Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1445448 | Efficacy and safety of 10-deazaaminopterin in the treatment of rheumatoid arthritis. A one | 1992 Nov | OBJECTIVE: To determine the long-term safety and efficacy of 10-deazaaminopterin (10-DAM) in the treatment of rheumatoid arthritis (RA). METHODS: A 1-year continuation of an initial 15-week randomized, double-blind clinical trial of 10-DAM and methotrexate (MTX). RESULTS: 10-DAM (n = 10) and MTX (n = 8) had comparable safety and efficacy profiles. One 10-DAM-treated and 2 MTX-treated patients experienced transient side effects; 1 MTX-treated patient experienced recurrent nausea and discontinued MTX. CONCLUSION: 10-DAM appears to be as beneficial and as safe as MTX for the treatment of RA. | |
| 8105986 | [The coexistence of rheumatoid arthritis, ankylosing spondylitis and intestinal necrotizin | 1993 Sep | We present the case of a 44-year-old male with ankylosing spondylitis and seropositive rheumatoid arthritis whose evolution was complicated by an intestinal necrotizing vasculitis type nodose panarteritis with fatal consequences. We discuss this exceptional association and its clinicopathological characteristics. | |
| 8748801 | Crowned dens syndrome: a manifestation of hydroxy-apatite rheumatism. | 1995 | Crowned dens syndrome is defined as an association of acute cervical pain and calcifications in the peri-odontoid space. The authors report one case of this rare localization of hydroxy-apatite rheumatism and review 12 similar cases in the literature. This disease affects only adult females. Patients present with inflammatory signs, can be treated with non-steroid anti-inflammatory drugs and recover without sequela. Calcium pyrophosphate dihydrate deposition can also lead to this syndrome. Other perioodontoid calcifications and ossifications, usually asymptomatic, appear only as a radiologically crowned dens. | |
| 7492245 | Interleukin-1 expression by neutrophils in rheumatoid arthritis. | 1995 Nov | OBJECTIVE: To determine if neutrophils from blood and synovial fluid of patients with rheumatoid arthritis and other joint arthropathies express interleukin-1 beta mRNA. METHODS: RNA was isolated from neutrophils from patient and control blood, and synovial fluid of patients, probed in northern blots, and quantified by densitometry. It was also isolated and analysed from control blood neutrophils after incubation in vitro with granulocyte macrophage colony stimulating factor (GM-CSF). RESULTS: Neutrophils from the synovial fluid of patients with rheumatoid arthritis contained low levels of mRNA for interleukin-1 beta--between 0.1 and 2% of those observed during stimulation of control neutrophils with GM-CSF for one hour. Higher levels (4-40% of the maximal GM-CSF values) were observed in blood neutrophils from patients with rheumatoid arthritis. CONCLUSIONS: Neutrophils contribute to the cytokine network in rheumatoid arthritis. In some circumstances, activation of transcription may occur within the circulation of these patients. | |
| 8699039 | Frequency of cervical spine involvement in rheumatoid arthritis. | 1995 Apr | The cervical spine x-rays of a random number of patients with confirmed rheumatoid arthritis were taken. The presence of atlanto-axial subluxation, atlanto-axial impaction, subaxial subluxation and any other associated abnormalities was noted. The spinal canal diameter was also measured which was not significantly altered in rheumatoid arthritis cases. Cervical spine disorders were seen to occur in 16 cases (69.6%) out of 23 patients. Spondylosis was the most frequent disorder ie, in 10 cases (62.5%) out of 16. Obliteration of the normal lordotic curve and disc lesions occurred in 3 cases (18.7%) each out of 16. The mean spinal canal diameter was 16.30 +/- 2 mm with a range of 13-23 mm. Female patients (73.3%) had an increased cervical spine disorder than males (62.5%). Seropositive rheumatoid arthritis cases (87.5%) were mostly involved in occurrence of disorder than those of seronegative arthritis cases (46%). | |
| 8849352 | Comparison of azathioprine, methotrexate, and the combination of the two in the treatment | 1995 Dec | OBJECTIVE: To assess the relative efficacy of methotrexate (MTX), azathioprine (AZA), and their combination in the treatment of rheumatoid arthritis (RA) in a double-blind, prospective, multicenter, controlled trial. METHODS: Two hundred nine patients with active RA were treated with escalating doses of MTX (5-15 mg/week), AZA (50-150 mg/day), or combination (5mg MTX/week plus 50 mg AZA/day-7.5 mg MTX/week plus 100 mg AZA/day), with opportunity to increase the dosage at 6-week intervals. The patients were evaluated for significant clinical and laboratory improvement and assessed for radiologic progression at 48 