Activity Of RA Research Articles

Rheumatoid arthritis disease activity significantly impacts on the severity of interstitial lung disease

ObjectivesRheumatoid arthritis (RA) related interstitial lung disease (ILD) impacts on the treatment strategy and its prognosis in patients with RA. However, the relationship between RA disease activity and the severity of comorbid ILD has not been fully investigated. This study aimed to investigate the impact of RA disease activity on the severity of comorbid ILD in detail based on currently established visual scoring method along with physiological severity.MethodsConsecutive patients with RA visiting to our Rheumatology Centre between December 2020 and December 2023 were analysed. The radiological severity of ILD was evaluated by averaging the extent of the combined lesion of ground glass opacity, reticulation and honeycombing in 5% increments in six representative high-resolution computed tomography slices ranging from 0% (no involvement) to 100% (all lung fields affected) according to Goh and Walsh’s method. Associations between the radiological and physiological severity of ILD and patients’ features were investigated using linear regression analysis.ResultsAmong 124 patients (32 men, 92 women), the median age was 70 years, and the median disease duration was 2.92 years. Radiological severity of ILD was 0% (without ILD) in 107 (86.2%), ILD with extent < 10% in nine (7.2%), ILD with extent ≥10% and < 20% in three (2.4%), ILD with extent ≥20% in five (4.0%). Both disease activity score (DAS)28-erythrocyte sedimentation rate (ESR) (standardized coefficient = 0.199, P = 0.03) and rheumatoid factor titre (standardized coefficient = 0.247, P = 0.01) were significantly associated with the radiological quantitative severity of ILD in multivariate analysis adjusted for age, sex, disease duration, smoking status and anti-citrullinated peptide antibody titre. DAS28-ESR was significantly associated with forced vital capacity% predicted (standardized coefficient = -0.230, P = 0.047).ConclusionsDisease activity of RA was significantly associated with the severity of RA-ILD both radiologically and physiologically.

Nanoparticle-encapsulated retinoic acid for the modulation of bone marrow hematopoietic stem cell niche

More effective approaches are needed in the treatment of blood cancers, in particular acute myeloid leukemia (AML), that are able to eliminate resistant leukemia stem cells (LSCs) at the bone marrow (BM), after a chemotherapy session, and then enhance hematopoietic stem cell (HSC) engraftment for the re-establishment of the HSC compartment. Here, we investigate whether light-activatable nanoparticles (NPs) encapsulating all-trans-retinoic acid (RA+NPs) could solve both problems. Our in vitro results show that mouse AML cells transfected with RA+NPs differentiate towards antitumoral M1 macrophages through RIG.1 and OASL gene expression. Our in vivo results further show that mouse AML cells transfected with RA+NPs home at the BM after transplantation in an AML mouse model. The photo-disassembly of the NPs within the grafted cells by a blue laser enables their differentiation towards a macrophage lineage. This macrophage activation seems to have systemic anti-leukemic effect within the BM, with a significant reduction of leukemic cells in all BM compartments, of animals treated with RA+NPs, when compared with animals treated with empty NPs. In a separate group of experiments, we show for the first time that normal HSCs transfected with RA+NPs show superior engraftment at the BM niche than cells without treatment or treated with empty NPs. This is the first time that the activity of RA is tested in terms of long-term hematopoietic reconstitution after transplant using an in situ activation approach without any exogenous priming or genetic conditioning of the transplanted cells. Overall, the approach documented here has the potential to improve consolidation therapy in AML since it allows a dual intervention in the BM niche: to tackle resistant leukemia and improve HSC engraftment at the same time.

