Search for: rheumatoid arthritis methotrexate autoimmune disease biomarker gene expression GWAS HLA genes non-HLA genes
| ID | PMID | Title | PublicationDate | abstract |
|---|---|---|---|---|
| 1393376 | Bronchiectasis and rheumatoid disease: is there an association? | 1992 Oct | Rheumatoid arthritis is associated with a number of pleuropulmonary disorders. A retrospective study of the frequency of rheumatoid disease in patients with bronchiectasis and pulmonary fibrosis was performed. The results suggest that the frequency of bronchiectasis and rheumatoid disease is similar to that of the well established, but rare, association between pulmonary fibrosis and rheumatoid arthritis. We therefore suggest that bronchiectasis should be remembered as a pulmonary association of rheumatoid disease which occurs as commonly as pulmonary fibrosis. | |
| 7748214 | Every-other-week methotrexate in patients with rheumatoid arthritis. A double-blind, place | 1995 May | OBJECTIVE: To determine if patients with rheumatoid arthritis (RA) that is stable with weekly methotrexate (MTX) therapy could be switched to an every-other-week regimen of MTX. METHODS: Forty-seven patients with classic or definite RA who had received MTX for at least 8 months were studied. Clinical measurements consisted of the number of tender and swollen joints, physician and patient global evaluation of disease activity on a 5-point scale, grip strength, patient evaluation of pain, morning stiffness, and the interval to onset of fatigue from time of awakening. Laboratory measures included the erythrocyte sedimentation rate (ESR), rheumatoid factor, C-reactive protein (CRP), and baseline serum folate levels. Uptake of MTX was measured with tritiated thymidine from peripheral blood mononuclear cells (PBMC) from patients ex vivo. Serum measures of interleukin-1 beta (IL-1 beta), IL-6, and tumor necrosis factor alpha (TNF alpha) were performed in sera, and TNF alpha was also measured on PBMC supernatants. RESULTS: Twelve of the 23 patients receiving every-other-week MTX (52%) were able to complete 6 months of this treatment without experiencing a disease flare. Eleven of the 23 patients receiving every-other-week MTX (48%) withdrew from the study before completing 6 months of treatment, because of a flare. No significant differences in clinical or laboratory parameters were seen when the 24 patients receiving weekly MTX were compared with the 12 patients in the every-other-week MTX group who successfully completed 6 months of the study. None of the changes in serum cytokine levels were significantly different between the patients receiving MTX weekly versus those receiving it every other week, and changes in ESR and CRP did not differ between groups. Age, sex, RA disease duration, MTX weekly dose or duration, baseline joint counts, or serum folate status did not predict a flare. Tritiated MTX uptake did not differ between groups. CONCLUSION: Some patients with RA that is stable on weekly dosing are able to change to every-other-week dosing without experiencing a flare in their disease activity. | |
| 7721528 | Non-contraceptive hormones and the risk of rheumatoid arthritis in menopausal women. | 1994 Dec | BACKGROUND: Several reproductive factors appear to affect a women's risk of developing rheumatoid arthritis. This study's purpose was to determine whether use of non-contraceptive hormones is among them. METHODS: A population-based case-control study was conducted in King County, Washington and Group Health Cooperative of Puget Sound, a prepaid health plan. New cases of rheumatoid arthritis in peri- or postmenopausal women (n = 135) were verified through clinical examination and compared with 592 controls. Both groups were interviewed in person about hormone use and demographic and reproductive factors. RESULTS: The age-adjusted relative risk (RR) among women who had ever used non-contraceptive oestrogens was 1.04 (95% confidence interval [CI]: 0.70-1.55), and among women who had ever used progestins it was 0.66 (95% CI: 0.40-1.08). For current users of oestrogen only, the RR was 0.97 (95% CI: 0.62-1.53), and among current users of oestrogen plus progestin it was 0.81 (95% CI: 0.45-1.45). Multivariate analyses yielded similar results. There was little evidence of a dose-response relationship with duration of use or with frequency of progestin use. CONCLUSIONS: Use of non-contraceptive oestrogens appears to have little effect on the risk of developing rheumatoid arthritis in menopausal women. There may be a modest reduction in risk among progestin users. | |