weeks. RESULTS: One hundred ten patients remained on the initial, randomly assigned therapeutic regimen. The percentage of patients who were responders, defined as those who had 30% or greater improvement in at least 3 of 4 variables, was 38% for the combination treatment, 26% for AZA, and 45% for MTX (P = 0.06). A trend toward decreased radiologic progression was seen in the MTX-treated patients. Termination of treatment due to adverse experience occurred more frequently with combination and AZA treatments than with MTX treatment. Lack of effectiveness, adverse gastrointestinal effects, and liver enzyme elevation were the most frequent causes of treatment discontinuation. CONCLUSION: This study establishes that the combination of MTX and AZA in the dosages utilized is not associated with more toxicity than treatment with single agents; however, enhanced efficacy is also not seen. There is a trend toward decreased radiologic progression in patients treated with MTX. | |
| 1500954 | Clinical and immunological characteristics of patients with rheumatoid arthritis and perio | 1992 Jun | Various clinical and immunological parameters were determined in patients with RA and patients with adult periodontitis. There were no significant differences between the two groups with regard to the number of missing teeth, although pocket depths and gingival inflammation scores were significantly increased in the periodontitis group (p less than 0.05). Salivary IgM levels were below the minimum detectable level in both groups, and no significant differences were evident between the two groups with regard to salivary IgG and IgA levels. However, serum IgG, IgA and IgM levels in RA patients were significantly higher than in periodontitis patients (p less than 0.05), indicating enhanced humoral immunity. The present findings suggest that RA patients are not a risk group for advanced periodontal problems in comparison with age- and sex-matched systemically healthy controls. | |
| 8573295 | Management of adverse effects of disease-modifying antirheumatic drugs. | 1995 Oct | Therapy with disease modifying antirheumatic agents (DMARDs) is often complicated by the occurrence of adverse effects. Although risk factors for several DMARDs have been reported, the prediction of adverse drug reactions is not yet possible. Therefore regular monitoring remains mandatory. Monitoring for adverse effects to DMARDs usually includes one or more of the following: blood count, liver, kidney, urine or ophthalmologic tests. Since most adverse reactions occur during the first few months of treatment, monitoring should be more intense and frequent in this initial phase. Some adverse effects are dose-dependent, and therefore dosage reduction may help alleviate these. Others are idiosyncratic, and often necessitate drug withdrawal. Except for (hydroxy)chloroquine-induced retinopathy and methotrexate-induced liver cirrhosis, most adverse reactions to DMARDs are fortunately reversible. | |
| 7722251 | Proximal interphalangeal joint silicone replacement arthroplasty: clinical results using a | 1995 Jan | Sixty-nine proximal interphalangeal joint silicone arthroplasties in 36 patients inserted through an anterior approach were reviewed. Average followup time was 3.4 years. The average extension deficit was slightly improved from 17 degrees to 8 degrees, but the total active motion (active flexion minus active extension) did not significantly increase (44 degrees to 46 degrees). Coronal plane deformities were not successfully corrected. Pain relief was obtained in 67 of 69 digits. There were 12 digits with complications, and five implants fractured. The anterior approach allows preservation of the central slip insertion and initiation of immediate active and passive joint motion. With proper indications, careful surgical technique, and a supervised therapy protocol, proximal interphalangeal joint silicone arthroplasty is a useful operation for pain relief and functional gain. | |
| 1337108 | Pituitary-adrenal axis responsiveness to ovine corticotropin releasing hormone in patients | 1992 Nov | Ovine corticotropin-releasing hormone (oCRH) stimulation tests were performed in 8 female patients with active rheumatoid arthritis treated chronically with daily low dose prednisone and 16 age matched female controls. Patients were tested on the day of treatment, 12 h after their last prednisone dose, and after withholding prednisone for 36 h. Basal levels of plasma ACTH and to a lesser extent plasma cortisol levels were elevated before each test, and significant increases in ACTH and cortisol were induced with oCRH. The dose response relationship between total ACTH and total cortisol was shifted to the right, suggesting that the patient group had mildly deficient adrenocortical responsiveness compensated for by elevated basal evening ACTH concentrations. It is not known whether the neuroendocrine abnormalities demonstrated are due to an intrinsic preexisting abnormality, active disease, drug therapy or all these factors. | |
