Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8591653 | Diet and arthritis. | 1995 Nov | Choice of diet is one way in which an individual can influence his/her own health, and it is to be expected that patients will seek their physician's expert opinion regarding dietary matters. Respect for the legitimacy of these enquiries and balanced informed discussion, which includes general advice for a prudent diet, as well as disease-specific recommendations when indicated, can be the key to a productive relationship between patients and physician. The issue of dietary advice has an impact on the management of most forms of arthritis including osteoarthritis (obesity/energy balance), gout (dietary purines, energy balance, alcohol, fluid intake) and rheumatoid arthritis (n-3 fatty acids). Food hypersensitivity appears to be a rare cause of polyarthritis, and elimination diets and fasting have little or no place in routine practice. Strategies under investigation include oral tolerization, the utility of which remains to be established. | |
| 7737076 | On babies and bathwater: disease impact and negative affectivity in the self-reports of pe | 1995 Jan | The degree to which self-reports of health and functioning reflect negativity (NA), a dispositional tendency to emphasize the negative, was examined with data from a 7-year longitudinal study of adaptation to rheumatoid arthritis. Principal component analyses performed on each of 8 waves of data consistently indicated that the dominant factor in these data was defined by measures of pain and functional impairment. In the final wave, Disease Impact, a scale derived from this component, was directly compared to NA. The 2 scales demonstrated considerable discriminant validity, and most of the significant intercorrelations among Disease Impact and the other variables examined remained statistically significant after the influence of NA was partialed out. These results suggest that reports of pain, impairment, and associated variables reflected disease-related outcomes and processes and not simply NA. | |
| 7983661 | A comparison of 6 months' compliance of patients with rheumatoid arthritis treated with te | 1994 Aug | OBJECTIVE: To assess longterm compliance in patients with rheumatoid arthritis (RA) of 20 mg tenoxicam or 500-1000 mg naproxen taken daily and to evaluate patient computer data collection. METHODS: Three hundred and seven patients were treated in a double blind, randomized multicenter study for 6 months. The first 4 weeks of treatment data were collected daily via patient operated computers in parallel with standard assessment at weekly visits to the clinics. RESULTS: Daily patient data collection was more sensitive than weekly clinical assessments. Six months' compliance was 62% for tenoxicam and 67% for naproxen with comparable rates of withdrawal due to lack of efficacy or adverse drug experiences in both groups. The spectra of adverse drug events found were very similar for both drugs but the rates were higher than in short term studies. CONCLUSION: Daily computer data collection by patients is superior to classical clinical evaluation in drug studies. The longterm compliance of tenoxicam and naproxen are comparable when treating patients with RA. | |
| 8833059 | Combination therapy with cyclosporine in rheumatoid arthritis. | 1996 Mar | The role of combination therapy in rheumatoid arthritis is increasing with the recent development of various new treatment modalities. While past combinations of slow acting antirheumatic drugs have resulted in either excessive side effects or lack of efficacy over single agent therapy, recent combinations appear more promising. Recently, the combination of cyclosporine and methotrexate (MTX) was shown to be more efficacious than MTX alone. Improved methodology and a better understanding of the mechanisms of action of these newer agents is responsible for these exciting results. | |
| 7520139 | Neuropeptides and interleukin-6 in human joint inflammation relationship between intraarti | 1994 Apr 11 | Plasma and synovial fluid concentrations of interleukin-6 (IL-6), using an enzyme-linked immunosorbent assay, as well as immunoreactive levels of calcitonin gene-related peptide (CGRP), substance P and vasoactive intestinal peptide (VIP) were measured in 18 patients with rheumatoid arthritis and 20 with osteoarthritis of the knee. The concentrations of IL-6 were elevated in both plasma and synovial fluids from patients with rheumatoid arthritis whereas higher levels of substance P-, CGRP- and VIP-like immunoreactivities were found in the synovial fluid, but not in plasma, from patients with rheumatoid arthritis when compared with those in osteoarthritis. Furthermore, IL-6 and substance P levels in synovial fluid were significantly correlated both in rheumatoid arthritis and osteoarthritis patients. Our data seem to support the idea of an important role shared by neuropeptides and IL-6 in the pathogenesis of human inflammatory joint disease. | |