Association between disease activity of rheumatoid arthritis and maternal and fetal outcomes in pregnant women: a systematic review and meta-analysis

BackgroundA meta-analysis has compared the pregnancy outcomes between women with and without RA, while the effect of disease severity on pregnancy outcomes within women with RA has not been explored. Therefore, we performed a systematic review and meta-analysis to assess the association between disease activity of RA and pregnancy outcomes.MethodsFour English databases (Pubmed, Embase, Cochrane Library, and Web of Science) and three Chinese databases (China National Knowledge Infrastructure [CNKI], VIP, and Wan Fang) was searched for eligible studies up to August 13, 2023. Cochran’s Q test and the I2 statistic were used to assess the heterogeneity of the included studies. The odds ratio (OR) (for counting data) and weighted mean difference (WMD) (for measurement data) were calculated with 95% confidence intervals (95%CIs) using random-effect model (I2 ≥ 50%) or fixed-effect model (I2 < 50%). Subgroup analysis based on study design and regions was used to explore the sources of heterogeneity. Sensitivity analysis was performed for all outcomes and the publication bias was assessed using Begg’s test.ResultsA total of 41 eligible articles were finally included. RA women had higher odds to suffer from preeclampsia, gestational diabetes, spontaneous abortion, and cesarean delivery (all P < 0.05). The infants born from RA mother showed the higher risk of stillbirth, SGA, LBW, congenital abnormalities, diabetes type 1, and asthma (all P < 0.05). The high disease activity of RA was significantly associated with the higher risk of cesarean delivery (OR: 2.29, 95%CI: 1.02–5.15) and premature delivery (OR: 5.61, 95%CI: 2.20–14.30).ConclusionsHigh disease activity of RA was associated with the high risk of adverse pregnancy outcomes, suggesting that it was important to control disease for RA women with high disease activity who prepared for pregnancy.

A study of the association between Galectin-9 gene (LGALS9) polymorphisms and rheumatoid arthritis in Egyptian patients

BackgroundRheumatoid arthritis (RA) is an incessant synovial inflammation of an autoimmune origin, destroying articular cartilages and bones. Galectins are an evolutionarily conserved family of immune-modulatory animal lectins detected in a number of immune cells like T cells, fibroblasts and macrophages. Galectin 9 (Gal-9) has been the subject of many studies for being linked to regulation of both innate and adaptive immune reactions. The objective of the study was to evaluate the link between the Galectin-9 gene (LGALS9) polymorphisms and the susceptibility of RA in Egyptian patients, as well as, detection of the serum level of Gal-9 in RA and its association with LGALS9 polymorphisms, the activity of RA and radiological damage.MethodsA study of 85 participants; group (I): 60 RA cases and group (II): 25 apparently healthy subjects. RA Disease activity index (DAS-28) and Larsen index score were assessed. LGALS9 gene and serum Gal-9 were investigated.Resultsrs4239242 TT genotype and T allele occurred more frequently in RA cases than controls with a significant difference (P = 0.006; P < 0.001 respectively). Gal-9 level was significantly higher among RA cases than control group (P = 0.017). The Gal-9 level showed negative significant correlations with DAS-28 and Larsen score (P < 0.001).ConclusionRA is strongly linked to genetic alterations in the LGALS9 gene and the single nucleotide polymorphism (SNP) rs4239242 TT genotype in the Egyptian population. RA cases in remission or those with low disease activity had higher levels of serum Gal-9 in comparison to cases with moderate and high disease activity and this would be promising in the future of RA treatment.

A simplified workflow with end-point validation of real-time electrical cell-substrate impedance sensing of retinoic acid stimulated neurogenesis in human SH-SY5Y cells in vitro

ObjectiveRetinoic acid (RA) is known to transition proliferating SH-SY5Y neuroblastoma cells towards functional neurons. However, the activity of RA is restricted due to its photolability where any findings from prolonged time course observations using microscopy may alter outcomes. The aim of the study was to establish a real-time, long-term (9-day) protocol for the screening of differentiation events using Electrical cell-substrate impedance sensing (ECIS).Results and discussionA differentiation baseline for SH-SY5Y cells was established. Cells were seeded and exposed to repeated spikes of RA using the xCELLigence real-time cell analyser single plate (RTCA-SP) for real-time monitoring and identification of differentiation activity over a 9 day period in order to be more representative of differentiation over a prolonged timeline. Specific features associated with differentiation (growth inhibition, neurite outgrowths) were confirmed by end-point analysis.RA-induced growth inhibition and assumed phenotypic changes (i.e. neurite outgrowth) were identified by the xCELLigence analysis and further confirmed by end-point metabolic and phenotypic assays. Change in cellular morphology and neurite outgrowth length was identified by end-point fluorescence detection followed by computational analysis. Based on this it was possible to identify SH-SY5Y phenotypic differentiation with distinct phases observed over 9 days using Electric cell-substrate impedance sensing (ECIS) cell index traces providing a path to application in larger scale neurotrophic factor screening using this scalable technology.

