Characteristics Of Rheumatoid Arthritis Patients Research Articles

Clinical Characteristics of Rheumatoid Arthritis Patients in Malang: Where Are We Now According to the Treat-to-Target Strategy?

Background: Rheumatoid arthritis (RA) is the most frequent type of systemic inflammatory arthritis.
 Aim: to observe RA patients' clinical characteristics in Malang and assess the adherence of the clinical data to the existing guideline for the treat-to-target (T2T) strategy.
 Methods: This survey included 111 RA patients who visited the Rheumatology Clinic at Saiful Anwar Hospital in Malang. Patient's demographic information, medical and drug history, body mass index (BMI), tender joint count (TJC), swollen joint count (SJC), visual analogue scale (VAS) for pain, erythrocyte sedimentation rate (ESR), anti-cyclic citrullinated protein (CCP), and rheumatoid factor (RF) were all collected. The disease activity score for 28 joints - ESR (DAS28-ESR) was used to assess disease activity and remission.
 Results: The mean duration of the disease was 2.9±1.6 years. Among those patients, four patients (3.6%) got disease remission, and two patients (1.8%) had low activity. Methotrexate (MTX) was given to all subjects for an average of 78.4±11.7 months at a dose of 9.5±2.8 mg/week. Six patients (5.4%) received the DMARD combination of MTX+LEF (4.5%) and MTX+SSZ (0.9%). Most subjects had delayed MTX initiation (mean duration 6.0±2.2 months after the first onset); 77 patients (69.3%) initiated their MTX after >6 months since the first onset. Most subjects got 7.5 mg/weeks (45.0%), while only 11.7% of patients had ≥15 mg/weeks of MTX.
 Conclusion: The remission rate of RA patients in Malang is still low, which can be caused by inadequate adherence to the relevant guidelines and T2T strategy in clinical practices.

Clinical characteristics of rheumatoid arthritis patients with interstitial lung disease: baseline data of a single-center prospective cohort

BackgroundTo introduce a prospective cohort for rheumatoid arthritis (RA) patients with interstitial lung disease (ILD) and to identify their clinical features in comparison with RA patients without ILD.MethodsUsing a multidisciplinary collaborative approach, a single-center cohort for RA patients with ILD (RA-ILD) was established in May 2017, and enrolment data from May 2017 to March 2021 were used to compare the clinical features of RA patients without ILD (RA-non ILD). Multivariable logistic regression analysis was used to identify factors associated with ILD in RA patients.ResultsAmong 148 RA-ILD and 410 RA-non ILD patients, participants in the RA-ILD group were older (65.8 ± 9.9 vs. 58.0 ± 10.4 years, P < 0.001) and included more males (35.8% vs. 14.6%, P < 0.001) than in the RA-non ILD group. The RA-ILD group had a higher proportion of late-onset RA patients (age ≥ 60 years) than in the comparator group (43.9% vs. 14.2%, P < 0.001). Multivariable logistic regression analysis showed that higher age at RA onset (OR 1.056, 95% CI 1.021–1.091), higher body mass index (BMI; OR 1.65, 95% CI 1.036–2.629), smoking history (OR 2.484, 95% CI 1.071–5.764), and oral glucocorticoid use (OR 3.562, 95% CI 2.160–5.874) were associated with ILD in RA patients, whereas methotrexate use was less likely to be associated with ILD (OR 0.253, 95% CI 0.155–0.412).ConclusionsHigher age at RA onset, smoking history, and higher BMI were associated with the presence of ILD among RA patients. Oral glucocorticoids were more frequently used whereas methotrexate was less likely to be used in RA-ILD patients.

Clinical characteristics of rheumatoid arthritis patients complicated with pulmonary nontuberculous mycobacterial disease: A cross-sectional case series study.