| 8052594 | [Fatal diffuse alveolar damage after gold medication]. | 1994 May | We report about the case of a 74-year-old woman who suffered diffuse alveolar damage and consecutive lethal pulmonary failure after gold therapy for rheumatoid arthritis. This is the fourth documented case of fatal pulmonary failure following gold therapy. The clinical findings were dominated by severe dyspnoea that warranted respirator therapy shortly after admission. Chest radiographs showed progressing confluent perihilar patchy infiltrates that suggested interstitial involvement. Steroid therapy had only a short-lasting effect on the respiratory failure, the patient died in prolonged hypoxic circulatory failure. Post-mortem examination showed the organotypical findings of diffuse alveolar damage in proliferative stage with advanced pulmonary fibrosis. With the discontinuation of gold medication and early steroid therapy, this disease which is based on immunological pathomechanisms is usually reversible. Both the knowledge of this entity and early diagnosis are essential for a promising therapeutic intervention. | |
| 7914409 | Nonsteroidal antiinflammatory drug-induced small intestinal inflammation and blood loss. E | 1994 Aug | OBJECTIVE: To identify the source of intestinal blood loss in rheumatoid arthritis patients being treated with nonsteroidal antiinflammatory drugs (NSAIDs) and assess the response to sulfasalazine and other disease-modifying antirheumatic drugs (DMARDs). METHODS: Intestinal inflammation, blood loss, and gastroduodenal damage, and the response to treatment with DMARDs, were assessed in 46 patients taking NSAIDs. RESULTS: Intestinal inflammation and blood loss correlated significantly with one another (r = 0.43, P < 0.003), but not with the macroscopic or microscopic appearance of the gastroduodenal mucosa. Sulfasalazine reduced both intestinal inflammation and blood loss, whereas the other DMARDs did not. CONCLUSION: The small intestine is the main site of mild chronic blood loss in patients receiving NSAIDs, and this blood loss can be reduced with sulfasalazine treatment. | |
| 8315087 | The temporomandibular joint in rheumatoid arthritis: correlations between clinical and tom | 1993 Jun | Clinical and radiological involvement of the temporomandibular joint (TMJ) in rheumatoid arthritis (RA) varies greatly in the literature. Clinical and tomographic (sagittal plane) examination of the TMJ was performed in 26 patients with RA and 26 control subjects. Sixty-one per cent of the RA group had physical signs in the TMJ, compared with 42% in the control group (NS). Sixty-nine per cent of the RA group had erosive or cystic lesions of the TMJ compared with 31% of control subjects (P < 0.01). The clinical dysfunction score did not correlate with the tomographic TMJ score in patients with RA. It was found that a wide range of tomographic abnormalities occurs in patients with RA and in patients without the disease, and that there are no tomographic abnormalities specific for RA; however, the incidence of erosions and cysts of the mandibular condyle are significantly higher in patients with RA (P < 0.01), and should suggest the diagnosis. It was also found that there is no correlation between the clinical and tomographic findings of the TMJ in RA, and that the intensity of destructive lesions of the TMJ on tomography in RA is well correlated to the severity of the disease (evaluated with clinical and laboratory features). | |
| 8475347 | [Understanding of and coping possibilities in chronic rheumatoid arthritis in a family set | 1993 Mar 30 | Results of a Swiss study dealing with the coping potential of patients suffering from rheumatoid arthritis and their family members are presented. Patients and their families have their own understanding of rheumatic disease which must be respected by the physicians. Whereas women are prone to suffer in a passive manner, men more often tend to be more heroic. It is recommendable to counsel occasionally family members of rheumatic patients to diminish stress and to give precise informations to protect from over-responsibility. | |