Hypermethylation of Smad7 in CD4+ T cells is associated with the disease activity of rheumatoid arthritis.

Smad7 is protective in a mouse model of rheumatoid arthritis. Here we investigated whether Smad7-expressing CD4+ T cells and the methylation of Smad7 gene in CD4+ T cells contribute to the disease activity of RA in patients. Peripheral CD4+ T cells were collected from 35 healthy controls and 57 RA patients. Smad7 expression by CD4+ T cells were determined and correlated with the clinical parameters of RA including RA score and serum levels of IL-6, CRP, ESR, DAS28-CRP, DAS28-ESR, Swollen joints and Tender joints. Bisulfite sequencing (BSP-seq) was used to determine the DNA methylation in Smad7 promoter (-1000 to +2000) region in CD4+ T cells. In addition, a DNA methylation inhibitor, 5-Azacytidine (5-AzaC), was added to CD4+ T cells to examine the possible role of Smad7 methylation in CD4+ T cell differentiation and functional activity. Compared to the heath controls, Smad7 expression was significantly decreased in CD4+ T cells from RA patients and inversely correlated with the RA activity score and serum levels of IL-6 and CRP. Importantly, loss of Smad7 in CD4+ T cell was associated with the alteration of Th17/Treg balance by increasing Th17 over the Treg population. BSP-seq detected that DNA hypermethylation occurred in the Smad7 promoter region of CD4+ T cells obtained from RA patients. Mechanistically, we found that the DNA hypermethylation in the Smad7 promoter of CD4+ T cells was associated with decreased Smad7 expression in RA patients. This was associated with overreactive DNA methyltransferase (DMNT1) and downregulation of the methyl-CpG binding domain proteins (MBD4). Inhibition of DNA methylation by treating CD4+ T cells from RA patients with 5-AzaC significantly increased Smad7 mRNA expression along with the increased MBD4 but reduced DNMT1 expression, which was associated with the rebalance in the Th17/Treg response. DNA hypermethylation at the Smad7 promoter regions may cause a loss of Smad7 in CD4+ T cells of RA patients, which may contribute to the RA activity by disrupting the Th17/Treg balance.

BDNF enhances electrophysiological activity and excitatory synaptic transmission of RA projection neurons in adult male zebra finches

The singing of songbirds is a complex vocal behavior. It was reported that brain-derived neurotrophic factor (BDNF), a key neurotrophic factor involved in neuronal survival and activity, plays an important role in regulation of songbirds' song behavior. In all song-related nuclei, the electrophysiological activity of robust nucleus of the arcopallium (RA) in the forebrain of songbirds is directly related to birdsong output. Whether BDNF regulates the electrophysiological activity and synaptic transmission of RA causing the change of song behavior need be further explored. In this study, the effects of BDNF on the electrophysiological activity and excitatory synaptic transmission of RA projection neurons (PNs) in adult male zebra finches were investigated using whole-cell patch clamp recordings in vitro. Our results showed that BDNF increased the firing of evoked action potentials in RA PNs and decreased the membrane input resistance and membrane time constant of RA PNs, indicating that BDNF can promote RA PNs excitability by reducing membrane input resistance and membrane time constant. Meanwhile, BDNF increased the frequency rather than amplitude of miniature excitatory postsynaptic currents (mEPSCs) in RA PNs. Moreover, the effects of BDNF on the excitability, intrinsic membrane properties and mEPSCs of RA PNs were blocked by its receptor TrkB antagonist K252a. These results indicate that BDNF via TrkB enhances the excitability and excitatory synaptic transmission of RA PNs in adult male songbirds through presynaptic mechanisms, suggesting a possible cellular mechanism by which BDNF regulates song behavior.