Pulmonary nontuberculous mycobacterial disease (pNTM) is a common pulmonary complication of rheumatoid arthritis (RA), but their association has rarely been researched. We aimed to reveal the clinical characteristics of RA with pNTM. Among all the RA patients who visited Tenri hospital from April 2017 to March 2018, we enrolled those fulfilling the 2007 ATS/IDSA diagnostic criteria of pNTM, and sex- and age- matched control group at a ratio of 1:5. Demographic characteristics were compared between the two groups. Among 865 RA patients, 35 (4.0%) patients were complicated with pNTM. RA patients with pNTM had significantly lower BMI and higher rheumatoid factor (RF) and anti-citrullinated protein antibody (ACPA) positivity. Bronchiectasis was the most frequent lesion, followed by clusters of small nodules, patchy consolidation and cavity. Multivariable logistic regression analysis revealed bronchiectasis as a strong independent associated factor of pNTM. Treatment for pNTM was needed in 14 of the 35 (40%) RA patients with pNTM and sputum negative conversion was accomplished in 11 of the 14 cases (78.6%). RA patients with lower BMI, RF/ACPA positivity, and bronchiectasis were associated with pNTM. Treatment for pNTM may attain sputum negative conversion and radiological improvement in patients with RA.

MiR-10 and Its Negative Correlation with Serum IL-35 Concentration and Positive Correlation with STAT5a Expression in Patients with Rheumatoid Arthritis.

Circulating free-cell miRNAs are increasingly important as potential non-invasive biomarkers due to the easy accessibility of clinical materials. Moreover, their epigenetic role may provide insight into the mechanisms of pathogenesis. Nevertheless, these aspects are mostly studied in the area of oncological diseases. Therefore, this research aimed to find the potential association of selected miRNAs in serum with the expression of Th17/Treg transcription factors and clinical features in RA patients. Accordingly, experiments was conducted on rheumatoid arthritis (RA), osteoarthritis (OA) and healthy subjects (HC). Analysis of miRNAs level in serum was performed using LNA miRNA PCR assays. mir-10 was detected only in RA patients. Furthermore, its expression was correlated with IL-35 serum concentration and the mRNA level of STAT5a in whole blood in RA. Additionally, a tendency of the raised level of miR-10 was noted in RA patients with high activity disease. miR-326 was significantly upregulated in RA patients with rheumatoid factor presence. In HC the correlation between miR-26 and IL-21 serum levels and expression of SMAD3 have been found. In OA patients, correlations between miR-126 and HIF1 expression and between miR-146 and RORc have been noted. The differential association of transcription factor expression with serum miRNA levels may be important in the diagnosis and progression of RA and OA.

Inflammatory and bone biomarkers/composites as a predictive tool for clinical characteristics of rheumatoid arthritis patients

Rheumatoid arthritis (RA) is related to alterations in different inflammatory and connective tissue biomarkers. The diagnostic values and the factors affecting these biomarkers are conflicting. In the present study, a bone-related composite (B-composite), made from the z-score of stromelysin-1 (MMP3), colony-stimulating factor 2 (CSF2), and osteopontin (OPN), and I-composite, reflecting immune activation, made from the z-score of tumor necrosis factor-α (TNFα), interferon-γ (INFγ), and vascular endothelial growth factor-A (VEGF) were examined in RA patients. The biomarkers were measured by ELISA technique in 102 RA patients and 58 age-matched healthy control subjects. Serum MMP3, TNFα, IFNγ, and CSF2 showed significant elevation in RA patients. Multivariate general linear model (GLM) analysis revealed a significant high effect of diagnosis on biomarkers' level (partial η2 = 0.415). Duration of disease is significantly associated with VEGF, OPN, and B-composite and negatively correlated with TNFα. B-composite is significantly associated with CRP. A significant fraction of the DAS28 score variance can be explained by the regression on zlnINFγ. The variance in the CRP was explained by zlnOPN and B-composite. More than half of anti-citrullinated protein antibodies (ACPA) variation can be explained by the regression on serum MMP3 and I-composite. The top 3 sensitive predictors for RA disease are INFγ, MMP3, and TNFα. B-composite is associated with the duration of disease and CRP. At the same time, I-composite is negatively associated with the ACPA level. The biomarker composites have potential use as RA disease characteristic biomarkers.