| 8164202 | Functional magnetic resonance imaging should be included in the evaluation the cervical sp | 1993 Sep | OBJECTIVE: To determine the value of functional (flexion) magnetic resonance imaging (MRI) studies in patients with rheumatoid arthritis (RA) suspected of having cervical (C)-spine involvement. METHODS: Four patients with RA suspected of having C spine involvement, with neurological symptoms and/or signs, and who had normal MRI in neutral position, underwent functional MRI. RESULTS: In all 4 patients functional MRI provided additional information. Cord compression (3 patients) and angulation of the cord (1 patient) were evident only in this view. CONCLUSION: Functional MRI provided additional information in these patients and may be indicated in patients with RA suspected of having C spine involvement who have a normal MRI study in a neutral position. | |
| 8588077 | [Treatment of rheumatoid arthritis of senile onset with methotrexate]. | 1995 Dec | Elderly onset rheumatoid arthritis is a not rare disease with relevant social implications. The most important question is represented by the therapeutic choice, in relation to the typical problems of the elderly patients and to the frequent coexistence of other diseases. In this work, we evaluated the practicability and the efficacy of methotrexate therapy, at the dose of 5 mg/week, in 27 patients affected by elderly onset rheumatoid arthritis (mean age 73.76 +/- 3.39 years, range 70-83). Low dose prednisone was associated in order to control painful symptoms. Also sulindac was allowed. Frequent clinical and hematochemical controls were made in order to precociously evaluate the appearance of side effects. All the 27 patients completed the first year of treatment; during this period there was no drop out. Sixteen patients finished the second year too; during this year one patient dropped out because of significant hypertransaminasemia and another patient did not respect the follow-up. Clinical and hematochemical parameters were monitored. A significant improvement of all data was observed from the third month. A further amelioration was recorded in the following months. Our data suggest the efficacy and the safety of low dose methotrexate in the treatment of elderly onset rheumatoid arthritis. A careful evaluation of side effects is obviously necessary. | |
| 8181184 | Impaired release of sCD23 by activated B-cells from RA patients. | 1994 May | To determine the basis of a differential response among B-cells derived from rheumatoid arthritis (RA) patients and their normal counterpart to anti-CD3-activated T-cells (HUT-78 CD4+), B-cell responsiveness was measured in vitro with a focus on IgG and IgM secretion, the ability to differentiate into plasma cells, and the release of soluble CD23 (sCD23) into the culture media. In the patients with RA, plasma sCD23 levels were measured and studied to see if it related to the rheumatoid factor (RF) titer, age, sera immunoglobulin, therapy, and disease activity. Patients with RA were found to have a significantly increased level of sCD23 in the plasma when compared to control individuals, yet their peripheral blood B-cells were unable to secrete normal levels of sCD23 following in vitro stimulation by T-cells. The plasma level of sCD23 found in the RA patients correlated (P < 0.0001) with the RF titer. B-cells from the RA patients secreted significantly increased amounts of IgG and IgM after in vitro stimulation by T-cells. It appears that peripheral blood B-cells of RA patients are more activated initially and it is likely that at the time of coculture with T-cells they had already passed through the narrow window in cell maturation when sCD23 is released. | |
| 8674145 | Course of gut inflammation in spondylarthropathies and therapeutic consequences. | 1996 Feb | Gut inflammation plays a crucial role in the pathogenesis of spondylarthropathies (SpA) since ileocolonoscopic studies have demonstrated the presence of gut inflammation in different forms of this concept: in ankylosing spondylitis (AS) (60%), in enterogenic (90%) and urogenital reactive arthritis (20%), in undifferentiated SpA (65%), in the pauciarticular and axial forms of psoriatic arthritis (16%), in late onset pauciarticular juvenile chronic arthritis (80%) and in acute anterior uveitis (66%). The strong relationship between gut and joint inflammation was demonstrated by performing a second ileocolonoscopy: