Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8151592 | Can specially trained physiotherapists improve the care of patients with rheumatoid arthri | 1994 Jan | OBJECTIVE: To examine the influence of specially trained physical therapists (PT) on patterns and outcome of care, relating to inflammatory disease status as measured by disease outcomes. METHODS: Fifty-four patients were allocated at random to specially trained PT, and to traditional PT. Outcomes were measured at baseline and at 4 months by independent assessors. RESULTS: There was no statistically significant or clinically important difference in outcome between the 2 groups. The advice of specially trained PT significantly improved compliance with salicylates. CONCLUSION: The effectiveness of this therapy was not demonstrated, likely due to incomplete compliance along the therapeutic chain, beginning with the PT's report, through a variety of possible responses, and ending with patient outcome. | |
| 7611283 | Genetic epidemiology of rheumatoid arthritis. | 1995 Jul | We conducted family studies and segregation analyses of rheumatoid arthritis (RA) that were based on consecutive patients with RA ascertained without regard to family history or known risk factors. First-degree relatives from 135 simplex and 30 multiplex families were included in the analyses. A highly penetrant recessive major gene, with a mutant allele frequency of .005, was identified as the most parsimonious genetic risk factor. Significant evidence for heterogeneity in risk for RA was observed for proband gender but not for proband age at onset. Kaplan-Meier risk analysis demonstrated significant evidence for differences in the distribution of risk among first-degree relatives. These analyses demonstrated that both proband gender and age at onset are important risk factors but that proband gender appears to be the more important determinant of risk, with relatives of male probands having the greatest cumulative risk for RA. In addition, log-linear modeling identified proband gender, familiality (multiplex or simplex), and an interaction term between these two variables as being adequate to define the distribution of risk in families. The pattern of risk for RA among susceptible individuals and its inheritance is thus heterogeneous. For future genetic analyses, families with an excess of affected males having a young age at onset may be the most informative in identifying the putative recessive gene and its modifiers. | |
| 7867981 | [Pathology of the sesamoid bones of the hand]. | 1994 Nov | Sesamoid bones are osseous parts of certain joints and can either be included in pathological changes of these joints or separately in those of the sesamoidal joint itself. The clinical relevance of such findings is described in the following examples: Rheumatoid variants, psoriasis, different types of hyperostotic forms, chronic sesamoiditis as well as post-trauma. In three out of four cases of fracture, the ulnar sesamoid bone of the metacarpophalangeal joint of the thumb was affected. | |
| 1734904 | Timing of pregnancy in relation to the onset of rheumatoid arthritis. | 1992 Feb | The interval between the onset of rheumatoid arthritis (RA) and the most recent pregnancy prior to RA onset in 88 women was determined. These data were compared with data obtained from a group of 144 age-matched normal women (controls) who had been assigned a "dummy date for RA onset" for the purposes of analysis. The frequency of disease onset during 3 time intervals within the period from conception to 1 year postpartum was compared with the frequency of disease onset outside this period. There was a reduction in the incidence of disease onset during pregnancy (adjusted odds ratio [OR] 0.30, 95% confidence interval [CI] 0.04-2.6) and a numerically greater increased risk of RA onset during the first 3 months postpartum (OR 5.6, 95% CI 1.8-17.6), which persisted for the subsequent 9 months (OR 2.6, 95% CI 0.8-7.9). A reduction in the incidence of disease onset was seen during all pregnancies; in contrast, the postpartum increase was greater in those with RA onset after the first pregnancy. The reduced incidence of RA onset during pregnancy, with the increased risk postpartum, mirrors the previously described suppression of disease activity during pregnancy and the subsequent flare postpartum in women with established RA. In addition, the increased postpartum risk after the first pregnancy might suggest that in susceptible women, either the hormonal changes or the exposure to the fetus's paternal HLA might represent a risk factor for disease causation. | |
