Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 8904958 | Synovial fluid levels of proinflammatory interleukins and their inter-relationships in eld | 1996 Aug | Elderly-onset rheumatoid arthritis (EORA) is thought to be different from younger-onset disease (YORA) for many reasons, including a more elevated acute phase response and a more abrupt onset; both events are mainly regulated by pro-inflammatory interleukins (ILs), in particular, IL-1, IL-6 and IL-8. To compare the synovial fluid (SF) levels of these ILs, and their relationship to local inflammation as well as the acute phase response, erythrocyte sedimentation rate (ESR) and serum C-reactive protein (CRP) in the two RA subsets, we determined white blood cell (WBC) number, total protein (TP), IL-1beta, IL-6 and IL-8 concentrations in the SF of 50 patients, 15 with EORA and 35 with YORA. Both ESR and CRP were higher in EORA than in YORA. IL-6 was higher in SF of EORA (2111.37 +/- 1425.03 pg/mL) than YORA (1077.53 +/- 757.62 pg/mL, p = 0.002), while no difference was observed for SF IL-1beta and IL-8. There was a weak correlation between SF IL-6 and IL-1beta in EORA, whereas SF ILs and CRP and/or ESR did not show any correlation in both groups. Our study indicates that in EORA, as in other diseases occurring in the elderly, there are elevated levels of IL-6. Higher SF levels of IL-6 may be, at least in part, responsible for the different behavior of EORA with respect to YORA. | |
| 8575488 | New agents for scintigraphy in rheumatoid arthritis. | 1995 Nov | Radiopharmaceuticals have been used as investigative tools for the detection and treatment of arthritis activity in rheumatoid arthritis (RA) since the 1950s. Against the background of the pathophysiology of RA, the current status of joint scintigraphy and possible future developments are reviewed. Both non-specific (radiolabelled leucocytes and technetium-99m labelled human immunoglobulin) and specific targeting radiopharmaceuticals (including radiolabelled antibodies) are considered. The use of radiopharmaceuticals in the detection of arthritis activity has the advantages of allowing direct imaging of joints by means of whole-body scintigraphy and of joints that are difficult to assess clinically or radiographically. Promising results have been obtained with radiolabelled anti-CD4 and anti-E-selectin antibodies and with somatostatin receptor imaging, but more data are available regarding 99mTc-IgG scintigraphy, which differentiates between the various degrees of arthritis activity and thus facilitates the choice of antirheumatic drug. Newer promising approaches to the imaging of RA include the use of radiolabelled J001 and cytokines, though studies on these are limited at present. | |
| 7779641 | Dual-energy X-ray absorptiometry in rheumatoid arthritis: comparison between axial and app | 1995 Mar | Bone mineral density was measured by dual-energy x-ray absorptiometry (DXA) at the lumbar spine, both hips and distal radius in 10 postmenopausal patients with rheumatoid arthritis (RA). DXA values at the lumbar spine and distal radius were compatible with osteoporosis in all but 1 patient. Only 4 patients had osteoporosis of the hip, and 3 of these were over 65. Preliminary results over this small population suggest that in RA a correlation may be expected between DXA values in lumbar spine and distal radius, but not between either of these and the hip. | |
| 8222739 | A double-blind comparison of oral ketoprofen 'controlled release' and indomethacin supposi | 1993 | A double-blind, double-dummy, crossover study was carried out in 8 centres to compare the efficacy and tolerability of 'controlled-release' ketoprofen tablets (200 mg) with that of indomethacin suppositories (100 mg) in out-patients with definite or classical rheumatoid arthritis. Patients were allocated at random to receive a daily bedtime dose of either 1 ketoprofen tablet or 1 indomethacin suppository plus the dummy of the other formulation for a period of 3 weeks. They were then crossed over to the alternative treatment for a further 3 weeks. Daily diary records were kept by patients of the number of night-time awakenings due to pain, pain severity at awakening in the morning and the duration of early morning stiffness. Treatment efficacy was also assessed at the end of each trial period by means of an articular index and by physician's and patient's overall evaluation of response. Adverse effects spontaneously mentioned by the patients or elicited by direct questioning using a symptom check-list were recorded. Statistical analysis of the results from 83 evaluable patients showed that the 'controlled-release' tablet formulation of 200 mg ketoprofen was equally as effective as the 100 mg indomethacin suppository in the treatment of rheumatoid arthritis, especially with regard to pain at awakening and morning stiffness. Side-effects in both groups were those commonly seen with non-steroidal anti-inflammatory drugs and, as expected, gastro-intestinal and CNS disturbances predominated. Overall, side-effects were fewer with ketoprofen than with indomethacin. | |