| 9455440 | [The antioxidant systems in rheumatoid polyarthritis]. | 1996 Jul | The inflammatory process from rheumatoid arthritis (RA) is marked by complexity, maintenance and destruction. The inflammatory lesions are induced by oxygen free radicals, that have a great capacity of destruction. We studied 52 patients with RA (defined by ARA criteria--1987). We have observed the inflammatory rheumatic syndrome, humoral and cellular immune syndrome and the antioxidant systems, i.e.: superoxidedismutaze, glutathione and its fractions, glutathione peroxidase, the total SH groups. We have observed the decrease of the glutathione in 40% of patients and the decrease of the total SH groups in 65% of patients. The total SH groups are correlated with the severe forms of the disease. Superoxide dismutase had decrease values in 85% of cases. We have remarked that the treatment with corticosteroids and D-penicillamina improved the serum levels of the glutathione and total SH groups. | |
| 7747113 | Synovial fibroblast-like cells strongly express jun-B and C-fos proto-oncogenes in rheumat | 1995 | To identify recently activated cells in the synovial membrane (SM) of patients with rheumatoid arthritis (RA), the in situ expression of the proto-oncogenes jun-B, c-jun, jun-D, and c-fos was assessed by means of immunohistochemistry and in situ hybridization techniques. SM from patients with osteoarthritis (OA) or joint trauma (JT), as well as from normals (No) were used as controls. Numerous cells expressing high levels of jun-B and c-fos were found within lining layer and diffuse infiltrates in the vicinity of inflammatory cells, but only a few in lymphoid follicles and endothelia. The positive cells were spindle-shaped, CD14- and CD3-negative and, in addition, expressed mRNA for collagen alpha 2 (I) and alpha 1 (III), indicating that they were fibroblasts. In control OA, JT, and even No SM, individual fibroblast-like cells stained as strongly as in RA; however, the density of positive cells was substantially lower. In RA SM, fibroblasts, but not lymphocytes or macrophages, appear to undergo in situ activation. Quantitative differences among RA, OA, and JT may be related to different degrees of inflammatory infiltration. | |
| 7871334 | Anti-neutrophil cytoplasm antibodies (ANCA) in rheumatoid arthritis: relationship to HLA-D | 1994 | To investigate a possible relationship between the presence of anti-neutrophil cytoplasm antibodies (ANCA), rheumatoid factors (RF), anti-nuclear antibodies (ANA), disease severity and HLA-DR phenotypes, 46 consecutive ANCA+ and 48 ANCA-, clinically well-documented RA patients were studied for RF, ANA and HLA-DR phenotypes. The 46 ANCA+ patients showed predominantly an atypical perinuclear staining pattern (89%). ANCA positivity was associated with higher RF titres (P < 0.005) and advanced functional Steinbrocker grades III/IV (P < 0.015). ANCA+ patients were also more often positive for ANA than ANCA- patients (P < 0.008). There was no correlation between ANCA positivity and certain HLA-DR phenotypes although the frequency of DR4+ (67% vs 52%) and, in particular, of DR4+ blanks (phenotypically homozygous) was increased in ANCA+ as compared to ANCA- patients (20% vs 8%). DR4-DR1-RA patients were twice as frequent in the ANCA- than in the ANCA+ group (22.9% vs 8.7%). Correspondingly, the DR4+DR1- phenotype was increased among ANCA+ RA patients. Regarding functional Steinbrocker grades, the DR4+ phenotypes were slightly but not significantly increased in grades III and IV whereas ANCA positivity was significantly associated with severe functional Steinbrocker grades III/IV (66% ANCA+ vs 39% ANCA-, P < 0.015). ANCA positivity identified a population of RA patients with a long-standing and severe clinical course of the disease. There was no correlation between ANCA positivity and certain HLA-DR phenotypes. | |
| 8823705 | Cryocrystalglobulinemia mimicking rheumatoid arthritis and vasculitis. | 1996 Jul | We describe a patient with longstanding arthropathy resembling rheumatoid arthritis (RA) and cold induced purpura for many years, concomitant with IgG kappa paraproteinemia. At autopsy, the patient was found to have evidence of widespread vascular occlusions due to precipitated crystals as well as tissue deposition of crystals. Neither vasculitis nor synovitis was observed despite the clinical picture of both. Blood and synovial fluid obtained antemortem were found to spontaneously form crystals when stored at 4 degrees C, and the washed crystals were composed of the same monoclonal IgG kappa previously found in serum. Cryocrystal formation occurred at 33 degrees C and neutral pH. This patient thus had cryocrystalglobulinemia mimicking clinical manifestations of RA and vasculitis. | |