remission of the joint inflammation was always connected with a disappearance of gut inflammation, whereas persistence of locomotor inflammation was mostly associated with the persistence of gut inflammation. During further evolution 20% of the non-ankylosing spondylitis SpA patients can develop AS. About 6% of the total group SpA patients, in whom inflammatory bowel disease (IBD) was excluded, developed Crohn's disease 5 to 9 years later. All these patients initially presented with gut inflammation, which indicates that this finding has prognostic value. The high prevalence of evolution to IBD in SpA patients confirms the thesis that both disease entities bear common pathogenic mechanisms, and confirms the place of IBD in the concept of SPA. Sulphasalazine (SASP), a successful drug in the treatment of IBD, has demonstrated its effectiveness in the treatment of SpA. The beneficial effect of the drug in this disease entity could be due to its anti-inflammatory effect on the gut wall, by normalizing its permeability and by preventing the entrance of antigens through the defective gut wall. However, SASP could not prevent the evolution to IBD. | |
| 7535639 | Prostanoid modulation of synovial antigen-specific CD4+ T-cell cytotoxic function in rheum | 1995 Feb | The recent demonstration of cytolytic mediators within synovial CD4+ T-cells of patients with rheumatoid arthritis (RA) has suggested an additional role for these cells in the pathogenesis of the disease. In this study we have investigated the function and regulation of antigen-specific class II-restricted cytotoxic T-cells from the synovial fluid (SFMNC) and peripheral blood (PBMNC) of 20 seropositive RA patients, and correlated in vitro findings with clinical data. Regulatory factors including prostaglandin E2 (PGE2), interferon-gamma (IFN-gamma) and interleukin-4 (IL-4) were measured in cell supernatants. A diversity in SFMNC antigen-specific cytotoxicity that correlated with therapy and PGE2 production was found, and shown to be mediated by synovial prostanoid (products of cyclooxygenase metabolism) inhibition of effector function. Our findings indicate that SFMNC cytotoxicity may be important in the pathogenesis and treatment of RA. Cyclooxygenase inhibition as the sole treatment early in RA may reduce the potentially beneficial inhibitory effect of synovial prostanoids on antigen-specific SFMNC cytotoxicity. | |
| 8350327 | Serial soluble interleukin 2 receptor levels in rheumatoid arthritis: differences in respo | 1993 Jun | OBJECTIVE: To analyze the changes in soluble interleukin 2 receptor (sIL-2R) levels following treatment of patients with rheumatoid arthritis (RA). METHODS: Serial measurements of sIL-2R levels were made over 24 weeks in 40 patients with RA, treated with intramuscular (im) gold plus 3 im injections of either 120 mg methylprednisolone acetate or placebo. RESULTS: sIL-2R levels were reduced in the glucocorticoid treated group in contrast to the gold only group, where levels initially increased. At 24 weeks, mean sIL-2R levels did not significantly differ from pretreatment levels in either group, despite improvements in clinical measures. CONCLUSIONS: In our study, sIL-2R levels do not correlate with short term clinical measures of disease activity. Their significance for longer term prognostic use remains to be determined. | |
| 8992005 | Quantitative analysis of hand radiographs in rheumatoid arthritis: time course of radiogra | 1995 Oct | Quantitative studies of hand radiographs in patients with rheumatoid arthritis (RA) indicate that radiographic joint space narrowing and erosion are seen in more than 67% of patients within the 1st 2 years of disease, and progresses most rapidly during the 1st 5 years of disease, according to currently used scoring methods. Radiographic malalignment is rarely seen until after 5 years of disease. In cross sectional studies, correlations of radiographic scores with physical examination scores are minimally significant for joint tenderness, modestly significant for joint swelling, and highly significant for joint deformity and limited motion. In cross sectional studies, 3 quantitative methods, the Steinbrocker radiographic stage, modified Sharp method, and Larsen method, are highly significantly correlated and yield similar results in comparisons with other clinical measures. | |