| 7575713 | Longitudinal study of hand bone densitometry in rheumatoid arthritis. | 1995 Sep | OBJECTIVE: To measure hand bone mineral content (BMC) by dual x-ray absorptiometry and to seek clinical correlates in patients with rheumatoid arthritis (RA), in a prospective, longitudinal study. METHODS: Eighty-one patients with non-steroid-treated RA were assessed at baseline and at month 12, for hand BMC and for disease activity and severity. Hand BMC in patients was compared with that in a control group of 95 normal volunteers, and rate of loss was compared with that in 37 controls. RESULTS: At the initial assessment, male and female patients with RA had lower hand BMC than controls, after correction for age, height, and weight (mean reduction 7.5% in men [P = 0.003] and 7.8% in women [P = 0.01]). After 1 year, there was a further loss of hand BMC in patients (median loss 3.25% in men [P = 0.001] and 1.46% in women [P = 0.05]), but normal controls did not have significant changes in their hand BMC. In patients with disease duration of < 2 years at study entry, the parameters of disease activity improved over 1 year, but they lost significant amounts of hand BMC. Hand BMC loss correlated with baseline C-reactive protein levels. In those with RA of > 2 years duration at entry, the Health Assessment Questionnaire scores and Larsen scores had worsened after 1 year, but there was no significant loss of hand BMC. CONCLUSION: Patients with RA had low hand BMC compared with normal controls, even within 2 years of disease onset. The rate of loss was highest in patients with early disease and correlated with measures of initial disease activity. This loss continued despite clinical improvement. | |
| 8187444 | Normal vibration perception thresholds in rheumatoid arthritis--evidence against the neuro | 1994 Mar | Patients with arthritis consistently report joint stiffness, but recent attempts to quantify joint stiffness objectively have been unable to demonstrate any increase in stiffness in arthritic joints. This discrepancy between subjective and objective measures may be explained by postulating decreased mechano-receptor thresholds in arthritis (the neurogenic hypothesis). To test this hypothesis digital cutaneous mechano-receptor threshold (vibration perception threshold, VPT) was measured in 50 patients with rheumatoid arthritis, comparing results with previously established normative data. No difference was found between RA and normals in respect to VPT. This result does not support the theory that altered mechano-receptor thresholds are important in the experience of joint stiffness in rheumatoid arthritis, but further data on articular mechano-receptor thresholds are required before the hypothesis can be rejected. | |
| 1386548 | Prognostic factors for radiographic damage and physical disability in early rheumatoid art | 1992 Aug | We studied the influence of demographic, clinical, laboratory and genetic features and radiographic damage at onset on the outcome after 2 years in a prospective study of 147 patients with classical or definite RA with disease duration shorter than 1 year at entry. Outcome was determined by physical disability and by radiographic damage of hands and feet. By means of multiple regression analysis and discriminant analysis outcome was explained from variables at the start and during the first 6 months. No clinically relevant conclusions could be made for physical disability due to the low explained variance and small number of patients with bad physical disability. Radiographic damage after 2 years was predicted by high disease activity at the start (measured as erythrocyte sedimentation rate, C-reactive protein or Disease Activity Score) combined with DR4 or DR2 (as a prognostically favourable factor) and rheumatoid factor positivity. Radiographic damage could be better predicted if disease activity during the first 6 months was included. Absence or presence of progression of radiographic damage could be correctly predicted in 83% of the patients. | |
| 8717102 | IgM rheumatoid factor estimation by ELISA in seronegative rheumatoid arthritis before and | 1996 | We looked for the presence of IgM rheumatoid factor (RF) using an enzyme-linked immunosorbent assay (ELISA) in 25 patients with active seronegative rheumatoid arthritis. In unfractionated sera, 12 patients (48%) were positive for IgM RF (classical), but after IgM fractionation of 23 samples (2 samples were not available) using high performance liquid chromatography for fractionating IgM, 12 patients were positive for RF by ELISA indicating the presence of hidden RF. Finally, three patients were labelled as truly seronegative for IgM RF. Classical IgM RF as detected by ELISA correlated significantly with erosive disease. Hidden RF did not correlate with disease activity or severity in this cross-sectional study, and though its presence was associated with shorter disease duration this did not reach statistical significance. | |