Inflammatory and bone biomarkers/composites as a predictive tool for clinical characteristics of rheumatoid arthritis patients

Rheumatoid arthritis (RA) is related to alterations in different inflammatory and connective tissue biomarkers. The diagnostic values and the factors affecting these biomarkers are conflicting. In the present study, a bone-related composite (B-composite), made from the z-score of stromelysin-1 (MMP3), colony-stimulating factor 2 (CSF2), and osteopontin (OPN), and I-composite, reflecting immune activation, made from the z-score of tumor necrosis factor-α (TNFα), interferon-γ (INFγ), and vascular endothelial growth factor-A (VEGF) were examined in RA patients. The biomarkers were measured by ELISA technique in 102 RA patients and 58 age-matched healthy control subjects. Serum MMP3, TNFα, IFNγ, and CSF2 showed significant elevation in RA patients. Multivariate general linear model (GLM) analysis revealed a significant high effect of diagnosis on biomarkers' level (partial η2 = 0.415). Duration of disease is significantly associated with VEGF, OPN, and B-composite and negatively correlated with TNFα. B-composite is significantly associated with CRP. A significant fraction of the DAS28 score variance can be explained by the regression on zlnINFγ. The variance in the CRP was explained by zlnOPN and B-composite. More than half of anti-citrullinated protein antibodies (ACPA) variation can be explained by the regression on serum MMP3 and I-composite. The top 3 sensitive predictors for RA disease are INFγ, MMP3, and TNFα. B-composite is associated with the duration of disease and CRP. At the same time, I-composite is negatively associated with the ACPA level. The biomarker composites have potential use as RA disease characteristic biomarkers.

Clinical Characteristics of Rheumatoid Arthritis Patients with Interstitial Lung Disease: Baseline Data of a Single Center Prospective Cohort

Clinical Characteristics of Rheumatoid Arthritis Patients with Interstitial Lung Disease: Baseline Data of a Single Center Prospective Cohort

Demographic and Clinical Characteristics of Patients with Sustained and Switching Treatments Using Biological and Targeted Synthetic Disease-Modifying Antirheumatic Drugs: A Multicenter, Observational Cross-Sectional Study for Rheumatoid Arthritis.

IntroductionRheumatoid arthritis is a chronic inflammatory disease with different disease activity grades. Several registries have been designed to determine the appropriate regimens of disease-modifying antirheumatic drugs to obtain sustained clinical remission. We examined epidemiological and clinical characteristics of rheumatoid arthritis patients using a clinical registry database (BioSTaR) and analyzed the differences in patients with sustained and switched therapies.MethodsA multicenter, observational cross-sectional study for rheumatoid arthritis was performed between February 2019 and September 2020 using the BioStaR-RA registry.Demographic and clinical characteristics were prospectively recorded into a specifically designed electronic database. The patients were divided into three groups due to the heterogeneity of the study cohort. Patients were grouped as Group I (Initial; within the first 6 months of treatment with biological/targeted synthetic drugs), Group ST (Sustained Treatment; any first drug lasting for at least 6 months without any change), and Group S (Switch; any switching to another drug). Comparative analysis was performed between sustained treatment (Group ST) and drug switching (Group S) groups.ResultsThe study included a total of 565 patients. The mean age was 53.7 ± 12.8 years, and the majority were female (80.4%). There were 104, 267, and 194 patients in Groups I, ST, and S, respectively. Erosive arthritis and hematological extra-articular involvement were more frequently detected in Group S than Group ST (p = 0.009 and p = 0.001). The patients in Group S had significantly higher disease activity scores (DAS28-CRP, CDAI, and SDAI) (p = 0.025, p = 0.010, and p = 0.003). There were significantly more patients with moderate disease activity in Group S (p < 0.05).ConclusionsThe groups with sustained treatment and switching included patients with different disease activity status, although higher disease activity was determined in switchers. Overall, moderate disease activity and remission were the most common disease activity levels. Lower disease activity scores, lower hematologic manifestations, better functional status, and lesser radiographic damage are associated with sustained treatment.

