Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1375727 | Effect of exposure to sauna heat on neuropathic and rheumatoid pain. | 1992 Apr | Exposure to sauna heat during sauna bathing raises the skin temperature of the bather near the hot pain perception threshold and enhances sympathetic activity. Self-reports provided by regular bathers of changes in intensity of their ongoing pain might, therefore, add novel information on the effect of intense heat on various pain conditions. We interviewed consecutive patients attending our pain clinic over a period of 1 year about their pain-related responses to sauna bathing and controlled the results by quantitated somatosensory tests. There were 61 patients with chronic neuropathic pain of peripheral origin, 13 patients with central pain and 59 patients with rheumatoid pain. Allodynia and hyperalgesia to heat were relatively infrequent in all groups (10%, 15% and 8%, respectively). Three out of 17 patients with postinjury nerve pain reported similar exacerbation. By contrast, mechanical allodynia was present in 48% of patients with peripheral neuropathic pain and in 54% of patients with central pain. The results speak against an important role for C-afferent or sympathetic postganglionic fibres in most subclasses of neuropathic pain. Animal models of neuropathic pain should be critically viewed against this finding. | |
| 8784927 | The evaluation and initial management of arthritis. | 1996 Jun | This article reviews the appropriate workup of the patient presenting with complaints referable to a joint, including the important information to be obtained during the interview and physical examination, as well as from laboratory and imaging studies. The clinical presentation of osteoarthritis, rheumatoid arthritis, gout, and joint sepsis are discussed, and the treatment approach for each is outlined. The specific indications for surgical intervention in the course of arthritis also are detailed. | |
| 10163527 | Humeral head replacement for glenohumeral arthritis. | 1995 Oct | From July 1977 through March of 1983, humeral head replacement was performed on 35 shoulders with osteoarthritis and 32 shoulders with rheumatoid arthritis and followed-up for an average of 9.3 years. Satisfactory pain relief was achieved in 44 (66%) and 52 of the shoulders (78%) were described by patients as being much better or better. Active elevation was improved from an average of 84 degrees to an average of 110 degrees with external rotation improving from 20 degrees to 44 degrees. Strength improvement also occurred. Only three complications developed, and these did not affect the final outcome. Because of moderate or severe pain, 12 shoulders (18%) required revision to total shoulder arthroplasty, and all patients were relieved of their pain. The result ratings were excellent in 10 shoulders, satisfactory in 23, and unsatisfactory in 34 (51%). With longer follow-up, a satisfactory level of pain relief may not continue for those patients with osteoarthritis and rheumatoid arthritis who have had humeral head replacement alone. Whereas this form of treatment should certainly be considered in those patients who have inadequate glenoid bone to support a glenoid implant and probably be considered in younger patients or patients who wish to remain more active, these latter patients must be fully appraised that the probability of continuing pain relief is less than has often been appreciated. | |
| 7722250 | Uncemented total wrist arthroplasty. | 1995 Jan | We report our experience with a non-cemented wrist implant we developed in 1986. Between 1986 and 1991, 50 prostheses were implanted in 45 patients, 33 with rheumatoid arthritis and 12 with traumatic arthritis. After an average of 4.5 years (range, 2-6 years), we evaluated pain, daily activities, motion, grip strength, and x-ray films. The results were excellent in 24 wrists, good in 12, fair in 5, and poor in 8. | |
| 8909256 | Pristane-induced arthritis in rats: a new model for rheumatoid arthritis with a chronic di | 1996 Nov | We present a novel animal model for rheumatoid arthritis induced with a well defined synthetic adjuvant oil, pristane. Two weeks after a single intradermal injection of 150 microliters of pristane, the rats developed severe and chronic arthritis. The inflammation was restricted to the joints and involved pannus formation, major histocompatibility complex (MHC) class II expression, and T lymphocyte infiltration. The initial development as well as the chronic stage of pristane-induced arthritis was ameliorated by treatment with antibodies to the alpha beta-T-cell receptor showing that the disease is T cell dependent. Increased levels of interleukin in serum was seen after pristane injection but not during the chronic stage of arthritis. Joint