| 8846540 | Osteoporosis in rheumatoid arthritis. | 1995 Sep | OBJECTIVE: To answer and comment on a number of controversial issues in relation to osteoporosis and rheumatoid arthritis (RA), including: Is osteoporosis an extra-articular manifestation of rheumatoid arthritis? Does periarticular osteoporosis reflect disease activity in early arthritis? Is there a threshold for corticosteroid-induced osteoporosis? Can anti-resorbing drugs prevent rheumatoid arthritis progression? Are stress fractures rare in rheumatoid arthritis Is methotrexate toxic for bone? METHODS: Confrontation of current literature and our own experience in order to formulate a general opinion. RESULTS AND CONCLUSIONS: Because most studies agree that osteoporosis in postmenopausal women and in men with RA is more evident at the hip and radius than at the spine, and that the most important determinants of bone loss are disability, local disease activity and cumulative corticosteroid dose, osteoporosis is not a common systemic extra-articular manifestation of RA. In early arthritis, periarticular osteoporosis does indeed reflect disease activity because it is closely related to the acute phase reactants, but once periarticular osteoporosis is established it is no longer a marker of disease activity. The threshold does for corticosteroid-induced osteoporotic fractures is the cumulative rather than the actual dose. Statements based on quantitative computed tomography concerning the acute effects (and their reversal) of corticosteroids on bone have to be interpreted with care because of important body composition changes, in particular in bone marrow fat, during corticosteroid treatment. At present there is no evidence that anti-resorbing drugs can change the progress of RA erosions, probably because erosions are the result of non-osteoclast mediated mechanisms. Stress fractures in RA are underdiagnosed and are often confused with synovitis, and therefore it is likely that they are more frequent than commonly thought, in particular at the lower limbs. Methotrexate osteopathy is known in oncological practice. Whether low dose methotrexate is toxic for bone is not clear, but a number of clinical observations suggest that the occurrence of spontaneous fractures and lower extremity pain is more frequent in methotrexate treated patients than expected. Prospective studies are necessary to confirm these impressions. | |
| 7966057 | Increased capillary permeability in systemic rheumatoid vasculitis: detection by dynamic f | 1994 Jul | OBJECTIVE: Several histological studies suggest a vascular involvement in rheumatoid arthritis (RA). We evaluated morphological and functional changes of skin capillaries in patients with RA. METHODS: We studied capillary permeability by nailfold fluorescence videomicroscopy in patients with RA with and without systemic vasculitis to establish the sensitivity, specificity, and the prognostic value of the technique for the diagnosis of systemic rheumatoid vasculitis (SRV). Nine patients with SRV, 22 patients with active RA without signs of vasculitis, and 16 controls were evaluated. RESULTS: No difference in conventional capillaroscopy was observed when we compared patients with SRV and RA. Using fluorescence videomicroscopy after intravenous injection of fluorescein sodium, we observed an increase of transcapillary dye diffusion in 9/9 patients with SRV, in 13/22 patients with RA without vasculitis and in 4/16 control patients. Our results give a sensitivity of 100% in SRV, a specificity of 44%, a positive predictive value of 34% and a negative predictive value of 100%. CONCLUSION: Our present study points out the functional alteration of the capillary wall in patients with RA with or without vasculitis and suggests the usefulness of dynamic fluorescence nailfold capillaroscopy in patients with RA when systemic vasculitis is suspected, not as a diagnostic tool, but because of the high negative predictive value of the technique. | |
| 1481581 | [Sports in advanced age in inflammatory rheumatic diseases]. | 1992 Nov | The positive effect of moderate physical activity on cardiovascular system, psychological condition, immune reactions and joint biology are wellknown. They seem to facilitate pain control and to stimulate the metabolism of skeletal tissue and joints also in elder patients with rheumatoid arthritis if certain prerequisites are considered. The possible influence of physical activity on the natural course of the disease has not yet been investigated. The recommended type and extent of sports activity therefore have to be carefully selected with regard to the pathogenesis of the disease and their inflammatory changes as well as the patients individual medical conditions. | |
