Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1592336 | [Upper gastrointestinal endoscopic findings and gastric mucosal blood flow in patients wit | 1992 Feb | In order to clarify the mechanism of peptic ulceration complicating rheumatoid arthritis (RA), the endoscopic examination of the stomach and duodenum, and the measurement of gastric mucosal blood flow (GMBF, ml/min/100 g) were performed in 49 patients with RA, in relation to the clinical variables (age, sex, disease duration, anatomical stage, functional class and disease activity) and drugs administered. Most of peptic ulcer (88%, 22/25) was found in the gastric mucosa in RA patients, of which antral ulcer occupied 82% (18/22). GMBF in the antrum was significantly lower in RA patients with antral ulcer than in those with normal gastric findings, while GMBF in the gastric body was rather higher in either patients with antral or other gastric ulcer, especially in patients with the angle or body ulcer. The prevalence of antral ulcer tended to be higher in females than in males, and GMBF in the antrum was significantly lower in the former than in the latter (42.7 +/- 11.0 vs 55.6 +/- 12.6). There was no relationship between the prevalence of antral ulcer or GMBF and the activity of RA. All the patients except 4 had received non-steroidal anti-inflammatory drugs (NSAIDs), and of these 45 patients, 24 had also steroids. The prevalence of antral ulcer was higher in patients taking NSAIDs and steroids more than 5mg prednisolone concomitantly than in those taking NSAIDs only, although there was no difference in GMBF in the antrum between them. The prevalence of antral ulcer in patients taking NSAIDs, according to the kind of NSAIDs taken, was the highest in phenylacetic acids group. The difference was significant between propionic acids group and phenylacetic acids group. GMBF in the antrum of phenylacetic acids group was the lowest among the three groups (34.7 +/- 7.1 in phenylacetic acids, 46.6 +/- 11.2 in oxicams and 47.7 +/- 12.6 in propionic acids). Those results indicate that long-term administration of NSAIDs may selectively inhibit GMBF in the antrum, leading to impairment of the protective mechanism in the gastric wall and subsequent occurrence of antral ulcer. | |
| 7570207 | [Fracture threshhold of rheumatoid arthritis patients]. | 1995 Jun | The Bone mass measurement had been difficult while the fracture risk of the rheumatoid arthritic patient had been depended on osteoporosis. Recently, the accuracy of bone mass measurement became reliable that the adequate data could be obtained from the patients. This study shows the fracture threshold of rheumatoid patients by obtaining the bone mass density of those who had been suffering from fracture by DEXA. Twenty two limbs of 21 female patients were affected, average age of 65 and duration of 18 years, and the sites of fracture were femoral neck in 9 cases and humeral neck in 4 cases (62% of the fracture). The BMD of the spine in these patients shows. 828 g/cm2 which was below -3.4 sd of the normal japanese female and thought to be a fracture threshold in RA patients. The risk factors of the fractures in RA were ADL in the limbs, history of total joints arthroplasty and low body mass index. | |
| 8624634 | Bone mass measurement and bone metabolism in rheumatoid arthritis: a review. | 1996 Apr | The involvement of bone in rheumatoid arthritis (RA) is well recognized, and hand bone densitometry appears to be a promising new technique to monitor disease progression by assessing serial changes in hand bone mass in patients with RA. New biochemical markers of bone formation (i.e. osteocalcin) show contradictory results in different studies, although markers of bone resorption (i.e. urinary collagen cross-links) have shown significant increase in patients with RA. Bone histomorphometric studies suggest that the periarticular osteopenia in RA could be related to increased bone turnover locally, whereas generalized osteoporosis could be due to a global negative remodelling balance. The important factors implicated in the pathogenesis of the bone loss are circulating cytokines [e.g. tumour necrosis factor alpha (TNF alpha), interleukin (IL) 1 and IL6] produced by the inflammatory process, use of oral corticosteroids (in the dose of > or = 5 mg) and reduced mobility due to functional impairment. Apart from this underlying osteoporosis, patients with RA have an increased risk of falls secondary to functional impairment and there is an increased risk of fractures in patients with RA. Very few studies are presently available looking at the therapeutic measures to prevent osteoporosis in RA. Future drug trials on the treatment of RA should include bone mass measurement, especially of the hand, as one of the outcome measures. | |