| 1731812 | Variable-constant segment genotype of immunoglobulin kappa is associated with increased ri | 1992 Jan | OBJECTIVE: To further investigate the association of rheumatoid arthritis (RA) with a particular genotype identified by a restriction site polymorphism near the constant segment of immunoglobulin kappa (C kappa). METHODS: The frequencies of genomic DNA polymorphisms detected within or near C kappa (the most C kappa-proximal variable segment [V kappa] B3 and a T lymphocyte marker [CD8A]) were determined by Southern blotting and hybridization. The frequencies of coding-region polymorphisms of C kappa (Km allotypes) were determined by amplification by polymerase chain reaction followed by restriction enzyme digestion. RESULTS: Although the frequencies of B3, Km, and CD8A genotypes were not different between RA and normal control populations, more individuals were homozygous for both C kappa and B3 in the RA group (relative risk 2.2, P less than 0.01), especially in the DR4-negative RA subgroup (relative risk 3.9, P less than 0.001). CONCLUSION: The homozygous genotype of an approximately 30,000-base region including the C kappa segment confers an elevated risk for RA, particularly in the DR4-negative subgroup. | |
| 8216398 | HLA-linked susceptibility to rheumatoid arthritis. A study of forty-one multicase families | 1993 Oct | OBJECTIVE: To analyze segregation of rheumatoid arthritis (RA) with HLA-DR4 and/or other alleles in multicase RA families and to compare the segregation patterns among affected and unaffected sibs. METHODS: Forty-one multicase families (22 multiplex and 19 simplex) of northern Indian origin were studied for HLA haplotype segregation. RESULTS: HLA haplotype sharing among affected sibs was observed more often than expected in families in which both parents were healthy (P < 0.05). RA cosegregated with a DR4 haplotype among offspring only in multiplex families in which both parents were unaffected (P < 0.05), while in simplex families, the disease segregated with DR4 only when the allele was from the affected DR4-heterozygous parent. In DR4-negative affected sib pairs, DR1, DR6, and DR10 were inherited from healthy parents more often than expected. CONCLUSION: Dissimilar modes of inheritance are seen among multiplex and simplex RA families. The results of segregation analysis are compatible with the hypothesis that an epitope, rather than an individual DR antigen(s), is responsible for increased risk for development of RA. | |
| 9103056 | [Arthroscopic synovectomy and radiosynoviorthesis]. | 1996 Nov | Both procedures, radiosynoviorthesis and arthroscopic synovectomy, are well established in the local treatment of rheumatically deformed joints. By combining the two minimal invasive procedures one can increase the radicality and still decrease traumatization. A prospective study by Herresthal indicates the superiority of the combined therapy over the single nuclide therapy of knee joints in rheumatoid arthritis. This is due to the lesser traumatization as compared to the open synovectomy and to the possibility to remove fibrinous plaques which may impair the efficiency of radiosynoviorthesis. Histology, method and the respective indications regarding the joints of the upper and lower limbs are discussed. | |
| 10163531 | Rotator cuff insufficiency in the arthritic shoulder: treatment alternatives. | 1995 Oct | Shoulder arthroplasty can relieve the pain and improve the functional status of an arthritic shoulder. Because of the unique anatomic characteristics of the glenohumeral joint, the rotator cuff provides stability and control of shoulder motion. Thus, an intact, functioning rotator cuff is necessary for successful shoulder arthroplasty. There are clinical situations where the rotator cuff is torn, absent, or incompetent and an arthritic condition affects the shoulder. The patient must understand that, when confronted with rotator cuff insufficiency and shoulder arthritis, the goal of surgical treatment is limited to pain relief, with shoulder function often limited by the condition of the rotator cuff. We will discuss the incidence of rotator cuff disease associated with differing arthritic conditions, the treatment options available, and expected outcomes in these difficult and challenging clinical situations. | |