| 8339131 | Validity and reliability of joint indices. A longitudinal study in patients with recent on | 1993 Jul | This prospective longitudinal study evaluates the validity and reliability of joint indices (JIs) used to measure disease activity in patients with RA. From seven traditional JIs (Ritchie Articular Index (RAI), Modified RAI, Thompson score, 28 JI, 36 JI, total tender and total swollen joints) 37 'new' JIs were computed by considering three different characteristics of joint inflammation, tenderness, swelling and the combination of tenderness and swelling, and by grading for tenderness and/or weighting for surface area of the joints. Several aspects of validity were investigated, the construct (correlation with radiographic damage), correlational (correlation with ESR, general health) and criterion validity (correlation with a Health Assessment Questionnaire, discrimination between high and low disease activity). It was found that the validity and reliability of traditional JIs do not differ substantially. Graded JIs are almost always more valid than ungraded JIs. Weighted JIs are almost always less valid and reliable than unweighted JIs. Therefore no JI proved to be superior for measuring the disease activity under consideration. Taking simplicity into account the 28 JI, not graded and not weighted, was preferable. | |
| 9355682 | Outlooks of systemic enzyme therapy in rheumatoid arthritis and other immunopathological d | 1994 | Systemic enzyme therapy (SET) represents a specific therapeutic approach consisting in peroral application of blends of animal and plant hydrolytic enzymes. A significant part of the swallowed enzymes (about 25%) is resorbed in the intestine in functionally active form. After being complexed with natural antiproteases, enzymes set concentrated in wounds, inflammation sites and immunopathological foci. SET has many important indications in traumatologic, thrombotic, infectious, inflammatory, immunopathologic and even tumorous processes. Rheumatoid arthritis, Bechterew's disease, activated arthrosis and extraarticular rheumatism represent important and sensitive targets of SET. In situ and in vivo studies continue to elucidate selective interferences of absorbed proteolytic enzymes with the crucial pathogenic mechanisms of rheumatoid processes. | |
| 1588749 | [Physical therapy and Oriental medicine applied to rheumatoid arthritis]. | 1992 Mar | Since the etiology of rheumatoid arthritis is unknown, etiological treatment of this disease is impossible. The most important thing is how to prevent joint destruction and maintain function. Physical therapy and Japanese oriental medicine therapy are highly useful in that meaning. In this article, heat & cold therapy, light therapy, massage, and acupuncture and moxibustion are discussed from the viewpoint of the methods of application, as physical therapy. Japanese herb medicine is also discussed along with general medicine. | |
| 8619100 | Biologic interventions in rheumatoid arthritis. | 1995 Aug | An increasing understanding of the immunopathogenesis of rheumatoid arthritis and advances in biotechnology have lead to the therapeutic application of immune-specific interventions. The complexity of this disorder has generated numerous investigations using a wide range of biologic interventions. This article presents the current and potential targets for such biopharmaceutical agents and discusses their utility in rheumatoid arthritis. | |
| 8278815 | Inverting the therapeutic pyramid: observations and recommendations on new directions in r | 1993 Oct | In evaluating current therapy for rheumatoid arthritis (RA), it is increasingly being recognized that sequential single-drug treatment, as exemplified by the traditional therapeutic pyramid, is often too little, too late, and ineffective in preventing disease progression or joint damage in patients with "at-risk," aggressive synovitis or what might be called type 2 RA. Designation of drugs as either antiinflammatory or disease-modifying is not supported by the author's experience. Evidence exists that prevention of joint damage correlates best with control of clinical and laboratory measures of inflammation, regardless of the medication used. The earlier and more effective the control of the inflammation, the better the patient response. Until a major breakthrough occurs, the author recommends that patients with aggressive RA be treated with a combination of fast-acting and slow-acting medications to achieve early control and then "bridge down" to a simplified maintenance program. Retrospective observation by the author of 54 patients with early, intermediate, and late disease treated with combinations of prednisone, methotrexate, auranofin, hydroxychloroquine, and azathioprine showed maximum response in patients with disease duration of less than 2 years, minimal toxicity, and lack of erosions in patients with control of inflammation. Twelve patients with inflammation not initially suppressed by prednisone and methotrexate had improved control with additional drugs in combination, including auranofin, hydroxychloroquine, and azathioprine. After inflammation was controlled, reduction of prednisone and methotrexate doses was possible in 60% of patients, primarily those with early disease.(ABSTRACT TRUNCATED AT 250 WORDS) | |