erosions were accompanied by elevated serum levels of cartilage oligomeric matrix protein. Comparison of MHC congenic LEW strains showed that the severity and chronicity of arthritis varied among the different MHC haplotypes. Rats with RT1f haplotype showed a significantly higher susceptibility to pristane-induced arthritis. A strong influence of non-MHC genes was also suggested by the variability of arthritis susceptibility among different strains with the same MHC haplotype; the most susceptible background was the DA and the least susceptible was the E3. Arthritis induced with a well defined nonimmunogenic adjuvant, with a disease course that closely resembles that of rheumatoid arthritis, makes a suitable animal model for future studies of the pathology and genetics of rheumatoid arthritis. | |
| 7863279 | The effect of regular intramuscular corticosteroid therapy on bone mineral density in rheu | 1995 | To evaluate the effect of long term regular bolus doses of intramuscular corticosteroid on bone mineral density in rheumatoid patients we undertook a retrospective cross-sectional study of 68 rheumatoid patients. Patients were divided into three groups; those who had received maintenance doses of intramuscular corticosteroid (steroid), those who had been taking regular doses of oral steroid and those who had never received steroid by either route. Bone mineral density (BMD) was measured at the hip and lumbar spine by dual photon X-ray absorptiometry (DEXA). Z scores were calculated for each patient at both sites. There is a statistical difference in Z scores at the hip in both steroid treated groups compared with the no steroid group (p < 0.001). Total steroid was less in the IM treated group compared to the oral steroid group. These results suggest that maintenance therapy with IM steroids produces significant losses of bone mineral density at the hip in rheumatoid patients and that this effect appears to be independent of the total dose. | |
| 8916295 | Rheumatoid arthritis as a bone marrow disorder. | 1996 Oct | Both the concept of rheumatoid arthritis (RA) as an autoimmune process restricted to joints and the major role of T cells in its pathogenesis have been challenged in the literature. Fibroblastlike and macrophagelike synoviocytes play an important role in RA pannus, and these cells originate in or have their counterpart in bone marrow (BM). Yet the B cell autoimmunity characteristic of RA occurs early, and synovial tissue, like BM, favors the B cell response. Because BM is abnormal in RA, and because germinal centers are unique to RA synovium, RA could be regarded as a disorder of the microenvironments able to sustain B cell response. In fact, RA could even begin in BM, with its onset facilitated by stem cell abnormalities. Moreover, most viruses suspected of playing a role in RA share a BM tropism. This may explain why RA frequently overlaps with other autoimmune disorders and benign lymphoproliferations, such as large granular T lymphocytosis. Because remissions from RA have been reported after BM transplantation, careful studies of the rheumatological outcome of RA patients undergoing such therapeutic procedures are needed. Although RA is a complex process, it can be considered initially as a stem cell disorder requiring treatment similar to that administered to transplant patients. Animal models have provided convincing evidence for these assumptions. | |
| 8369897 | Remission of severe rheumatoid arthritis following liver transplantation. | 1993 Sep | We present the case of a 32-year-old male who suffered from severe RA from the age of 21 years. After 9 years of active disease and poor response to therapy the patient developed severe hepatitis induced by the NSAID pirprofen. He went into fulminant hepatic failure necessitating emergency liver transplantation. Liver transplantation was followed by clinical and laboratory remission of his RA and he has remained virtually asymptomatic for more than 3.5 years. The possibility that this favourable clinical course was due to the immunosuppressive effect of the liver transplant rather than the ensuing immunosuppressive therapy is discussed. | |
| 8612229 | HLA-DR4 and HLA-DR10 motifs that carry susceptibility to rheumatoid arthritis bind 70-kD h | 1996 Mar | Most patients with rheumatoid arthritis express particular HLA-DR alleles. The DRbeta1 chains of these alleles share a highly homologous amino acid motif, in their third hypervariable (HV3) region, and this motif seems to help the development of rheumatoid arthritis via unknown mechanisms. In an attempt to identify a ligand of this motif, we screened bacterial proteins. HV3 peptides from HLA-DRB1 alleles containing a QKRAA or RRRAA motif bound the 70-kD heat shock protein (HSP) from Escherichia coli, dnaK. In lymphoblastoid cells homozygous for these same HLA-DRB1 alleles the constitutive 70-kD HSP, HSP73, that targets selected proteins to lysosomes coprecipitated with HLA-DR. Thus the QKRAA and RRRAA amino acid motifs of HLA-DR mediate binding of HLA-DR to HSP73. This property may influence the intracellular route, processing or peptide associations of the HLA-DRbeta1 chain in these two rheumatoid arthritis-associated alleles. | |