| 1731806 | AIMS2. The content and properties of a revised and expanded Arthritis Impact Measurement S | 1992 Jan | OBJECTIVE: The goal of this project was to develop a more comprehensive and sensitive version of the Arthritis Impact Measurement Scales (AIMS). METHODS: AIMS scale items were revised, and 3 new scales were added to evaluate arm function, work, and social support. Sections were also added to assess satisfaction with function, attribution of problems to arthritis, and self-designation of priority areas for improvement. The new instrument was designated the AIMS2. A pilot test of format and content and a performance test of reliability and validity were carried out. RESULTS: Questionnaire completion times in a pilot study of 24 subjects averaged 23 minutes, and evaluations were positive regarding the instrument's length and ease of completion, and the subjects' willingness to complete serial forms and return them by mail. Measurement performance was tested in 408 subjects: 299 with rheumatoid arthritis (RA) and 109 with osteoarthritis (OA); 45 of these subjects completed a second AIMS2 within 3 weeks. Internal consistency coefficients for the 12 scales were 0.72-0.91 in the RA group and 0.74-0.96 in the OA group. Test-retest reliability was 0.78-0.94. All within-scale factor analyses produced single factors, except for mobility level in OA. Validity analyses in both the RA and the OA groups showed that patient designation of an area as a problem or as a priority for improvement was significantly associated with a poorer AIMS2 scale score in that area. Reliability, factor analysis, and validity results were consistent in age, sex, and education subgroups. Satisfaction was moderately correlated with level of function in the same health status area, and the satisfaction items formed a reliable scale. Responses to the arthritis attribution items showed that most dysfunction in this sample was due to arthritis. CONCLUSION: The AIMS2 is a revised and expanded health status questionnaire with excellent measurement properties that should be useful in arthritis clinical trials and in outcomes research. | |
| 8838506 | B lymphocytic clonal expansion in rheumatoid arthritis. | 1996 Jan | OBJECTIVE: To learn whether rheumatoid factor (RF), HLA-DR4, or current therapy influences clonal expansion of B lymphocytes (B cells) in persons with rheumatoid arthritis (RA). METHODS: We measured clonal expansion by analysis of cell surface staining for immunoglobulin light chains. Double staining methods detected a B cell marker (CD19) plus either kappa or lambda on peripheral blood lymphocytes from subjects with RA (n = 26) and controls (n = 26). The difference between frequency histograms of surface kappa and lambda staining was determined by the Kolmogorov-Smirnov statistic D that represents the fraction of clonally expanded B cells. RESULTS: The mean D value in RA was over 50% higher than in the controls [0.225 +/- SD 0.155 versus 0.144 +/- 0.025 (p < 0.0001)]. Ten subjects with RA had values exceeding +2 SD for controls (p = 0.0007). Mean D correlated with RF titer (Spearman's rank correlation coefficient rSp + 0.53, p = 0.006). All 10 high D values were found in the RA subgroups with positive serum tests for RF and with the HLA-DR4 positive genotype. The channel of maximal difference between kappa and lambda staining was higher in the RA group than in controls, showing that clonal expansion was most marked among brightly staining cells. Patients with RA currently receiving low dose methotrexate (MTX) tended to have higher D values than those not receiving MTX (mean 0.29 versus 0.18, respectively, p < 0.025). The RA group currently receiving MTX had a higher frequency of abnormal D values (7 of 11 versus 3 of 15 not currently receiving MTX, p = 0.03). This probably reflects preferential use of MTX for severely affected individuals. Confirmatory studies to detect clonal immunoglobulin gene rearrangements were attempted in selected individuals with high D values, but none was demonstrated in total leukocytic or B cell enriched fractions. CONCLUSION: Findings consistent with B cell clonal expansion occur in about 40% of persons with RA, particularly in the subgroups with positive serum tests for RF and with the HLA-DR4 genotype. However, the clonal expansion level must be below the sensitivity of confirmatory methods. | |
