Inflammatory Articular Diseases Research Articles

A Real-World Analysis on Weather Variation Disease Activity and Patient Reported Outcomes in Psoriatic Arthritis.

Anecdotally, patients with inflammatory articular diseases (IAD) such as psoriatic arthritis (PsA) report weather changes in their symptoms. The objective is to investigate the correlation between weather variation, disease activity (DA) and patients reported outcomes (PROs) in patients with PsA. Hourly measurements of temperature, relative humidity, and pressure were obtained from 2015 to 2020 from Montreal (Environment Canada) and were matched with DA and PROs of PsA patients enrolled in RHUMADATA™. The difference in mean DA and PROs were examined between winter and summer. Pearson Correlation Coefficients were calculated between clinical profile and weather measurements. Among PsA patients, 2665 PROs were collected for a total of 858 patients. The CDAI (p=0.001) and SDAI (p<0.001) were lower in winter. Summer revealed positive correlations between humidity and symptoms (PtGA, fatigue, pain, CRP, BASDAI, BASFI) while negative correlations between temperature and HAQ-DI were reported. In winter, positive correlations were observed between temperature, fatigue, and pain. This is the first study to investigate weather variations through subjective and objective PROs matched with PsA patients. Significant differences in clinical profile were evident between winter and summer and their correlation with weather measurements. However, these distinctions lack clinical significance, which suggests their small impact on PsA patients.

The role of boron in the functioning of the osteoarticular system

Background: Boron was classified by the World Health Organization as ‘possible essential elements for human health’. It can be found in different forms in the environment, has beneficial effects on bones and its deprivation can impair calcium and magnesium metabolism and bone development, their health and maintenance. Dietary boron supplementation can help prevent and manage degenerative and inflammatory bones and articular diseases, such as arthritis, osteoarthritis, rheumatoid arthritis and osteoporosis. Relevant articles were identified in PubMed, Google Scholar, ProQuest, and Scopus databases published until June 2021, describing the role of boron in the functioning of the osteoarticular system. Conclusions: From organic and inorganic boron forms that can enter the human body, organic plant based boron compounds are highly bioavailable. In the functioning of the osteoarticular system boron acts by regulation of calcium and magnesium metabolism, enhancing the vitamin D activation process and influencing serum steroid hormone levels. A boron intake equal to or higher than 3 mg per day can help prevent/or correct arthritis, osteoporosis and osteoarthritis. Calcium fructoborate can reduce pain, joint discomfort and increase endogenous vitamin D level in patients with osteoarthritis. Boron may play a role in pathophysiology of rheumatoid arthritis and its severity and a supplementation with boron element may be useful.

Incidence and case fatality rate of COVID-19 in patients with inflammatory articular diseases.

To describe the incidence and fatality of coronavirus disease 2019 (COVID-19) and identify risk factors to fatality in patients with inflammatory articular diseases (IAD). This is a cross-sectional observational study of IAD patients and COVID-19 with controls matched for age, sex, and RT-PCR. A control group was used to compare the cumulative incidence (CI) and case fatality rate (CFR). The main outcomes of the study were CI and CFR. Other variables included comorbidities, treatments, and characteristics of the COVID-19. Multiple logistic regression analysis was performed to investigate risk factors for fatality in patients with IAD. Of the 1537 patients who fulfilled the inclusion criteria, 23/1537 (1.49%) had IAD 13 (0.8%) had rheumatoid arthritis (RA), 5 psoriatic arthritis (PsA) (0.3%) and 5 axial spondyloarthritis (0.3%). There were no significant differences in CI of COVID-19 and CFR in patients with IAD compared with COVID-19 patients without IAD. In RT-PCR positive patients, the CI of COVID-19 in PsA and AS was higher. Of the 23 IAD patients, 2 RA patients (8.6%) died. The patients did no show characteristics of the COVID-19 disease different from the population. In multivariate analysis, the factor associated with fatality in patients with IAD was older age (OR [95% CI], 1.1 [1.0-1.2]). COVID-19 CI, fatality rate and other features do not seem to be increased in IAD patients. Older age was associated with fatality in patients with IAD.