| 8975282 | [Arthritis: imaging and therapy. Past, present and future]. | 1996 Aug | Osteoarthritis (OA) and rheumatoid arthritis (RA) are chronic diseases in which pathological anatomy changes very slowly. Whilst clinical and laboratory measures can be used to evaluate therapeutic response, assessment of disease progression requires imaging. Conventional radiography has performed well in RA but is too insensitive in OA. Never have imaging techniques been discussed which focus on the sites of fundamental pathological change in cartilage and synovia. Such techniques would provide potential end-points for measuring disease progression and the efficacy of therapeutic intervention. Many are non-invasive but are still at a developmental stage. Expense and complexity currently restricts their use to research. However, improving imaging hardware and information technology provide an exciting future for radiologists involved in joint imaging. Clinical trials involving techniques described here are just around the corner. | |
| 8266109 | Indications for upper extremity surgery in rheumatoid arthritis patients. | 1993 Oct | In selected circumstances, especially those associated with pain and mechanical instability, early surgical therapy is indicated for patients with rheumatoid arthritis. Close consultation between the rheumatologist and surgeon enables identification of focused goals attainable by synovectomy, ligament or tendon reconstruction, joint replacement, or arthrodesis. If these goals are met, the result can be a gratifying return of function and independence. This article describes some of the more common deformities of the hand, wrist, and elbow in patients with rheumatoid arthritis. Current surgical therapy, along with outcome and complications, is also discussed. Emphasis is placed on decisions and indications for surgical evaluation. | |
| 1366147 | [Phagocytic activity in rheumatoid arthritis]. | 1992 | The phagocytic activity of leukocytes was studied in 41 patients with active rheumatoid arthritis, 24 of whom were treated with gold compounds and the remaining 17 with non-steroidal anti-inflammatory drugs. The control group comprised 137 patients with no signs of inflammatory rheumatic diseases. The mean age of patients was 54.8 years (range: 32-75) and that of the controls, 53.5 years (range: 32-75). Spontaneous mobility (P < 0.001), phagocytic activity (P < 0.001) and antibody-dependent cytotoxicity (P < 0.001) of leukocytes were significantly lower in patients with rheumatoid arthritis compared to the control group. No significant differences were observed between patients treated with gold compounds and those receiving nonsteroidal anti-inflammatory drugs with respect to mean spontaneous mobility (U = 198, P = 0.44), phagocytic activity (U = 185, P = 0.31) and antibody-dependent cytotoxicity (U = 183, P = 0.29) of leukocytes. Among patients treated with gold compounds phagocytic activity was significantly lower in those receiving TauredonR compared to those receiving AuropanR (U = 33.5, P = 0.05). The antibody-dependent cytotoxicity was comparable in patients receiving Tauredon and Auropan, respectively (U = 58.5, P = 0.48). | |
| 8344676 | [IgE rheumatoid factors: occurrence and diagnostic significance]. | 1993 Apr | Sera from 80 patients suffering from rheumatoid arthritis--30 of them with extraarticular manifestations (EAM)--were analyzed for the presence of IgE rheumatoid factors (IgE RF), IgM RF, and immune complexes. Despite of a close correlation between IgM RF and IgE RF, IgE RF allow a better discrimination between patients with and without EAM (73.3 and 38.0%) compared to IgM RF (86.7 and 78.0%). IgE RF could be found in 5% of patients suffering from bronchial asthma, but up to now not in nonrheumatic joint diseases. | |
| 1599518 | Effect of food on the bioavailability of low-dose methotrexate in patients with rheumatoid | 1992 Jun | OBJECTIVE: To evaluate the influence of food on the bioavailability of an oral dose of methotrexate in patients with rheumatoid arthritis. METHODS: Methotrexate (15 mg) was given intravenously and orally, with or without a meal, to 10 patients. Blood samples were drawn at specific intervals to evaluate drug levels. RESULTS: Food reduced the peak concentration, from a mean of 0.71 mumoles/liter to 0.49 mumoles/liter (P less than 0.02), and slightly increased the time to peak concentration, from a mean of 1.3 hours to 2.0 hours. Bioavailability was highly variable (range 28-94%) but was not affected by food intake. CONCLUSION: Bioavailability of oral methotrexate shows marked interindividual variation but is not affected by the presence of food. | |