| 7945476 | Effect of hormone replacement therapy on bone mass in rheumatoid arthritis patients treate | 1994 Oct | OBJECTIVE: To assess the effect of hormone replacement therapy (HRT) on bone mass in rheumatoid arthritis (RA) patients treated with and those not treated with steroids. METHODS: Two hundred postmenopausal women with RA (ages 45-65 years) were randomly allocated to receive transdermal estradiol (hormone replacement therapy; HRT) (50 micrograms daily) or calcium supplementation (400 mg daily) for 2 years. Forty-two of the patients (21%) were taking corticosteroids. Bone mineral density of the lumbar spine (BMDLS) and of the proximal femur (BMDF) was measured at study entry and at 12 months and 24 months. RESULTS: In the HRT group overall, mean BMDLS had changed by +2.22% (95% confidence interval [95% CI] +0.72, +3.72) and mean BMDF by -0.41% (95% CI -1.89, +1.07) after 24 months. In the calcium group, mean BMDLS changed by -1.19% (95% CI -2.29, -0.09) and mean BMDF by -0.56% (95% CI -2.60, +1.48). Differences between treatment groups were significant for the spine only (P < 0.001). In the 21 HRT-treated patients taking steroids, BMDLS increased by 3.75% (95% CI +0.72, +6.78) and BMDF by 1.62% (95% CI -1.27, +4.51). CONCLUSION: This study shows that HRT increases spinal BMD and maintains femoral BMD in postmenopausal RA. HRT is also an effective agent in preserving bone mass in patients taking low-dose corticosteroids. | |
| 8970912 | Effects of perceived stress on pediatric chronic pain. | 1996 Dec | The dearth of theoretically driven research on the predictors of pediatric chronic pain may unwittingly contribute to needless suffering in children and adolescents by underinvestigating a potentially treatable condition. The objective of the present study was to investigate the hypothesized predictive effects of perceived stress on pediatric chronic pain intensity in 148 children and adolescents. Consistent with the a priori Biobehavioral Model of Pediatric Pain, higher perceived stress was predictive of greater pediatric pain intensity. The results are discussed with regard to the implications for cognitive-behavioral pediatric pain treatment. | |
| 8452772 | Temporomandibular disorders. | 1993 Mar | Temporomandibular disorders include a variety of intracapsular and extracapsular disorders that may or may not be related to each other and the diagnosis of which can be complicated. The causes of these disorders have not been identified scientifically and instead rely on anecdotal clinical experience. Preliminary epidemiologic studies have begun to identify predisposing, initiating, or perpetuating factors. Recent advances in imaging techniques have created opportunities for a more rational approach to the treatment of these disorders. Nonsurgical therapies are used to manage most of these disorders. Refinements in surgical procedures have increased the predictability of results for patients who have followed nonsurgical treatments. Arthroscopy has added to the macroscopic and microscopic knowledge of intracapsular disorders and offers a less invasive approach to surgical management. With proper diagnosis and treatment selection, quality of life of the majority of patients can be improved. | |
| 8337188 | Social support, rheumatoid arthritis and quality of life: concepts, measurement and resear | 1993 May | In recent years, medical technology has improved considerably and the possibilities to replace destroyed parts of the body that have been affected by rheumatoid arthritis (RA), have grown also. However, the availability and application of advanced techniques does not automatically entail an improvement of quality of life of individuals. Although the physical (dis)ability of RA patients very often leads to certain restrictions, it is not the only element in the evaluation of life-as-a-whole. The way in which the RA-patient copes with the uncertainty of tomorrow and the management of pain and fatigue is another important element in evaluating quality of life. Beside personality factors, social network and social support are regarded to play an important role in this respect and subsequently in the well-being of individuals in general, and especially where it concerns individuals suffering from a chronic disease. Today, a growing number of evidence of the beneficial impact of social support is available some of which are discussed. |