Performance of the new 2012 EULAR/ACR classification criteria for polymyalgia rheumatica: comparison with the previous criteria in a single-centre study

ObjectiveTo compare the performance of published classification/diagnostic criteria for polymyalgia rheumatica (PMR), including the new 2012 European League Against Rheumatism (EULAR)/American College of Rheumatology (ACR) criteria, in a single-centre study.MethodsWe...

The bisphosponates: chemical characteristics, skeletal biological effects and extra-skeletal effects

Bisphosphonates (BP) are pharmacological compounds whose the most important biological effect is the reduction of bone remodelling, explaining the reason for their use in pathological conditions characterised by an increased bone resorption, such as osteoporosis, Paget's disease, malign hypercalcemia during myeloma and osteolytic bone metastasis. Nevertheless there are several experimental evidence that BP possess different extra-skeletal biological effects, ranging from analgesic properties, anti-inflammatory and pro-inflammatory effects and the capacity of modifying the biological activity of cells other than osteoblasts and osteoclasts, such as the immune system cells and other cells of mesenchymal origin. Several data report the beneficial effects of BP as anti-inflammatory agents in different inflammatory chronic articular diseases, which make BP suitable drugs for treatment of pathologies other than bone disease.

Activity of plasminogen activators and plasmin inhibitors in the joint capsule in various articular diseases (author's transl)

The activity of plasminogen activators and plasmin inhibitors in articular capsules of the hip and knee joints in rheumatoid arthritis, chronic traumatic inflammation, arthrosis and aseptic loosening of prosthesis was determined histochemically and correlated with the degree of mobility in osteoarthrosis of the hip. Microscopically unchanged articular capsules were employed as reference sites. In inflammatory articular diseases the plasminogen activator activity was significantly reduced, whereas it remained unchanged in arthrosis and necrosis of the heas of the femur, and significantly enhanced in aseptic loosening of prosthesis. Plasmin inhibitor activity was established in joint capsules with inflammatory changes only; in case of rheumatic inflammation, it was higher than with traumatic inflammation. In osteoarthrosis of the hip there is a positive correlation between joint mobility and plasminogen activator activity. The results point towards involvement of the local fibrinolytic system in joint diseases; however, no definite statement can be made with regard to possible causative linkups.

Endothelin-1 induces extracellular matrix degradation via matrix metalloproteinases induction in human osteosarcoma cells

Extracellular matrix (ECM) degradation plays an important part in many musculoskeletal pathologies including arthritis and bone tumour. Matrix metalloproteases (MMPs) degrade the ECM and are thus important in the development of these pathologies. Furthermore, recent evidence suggest the existence of interactions between endothelin-1 (ET-1) and MMPs. This study aimed at determining the effect of ET-1, Big ET-1 (the immediate precursor of ET-1) and IL-1β (a proinflammatory cytokine that induces MMP synthesis) on MMPs in order to determine the mechanism of action of these factors in chondrosarcoma and osteosarcoma cells. We have also studied the effects of the NF-κB inhibitor and the inhibitor of furine convertase that is involved in Big ET-1 maturation. Here we characterized the MMPs, ET-1 and ET-1 receptors in SW1353 and MG63 cells by western blot, zymography, northern blot, immunohistochemistry, RT-PCR, and in situ hybridization. First, we showed that ET-1 and its two receptors (ETA and ETB) areconstitutively expressed in osteosarcoma and chondrosarcoma cells. Then, we demonstrated that both ET-1 and Big ET-1 markedly induce synthesis and enzymatic activity of MMP-2 and that enzymatic activity is significantly increased when compared with MMP-9. Furthermore, inhibition of NF-κB activation (by pyrrolidinecarbodithioic acid) blocked MMP-2 production and activity, indicating the involvement of NF-κB. Similarly, inhibition of Big ET-1 maturation by the furin convertase inhibitor abrogated MMP-2 synthesis. ET-1 and as its immediate precursor Big ET-1 can be considered as autocrine factors contributing to the activation of MMPs, thus favouring ECM degradation. MMPs, particularly MMP-9 and MMP-2, are hyperexpressed in chondrosarcoma and osteosarcoma cells. Their production is stimulated by ET-1, Big ET-1 and IL-1β while it is diminished when the NF-κB and furine convertase pathways are inhibited. Our study provides new insights on the catabolic role of ET-1 in ECM degradation. Thus ET-1 could be involved in diseases where ECM destruction is caused by an excess of MMP, including bone tumour, degenerative and inflammatory articular diseases. In an attempt to diminish this degradation, it would be beneficial to propose a double inhibition of both ET-1 receptors and MMPs.