Anti-Carbamylated Protein Antibodies, Tumour Necrosis Factor Alpha and Insulin Resistance in Egyptian Patients With Rheumatoid Arthritis and Systemic Lupus Erythematosus

BackgroundRheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) are autoimmune diseases. Premature atherosclerosis and cardiovascular diseases are two of the most important complications of these diseases. Anti-carbamylated protein antibody (Anti-carP Ab) is one of the antibodies which was studied in RA and SLE. In our study, we studied the relation between anti-carP Ab, disease activity and insulin resistance in RA and SLE patients. Methods90Patients with SLE and RA were enrolled and subjected to history taking, clinical examination and assessment of disease activity using SLE disease activity index 2000 (SLEDAI-2K) scoring for SLE patients and disease activity score 28 (DAS28-ESR) for RA patients. Samples were examined for complete blood count (CBC), creatinine, inflammatory markers, Tumour necrosis factor alpha (TNF alpha), fasting insulin, fasting blood sugar (FBS), lipid profile and anti-carPAb. HOMA-IR (homeostasis model assessment for insulin resistance) was calculated. ResultsPatients with RA and SLE showed higher levels of anti-carPAb in comparison with healthy subjects (8.25ng/ml for RA, 7ng/ml for SLE and 0.6ng/ml for healthy subjects with p value <0.001). There was a positive correlation between anti-carPAb and disease activity of RA (p value <0.001) and a positive correlation between anti-carPAb and TNF alpha in RA. In SLE, there was no correlation of anti-carP Ab with disease activity while, HOMA-IR showed a positive correlation with nephritis (p value 0.04). ConclusionAnti-carP antibody is a marker of disease activity in RA patients and has high specificity for both RA and SLE detection.

Hydroxychloroquine non-availability during COVID-19 pandemic and its relation to anxiety level and disease activity in rheumatoid arthritis and lupus patients: a cross-sectional study

BackgroundDuring COVID-19 disease era, there is an accelerated demand for hydroxychloroquine since it was suggested by some centers as potential therapy for COVID-19 which has led to diminished supplies for patients with rheumatic disease and which carried unexpected risk for disease flare particularly in patients with systemic lupus erythematosus and rheumatoid arthritis. The purpose of the work is to detect the effect of HCQ shortage in patients with RA and SLE on anxiety and disease activity.ResultsA total of 320 patients were divided into two groups: group 1—216RA patients with mean age 45.5 ± 9.59 years, disease duration 43.4 ± 25.6 months with female predominance (62.5%). Group 2—104 SLE patients with mean33.4 ± 7.9 age years, disease duration 52.1 ± 34.6 months with female predominance (85.6%). HCQ shortage occurred in 174 RA patients (80.5%) and 76 lupus patients (73.1%). Despite HCQ shortage, there were no significant change in disease activity of RA (using CDAI) and SLE (using SELENA) p = 0.063 and 0.064 respectively before and after HCQ shortage. Anxiety level was higher in patients who were exposed to HCQ shortage in both groups (SLE p 0.0058 and RA p 0.0044) when we compared them to those without HCQ shortage.ConclusionIn most patients with RA and SLE, the COVID-19 pandemic resulted in a HCQ scarcity, with no effect on disease activity. Anxiety was found to be associated with HCQ shortage in both diseases.

Could IL-1β, IL-6, IFN-γ, and sP-selectin serum levels be considered as objective and quantifiable markers of rheumatoid arthritis severity and activity?