| 8436986 | Five to eight year results of the Johnson-Elloy (Accord) total knee arthroplasty. | 1993 Feb | Between February 1982 and December 1985, 133 knees in 107 patients were replaced with a cemented Johnson-Elloy (Accord) total knee arthroplasty. Thirty-five knees were lost during the follow-up period because of death in 29, revision in 3, infection in 1, and refusal of follow-up evaluation in 2. The results of the remaining 98 knees in 76 patients with a 5-8 year follow-up period are presented. The procedure was carried out in all cases presenting for surgery, irrespective of pathology and degree of deformity. The range of flexion achieved as a mean of 93.5 degrees in the osteoarthritic group and 100 degrees in the rheumatoid arthritic group. Eighty-seven percent of the osteoarthritic group and 95% of the rheumatoid arthritic group achieved between 10 degrees and 50 degrees of rotation at 90 degrees of flexion, which was maintained for the duration of the study. Adequate stability in both groups, valgus-varus and rotation in extension, and anteroposterior in flexion was achieved. Survivorship was 97.7% at 80 months. | |
| 1413978 | [Results 2 to 5 years after implantation of the cement-free "APS" total knee prosthesis. A | 1992 Jul | One hundred-and-forty-seven out of 160 cementless APS total knees replacements have been clinically and radiologically evaluated with a mean follow-up period of 38 (24-60) months. Primary diagnosis has been osteoarthrosis in two thirds and rheumatoid arthritis in one. Reoperations have been performed in 4.9% due to aseptic loosening of the tibial tray, and in 3.7% due to patellar problems (aspetic loosening in 1.2% and luxation in 2.5%). There have been three late infections of the joint leading to arthrodesis in two or exchange operation in one case. The radiologic course of the remaining 126 implants showed excellent or good osseous integration of the implants in more than 80%. We were able to show that rheumatoid arthritis as well as malimplantation of the prosthesis can decrease the rate of osseous integration. | |
| 7799385 | Other special considerations in assessing DC-ART: The need for patient stratification. | 1994 Sep | Given the heterogeneity of rheumatoid arthritis (RA), even in disease of the same duration, it seems likely that some therapeutic regimens will satisfy DC-ART criteria to different degrees in different strata of patients with RA. Since it entails its own problems, it is recommended that the value and feasibility of stratification be evaluated before any attempt to design a DC-ART trial. | |
| 8036608 | [The level of the tumor necrosis factor in the blood serum of patients with systemic lupus | 1993 | The contents of tumor necrosis factor alpha (TNF alpha) was measured by enzyme immunoassay in the serum from 43 healthy donors against 49 patients with systemic lupus erythematosus (SLE) or rheumatoid arthritis (RA). In all the donors the cytokine did not reach 50 pg/ml, in SLE and RA running actively TNF alpha levels got elevated in the absence of previous long-term immunocorrection. Under the treatment effect blood levels of the cytokine fell in inhibition of the autoimmune process. Resistant to therapy patients with active rheumatic process kept for a long period on steroids exhibited TNF alpha concentrations less than 50 pg/ml. Low activity of the process and no need in corrective therapy were attended by normal TNF alpha content. The findings urge further efforts in the search for new approaches to SLE and RA treatment. | |
| 8135100 | [Sudden deafness and acute synovitis: a case report]. | 1993 Jan | A case of sudden deafness followed by arthritic manifestations is reported. The importance of immunologic tests, such as circulating immune complexes and the HLA system, in making a correct diagnosis is emphasized, which in turn suggests the possibility of establishing new diagnostic strategies. | |
| 1588754 | [Osteoporosis in rheumatoid arthritis]. | 1992 Mar | Rheumatoid arthritis may be associated with generalized, as well as, juxta-articular osteoporosis. To assess the skeletal distribution of bone loss, bone mass was measured in women with rheumatoid arthritis, using single photon absorptiometry and dual energy X-ray absorptiometry. Bone loss was more rapid in the distal metaphyseal region of the radius than in the diaphyseal region. Bone loss in the legs was correlated with gait disturbance and bone loss in the third lumbar vertebra was recognized only in the patients treated with corticosteroids for more than 1 year. These results indicate that rheumatoid arthritis was not universally associated with generalized osteoporosis. Patients treated with corticosteroids are likely to be at risk from generalized osteoporosis. | |