| 8730114 | Functional status assessment of physical impairment in a community based population with r | 1996 Apr | OBJECTIVES: To determine the severity of impairment due to rheumatoid arthritis (RA) in a community based population. METHODS: The level of impairment in the study group, which represented 88% of the subjects known to have RA in a rural community in Finland, was assessed using the Keitel function test (KFT), a series of 23 range of motion tasks, with score ranging from 96 (worst) to 0. RESULTS: According to the KFT results, 10% of the subjects had severe impairment with a KFT score of 65-96. As to the different Keitel components, the mean hand function index was 22.6 from a possible score of 42, and the mean lower limb function 8.9 out of 44. CONCLUSIONS: Our results showed that severely incapacitated patients with RA are rare in the community. The reasons remain speculative. Multidisciplinary care, including early and active treatment with disease modifying antirheumatic drugs and a high number of orthopedic operations may be an explanatory factor. Total joint replacement surgery of the large joints, performed in 19% of patients, may explain the absence of marked restriction in mobility and the divergence between the limitations in the upper and lower limb functions in this series. | |
| 1279167 | The immunoregulation of rheumatoid factor by the CD8 T lymphocyte subset in rheumatoid art | 1992 Sep | Flow cytometric analysis on 81 peripheral blood samples from patients with rheumatoid arthritis (RA) showed that levels of serum IgM rheumatoid factor (RF) were associated with the CD8+ cell level. A significant elevation of natural killer (CD56) cell levels was also observed in RA peripheral blood. Using in vitro antibody production techniques, CD8+ cells from patients with RA appeared to act as suppressors of RF production. Paired blood and synovial fluid samples from 9 patients with RA indicated a significant increase in SF CD8+ cells and DR+ T cells over the corresponding peripheral blood levels. The data suggest that CD8+ cells in RA may respond to immunological abnormalities occurring during the course of the disease. | |
| 7863771 | Wound healing after total elbow replacement in rheumatoid arthritis. Wound complications i | 1995 Feb | Wound healing complications, predisposing to deep infection, are common following prosthetic surgery of the elbow. 50 capitellocondylar elbow prostheses were inserted, using a lateral approach, in 42 patients with rheumatoid arthritis. The first 5 elbows were immobilized postoperatively for 5 days and the following 45 elbows for 12 days, because of delayed wound healing in 2 of the first 5 elbows. No wound healing complications were recorded in elbows immobilized for 12 days and elbow motion was not compromised. 5 elbows were investigated with laser-Doppler imaging (LDI) technique, both pre- and postoperatively. Postoperative LDI values were considerably higher than preoperative ones, indicating no impairment of local skin microcirculation. The authors conclude that the lateral approach is safe to use in prosthetic surgery on the elbow. Early mobilization can delay wound healing, but this can be prevented by 2 weeks of postoperative immobilization. | |
| 1597326 | Protective & risk DR phenotypes in Asian Indian patients with rheumatoid arthritis. | 1992 Feb | This study of 168 north Indian patients with rheumatoid arthritis (RA) confirms the significant association of susceptibility to RA with DR4 specificity (P less than 0.0001). This association was observed equally in familial as well as sporadic patients. The HLA-DR2 and DR5 alleles were identified to be conferring protection in RA, DR5 being reduced significantly in the non-familial patients only. None of the other DR antigens revealed any association with RA in this population, including the DR4 negative group of patients. An analysis of the DR phenotypes in patients and controls revealed that DR4 in combination with DR1 provided the highest relative risk (71.9) followed by DR4, DR4 (RR = 4.1). These results demonstrate that susceptibility to RA is not due to a single HLA specificity but the effect of a group of related epitopes occurring in common among subtypes of DR4 as well as in some DR1 alleles. | |