ObjectivesRheumatoid arthritis (RA) is a multisystem, chronic, T-cell-mediated disease in which immunological abnormalities result in symmetrical small joint inflammation, articular destruction due to synovitis, and extra-articular organ involvement. An important role in the pathogenesis of RA is attributed to a combination of genetic factors and environmental triggers. Literature data on the utility of circulating IL-1β, IL-6, IFN-γ, and sP-selectin concentration evaluation depending on the activity and advancement of RA seems to be inconclusive. The aim was a case-control study evaluating IL-1β, IL-6, IFN-γ, and sP-selectin concentrations in 77 RA patients dependent on the Steinbrocker classification as well as the disease activity score with examination of 28 joints (DAS28), and compared to 30 control subjects.Material and methodsSerum IL-1β, IL-6, IFN-γ, and sP-selectin concentrations were measured using ELISA kits.ResultsThe concentrations of all molecules tested, except for IL-1β, were significantly different from the control group. Univariate logistic regression analysis indicated that their levels significantly influenced the likelihood of RA diagnosis. Differences between IL-1β, IL-6, IFN-γ, and sP-selectin concentrations dependent on the disease activity assessed on the basis of the DAS28 score, as well as the severity of the disease assessed based on the Steinbrocker classification, were not observed. IL-6 positively correlated with the DAS28 score.ConclusionsAmong the tested molecules, only IL-6 positively correlated with the DAS28 score. Thus, we postulate that next to C-reactive protein and the erythrocyte sedimentation rate, also IL-6 could be clinically relevant and possibly reflects RA activity. Because recently the IL-6 concentration can be determined in applied in vitro diagnostic tests, it presents us with the possibility to test this protein as a marker of RA activity in routine laboratory practice.

Effects of salinity and particle size on radium desorption from river sediments in the Qinghai-Tibet Plateau

Natural radium isotopes have been widely used to study groundwater discharge in different systems. Therefore, it is of great significance to understand the desorption behavior of radium isotopes on sediments to trace water-land exchange processes. However, there is very limited studies observing the desorption Ra isotopes to lake water of the brine lake. 224Ra desorption experiments with different salinities and particle sizes were carried out by collecting samples of brackish water from Qinghai Lake, brine from Dabuxun Lake and river sediments entering the lakes. The results show that the desorption activity of 224Ra from the river sediments to lake water of Qinghai Lake is 0.2 dpm/g when the salinity is 10.07‰. The maximum desorption activity of 224Ra from river sediments to lake water of Dabuxun Lake is 0.195 dpm/g at a salinity of 40.81‰. A salinity of 41.81‰ and particle size of 16.28 μm are the threshold points affecting the desorption behavior of Ra. When the salinity is less than 40.81‰, the desorption activity of Ra increases linearly with increasing salinity. When the salinity is greater than 40.81‰, the desorption activity of Ra decreases nonlinearly with increasing salinity and tends toward a stable low value. When the particle size is larger than 16.28 μm, the small particle size promotes desorption. The smaller the particle size is, the greater the desorption activity is. When the particle size is less than 16.28 μm, the small particle size inhibits desorption. The smaller the particle size is, the smaller the desorption activity. The co-precipitation of Ra2+ with supersaturated Ca2+, SO42− and other ions may be the main reason for the threshold point of salinity and particle size in Ra desorption process in salt lake system.

Predictive clinical factors in rheumatoid arthritis using disease activity and functional score.

ObjectivesRheumatoid arthritis (RA) is a chronic inflammatory arthritis that may lead to severe joint pain. There are several scores to evaluate the disease activity of RA. This study aimed to evaluate if clinical factors which representing activity scores and health assessment score.Material and methodsThis study was conducted prospectively by including adult patients with RA. Clinical factors and 5 RA disease activity and health assessment scores were evaluated. Each activity score was executed for clinical predictors by using multivariate linear regression analysis.ResultsThere were 33 female adult patients in the study. The average (SD) age was 52.33 (11.11) years, while the duration of RA was 7.65 years. The DAS28 ESR had 1 predictor: RA duration with a coefficient of –0.04. For DAS28 CRP, CDAI, and SDAI scores, body mass index (BMI) and RA duration were independent factors for the scores with negative coefficient values. For the HAQ score, both age and rheumatoid duration were positively associated with the score. The coefficients of both factors were 0.02 and 0.03, respectively.ConclusionsAge, RA duration, and BMI were associated with RA activity and functional score. Body mass index is a potential modifiable factor that may be associated with RA activities.