| 8697653 | Decreased levels of a soluble form of the human adhesion receptor CD58 (LFA-3) in sera and | 1996 Jan | OBJECTIVE: Soluble forms of adhesion molecules (sAM) can block cellular interactions and potentially prevent the adhesion of mononuclear cells to inflammatory tissue. We therefore wondered whether levels of a soluble form of the CD2-ligand CD58 (sCD58) are decreased in patients with different types of joint disease. METHODS: SCD58 concentrations were measured by an enzyme-linked immunosorbent assay (ELISA) of sera from 60 patients with rheumatoid arthritis (RA), 13 patients with osteoarthritis (OA), 16 patients with psoriatic arthropathy (PsA), 15 patients with spondylarthropathy (SpA), and 61 age-matched normal controls (NC). SCD58 was also determined in synovial fluid samples (SF) from 42 patients with RA, 12 with PsA, and 12 with SpA. Concentrations of sCD58 were correlated with clinical and laboratory measures of disease activity. Binding of biotinylated human albumin to recombinant CD58 or casein was assessed by a modified ELISA: RESULTS: SCD58 levels were significantly reduced in sera from RA patients compared to NC (p < 0.0001), OA (p = 0.019), and SpA (p < 0.0001). Normal concentrations were found in sera from patients with OA, PsA, or SpA. SF sCD58 concentrations were generally lower than serum concentrations (between 18 and 28%). RA SF had significantly lower sCD58 levels than SpA SF (p = 0.01). Reduction of serum sCD58 levels correlated significantly with the ESR (r = 0.56; p < 0.0001), CRP (r = 0.4; p = 0.003), and TJS (r = 0.47; p = 0.0001). In addition, sCD58 serum levels correlated significantly with the reticulocyte count (r = 0.47; p = 0.02) and serum albumin (r = 0.42; p = 0.002). Accordingly, biotinylated human albumin bound to recombinant CD58 in a dose dependent fashion, but not to casein. CONCLUSION: This study indicates that serum and SF sCD58 levels in patients with RA are reduced compared to the levels in normal controls and patients with OA or SpA. Decreased albumin concentrations due to systemic inflammation may lead to reduced sCD58 levels. Since sCD58 may normally mediate de-adhesion, such a reduction could result in increased T cell adhesiveness. | |
| 8966685 | [Questionable gonarthritis--assessment and therapy]. | 1996 Oct | The differential diagnosis of gonarthritis is widespread due to the fact that the knee participates in diseases ranging from infections to autoimmunopathies and metabolic disorders. The analysis of the synovial fluid provides important information and has to be performed without delay, if septic arthritis is suspected. Characteristics, symptoms and signs of underlying diseases help in the diagnostic work-up. Whereas radiologic examination is primarily done to document the evolution of the process, ultrasonography may add substantial morphological information. Therapy is based on drug treatment and physical measures. The primary goals of physiotherapy are analgesia and rehabilitation. | |
| 8556924 | [The diagnostic significance of rheumatoid factors in patients with early rheumatoid arthr | 1995 Jul | The early phase of rheumatoid arthritis has attracted increasing attention due to the concern with prognosis of the disease. In this study IgM rheumatoid factor (RF) and IgA immunoglobulin were measured twice a year in 96 patients. Their joint damage was assessed yearly with radiographic examination. Radiological abnormalities detected included osteoporosis, bone erosion and joint space narrowing. The patients were followed up for three years. The changes of joint damage might be of three types: worsening, nonchange and improvement. A significant correlation between the levels of IgM RF and IgA immunoglobulin and disease activity was observed. A high level of IgM RF was prognostic for a more severe disease. One patient with 7 g/L IgA immunoglobulin exhibited considerable joint damage progression in a year, while 2 cases with minor IgA immunoglobulin showed remarkable improvement. These two parameters can be considered the important laboratory indicators for the early disease. The results may also be applied to guide second line antirheumatic drug therapy. |