| 7590820 | Therapeutic regulation of T cells in rheumatoid arthritis. | 1995 Apr | TCR repertoire studies in RA have yielded conflicting data. These studies were initiated on the premise that clonal expression of T cells at the site of inflammation could serve as a target for immune therapies designed on the basis of the option to inactivate or eliminate the presumed pathogenic T cells. These analyses have demonstrated the existence of a highly diverse overall TCR repertoire on the basis of extensive usage of TCR V genes both in synovial fluid and tissue. However, clusters of RA patients can be recognized who share increased usage frequencies of defined TCR V genes among synovial fluid or synovial tissue lymphocytes. Subsequent analysis of the CDR3 regions among diverse overall TCR repertoires have revealed the presence of conserved amino acid sequences in the CDR3 regions of the variable portions of TCRs in T lymphocytes derived from the site of inflammation. These findings suggest that a selective, antigen-driven expansion of T lymphocytes is occurring in the inflamed joints. Parallel to the TCR-repertoire studies, we investigated whether vaccines prepared from synovial T cells could modulate T-cell reactivity. The studies were based on previous work on TCV in animals, revealing that attenuated non-specific T-cell lines could serve as a vaccine. The results obtained in 13 RA patients showed no clear indication for a cellular or humoral immune response. Our experience with TCV in RA patients showed that this technique is feasible and safe. We found some evidence for a modulated T-cell reactivity both in vivo and in vitro. These results show at least some immunomodulatory effect af T-cell vaccination, although the antigen specificity of the effect of this intervention remains to be shown. Because of the convincing studies in animals and MS patients, further studies in RA should focus on the effect of vaccination using vaccines prepared from disease-inducing cells. In this respect, determination of the CDR3 regions of synovial T cells could lead to the identification of those T cells that are relevant for the disease. | |
| 8019795 | Validity of Euroqol--a generic health status instrument--in patients with rheumatoid arthr | 1994 Jul | The main aim of this pilot study was to test the 'construct' validity of Euroqol, a new generic health status instrument which consists of a questionnaire and visual analogue scale. Its ability to measure both current health status and change in health status was assessed in 55 patients with RA. The Euroqol questionnaire and visual analogue scales showed significant and clinically relevant correlations with other condition-specific instruments measuring loss of function, joint pain, joint tenderness and mood; change in these symptoms as measured by the condition-specific instruments was also predictive of change in Euroqol scores. Either component of the Euroqol instrument provide an index of current clinical status and these data provide preliminary evidence for the 'construct' validity of Euroqol in RA. Further work is needed to evaluate more fully the sensitivity of Euroqol to change over time. | |
| 7799338 | The severity of rheumatoid arthritis: a 6-year followup study of younger women with sympto | 1994 Sep | OBJECTIVE: In rheumatoid arthritis (RA), not only outcome measurements taken at a single point in time, but also the severity during the entire disease period is important. In this investigation we measured severity in terms of the course of disease activity. It is the activity of the disease which leads to most suffering in the patient, and which we try to alleviate. METHODS: Patterns of disease activity were investigated in 132 female patients who were followed yearly from an early phase of the disease for a mean duration of 6 years. RESULTS: Sixty-seven patients (50.8%) continuously had < or = 4 swollen joints (low activity), 23 patients (17.4%) continuously had > or = 4 swollen joints (high activity), in 10 patients (7.6%) disease activity decreased from high to low, in 8 patients (6.1%) disease activity increased from low to high, and 24 patients (18.2%) had fluctuating levels of disease activity. The outcome of the disease as measured by the functional ability, the radiological abnormalities, and number of prescribed 2nd line drugs, was best in patients with continuously low levels of disease activity, and worst in patients with continuously high or increasing levels of disease activity. CONCLUSION: For about half of the female patients presenting to a rheumatology outpatient clinic, the severity of RA after 6 years of disease duration is characterized by continuous but low disease activity, and sufficient preservation of functional ability. For the other half of the patients RA is a progressive and disabling disease. | |