| 7598148 | Biological therapies: a novel approach to the treatment of autoimmune disease. | 1995 Jul | Biological therapies for rheumatoid arthritis (RA) make use of molecules (including derivative and recombinant forms) produced by cells of the immune system or by cells that participate in inflammatory reactions. Development of monoclonal antibodies against cell-surface structures that are lineage or subset specific has led to trials of anti-T-cell reagents in RA, but results thus far must be regarded as a significant therapeutic disappointment. A monoclonal antibody designed to interfere with the action of a cytokine, tumor necrosis factor alpha (TNF-alpha), has been studied in both open and controlled trials. Treatment with this antibody resulted in marked changes in indices of inflammation, but duration of responses may be limited by the eventual development of antibodies to the anti-TNF-alpha antibody. Immunomodulatory strategies that use the immune system to regulate autoimmune activity have been developed based on animal studies, and evaluation of oral collagen as a treatment in RA is currently underway. If successful, this approach would represent a new direction in the treatment of human autoimmune disease. In the future, use of gene therapy directed to the joint could be a powerful approach to treatment of RA. Rational use of biological therapies in RA will depend, in part, on improved understanding of the pathogenesis of this condition. | |
| 7791152 | An open study of pentoxifylline in the treatment of severe refractory rheumatoid arthritis | 1995 Apr | OBJECTIVE: Recent data implicates the cytokine, tumor necrosis factor alpha (TNF-alpha), in the pathophysiology of rheumatoid arthritis (RA). In vitro data suggest that pentoxifylline may possess anti-TNF-alpha properties. We have therefore carried out a prospective 3-month open evaluation of pentoxifylline in a group of adult patients with RA refractory to conventional disease remittive therapies. METHODS: Nineteen patients with RA were included and clinical assessments were performed according to the World Health Organization/International League of Associations for Rheumatology (WHO/ILAR) criteria at baseline, and one and 3 months after the initiation of therapy. Laboratory assessments included a complete blood count, erythrocyte sedimentation rate (ESR), and whole blood assays of TNF-alpha production. TNF-alpha was assayed using ELISA and semiquantitative polymerase chain reaction methodologies. RESULTS: A significant diminution in number of tender and swollen joints as well as the ESR was noted after 3 months (p < 0.05) although no consistent effects on TNF-alpha production were observed. Furthermore, whole blood assays of TNF-alpha production shortly after initiation of pentoxifylline therapy were not predictive of the clinical response to this agent. CONCLUSION: Although pentoxifylline may possess therapeutic properties in RA, any beneficial effects appear to be unrelated to changes in TNF-alpha generation in whole blood assays. | |
| 7873109 | Effects of a modified dance-based exercise on cardiorespiratory fitness, psychological sta | 1995 Jan | Cardiorespiratory function and exercise tolerance appear very limited in persons with rheumatoid arthritis (RA). Many studies have demonstrated that aerobic exercise training is beneficial to prevent physical deconditioning without inducing adverse effects on an individual's joints and general health. The present study was conducted to demonstrate that a dance-based exercise program is a safe and efficient activity to improve physical fitness and psychological state in persons with RA. A group of 19 persons (mean age, 49.3 +/- 13 yr) participated in a 12-wk exercise program (twice weekly), whereas 10 persons (mean age, 49.4 +/- 12 yr) served as controls. Health status, use of medication, joint pain and swelling, physical fitness, activity of daily living and psychological state were assessed at baseline, after the 12-wk training program and 6 mo after the end of the program. Exercise training induced a mean improvement of 13% in aerobic power, with the highest values reaching 40%. No significant changes were observed in joint status, even though the count of painful joints tended to decrease in the exercise group. Positive changes in depression, anxiety, fatigue and tension were observed after the 12-wk exercise program. These findings provide some evidences in favor of aerobic exercise in individuals with RA. Furthermore, it is of primary interest to note that a weight-bearing activity with limited ground impacts do not provoke short-term adverse effects on joint status. Further studies, however, are required to determine the long-term effect of weight-bearing exercise on the health status of individuals with RA. | |