| 8081665 | Urinary hydroxypyridinium cross-links of collagen in rheumatoid arthritis. Relation to dis | 1994 Sep | Pyridinoline (Pyr) and deoxypyridinoline (Dpyr) are new markers of type I and II collagen degradation. Dpyr is a specific marker of type I collagen resorption in bone, whereas Pyr is released from type I and II collagen in bone and cartilage. We assessed the effect of six repeated iv methylprednisolone (MP) pulses or placebo at 4 week intervals in combination with DMARDs, on the excretion of Pyr and Dpyr in 86 patients with active RA. Pyr and Dpyr correlated significantly with clinical and biochemical markers of disease activity. After an initial decrease in Pyr on day 7 in the MP treated group, Pyr was significantly increased in both treatment groups at day 28. Dpyr remained unchanged after a single MP pulse in contrast to significant increases after 7 and 28 days in the placebo group. Pyr and Dpyr were significantly decreased after 24 and 52 weeks in the MP group, whereas no changes were observed in the placebo group. Pyr and Dpyr correlate with clinical and biochemical markers of disease activity in patients with active RA. Repeated MP pulses in combination with DMARDs in RA, do not seem to have a deleterious effect on bone resorption measured by Dpyr excretion, on the contrary MP pulses may even prevent an increase in bone resorption, as indicated by the decreased Dpyr observed in this group. | |
| 7642384 | [Skin ulcers in rheumatoid arthritis]. | 1995 Jun | The appearance of severe ulceration of the skin in patients with rheumatoid arthritis is often associated with a tendency to progression of the underlying disease, involvement of internal organs and increased mortality. In the pathogenesis of such ulceration there are multiple causes for their development, persistence and tendency to poor healing. They include localized or generalized immune complex vasculitis, treatment with anti-inflammatory drugs and their side effects following the treatment, arterial and venous insufficiency, and mechanical factors. The management of severe ulceration requires stabilization of the underlying autoimmune disease, e.g. with high doses of glucocorticosteroids or other immunosuppressive drugs or plasmapheresis. Adjuvant treatment of pain with analgesics, improvement of blood perfusion and anti-inflammatory drugs should accompany the topical therapy of ulcers. After suppression of the local inflammatory reaction surgical intervention becomes necessary in most of the patients, and vascularized muscle flaps should be used in preference to meshgrafts or split skin grafts for extensive ulceration in rheumatoid arthritis. A hopeful perspective in the treatment of severe rheumatoid arthritis might be opened up with immunotherapy using monoclonal antibodies. | |
| 8843862 | Rheumatoid arthritis lung disease. Determinants of radiographic and physiologic abnormalit | 1996 Oct | OBJECTIVE: To determine the prevalence and important clinical predictors of radiographic and physiologic abnormalities indicative of rheumatoid arthritis interstitial lung disease (RA-ILD). METHODS: An unselected cohort of patients with a confirmed diagnosis of RA and known lung disease were identified (n = 336) and evaluated for RA disease activity and severity. Outcomes included abnormalities determined by the pulmonary function tests of forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLco), and/or chest radiographic findings of interstitial infiltrates. We used multivariable statistical modeling to determine the independent significance of cigarette smoking and other RA-specific factors on the pulmonary abnormalities of interest. RESULTS: At least 1 of the 3 abnormal findings was identified by pulmonary tests in 32.4% of all patients. These abnormal findings included an FVC < 80% of predicted in 42 patients, a DLco < 80% of predicted in 64 patients, and evidence of radiographic interstitial infiltrates in 40 patients. After statistical adjustment for confounding factors, pack-years of cigarette smoking remained a significant predictor of low DLco (beta = -0.07, 95% confidence interval [95% CI] -0.09, -0.04), low FVC (beta = -0.003, 95% CI -0.006, -0.0004), and interstitial abnormalities on chest radiograph (odds ratio for > or = 25 pack-years = 3.76, 95% CI 1.59, 8.88). The Health Assessment Questionnaire (HAQ) Disability Index (DI) was also an important risk factor for the decline in both the DLco (beta = -1.15, 95% CI -2.00, -0.30) and FVC (beta = -0.23, 95% CI -0.32, -0.13). CONCLUSION: Although RA disease activity/severity (particularly as defined by the HAQ DI) was important, smoking was the most consistent independent predictor of radiographic and physiologic abnormalities suggestive of ILD in RA. | |