| 7783052 | T cell receptor distribution in rheumatoid synovial follicles. | 1995 Mar | OBJECTIVE: In rheumatoid arthritis (RA) joint erosion is accompanied by T cell infiltration of the synovial tissue. The resulting T cell receptor (TCR) repertoire is a combination of antigen driven shaping, nonspecific selection by endothelial cell-T cell interactions, and cytokine mediated chemoattraction. Considering the conflicting results of molecular biology studies of the TCR repertoire in RA, we attempted to obtain new data to clarify the situation through microscopic distribution analysis of TCR beta chain diversity in synovium follicular CD4/CD8 subsets. METHODS: We used dual color fluorescence confocal microscopy with CD4/CD8 monoclonal antibodies (Mab) and a panel of new anti-V beta Mab. The analysis focussed on lymphocyte rich, follicle-like areas of synovial tissue from 4 patients with RA. RESULTS: The expression of individual TCR beta families varied between areas within the T cell follicles, and between patients. Normal absolute levels of some beta chains can be completely skewed towards one subset, indicating that overall TCR evaluation is insufficient. CONCLUSION: Confocal microscopy analysis of localized TCR diversity in RA synovium offers novel insight into overall V beta gene usage, which appears to be the accumulation of several localized microexpansions. | |
| 8595756 | Supracondylar femoral fracture following total knee arthroplasty. | 1996 Mar | Twenty-nine supracondylar femoral fractures above total knee arthroplasty were studied retrospectively. Group 1 consisted of 5 nondisplaced fractures managed with closed treatment, yielding 5 satisfactory results. Group 2 consisted of 9 displaced fractures managed with closed treatment. There were no satisfactory results in Group 2; there were 8 malunions and 2 knees requiring revision. Group 3 consisted of 15 displaced fractures managed with open reduction and internal fixation. There were 10 satisfactory results in Group 3; there were 2 malunions and 3 knees requiring revision or repeat fixation. On the basis of these results, closed treatment for nondisplaced fractures is recommended. If displacement exists, early open reduction and internal fixation yields the greatest chance for a satisfactory result, though it has a significant complication rate. | |
| 1440089 | [A case of rheumatoid arthritis associated with progressive systemic sclerosis and primary | 1992 Oct | The patient (a 49 year-old, female) had been diagnosed in Apr. 1987 as having rheumatoid arthritis (RA) following the history as chronic non-A, non-B hepatitis for 4 years. Progressive systemic sclerosis (PSS) and primary biliary cirrhosis (PBC) were also defined on 1989 in the same patient mainly due to proximal scleroderma and histological findings of liver biopsy. On the other hand, the coexistence of rheumatoid factor, anti-Scl-70 antibody, anti-mitochondrial antibody (anti-MC, anti-MD and an unidentified fraction) and anti-centromere antibody have been observed with marked polyclonal hypergammopathy in her sera since July 1990. Her disease activity has been controlled well with the administration of D-penicillamine and ursodeoxycholic acid during recent clinical course. Few cases of RA associated with PSS and PBC, showing various autoantibodies as a disease marker in sera, have been reported. In order to evaluate the mechanisms of autoimmune disease especially chain reaction of autoimmunity, it should be important to accumulate the reports concerning such cases. | |
| 8372723 | Insights from pharmacokinetic and pharmacodynamic studies of hydroxychloroquine. | 1993 | There is wide variability between subjects in the pharmacokinetic parameters of hydroxychloroquine. A range of concentrations is achieved by individuals receiving the same dosage. In a cross-sectional study, mean hydroxychloroquine concentrations in patients with shorter duration and lower intensity of morning stiffness and no rheumatoid factor were significantly higher than in patients with worse disease activity. Variable kinetic parameters, causing variable concentrations, are likely to be contributing to the variability in response to hydroxychloroquine in rheumatic diseases. | |
| 1345881 | Treatment of rheumatoid arthritis. New thoughts on the classic pyramid approach. | 1992 Jan | Treatment of rheumatoid arthritis can be quite challenging. Toxicity profiles of the various anti-inflammatory agents are often unacceptable, mainly because of gastrointestinal intolerance or bleeding. In addition, epidemiologic data suggest that rheumatoid arthritis is a disease with substantial morbidity and increased mortality. Consequently, newer trends in therapy involve earlier use of remittive agents as well as use of low-dose steroids. These modifications of the classic pyramid approach and the investigation of other methods may significantly influence the future of rheumatoid arthritis therapy and improve quality of life in those with the disease. | |