Handgrip Strength Features in Rheumatoid Arthritis Patients Assessed Using an Innovative Cylindrical-Shaped Device: Relationships With Demographic, Anthropometric and Clinical Variables

To investigate the relationship between handgrip strength (HGs) features, evaluated with an innovative cylindrical-shaped grip device, and demographic, anthropometric and clinical variables, in patients with rheumatoid arthritis (RA). Consecutive RA patients were prospectively enrolled for this cross-sectional study. For each patient were collected demographic, anthropometric, clinical data related to disease activity. HGs was assessed in terms of area under the force–time curve (AUC-FeT), peak grip force and time to reach the curve plateau. The correlations between the variables were studied with the Spearman’s rho correlation coefficient. The receiver operating characteristic (ROC) curve analysis was used to test the discriminant accuracy of HGs features in identifying patients in moderate/high disease activity. A multivariate analysis was performed to estimate the contribution of covariates on the AUC-FeT. A significant correlation was found among AUC-FeT, age, Simplified Disease Activity Index (SDAI), Ultrasound-Clinical Arthritis Activity (US-CLARA) (all at p < 0.0001), and body mass index (BMI) (p = 0.0001). Any correlation was found between HGs and radiographic damage. The discriminatory power of AUC-FeT was good [area under-ROC curve = 0.810 (95% CI 0.746–0.864)]. Variables significantly associated with AUC-FeT in multivariate analysis were age (p = 0.0006), BMI (p = 0.012), gender (p = 0.004), SDAI (p = 0.047) and US-CLARA (p = 0.023). HGs is negatively influenced by demographic (gender and age), anthropometric (BMI), and disease activity variables (SDAI and US-CLARA). These findings highlight the role of HGs in RA patients' functional impairment and disability.

Diagnostic value of serum connective tissue growth factor in rheumatoid arthritis.

Serum connective tissue growth factor (CTGF) is reported to be a potential biomarker for the diagnosis of rheumatoid arthritis (RA). Our study aimed to investigate the prevalence of serum CTGF and the association with the clinical features in RA patients. Serum samples were obtained from 180 patients with RA, 168 patients with other rheumatic diseases, including 43 systemic lupus erythematosus (SLE), 34 osteoarthritis (OA), 17 primary Sjögren's syndrome (pSS), 20 ankylosing spondylitis (AS), 23 psoriatic arthritis (PsA), 6 reactive arthritis (ReA), 20 systemic sclerosis (SSc), and 5 systemic vasculitis (SV), and 64 healthy individuals. The clinical and laboratory data of patients with RA were collected. Levels of CTGF in serum were measured by enzyme linked immunosorbent assay (ELISA). Associations between CTGF and the clinical features of RA were analyzed. The positivity of serum CTGF among RA patients (33.89%) was significantly higher than those of SLE (9.3%), OA (0%), AS (0%), pSS (0%), PsA (0%), ReA (0%), SSc (5%), SV (0%), and healthy controls (4.69%) (p< 0.0001). The mean concentration of serum CTGF in RA was also significantly higher than those in other rheumatic diseases and healthy controls (p< 0.001). At the cut-off value of 263.30pg/ml, the sensitivity, specificity, positive predictive value, and negative predictive value of serum CTGF for RA were 33.89%, 96.55%, 88.41%, and 55.45%, respectively. Anti-cyclic citrullinated peptide (anti-CCP) antibody (p< 0.001), rheumatoid factor (RF) (p < 0.001), IgG (p= 0.025), and IgM (p= 0.004) in CTGF-positive patients were higher than those in CTGF-negative patients. Besides, the positive rate of serum CTGF was significantly higher in RA patients with interstitial lung disease (ILD) (53.1%, 26/49) than RA-non-ILD patients (26.7%, 35/131, p= 0.003). Serum CTGF, as a novel biomarker, has certain diagnostic value for RA. Further studies are necessary to get more knowledge for the diagnostic performance of CTGF in RA. KEY POINTS: • Serum CTGF, as a novel biomarker, has certain diagnostic value for RA, the sensitivity, specificity, positive predictive value, and negative predictive value of which were 33.89%, 96.55%, 88.41%, and 55.45%, respectively. • Serum CTGF was more common to be positive in RA-ILD patients (53.1%, 26/49) than RA-non-ILD patients (26.7%, 35/131, p= 0.003).