| 8142924 | Cytokines and oncogenes in cellular interactions of rheumatoid arthritis. | 1994 Jan | Rheumatoid arthritis (RA) is a chronic systemic disorder of unknown etiology. Most of its debilitation sequelae are derived from progressive destruction of joints. The affected joints exhibit inflammation, abnormal immune responses and synovial hyperplasia. Although growth factors and cytokines derived from macrophages and endothelial cells contribute to the perpetuation of the inflammatory process, activated transformed-appearing synovial fibroblasts mediate cartilage and bone destruction. Based on the observation that synovial hyperplasia is associated with a transformed-appearing phenotype and an upregulated expression of protooncogenes and matrix degrading enzymes, the present studies are designed to explore the role of a heretofore unknown (retro) virus-like particle in the pathogenesis of RA. | |
| 1588727 | [Rheumatoid arthritis--general concepts]. | 1992 Mar | It is most important to recognize that Rheumatoid Arthritis (RA) is a multiple organ disease, and not a disease restricted only to the joint and muscle. RA is one of the collagen diseases or connective tissues diseases, and the pathogenesis is still not clear but an autoimmune phenomenon should be related with the genesis of the disease and a genetic background might be correlated. In this paper, the general concepts on RA are described from (1) the position of RA in collagen disease, connective tissue disease, autoimmune disease or auto-allergic disease and rheumatic disease, (2) recognition of pathophysiological and clinical figure of RA as a whole body disorder, (3) the procedures for diagnosis in various types of RA and (4) considerations of the treatment. | |
| 8761095 | [Guépar's total radio-carpal prosthesis in the surgery of the rheumatoid wrist. Apropos o | 1996 | PURPOSE OF THE STUDY: Total wrist arthroplasty is an alternative to arthrodesis in the treatment of the rheumatoid wrist. MATERIAL AND METHODS: Seventy-two GUEPAR total wrist arthroplasties in sixty-four patients with rheumatoid arthritis were reviewed 1 to 10 years after the operation (average follow-up of 4 years). GUEPAR total wrist arthroplasty is a bicondylar prosthesis. The radial component made of polyethylene is cemented in the radius. The carpal component made of metal is fixed by two screws in the second and the third metacarpal. This component is constitued by two pieces: a perforated lower part permitting the passage of the screws and its metacarpal fixation and a biconvex cover fixed on the lower part by a micro-screw. RESULTS: In preoperative evaluation, all patients had severe pain and loss of function. Post-operatively, 89 per cent had no pain or mild pain and 96 per cent had better function. The average arc of flexion-extension was 47 degrees preoperatively and 39 degrees postoperatively. There were no deep infections or dislocations. Seventy percent of the patients were satisfied but eleven wrists (15 per cent) required revision: 5 cases for prosthesis revision and 6 cases for implant removal and arthrodesis. Prosthesis revisions were justified by the unscrewing of the carpal component micro-screw: they gived good results. Arthrodesis was required for 4 radial component loosening and for 2 important bone resorptions under the carpal component. Radial component loosening was associated in 3 cases with unscrewing of the micro-screw. Radiographical analysis showed in nearly all cases of this serie a bone resorption under the carpal component. This resorption was 2 mm wide at an average of to 2 years and 4 mm wide at 4 years. DISCUSSION: Clinical results of this study are good but eleven wrists required revision. Nine of these revisions were due to anomalies of first prosthesis: the unscrewing of the carpal component micro-screw was accountable to abnormal use of polyethylene with reaction of the wear products and loosening of the radial component. This problem is now resolved. More disquieting is the bone resorption under the carpal component. In fact, this resorption was constant and evolutive. It was very likely due to micro-movements between the metacarpal screws and the carpal lower part. Also, the conception of the metacarpal-fixation of this prosthesis must be revised. CONCLUSION: In rheumatoid arthritis, wrist arthrodesis gives good results if nothings affects the fingers, elbow or shoulder. If they are affected, total wrist arthroplasty is an alternative. Long term loosening of total wrist arthroplasty is a significant problem so its indication must be reserved for old patients. |