| 7752802 | [Rheumatoid disorders in Crohn disease and ulcerative colitis. Dominance of non-inflammato | 1995 Mar | 82 consecutive outpatients with Crohn's disease (n = 52) and ulcerative colitis (n = 30) were examined ambulatory. Rheumatic complaints, objective results and diagnosis were correlated to the activity of the underlying illness and the extent of the bowel affected. 61% of the examined patients complaint about rheumatic pains. In two thirds this could be attributed to noninflammatory causes (30% insertion tendinitis. 16% degenerative arthritis, 16% wrong carriage), which appeared to be independent of the activity and severity of the underlying disease. One fourth of the rheumatic complaints was caused by inflammation (21% arthritis, 5% sacroileitis). In these cases a dependency on the disease activity and the extent of the colon involvement could be found. No cause was found for 12% of the rheumatic complaints. In patients with ulcerative colitis suffering from arthritis a significant increase of disease activity (Rachmilewitz index) could be shown as compared to ulcerative colitis patients without arthritis (p < 0.02). For patients with Crohn's disease no significant correlation between arthritis and disease activity could be established. In these cases the occurrence of arthritis was associated with the colon involvement (Chi2 = 8.48). The data indicate the high frequency of rheumatic complaints in inflammatory bowel diseases due to noninflammatory causes. | |
| 7730830 | Resection specimen analysis of proximal tibial anatomy based on 100 total knee arthroplast | 1995 Feb | Although it is known that there is some asymmetry of the tibial plateau, most total knee arthroplasty designs currently have a symmetric tibial component. Using resection specimen analysis of the tibial plateau from 100 total knee arthroplasty specimens, the authors have examined the tibial plateau to further delineate, quantitatively, the medial and lateral tibial configuration. Unmagnified radiographs of each of the specimens were produced. A line was drawn along the mediolateral axis. The midpoint and points 10, 20, and 30% from the medial and lateral peripheries were then calculated. The average anteroposterior medial 10, 20, and 30% dimensions were 3.79, 4.74, and 5.06 cm, respectively. The average anteroposterior lateral 10, 20, and 30% dimensions were 3.48, 4.10, and 4.16 cm, respectively. The ratios of the lateral/medial anteroposterior distances at 10, 20, and 30% from the periphery were 92.10, 86.77, and 82.46%, respectively. A total knee arthroplasty system that recognizes the difference in the medial and lateral tibial plateaus and designs a prosthesis to account for the smaller, lateral tibial plateau may achieve the goal of maximizing tibial coverage as well as eliminate the problems associated with a symmetric design. | |
| 8215626 | Molecular analysis of HLA-DR beta and DQ beta polymorphism in Chinese with rheumatoid arth | 1993 Aug | OBJECTIVES: Several studies have suggested that genetic predisposition to rheumatoid arthritis may be related to the presence of specific polymorphic HLA sequences that are often associated with HLA-DR4 haplotypes. This study was performed to determine if an association exists between Chinese with rheumatoid arthritis and a particular HLA-DR beta or DQ beta subtype. METHODS: This study used the polymerase chain reaction to amplify HLA-DR beta and DQ beta genes, and oligonucleotide probe hybridisation to examine the association of certain polymorphic sequences with rheumatoid arthritis in 23 Chinese patients from Shanghai. RESULTS: An HLA-DR4 associated sequence was significantly increased in the Chinese patients (43%) compared with healthy controls (14%) from the same location (relative risk = 4.6, 95% confidence limits 1.1 to 19.3). Analysis of the third hyperpolymorphic region of DR4 positive samples was performed to detect polymorphic sequences associated with Dw4, Dw10, Dw13, Dw14, Dw15, and KT2 cellular specificities. Examination of this region showed that 91% of patients had sequences encoding amino acids QRRAA (associated with Dw14 and Dw15) or QKRAA (associated with Dw4) compared with 64% of the DR4 positive controls. CONCLUSIONS: Rheumatoid arthritis in the Chinese is associated with HLA-DR4. There is a possible relationship between sequences within the third hyperpolymorphic region of the DRB allele and rheumatoid arthritis in the Chinese. |