Clinical characteristics of rheumatoid arthritis patients with peripheral neuropathy and potential related risk factors.

To investigate potential risk factors of peripheral neuropathy (PN) in rheumatoid arthritis patients (RA). Eighty-eight patients with RA were enrolled in this study, including patients with PN (n = 44; 28 patients with multiple nerves (MN) involvement and 16 patients with single nerve (SN) involvement) and without (n = 44) peripheral neuropathy were enrolled. Their clinical features were comprehensively collected including symptoms/signs, lab results, electromyogram data. T test or chi-squared test and further binary regression analysis were used to explore risk factors based on analyzing these clinical features. There was no difference as regards patients' age (59.50 ± 8.11 vs 58.68 ± 11.44years), gender ratio (female/male, 29:15 vs 29:15), and disease duration (6.34 ± 7.87 vs 8.13 ± 9.52months) between patients with and without PN. RA patients with PN had lower total protein (61.13 ± 7.06 vs 66.06 ± 6.44g/L), anti-CCP levels (239.13 ± 203.77 vs 361.41 ± 168.09U/ml) compared with control patients, while patients with MN had higher inflammatory parameters (white blood cells, platelet, C-reactive protein (CRP), erythrocyte sedimentation rate, rheumatoid factor) than patients with SN (p < 0.05). Low total protein (< 63g/L, 30/44 vs. 12/44) and anti-CCP (< 285.7U/ml, 27/44 vs. 11/44) were risk factors for patients with PN, while CRP (> 6mg/L, 26/28 vs. 6/16) and PLT (> 243 × 109/L, 25/28 vs.5/16) were related to the development of MN. RA patients with PN, especially MN can present various clinical symptoms, which will aggravate patients' anxiety and depression status. The increase of blood platelet, and CRP levels and decrease of blood albumin are probable risk factors for PN in RA patients.

A study on characteristics of rheumatoid arthritis patients achieving remission in depression with 6 months of bDMARDs treatment.

To investigate the relationship between baseline factors and depression remission after a 6-month biological disease-modifying antirheumatic drugs (bDMARDs) treatment in rheumatoid arthritis (RA) patients. The study was conducted in 152 RA patients treated with bDMARDs. The following patient's characteristics were studied: gender, age, disease duration, baseline prednisolone dosage, and serum matrix metalloproteinase3 (MMP3) levels. For assessment, we used the simple disease activity index (SDAI) for RA disease activity, Health Assessment Questionnaire Disability Index (HAQ-DI) for activities of daily living (ADL), Short Form-36 for nonspecific health-related quality of life (QOL), and Hamilton Depression Rating Scale (HAM-D) scores for the depression status. Depressed remission was clarified using HAM-D ≤7 after 6 months of treatment. The patients were divided into two groups according to the presence or absence of depression, and a retrospective study was conducted. Based on binominal logistic analyses, RA patients' with depression remission (n=124) compared to those without depression remission (n=28) had a younger age (p=0.0045, odd ratio: 0.94, 95% confidence interval [CI]:0.8-0.98), female sex (p=0.021, odd ratio:0.21, 95% CI:0.054-0.79), and lower HAM-D scores (p=0.0073, odd ratio:0.85, 95% CI:0.76-0.96) CONCLUSION: It was proposed that RA patients who are females, younger in age, and have lower depressed scores at baseline can achieve a depression remission status with the bDMARDs treatment.

Characteristics of rheumatoid arthritis patients undergoing reverse shoulder arthroplasty.