| 8619919 | Predictors of joint damage in rheumatoid arthritis. | 1996 Feb | Rheumatoid arthritis (RA) is the dominant form of destructive chronic arthritis with the potential to cause substantial disability and permanent functional impairment. The final extent and progression rate with time, however, varies markedly. In order to study effects of intervention and to support early aggressive and atoxic therapy in selected cases, predictive disease markers are needed. Recent advances regarding joint tissue composition and pathophysiology have defined a number of biological marker candidates which need to be explored for possible prognostic information. Some markers are characteristic for RA, such as rheumatoid factors and certain autoantibodies, which although they are more prevalent among patients with aggressive disease are not sensitive as predictors in early disease. Genetic susceptibility markers have been claimed to be good predictors of persisting arthritis in early synovitis clinics, but their role as severity markers in established disease is limited. Unspecific markers of inflammation, notably ESR or CRP when persistently elevated, are useful to monitor disease course and newer markers need to document their superiority over these. Another group of markers are attractive because of enriched or exclusive occurrence in joint tissue, and altered metabolism in joint disease. Thus, collagen type III propeptides, hyaluronates, and neopterin originating in the synovium could be useful, and, in particular, hyaluronate levels indeed do provide some predictive information. Highly tissue-specific cartilage metabolites include aggrecan fragments, collagen II fragments, cartilage oligomeric matrix protein (COMP) and the extraarticular cartilage matrix protein (CMP). When used alone or in combination in early disease some information can be obtained which may in the future facilitate prognostication. Bone metabolism can be monitored and there are different markers for synthesis and resorption. Meanwhile, whilst the new markers are essential research tools, their routine clinical usefulness remains to be proven. | |
| 7779124 | Osteoporosis in rheumatoid arthritis. A monozygotic co-twin control study. | 1995 Jun | OBJECTIVE: To quantify the magnitude and distribution of osteoporosis in rheumatoid arthritis (RA). METHODS: Bone mineral density (BMD) was measured by dual x-ray absorptiometry, in a monozygotic co-twin control study. RESULTS: BMD was reduced at most skeletal sites in the twin with RA compared with the co-twin (lumbar spine 4.6%, femoral neck 9.7%, total body 5.7%). Differences in lean soft tissue (5.6% for total body) correlated with differences in BMD between twins at multiple sites. CONCLUSION: Osteoporosis in RA is generalized and may be related to loss of mobility or muscle mass associated with the disease. | |
| 7912952 | Disease-modifying antirheumatic drugs in rheumatoid arthritis: current concepts. | 1994 Mar | Disease-modifying antirheumatic drugs are used in virtually all patients with established rheumatoid arthritis. An increasingly large number of new drugs is now available. Furthermore, old therapies are being used in novel ways. Treatment is now begun earlier and patients are rarely left untreated. This report summarises recent developments regarding the drugs currently in use and those that may be available in the near future. | |
| 8508266 | The acute-phase response in relation to radiographic progression in early rheumatoid arthr | 1993 Jun | Studies on the relationship between acute-phase protein (APP) production, clinical disease activity and progression of radiological damage in RA have been hampered by three factors: patients are studied at different stages of the disease; APP levels are taken incidentally rather than serially; and inter-individual differences in the relationship between the extent of the acute-phase reaction and the progression of radiological damage are not accounted for. A group of 110 newly diagnosed (complaints < 1 year) patients with RA were analysed for a follow-up period of at least three years. Damage was assessed radiologically according to the modified method of Sharp. As radiological progression is a cumulative event, APP production was also calculated by plotting serial CRP levels over time. Overall, a highly significant correlation was found between CRP production and radiological progression; however, a wide variation was observed due to inter-individual differences. The greatest variation was found in the lower range of CRP values, where inter-individual variation could not be accounted for by HLA-DR4, positive RF, sex or age. In conclusion, the prognostic use of serial measurement of APPs for the assessment of radiological progression is limited due to inter-individual variation. Knowledge of the factors underlying these inter-individual differences will increase the applicability of CRP in the prediction of joint damage for individual patients. | |
