achieved, as compared to using RF as the sole laboratory criterion, turned out to be moderate. This is because the criteria proved to be interrelated. Unlike RF, AKA and APF are not suited to the general laboratory, at least not in their present form. Moreover they so far lack the broad data base of RF. | |
| 8235491 | The prognostic value of HLA DR4 and B27 antigens in early rheumatoid arthritis. | 1993 | The prognostic significance of HLA DR4 and B27 antigens was investigated in a 3-year follow-up of 87 patients with early rheumatoid arthritis (RA). The frequencies of DR1, DR4 and also of B27 were increased and the frequencies of DR2, DR3 and DR7 decreased compared with the normal Finnish population. During the follow-up with antirheumatic treatment, a similar improvement in clinical variables and laboratory measure assessing disease activity was found in both DR4-positive and DR4-negative RA patients. Despite clinical improvement a fast radiological progression in peripheral joints was observed but the presence of DR4 or B27 had no impact on the progression of joint damage. In some patients cervical changes developed early in the course of RA but were not related to DR4 or B27 positivity. The earlier observation of increased prevalence of HLA B27 in the Finnish RA patients was confirmed but the presence of B27 did not modify the clinical picture of RA. | |
| 1604325 | The impact of endpoint measures in rheumatoid arthritis clinical trials. | 1992 Apr | In clinical trials on the effectiveness of disease-modifying antirheumatic drugs (DMARDs) in patients with rheumatoid arthritis (RA), it is common to apply a large number of endpoint measures. This practice has several disadvantages. To determine which endpoint measures are most valuable, reports of 32 clinical trials on six DMARDs were reviewed. The frequency with which each endpoint measure was used is described and discussed, as well as the frequency with which the values of each endpoint were significantly different in statistical comparisons within or between groups, thus showing ability to discriminate between drugs not equally effective. The results of this review are discussed and compared with other reports in the literature on the choice of endpoint measures in RA clinical trials. The authors conclude that it is still common practice to evaluate multiple outcome measures. The number of measures could be reduced by using only those that are generally considered important, are sensitive to change, and are able to differentiate between drugs in clinical trials. A joint count, assessment of pain, a questionnaire on functional status, and measurement of erythrocyte sedimentation rate are sufficient. | |
| 1512756 | Concordance between clinician and patient assessment of physical and mental health status. | 1992 Jul | The degree of concordance between clinicians' and patients' assessment of the patient's physical and mental functioning was examined in 166 consecutive eligible outpatients with rheumatoid arthritis (RA) using 4-category ordinal scales. The weighted kappa statistic was 0.39 for physical functioning and 0.30 for mental functioning, both indicating a fair degree of concordance. This disagreement differed in magnitude and direction depending on the level of disability present. We conclude that clinicians and their patients with RA often disagree in their assessment of the degree of physical and mental impairment that the patient experiences. These disagreements demonstrate the need for formal assessments of outcome and should be recognized and resolved when managing individual patients. | |
| 8681501 | [Recurrent rheumatism and idiopathic osteoporosis in young adults. Coincidence or associat | 1995 Dec | Although in literature are not reported any cases of an association between palindromic rheumatism and idiopathic osteoporosis, the Authors describe two patients, to whom the above-mentioned diseases appeared and were diagnosed at the same time, suggesting a possible interrelationship. | |
| 8443257 | Dietary intake and circulating vitamin levels of rheumatoid arthritis patients treated wit | 1993 Mar | The nutrient intakes and circulating vitamin levels of 32 patients with rheumatoid arthritis who were treated with methotrexate were evaluated over a 6-month period. Dietary data were obtained and blood was drawn prior to the initiation of and following 12 and 24 weeks of methotrexate therapy. More than 50% of the patients had food intakes providing less than 67% of the recommended dietary allowance for zinc, vitamin E, folic acid, pyridoxine, and magnesium. Patients 51 years or older had better nutrient intakes than patients less than 51 years. Of the patients, 22% consumed vitamin supplements at the time they were recruited for the study. Mean circulating vitamin levels measured over the 6-month period were within normal limits. Our findings agree with previously published reports that patients with rheumatoid arthritis, particularly the subpopulation taking methotrexate, consume diets that are marginal in some nutrients. Additional research needs to be done to identify more sensitive nutrient assays and to establish more definitively the nutrient needs of patients with rheumatoid arthritis taking several therapeutic agents. |