The risks and complication profile of reverse total shoulder arthroplasty (RSA) in rheumatoid arthritis (RA) patients has yet to be clearly defined as most studies have small cohorts. Using a large inpatient database, the purpose on our study was to determine the overall demographics, hospitalization characteristics, and early complication rates in rheumatoid patients and compared these to rotator-cuff arthropathy patients without RA undergoing RSA. Utilizing United States Nationwide Inpatient Sample from 2010 to 2013, we evaluated a total of 919 RA RSA and compared them to 8097 patients without RA undergoing RSA. The outcomes included demographic characteristics like age, race, sex, Deyo comorbidity score, perioperative complications, and mean length-of-stay. The RA cohort had 81% females versus 60% in the comparison cohort. This cohort was younger (p=0.006) and had longer hospitalization time (p=0.001), but the total inpatient costs were not significantly different (p=0.15). In regards to Deyo index, rheumatoid patients had significantly higher scores (p<0.001). The inpatient complication rates for infection (p=0.9), nerve injury (p=0.9), and instability (p=0.19) were similar, but the RA cohort had more prosthetic-related (p=0.001) and greater tuberosity-related (p=0.008) complications. The mortality rates were also similar (p=0.625). In RSA for RA patients, surgeons should be mindful of preoperative risk factors and demographic characteristics that may influence their outcomes. Caution should specifically be paid to the possibility of longer hospitalization time and increased incidence of certain complications, including intraoperative fracture, when compared to non-rheumatoid patients. Close collaboration between rheumatologists, surgeons, and primary care physicians is a must for optimizing and managing these patients.

Association of IL17A and IL17F genes with rheumatoid arthritis disease and the impact of genetic polymorphisms on response to treatment

BackgroundPrevious studies have reported an association between polymorphisms in Il17A and IL17F genes and the prevalence of rheumatoid arthritis (RA) in Caucasian populations. The aim of the current study was to investigate that polymorphisms in both genes may affect RA susceptibility in the Tunisian population and to study the relation between serum IL-17 levels and synovial fluid (SF) levels and risk in RA patients. We suggested also that these polymorphisms may influence response to treatment in Tunisian RA patients. MethodsWe studied IL17A-152 G/A (rs2275913), IL17F 7488 A/G (rs763780) and IL17F 7383 A/G polymorphisms in a Tunisian population. The genotypic and allelic distributions of IL-17A and IL-17F genes polymorphisms were analyzed by Polymerase Chain-Reaction (PCR) and Restriction Fragment Length Polymorphism (RFLP) for 108 patients and 202 healthy controls.IL-17 levels were measured in synovial fluid (SF) and in serum of both 108 patients and 47 controls (pg/ml) using enzyme-linked immunosorbent assay (ELISA) technique. ResultsOur results indicated that IL17F 7488 A/G and IL17F 7383 A/G polymorphisms were significantly associated with RA risk in the whole population. However, IL17A-152 G/A polymorphism did not show any significant association with RA prevalence in the Tunisian population. Stratification according to demographic and clinical features revealed differential significant associations of IL17A-152 G/A, IL17F 7488 A/G and IL17F 7383 A/G polymorphisms within different subgroups and subtypes of clinical-pathologic features in RA patients. IL17A-152 G/A polymorphism was associated with an enhanced response to biologic and MTX treatment. IL17F 7383 A/G polymorphism was associated with an enhanced response to biologic treatment. The IL17F 7488 A/G polymorphism decreased significantly good response to biologic treatment, but enhanced response to MTX treatment. The expression of IL-17 in serum and synovial fluid (SF) in RA patients was significantly higher than that observed in healthy controls (P<0.0001) and their levels depend on RA severity. The mean IL-17 levels in the anti-TNF α treated patients decreased significantly at 0 week, 14 weeks and 30 weeks (P=0.0032 and P<0.0001, respectively). ConclusionsOur results confirmed IL17A and IL17F as potential candidate genes involved in RA. They play pivoting roles in the susceptibility and in clinical features of RA disease. Responses to RA treatments are differently conditioned by polymorphisms in IL17A and IL17F genes.

Clinical Characteristics of Rheumatoid Arthritis Patients Achieving Functional Remission with Six Months of Biological DMARDs Treatment.