Impact of Th17/tregfoxp3 Cells Ratio on Rheumatoid Arthritis Patients Receiving Anti Tnf- Therapy-.

In order to determine the correlation between disease activity of RA with the Th17/TregFoxp3 cells ratio in patients undertherapy with Anti-TNF-alpha which is the aim of present study, Ninety-seven patients with RA and healthy control groups were included in this case control study, eighty-four patients divided into four groups; 25 patients receiving only MTX; 18 patients receiving monotherapy (anti- TNF); 26 patients receiving combined therapy (MTX + anti-TNF); 15 patients with RA not receiving any drug (positive control). Other thirteen healthy people considered as negative control were enrolled in this study. Patients with RA were attending Basrah General Hospital, Rheumatology Unite, Biological Therapy Center for receiving anti-TNF therapy. Flowcytometry was used for measuring TregFoxp3 and Th17 markers and DAS-28 score was used for measuring RA disease activity. Anti TNF inhibitors (Infliximab and Etanercept) were measured as well. Other inflammatory and hematological parameters were also measured (ESR, total WBC, Lymphocytes, monocytes and neutrophil counts). Resulted, DAS-28 as disease activity score was significantly correlated with Th17/ TregFoxp3 ratio and with the TH17 cells count. Statistically, Th17/ TregFoxp3 ration was not correlated with BMI, morning stiffness, and duration of the disease. In a Conclusion, Th17/Treg Foxp3 ratio correlated significantly with DAS-28 as RA disease activity. The lower Tregs Foxp3 frequency, the higher the DAS score reflecting higher disease activity. In combined therapy group, disease activity was found lower than other patient groups indicating for the effect of this combination between MTX and anti-TNF. Herein, we demonstrated that the main advantage of this combined therapy in RA patients was the reversion of Th17 cell expan­sion

The relationship of ADAMTSL2 and LRPAP1 gene methylation level with rheumatoid arthritis activity.

The role of epigenetic mechanisms in the pathogenesis and course of RA as well as response to treatment is increasingly being emphasised. The aim of our study was to determine the ADAMTSL2 and LRPAP1 gene methylation levels in RA patients' serum divided according to disease activity and in comparison with the results with the control group. Quantitative real-time methylation-specific PCR was used to analyse the methylation status of the investigated genes. We observed a significant difference in the methylation levels of both the ADAMTSL2 and the LRPAP1 genes in patients with high RA activity compared to patients in remission. ADAMTSL2 methylation status was inversely correlated with DAS28. High disease activity was associated with lower methylation levels than in remission as well as in the control group. Different results were obtained for the methylation levels of the LRPAP1 gene. High disease activity and the control group were characterised by a higher level of LRPAP1 gene methylation compared to patients in remission. We have proven that methylation may play an important role in the course and severity of RA. The level of ADAMTSL2 and LRPAP1 gene methylation might impact the development of disease and reflect the activity of RA.

Machine Learning Based Image Feature Recognition and Clinical Nursing of Children’s Rheumatoid Arthritis-Related Lung Injury

This work was aimed at investigating image feature recognition and clinical nursing of children’s rheumatoid arthritis- (CRA-) related lung injury under maximum correlation minimum redundancy algorithm of machine learning. In this study, 18 children with CRA in the hospital were selected as the rheumatoid group to explore the nursing method, and 18 healthy children were selected as the control group. The maximum correlation minimum redundancy algorithm of machine learning was compared with the information gain algorithm and the Fisher score algorithm and applied in computed tomography (CT) images of 18 CRA children. The classification accuracy of the algorithm in this study (94.52%) was higher than that of the information gain algorithm (88.64%) and Fisher score algorithm (81.24%). CT alveolitis score (2.35 ± 0.72 points) of children from the rheumatoid group was markedly higher than that of the control group (1.21 ± 0.24 points) (t = 2.147 and P &lt; 0.05 ). The nitric oxide level (14.00 ppb) of children from the rheumatoid group increased greatly compared with the control group (10.00 ppb) ( P &lt; 0.05 ). CRA can cause a decline of lung function in children, while the nitric oxide level exhaled by children can assess the activity of RA. In addition, adopting active nursing methods can help children get better.