Etanercept (Enbrel): update on therapeutic use

Tumour necrosis factor (TNF) is an important inflammatory disease mediator in a wide spectrum of articular diseases, including adult and juvenile rheumatoid arthritis (RA, JRA). Etanercept (Enbrel), approved in the...

Augmented plasma and tissue kallikrein like activity in synovial fluid of patients with inflammatory articular diseases

We studied some of the components of the kininogen-kallikrein-kinin system, simultaneously, in plasma and synovial effusions of patients with inflammatory articular diseases. Plasma and tissue kallikrein like activity and kininogen levels were evaluated. Active plasma and tissue kallikreins in plasma and synovial fluid were detected by their amidase activity upon specific chromogenic substrates. Kininogen levels were determined by a bioassay. Both specific amidase activity of plasma and tissue kallikreins were augmented in synovial effusions in relation to their own plasma activity. Kininogen levels in synovial fluid tended to be diminished in relation to plasma, however statistical significance was not reached. The consumption of kininogen is probably related to kinin production. This finding together with increased activities of plasma and tissue kallikreins reinforce the involvement of kinins in pathogenesis of inflammatory articular diseases.

La proteine C-reactive dans les affections inflammatoires articulaires: Comparaison des dosages sanguin et synovial

We evaluated the diagnostic value of measuring C-Reactive Protein (CRP) in blood and in synovial fluid for the detection of inflammatory articular diseases in 154 patients. High concentrations of CRP in blood were found in microcrystalin arthritis, polymyalgia rheumatica and Horton's disease. Our results show a good correlation between CRP and erythrocyte sedimentation rate for ankylosing spondylitis (p less than 0.01), systemic lupus erythematosus (p less than 0.01), rheumatoid arthritis (p less than 0.05), polymyalgia rheumatica and Horton's disease (p less than 0.05). The CRP measurement in blood did not separate seropositive versus seronegative rheumatoid arthritis, systemic lupus erythematosus versus rheumatoid arthritis and treated versus non-treated rheumatoid arthritis. There was a good correlation between CRP concentration in blood and in synovial fluid but the concentration was lower in synovial fluid than in blood (p less than 0.01). Then, the CRP measurement in synovial fluid does not have a higher diagnostic value than in blood.

Dynamic Investigation of Urine, Na, K and Ca Excretion after Administration of Tea, Acth and Acth with Calcium in Patients with Articular Disease

SummaryEighteen patients with inflammatory and degenerative articular diseases were tested for hourly excretion of urine, sodium, potassium and calcium after administration of tea, ACTH, and ACTH with calcium. ACTH induces retention of water and sodium, and transient retention of potassium. Intravenously administered calcium gluconate inhibits these retention phenomena and induces biphasic diuresis. Calcium, administered concomitantly with ACTH, is excreted in a significantly higher amount except for a short period at 3 hours postinjection. The presence of different regulatory mechanism for water, sodium, potassium and calcium is assumed.