| 7582717 | Oncogene expression in synovial fluid cells in reactive and early rheumatoid arthritis: a | 1995 Sep | Since it has been implied that cellular oncogenes might have a role in the pathogenesis of rheumatoid arthritis (RA), we have examined the expression of c-myc, c-myb, c-fos, c-jun and c-Ha-ras oncogenes in the cells from synovial fluid (SF) and peripheral blood (PB) of patients with reactive arthritis (ReA) and early RA. Oncogene expression was studied using RNA hybridizations with 32P-labelled probes. From the SF, mononuclear and granulocyte cell fractions were used separately. Significant differences between ReA and RA were observed only for c-myb in PB mononuclear cells and c-jun in SF granulocytes. Regarding the expression of c-myc, c-fos and c-Ha-ras oncogenes, no difference between ReA and RA was observed. Comparison to normal controls was made using PB mononuclear cells; only the expression of c-fos tended to be slightly increased in RA, without statistical significance, however. We conclude that oncogene activation in the synovial inflammation is not a phenomenon specific for RA. | |
| 1613729 | What a rheumatologist needs to know about T cell receptor structure and function. | 1992 Jan | By understanding normal immune response, it has been possible to develop therapeutic strategies toward the treatment of autoimmune disease. The association of autoimmune disease with the major histocompatibility complex (MHC) class II gene products suggests that the inductive events in which the putative autoantigen is presented on the surface of antigen presenting cells in the context of the MHC class II gene products and is recognized by CD4(+) helper or inducer T cells form an interesting target for immunotherapeutic intervention. By understanding the structure/function relationships of T cell receptors for antigen, it might be possible to develop novel immunotherapeutic strategies for the treatment of seropositive rheumatoid arthritis. Studies described below review recent progress in understanding the components of the ternary complex and suggest possible areas of immunotherapeutic intervention. | |
| 7858592 | [Comparison of azathioprine and methotrexate in rheumatoid arthritis: an open-randomized c | 1994 Oct | Thirty-eight patients with active rheumatoid arthritis (RA) were entered in an open randomized 24-week study comparing azathioprine (AZA; initial daily dose 1 mg/kg) with methotrexate (MTX; initial weekly dose 7.5 mg). The patients had previously been treated with antimalarials, gold salts and/or D-penicillamine. The groups were well balanced in baseline characteristics. There were three premature withdrawals in each group, all of which were due to toxicity. The present study did not show any significant differences between AZA and MTX in ability to reduce activity in RA after 24 weeks of treatment. | |
| 8772095 | [Muscular pathology in rheumatoid arthritis: a clinico-morphological study]. | 1996 | Muscular pathology was studied clinically, electromyographically, at light microscopy and assessment of tissue microcirculation in 34 patients with significant RA. 22 patients had systemic manifestations, in 12 patients articular lesions predominated. It was found that RA patients with systemic signs had more advanced muscular pathology, more frequent generalized amyotrophy, declined muscular function, low capacity of microcirculatory bed. These patients showed primarily vascular disorders. In RA patients with articular lesions muscular affections become more evident. | |
| 8891971 | Biaxial long-stemmed multipronged distal components for revision/bone deficit total-wrist | 1996 Sep | Revision total-wrist arthroplasty has a high incidence of complications. Loosening is a significant problem for the distal implant. Because of the high failure rate of single-pronged distal implants after revision total-wrist arthroplasty, a custom multipronged distal component (biaxial total-wrist implant) was designed for use in patients with deficient bone stock who undergo revision operation. Ten cases of total-wrist arthroplasty with a custom long-stemmed multipronged distal component are presented. The preoperative diagnosis was failed total-wrist arthroplasty in 9 cases. Mean time from previous total-wrist arthroplasty to revision procedure was 5.6 years. At follow-up evaluation (mean, 3.8 years; range, 3.0-4.8 years), 2 patients had undergone arthrodesis: 1 patient at an outside institution 1 year after surgery for periprosthetic fracture of the radius, and 1 patient at our institution for distal implant loosening. The 8 other patients had