Prevalence and predictive factors of difficult-to-treat rheumatoid arthritis: the KURAMA cohort

Difficult-to-treat rheumatoid arthritis (D2T RA) is a multifactorial condition in which disease activity of RA persists despite consecutive treatment with biological or targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs). To evaluate the prevalence and predictive risk factors of D2T RA in our institution, a single-center, retrospective study was conducted. Medical records of RA patients, who visited our hospital from 2011 to 2020 and had a follow-up of more than 6 months, were retrospectively reviewed. D2T RA was defined as RA with a disease activity score of 28 – erythrocyte sedimentation rate (DAS28-ESR) of 3.2 or higher at the last visit, despite the use of at least two b/tsDMARDs. A logistic regression model was used to identify risk factors. A total of 672 patients were enrolled. The mean age at disease onset was 52.1 years and females were dominant (76.3%). After a mean follow-up of 46.6 months, patients with D2T RA accounted for 7.9% of overall patients. Multivariate analysis identified high rheumatoid factor (RF) levels (≥156.4 IU/mL, odds ratio [OR]: 1.95), DAS28-ESR (OR: 1.24), and coexisting pulmonary disease (OR: 2.03) as predictive risk factors of D2T RA. In conclusion, high RF levels, high DAS28-ESR, and coexisting pulmonary disease at baseline can predict the development of D2T RA.

Comprehensive Medical System for Early Diagnosis of Rheumatoid Arthritis Based on Autoimmune Antibodies

With the development of understanding of the pathogenesis of rheumatoid arthritis, it has led to the development of new treatment targets and new treatment guidelines. In the past 10 years, the treatment effect of RA patients has improved significantly. Due to the special clinical symptoms of RA, it is very important to have a clear assessment of the overall activity of the patient’s disease and timely adjustment of treatment through joint monitoring of symptoms and laboratory indicators. Clinicians have always relied on clinical manifestations and imaging progress as the key basis for diagnosis. In addition, some markers that reflect disease activity are used to aid the diagnosis of RA, but in other autoimmune diseases, these markers are usually increased. The emergence of specific autoantibodies makes it easier for clinicians to distinguish RA from other autoimmune diseases and osteoarthritis. This study collected a large number of medical records through retrospective analysis, analyzed the epidemiological data, clinical characteristics, and laboratory indicators of RA patients, and analyzed the characteristics and laboratory indicators of patients in the stable disease group and active disease group. In order to further understand the clinical features, disease activity and related factors of RA in our country, and some new biomarkers for early rheumatoid arthritis, for example, the study found that the specificity of RF for the diagnosis of RA was 71.1%, the sensitivity was 73.3%, the combined detection of anti‐CCP antibody + RF increased the specificity to 97.8%, and anti‐CCP the combined diagnosis of antibody+RF + GPI antigen increases the specificity of diagnosis to 100%, which significantly reduces the sensitivity compared with all tests. These autoimmune antibodies can more effectively prevent the progression of the disease in the early diagnosis and treatment of rheumatoid arthritis, achieve long‐term remission, and obtain very effective therapeutic effects.