| 7955597 | Serum soluble interleukin-2 receptor levels in rheumatoid arthritis: correlation with clin | 1994 Jul | OBJECTIVE: 38 untreated patients suffering from rheumatoid arthritis (RA) were studied to evaluate the relationship between serum sIL-2R levels and laboratory and clinical indexes of disease activity and circulating lymphocyte subpopulations. Furthermore, we serially analyzed the correlation between the clinical response to oral gold (Auranofin) treatment and serum sIL-2R levels in 28 RA patients. METHODS: Patients received a complete rheumatological examination at entry and every 3 months during the study. A complete biochemical analysis was executed every month. Serum sIL-2R levels were evaluated before entering and at the 3rd and 6th month by ELISA: Phenotype analysis of peripheral blood mononuclear cells was performed by a two-color technique using the association of specific monoclonal antibodies. Samples were analyzed by a FACS-scan 440 cytofluorimeter with a single Argonion laser. RESULTS: Serum sIL-2R were significantly higher in RA patients than in controls and had a significant negative correlation with disease duration and a positive correlation with serum IgG and C3 levels. A significant positive correlation was found between serum sIL-2R levels and circulating CD3 + HLADR+, CD3-HLADR+ and CD20 + CD5-cells. After 6 months of auranofin therapy no differences in serum sIL-2R in comparison with basal levels were found in either responders or in non-responders. CONCLUSION: Serum sIL-2R level is not a good index of activity in RA patients and is not a useful marker of response to AU therapy. | |
| 8353981 | Copper and zinc status in rheumatoid arthritis: studies of plasma, erythrocytes, and urine | 1993 May | We studied the status of copper and zinc in rheumatoid arthritis (RA). The aims of the work were to ascertain whether or not RA is associated with copper and/or zinc deficiency, to establish the relationship between these trace metals and the main biohumoral and clinical indices of the disease, and to examine the effect on copper and zinc of the drugs normally used by RA patients. Metal levels were measured by atomic absorption spectroscopy in the plasma, whole blood cells and 24 hr urine of 120 RA patients; 70 patients suffering from primary osteoarthritis were used as the control group. In the plasma of RA patients copper and ceruloplasmin levels were found to be significantly increased whereas zinc levels were significantly decreased. No major variations were observed in the blood cell and 24 hr urine copper and zinc levels. Plasma copper was significantly correlated with some of the biohumoral markers of RA, but did not correlate with any of the clinical indices of the disease. Plasma zinc was significantly correlated with numerous of the biohumoral as well as clinical markers of RA. With the exception of an increased urinary excretion of copper in D-penicillamine treated RA patients, drug therapy did not influence the copper status in RA. Conversely, plasma zinc was found to be lower in RA patients taking NSAIDs and/or steroids. These results suggest the following conclusions: i) RA patients do not seem to be deficient in either copper or zinc; ii) plasma copper appears to be a poor index of RA severity; iii) plasma zinc could have some practical value in defining the overall severity of the disease. | |
| 8912479 | The prognosis of rheumatoid arthritis. | 1996 | Sixty patients with early diagnosed rheumatoid arthritis according ARA criteria were followed up for 6.6 years with the goal to determine prognosis. The parameters relevant to patient and physician were selected for follow up. Radiological and functional deterioration was evident after 6.6 years in 3/4 of patients and there was no one of them to satisfy remission criteria. The most unfavourable predictor of final outcome was the degree of functional incapacity in early stage of rheumatoid arthritis. Second important predictor of poor prognosis was degree of radiological destructive changes especially on feet. Poor prognosis could be expected in patients with previous attacks and the beginning of disease in elderly age. General symptoms and affection of mesomelic joints can be also undesirable predictor. Sex, morning stiffness, joint pattern, laboratory findings and rheumatoid factor were not significant predictors for prognosis but they could influence certain variables of global assessment. |