functional total-wrist arthroplasties. At follow-up evaluation, all patients reported they were satisfied. Six patients reported no pain and 2 reported mild pain. Mean range of motion at follow-up evaluation was within the previously defined limits that allow patients to function in activities of daily living: 78 degrees for supination, 77 degrees for pronation, 39 degrees for extension, 17 degrees for flexion, 12 degrees for radial deviation, and 18 degrees for ulnar deviation. Revision total-wrist arthroplasty with custom long-stemmed, multipronged distal components offers an alternative to those patients with deficient bone stock who refuse arthrodesis. Early results demonstrate greater longevity compared with single-pronged components for revision total-wrist arthroplasty. | |
| 7920511 | [Septic arthritis in rheumatoid polyarthritis. 24 cases and review of the literature]. | 1994 Mar | Twenty-four cases of septic arthritis in rheumatoid arthritis patients were compared with 99 cases of septic arthritis in patients without rheumatoid arthritis. In addition, 238 previously published cases of septic arthritis with rheumatoid arthritis were analyzed. Fifteen percent of our patients with septic arthritis had rheumatoid arthritis, which was typically of long duration (mean 15 years), erosive, and seropositive. Fifty-four per cent (28% in the literature) and 9% of patients with and without rheumatoid arthritis, respectively, had pyarthrosis of multiple joints. The knee represented one-third of infected joints and the elbows and wrists were more often infected in patients with than without rheumatoid arthritis. S. aureus was recovered in 80% versus only 60% of patients with and without rheumatoid arthritis, respectively. The source of sepsis was often a skin lesion, in particular at the foot, emphasizing the need for early orthopedic treatment of deformities responsible for skin lesions. Monoarticular infection was more likely to be due to an intraarticular injection. Mortality rate was 17% in patients with rheumatoid arthritis (23% in the literature) versus 7% in patients without rheumatoid arthritis. Staphylococcal infection and infection of multiple joints were associated with higher mortality rates (35% and 49%, respectively). The mortality rate in polyarticular infections has failed to decline over the last 35 years. Initial failure to distinguish septic arthritis from an exacerbation of rheumatoid arthritis contributes to the high mortality rate. The diagnosis of septic arthritis rests on a high index of suspicion. Septic arthritis cannot be ruled out based on absence of local inflammation, fever, or hyperleukocytosis or on presence of inflammation of multiple joints. Joint fluid specimens should routinely be sent to the microbiological laboratory and should be inoculated in blood culture bottles at the least suspicion. | |
| 8496858 | Combination therapy in rheumatoid arthritis--no benefit of addition of hydroxychloroquine | 1993 Apr | OBJECTIVE: To determine if there is any advantage in adding hydroxychloroquine to intramuscular gold therapy in patients with rheumatoid arthritis (RA) with a suboptimal response to gold after 6 months of treatment. METHODS: Prospective double blind placebo controlled study at the Centre for Rheumatic Diseases, Glasgow Royal Infirmary and Gartnavel General Hospital, Glasgow. Patients--440 patients with RA began intramuscular gold therapy. One hundred forty-two patients with a suboptimal response at 6 months were randomized to receive additional treatment with hydroxychloroquine (400 mg/day) or placebo, and followed for a further 6 months. Outcome measures were erythrocyte sedimentation rate, C-reactive protein, Ritchie articular index, grip strength, visual analog pain score, duration of morning stiffness, health assessment questionnaire, and rate of side effects. RESULTS: There was no difference in outcome in terms of efficacy or toxicity. CONCLUSION: There is no justification for using a combination of intramuscular gold and hydroxychloroquine in patients with RA with a partial response to gold. | |