Objective Although previous studies have reported the prognostic factors for functional remission, no reports have cited the predictive factors. Our aim was to study the predictive factors for functional remission, which is a treatment goal in rheumatoid arthritis (RA), after receiving biological disease-modifying antirheumatic drugs (bDMARDs) treatment for six months. Methods The study consisted of 333 RA patients treated with bDMARDs for six months. The following patient characteristics were investigated: age, gender, disease duration, type of bDMARDs, baseline steroid and methotrexate dosage, and levels of serum rheumatoid factor, matrix metalloprotease, anti-cyclic citrullinated peptides antibody, tumor necrosis factor-α, and interleukin-6. In our evaluation, we used the Simplified Disease Activity Index (SDAI) for RA disease activity, health assessment questionnaire disability index (HAQ-DI) for activity of daily living, Short Form (SF)-36 for quality of life, and Hamilton Depression Rating Scale (HAM-D) or Self-rating Depression Scale (SDS) to determine the patients' depression status. The subjects were divided into two groups: patients with HAQ-DI≤0.5 and HAQ-DI>0.5 at 6 months. Results A univariate analysis comparing a group of RA patients without functional remission (n=68) showed that the patients with functional remission (n=164) had the following in common compared with those without remission: younger age, shorter disease duration, lower baseline steroid dosage, lower SDAI, lower HAQ-DI, higher SF-36, and lower HAM-D. Only lower HAQ-DI scores and “mental health” score on the SF-36 were detected using a logistic regression analysis. Conclusion These findings suggested that RA patients with lower HAQ-DI and lower depression scores at baseline were more likely to achieve functional remission using bDMARDs treatment than those without these variables.

Vitamin K homologs as potential biomarkers for disease activity in patients with rheumatoid arthritis

The aim of this study was to evaluate the possible role of vitamin K homologs as potential biomarkers for disease activity in patients with rheumatoid arthritis (RA). In this study, 42 patients with RA and 40 healthy controls were enrolled. Serum levels of vitamin K homologs were measured using a high-performance liquid chromatography-fluorescence method. Different biochemical and clinical markers for disease activity were measured and correlated with serum levels of vitamin K homologs. There were no significant differences between RA patients and healthy subjects in demographic data. Patients with RA showed significantly higher levels of biochemical markers compared with healthy subjects (p<0.001). These markers included rheumatoid factor (RF), anticyclic citrullinated polypeptide (anti-CCP), undercarboxylated osteocalcin (ucOC), matrix metalloproteinase (MMP-3), C-reactive protein (CRP), and disease activity score assessing 28 joints with erythrocyte sedimentation rate (DAS28-ESR). In addition, serum levels of vitamin K homologs were reduced in RA patients, and the levels of menaquinone-4 (MK-4) and menaquinone-7 (MK-7) were moderately to strongly inversely correlated with the clinical articular features in RA patients, whereas phylloquinone (PK) levels were weakly correlated. Serum levels of MK-4, MK-7 and PK were strongly inversely correlated with ucOC, MMP-3 and DAS28-ESR in RA patients. In contrast, serum levels of MK-4, MK-7 and PK were weakly correlated with CRP, RF and anti-CCP. These results suggest that serum levels of vitamin K homologs may be considered as potential biomarkers for disease activity. In addition, the results confirm the role of vitamin K deficiency in the etiology of RA.

Association of XRCC1 and OGG1 DNA repair gene polymorphisms with rheumatoid arthritis in Egyptian patients