| 8976635 | Comparison of high and low intensity training in well controlled rheumatoid arthritis. Res | 1996 Nov | OBJECTIVE: To investigate the benefit of intensive dynamic exercises in comparison to range of motion (ROM) and isometric exercises in rheumatoid arthritis. METHODS: 100 consecutive rheumatoid arthritis patients on stable medication were randomly assigned to (1) intensive dynamic group exercises which included full weight bearing exercises and conditioning exercises on a stationary bicycle while the heart rate was maintained at 70-85% of the age predicted maximum heart rate, (2) range of motion (ROM) exercises and isometric exercises in a group, (3) individual isometric and ROM exercises, and (4) home instructions for isometric and ROM exercises. Variables of physical condition, muscle strength, joint mobility, daily functioning (HAQ), and disease activity were assessed before and after the 12 week exercise course, and 12 weeks thereafter. An intention to treat analysis was performed. RESULTS: Increases in aerobic capacity (n = 77), muscle strength, and joint mobility in the high intensity exercise programme were respectively 17%, 17% and 16% and differed significantly from the changes in aerobic capacity, muscle strength, and joint mobility in the other exercise groups. No deterioration of disease activity was observed. Twelve weeks after discontinuation of the exercise course the gain in physical capacity had disappeared. CONCLUSIONS: Intensive dynamic training is more effective in increasing aerobic capacity, joint mobility, and muscle strength than ROM exercises and isometric training in rheumatoid arthritis patients with well controlled disease. | |
| 8249371 | [Effect of penicillamine treatment on the occurrence of heart rhythm disturbances in patie | 1993 Jan | An ECG examination, prolonged over several hours was carried out in 30 patients aged from 29 to 66 years (mean age 51.3) with the diagnosis of rheumatoid arthritis made on the basis of the WHO criteria, before, and in the second and third month of treatment with penicillamine. The values were evaluated of the mean, minimal, and maximal heart rate per minute, and supraventricular and ventricular heart rhythm disturbances, and also conduction disturbances were assessed. In the study no statistically significant changes were recorded in the individual periods of the examination of the values of mean, minimal and maximal heart rate/min. In the initial examination, supraventricular arrhythmia occurred in 80% of patients, and ventricular arrhythmia in 33% of cases. As a result of the applied treatment a decrease was observed of incidence of arrhythmia both supraventricular and ventricular. | |
| 1562415 | Ultra low field MR imaging of cervical spine involvement in rheumatoid arthritis. | 1992 Mar | In a study of 30 patients with longstanding rheumatoid arthritis the diagnostic usefulness of ultra low field MR equipment was analyzed in assessing lesions of the craniocervical junction. It was found that at 0.04 T all the examinations were diagnostic and that in combination with plain radiography the diagnostic information obtained was valuable in further planning of the treatment strategies. The neurologic findings were related to the degree and severity of atlantoaxial luxation, either horizontal or vertical, and to the periodontoid pannus formation. The correlation between the degree of cord compression shown with MR imaging and the clinical symptoms, especially long tract symptoms, was poor. The only correlating factor was the duration of the disease. | |
| 1505111 | Intravenous corticosteroid therapy of cervical cord compression in rheumatoid arthritis. | 1992 Mar | We describe a case of atlantoaxial joint subluxation and cervical myelopathy in a patient with rheumatoid arthritis. Magnetic resonance imaging (MRI) demonstrated a large periodontoid pannus compressing the upper cervical cord. Neurological function improved rapidly after treatment with intravenous pulse corticosteroids given before surgical fusion of the cervical spine. Post operative MRI showed a significant reduction in size of the pannus. |