| 1613737 | Practice based evaluation of the longterm benefit of second line agents in rheumatoid arth | 1992 Jan | A hypothetical practice based consortium to evaluate treatment of early rheumatoid arthritis (RA) is discussed. It would consist of a coordinating center and many practicing rheumatologists. Patients with RA within 3 to 12 months of disease onset who met strict entry criteria would be offered enrollment in their choice from a menu of protocols that includes standard and aggressive treatment options and would be followed for a long time. Standard efficacy assessments would be carried out at fairly long intervals, with emphasis on erosive changes in wrist, hands and feet x-rays. Analysis would be done across drug protocols within homogeneous subgroups of patients who have been stratified by comparable entry characteristics, using those who develop erosions during treatment with nonsteroidal antiinflammatory drugs only as the standard for comparison. This approach can be used to identify risk factors that predict subsequent erosive joint damage, and to select a few promising drugs, combinations and therapeutic strategies for subsequent definitive studies. | |
| 1544961 | The press-fit Kinemax knee arthroplasty. High failure rate of non-cemented implants. | 1992 Mar | We report the results of 75 consecutive primary press-fit Kinemax arthroplasties with an average follow-up of 14 months (three to 28). We reviewed 26 cemented and 49 non-cemented tibial components implanted into 72 patients (30 men and 42 women, median age 70 years). At the latest follow-up the overall evaluation (Hospital for Special Surgery knee rating scale) for cemented cases was excellent in 54%, good in 42% and poor in 4%. No cemented prosthesis loosened. Of the non-cemented cases 55% were excellent, 23% good, and 2% fair. Ten tibial implants (20%) loosened and required revision. Residual pain marred the result in 24% of the non-cemented prostheses and in 4% of the cemented group. We do not recommend the press-fit, smooth-surfaced Kinemax prosthesis for non-cemented use. | |
| 8413046 | [Serotonin concentration in serum of patients with generalized tendomyopathy (fibromyalgia | 1993 Aug 15 | The serum concentration of serotonin (S-5-HT) was measured in 31 patients with primary fibromyalgia, 21 patients with rheumatoid arthritis (RA) (15 of them with secondary fibromyalgia) and 20 healthy volunteers. Both patients with primary fibromyalgia and rheumatoid arthritis had significantly lower S-5-HT levels when compared to healthy controls, and S-5-HT concentrations in patients with secondary fibromyalgia were even significantly lower than those of RA-patients. Unlike the patients with rheumatoid arthritis, a significant correlation between S-5-HT level and the number of "tender points" as well as mean pressure tenderness at 24 different points was found in patients with primary fibromyalgia. Conversely, in patients with rheumatoid arthritis the S-5-HT level correlated significantly with erythrocyte sedimentation rate. These results suggest different pathological mechanisms of S-5-HT decrease in patients with primary fibromyalgia and rheumatoid arthritis. On the other hand, they raise the question whether secondary fibromyalgia may be a pathogenetically different syndrome mimicking symptomatically primary fibromyalgia. | |
| 7936358 | [Cardiac tamponade and rheumatoid arthritis: medical approach or pericardiectomy?]. | 1994 Jul | The authors report the case of a sixty-seven-year-old man with seronegative rheumatoid arthritis since 1967. After the treatment was discontinued, a symptomatic pericardial effusion developed during an exacerbation of rheumatoid arthritis. Histological findings suggested a rheumatoid origin. Consecutive pericardiocentesis and a concomitant adequate treatment resolved cardiac tamponade, at least during short-term follow-up. However, a long term observation will be necessary to exclude recurrent effusion or evolutive constrictive pericarditis. | |
| 8478871 | OMERACT conference questionnaire results. OMERACT Committee. | 1993 Mar | Just prior to the OMERACT conference, participants completed a questionnaire that solicited explicit opinions on the issues discussed at the conference. The response rate was 77%. To determine the minimum level of important difference in a clinical trial comparing 2 active drugs, participants were asked to think of each of 6 separate measures in turn as designated primary outcome measure. In this situation, to decide that an important difference between the 2 groups was present, participants required a median of 20% difference in painful joints, swollen joints, and in disability, 30% in pain and patient global assessment, and 40% in physician global assessment. On each measure, between 3 to 12% of participants felt they could not decide on an important difference in that situation. Similar questions were asked for the minimum important improvement in a patient; required levels of improvement were similar but slightly higher than the responses given for trials, and more participants felt they could not decide. Correspondents indicated that acute phase reactants are also very important for assessing minimum levels of important difference and improvement in trials and patients. A large majority was in favor of applying an index of aggregated outcome measures if sensible and valid: 72% in patients, and 93% in trials. | |