Rheumatoid arthritis (RA) is a chronic autoimmune disease and can lead to deformities and severe disabilities, due to irreversible damage of tendons, joints, and bones. Previous studies indicated that the DNA repair system was involved in the pathology of RA. In this study, we investigated the association of two XRCC1 (X-ray repair cross-complementing group 1) (rs25487 and rs25489) gene polymorphisms and two OGG1 (8-oxoguanine glycosylase 1) gene polymorphisms (rs159153 and rs3219008) with the susceptibility to RA in 320 Egyptians individuals (160 RA patients and 160 controls). Genotyping was performed using restriction fragment length polymorphism polymerase chain reaction. We found an association between variant XRCC1 (rs25487 and rs25489) genotype polymorphisms, OGG1 (rs3219008) genotype polymorphism, and RA disease susceptibility. Moreover, the presence of the Gln/Gln, Arg/His, and His/His genotypes of XRCC1 was significantly more likely to have bone erosion and extra-articular features in RA patients. Further, patient's carrying the OGG1 A/G and G/G genotypes more likely to have bone erosion. However, the AA genotype and A allele were significantly more likely to have extra-articular features. Also, there were no significant associations between C/T OGG1 gene polymorphism and RA susceptibility, bone erosion, and extra-articular features occurrence in RA patients. We concluded that the XRCC1-Arg/Gln, XRCC1-Arg/His, and OGG1 A/G polymorphism have a role in the development of rheumatoid arthritis disease. Also, these variant are associated with the severity of RA.

Клинико-лабораторные и инструментальные особенности больных ревматоидным артритом с компьютерно-томографическим симптомом интерстициального поражения легких «матовое стекло»

Rheumatoid arthritis is an inflammatory rheumatic disease with unknown etiology characterized by symmetric, chronic and erosive arthritis (synovitis) of the peripheral joints and systemic inflammatory involvement of the viscera. Lung pathology, including interstitial lung disease, is one of the common extra-articular manifestations at the гheumatoid arthritis. The leading diagnosis method of interstitial lung disease is a computed tomography high resolution, which allows to identifying interstitial lung changes in 70% of the cases. The study of prognosis in patients with rheumatoid arthritis interstitial lung disease has been the subject of several studies in the past decade. In most studies it was stated that the average life expectancy from diagnosis is around 3 years. This work is devoted to study of interstitial lung disease as one of the most frequent extra-articular ma-nifestations of rheumatoid arthritis. The authors defined the significance of computed tomography high resolu-tion for the diagnosis of pulmonary interstitial lung changes at rheumatoid arthritis. They give comparative clini-cal and immunological, instrumental characteristics of rheumatoid arthritis patients with interstitial lung disease and without it. The role of smoking and positivity of anti-cyclic citrullinated peptide (anti-CCP) according to antibodies are determined as risk factors of interstitial lung disease development in patients with rheumatoid arthritis. The interrelation of the X-ray tomography symptom of interstitial lung disease &amp;#34;ground glass opacity&amp;#34; with the activity and duration of rheumatoid arthritis is revealed. &amp;#34;Ground glass opacity&amp;#34; symptom is associated with high index of DAS28 in patients with rheumatoid arthritis with interstitial lung disease.

Lifestyle characteristics of rheumatoid arthritis patients with sarcopenia

Lifestyle characteristics of rheumatoid arthritis patients with sarcopenia

Dopamine receptor DR2 expression in B cells is negatively correlated with disease activity in rheumatoid arthritis patients

ObjectiveDopamine receptor (DR) signaling is involved in the pathogenesis of autoimmune diseases. We aimed to measure the expression levels of DR1-5 on B cells from patients with rheumatoid arthritis (RA) and to analyze the relationship between DRs and clinical manifestations, inflammatory biomarkers, functional status and disease activity. MethodsA total of 29 patients with RA, 12 healthy donors and 12 patients with osteoarthritis (OA) were recruited in this study. Flow cytometry was used to measure the levels of DR1-5 expressed on B cells. The relationships between B cell DR expressions and clinical features in RA patients were analyzed using the Spearman correlation test. ResultsThe expression levels of B cell DR1-5 in both the RA and OA groups were lower than those in healthy controls. After 3 months of medication, all five receptors were elevated in RA patients, with DR2 and DR3 being significantly increased from the baseline. DR2 expression on B cells was negatively correlated with inflammatory biomarkers and disease activity. ConclusionRA patients had lower expression level of DR2 on B cells compared to the healthy controls, and the level of DR2 negatively correlated with the disease activity. DR2 and DR3 might be novel predictors of patient responses to disease modifying antirheumatic drug therapy.