Prevalence and impact of fibromyalgia on disease activity in a sample of Iraqi patients with rheumatoid arthritis

IntroductionRheumatoid arthritis (RA) is a chronic systemic autoimmune inflammatory disease. Fibromyalgia (FM) is a common diffuse pain syndrome in several rheumatic diseases. This study aimed to find the prevalence of FM in RA patients and to explore its impact on the disease activity of RA patients.Material and methodsA total of 170 RA patients diagnosed according to the 2010 American College of Rheumatology/European League Against Rheumatism classification criteria for RA were enrolled in this cross-sectional study. Age, gender, body mass index, marital status, educational level, occupation, smoking history, disease duration, and medications used were reported. Fibromyalgia was diagnosed by using the fibromyalgia criteria 2016 revision. The disease activity of RA patients was measured by using the clinical disease activity index (CDAI) and disease activity score-28 (DAS28).ResultsThe mean age of fibromyalgia syndrome (FMS) patients was 51.263 ±11.531 years, and for non-FMS patients it was 48.469 ±13.932 years. FM was present in 57 (42.7%) RA patients, among whom the prevalence of FMS among female patients was 36.4%, which was significantly higher than that among male patients, at 6.3% (p = 0.015). FM significantly increased the disease activity measured by DAS28 ( = 0.241, p = 0.001) and by CDAI ( = 0.359, p &lt; 0.001). Female gender and functional class of patients with RA positively increase the disease activity DAS28 ( = 0.142, p = 0.032;  = 0.396, p &gt; 0.001), while only functional class increased the disease activity measured by CDAI ( = 0.373, p &gt; 0.001).ConclusionsThe occurrence of FM in RA patients was common, and there was significant positive correlation between FMS severity and RA disease activity.

Effects of Inactivation of the Periaqueductal Gray on Song Production in Testosterone-Treated Male Canaries (Serinus canaria).

Male canaries (Serinus canaria) display seasonal changes in the motivation to sing which have been found to be dependent on the action of testosterone (T). During the breeding season when T is high, males sing at a higher rate compared with males with low T. The effect of T on song rate is known to be mediated by the medial preoptic nucleus (POM); however, it is unclear how T signaling in POM impacts song production. One potential mechanism is via modulation of dopaminergic input into song control nuclei by the periaqueductal gray (PAG). In order to test the role of PAG in T-mediated song production, we treated male canaries with peripheral T implants and implanted a guide cannula targeting the PAG. Through this guide cannula, we transiently inactivated PAG with injections of the GABAA agonist, muscimol. Each bird received multiple infusions of both muscimol and saline with a 48-h washout period between treatments. The order of injection type was randomized and counterbalanced between individuals. Muscimol infusion into the PAG, but not nearby regions, increased the latency to sing post-injection. These results support the hypothesis that PAG is involved in the production of song, potentially mediating the motivation to sing or alternatively interfering with the pre-motor activity of nucleus RA. Other song features were however not affected.

Study of Serum and Synovial Fluid Levels of Calprotectin of Rheumatoid Arthritis Patients in Correlation with Disease Activity and Severity

inflammatory autoimmune disease with a frequency of 0.5–1.0% between the adult population of developed countries. It is marked by chronic inflammation of synovial tissue and accompianed by damage of the articular cartilage and adjecent bone, leading to substantial disability. Objectives: The aim of this study is to determine serum and synovial fluid levels of calprotectin in rheumatoid arthritis patients and to determine its relation with disease activity and severity. Methodology: This study was carried out on 40 rheumatoid arthritis patients who were admitted to Rheumatology, Rehabilitation and Physical Medicine Outpatient’ clinic and Inpatient Department of Benha University Hospital .Also Thirty age and sex matched( 28 females and 2 males ) apparently healthy volunteers were included in the study as a control group . All patients were assessed by full medical history, clinical examination, functional assessment, laboratory investigations including CBC, ESR ,CRP, liver functions, RF, Anticcp antibody, and Xrays were done to both hands. Serum and synovial levels of calprotectien were measured using the ELISA technique. Results: Serum levels of calprotectien were significantly higher in RA patients than healthy subjects [p&lt;0.001], also there was a highly statistically significant increase in the mean synovial fluid calprotectin levels than mean serum calprotectien levels [p&lt;0.001]. Local and systemic levels of calprotectin correlate with clinical, immunological and instrumental assessments of disease activity and the inflammatory degree of the joint. Conclusion: Calprotectin could be used as a new biomarker for monitoring the disease activity and severity of RA. Larger sets are needed to confirm the diagnostic and prognostic accuracy of calprotectin in RA