| 8353979 | Lack of immunosuppressive effect of low-dose oral methotrexate on lymphocytes in rheumatoi | 1993 May | Whether methotrexate (MTX) is effective in rheumatoid arthritis (RA) because of immunosuppressive and/or anti-inflammatory mechanisms of action is controversial. Many lines of investigation point to the latter. We evaluated DNA synthesis in peripheral blood lymphocytes (PBL) from 33 RA patients on oral MTX (7.5-15 mg/wk) and in 30 healthy controls by flow cytometric cell cycle analysis (CCA). DNA synthesis was also evaluated with a thymidilate synthetase activity assay (TSA) (3H-deoxyuridine incorporation) in 12 patients and 21 controls (12 on MTX and NSAID, and 9 healthy subjects). The patients had taken MTX for at least 3 months and were in different stages of clinical activity. There were no significant differences in TSA or in the cell cycle phase distributions (especially the S phase) between treated RA patients and controls. These data suggest that low-dose oral MTX does not inhibit DNA synthesis and therefore does not have an immunosuppressive effect on lymphocytes from patients with RA. | |
| 1616321 | Rheumatoid arthritis in twins: a study of aetiopathogenesis based on the Australian Twin R | 1992 May | The 1980 cohort of the Australian Twin Registry contains 3808 pairs of twins, 258 of whom self reported a diagnosis of rheumatoid arthritis (RA) in one or both subjects. Seventy two pairs were lost to follow up by 1990. The remaining 186 pairs received a self administered questionnaire, followed, if necessary, by telephone interviews to them, their general practitioners, and their specialists. Twenty discordant and three concordant pairs of twins were verified as having RA. The prevalence of RA in this sample was 0.40%. There was an 89% false positive rate for the self reported diagnosis of RA. Pairwise concordance percentages for RA were as follows: monozygotic 21% (95% confidence interval (CI) = 6 to 44), dizygotic 0% (95% CI = 0 to 25). It was concluded that: (a) there is a high false positive rate in self reporting RA; (b) the prevalence of RA in Australia may be less than the 0.8-1.0% often quoted; and (c) genetic factors play some part in the aetiopathogenesis of RA but do not account entirely for its determination. | |
| 8356390 | Interleukin-6 in synovial fluid is closely associated with chronic synovitis in rheumatoid | 1993 | Interleukin-6 (IL-6) was detected at low levels in plasma [0.014 +/- 0.006 ng/ml (mean +/- SEM] and in high amounts in synovial fluid [SF; 2.6 +/- 2.2 ng/ml (mean +/- SEM)] of patients with rheumatoid arthritis. No correlation of IL-6 levels in plasma or SF with the ESR (n = 15) or with histological parameters of acute local synovitis (n = 10) was observed. In contrast, SF IL-6 was positively correlated with histological characteristics of chronic synovitis (n = 10; P < or = 0.01) and elevated plasma IgG concentrations (n = 15; P < or = 0.05). In vitro concentrations of IL-6 comparable to those detected in SF increased the production of both IgG and IgM by synovial membrane mononuclear cells. The present results contribute to the view that high local IL-6 concentrations in SF promote chronic synovitis in RA. | |
| 8081666 | Incidence of rheumatoid arthritis in a 10-year follow-up study of extended pedigree multic | 1994 Sep | A 10-year follow-up study was undertaken of 17 multicase RA families with extended pedigrees to (i) determine the incidence of RA in the previously unaffected members and (ii) to assess the stability of diagnosis as defined by the 1958 and 1987 ARA criteria. In all, eight individuals developed RA. Of these, six were surviving at 10 years--four first degree (FDR), one second degree (SDR) and one non-blood relative (NBR) of the proband equivalent to incidence densities of 9, 3, and 3 per 1000 person years of observation respectively. These are substantially greater than estimates for both the general population and a DR1/4 positive population. The risk of RA is greatest in FDR and this is likely to be due to both shared inherited and environmental factors. The risk in NBR, who share no genetic material is of similar magnitude to more distant blood relatives. Definite/classical RA is a stable diagnosis over time in the majority of cases unlike probable RA which may herald definite RA but usually does not. |