Presence Of Rheumatoid Arthritis Research Articles

Immunomorphological characteristics of the synovial membrane in rheumatic diseases

The synovial membrane is frequently a target in rheumatic diseases. A search for diagnostic criteria and determination of changes in the pathological process necessitate standardized biopsy diagnostic techniques and quantification of morphological changes using digital imaging methods. The paper considers main methods for obtaining synovial membrane samples. It presents major morphological and immunohistochemical variations in synovitis in the presence of rheumatoid arthritis, ankylosing spondylitis, and osteoarthrosis. It shows different immunological and autoinflammatory mechanisms of these diseases. Synovial membrane inflammation in rheumatoid arthritis, ankylosing spondylitis, and osteoarthrosis is characterized by different components of morphogenesis, which is proven by the expression of different cell markers. Rheumatoid synovitis is an autoinflammatory process; synovitis in ankylosing spondylitis is characterized by autoinflammatory processes; biomechanical factors as joint inflammation triggers are leading in osteoarthrosis.

Association of Cardiovascular Risk Factors with Carotid Intima Media Thickness in Patients with Rheumatoid Arthritis with Low Disease Activity Compared to Controls: A Cross-Sectional Study.

ObjectivesRheumatoid arthritis (RA) has been identified as an independent cardiovascular risk factor. The importance of risk factors such as hypertension and hyperlipidemia in the generation of atherosclerosis in RA patients is unclear. This study analyzed clinical parameters associated with carotid intima media thickness (cIMT) in patients with RA.MethodsSubjects with RA and healthy controls without RA, both without known cardiovascular disease, were included. Participants underwent a standard physical examination and laboratory measurements including a lipid profile. cIMT was measured semi-automatically by ultrasound.ResultsIn total 243 RA patients and 117 controls were included. The median RA disease duration was 7 years (IQR 2–14 years). The median DAS28 was 2.4 (IQR 1.6–3.2) and 114 (50.4%) of the RA patients were in remission. The presence of RA and cIMT were not associated (univariate analysis). Multivariable regression analysis showed that cIMT in RA patients was associated with age (B = 0.006, P<0.001) and systolic blood pressure (B = 0.003, P = 0.003). In controls, cIMT was associated with age (B = 0.006, P<0.001) and smoking (B = 0.097, P = 0.001).ConclusioncIMT values were similar between RA patients and controls. Hypertension was strongly associated with cIMT in RA patients. After adjustment, no association between cIMT and specific RA disease characteristics was found in this well treated RA cohort.

Serum Trace Element Concentrations in Rheumatoid Arthritis.

Rheumatoid arthritis (RA) is a condition that is associated with oxidative stress. Serum trace elements and their related transport proteins, e.g., albumin and ceruloplasmin, play an important role in the antioxidant defense. Trace element status may therefore be involved in the pathogenesis of RA or be affected by the disease activity of this chronic inflammatory condition. The study participants were 110 patients with RA and 100 sex- and age-matched healthy volunteers. Serum concentrations of albumin, ceruloplasmin, selenium, zinc, copper, and zinc/copper ratio were measured in all subjects. The relationship between these parameters and disease activity score was also assessed. Lower concentrations of serum Alb, Zn, and Se were independently related to disease activity index. High concentrations of serum copper were associated with the presence of RA. Serum Cu concentrations were positively related to disease activity as assessed by the disease activity score. Low serum concentrations of Zn and Se, and high serum Cu concentrations may be associated with the presence of RA or be a consequence of this condition. Of the trace elements that were investigated in the present study, only serum Cu was positively correlated with disease activity.

The Risk for Cardiovascular Events Associated with Hyperlipdemia among Patients with and Without Rheumatoid Arthritis.

To determine, using data from a real-world setting, the overall and sex-specific risk of cardiovascular (CV) events in patients with rheumatoid arthritis (RA), with or without comorbid hyperlipidemia, relative to those in a non-RA cohort. This retrospective cohort study using claims data from a US commercial health plan (2005-2011) included patients with RA and a matched non-RA cohort. Cox proportional hazards regression model determined the hazard ratio (HR) for CV events (myocardial infarction, stroke, revascularization procedures), using the presence of RA and hyperlipidemia as the independent variables, controlling for other covariates (age, sex, diabetes, and hypertension). The incidence of CV events per 1000 person-years was 10.19 for the RA cohort and 6.41 for the non-RA cohort (crude rate ratio [RR] =1.59). Within the RA cohort, incidence was 15.54 for patients with hyperlipidemia and 7.05 for patients without hyperlipidemia (crude RR=2.21); in the non-RA cohort, incidence was 10.55 and 3.82 for those with and without hyperlipidemia, respectively (crude RR=2.76). After controlling for covariates, the HR of CV events among RA patients was 1.68 (95% CI: 1.50, 1.87) relative to non-RA patients. After multivariable adjustment, hyperlipidemia conferred a significant risk of CV events in both RA and non-RA patients; the interaction between RA and hyperlipidemia was not significant (p=0.13). This real-world analysis demonstrates that patients with RA have an increased risk of CV events. Similar to a non-RA cohort, CV event rates were incrementally higher for those patients with hyperlipidemia. Cardiovascular disease is an increasingly visible topic of concern in the rheumatoid arthritis community. However, there are only limited data that informs both the absolute and relative rates of CVD events, and the contribution of various risk factors such as hyperlipidemia, compared to non-RA populationsThe 'lipid paradox' hypothesis in RA suggests that elevated LDL cholesterol has a negligible effect on CVD risk in RA, unlikely in the general population where it is a well-accepted CVD risk factorThe incidence of CVD events in RA patients was 10/1000 patient years, a 1.6 fold greater risk compared to non-RA patientsThe contribution of hyperlipidemia to CVD risk was associated with comparable or greater absolute increases in the rate of CV events compared to non RA patients, a finding that does not support the lipid paradox.

PREDICTION THE MANIFESTATION OF PYELONEPHRITIS IN PATIENTS WITH RHEUMATOID ARTHRITIS

Renal damage in patients with rheumatoid arthritis (RA) is the most frequent and serious among other systemic manifestations and holds a special place in connection with a significant impact on prognosis and approaches to therapy.&#x0D; Today we know that one of the main possible factors of occurrence and development of RA are external trigger factors, among which the most important factor are infectious, and its pathogenic effect on the body can be done in different ways. Based on the latest scientific evidence on the importance of infectious trigger factors in the manifestation of RA, chronic pyelonephritis among these triggers is one of the leaders. Great interest is also the probability of pyelonephritis manifestation while presence of RA.&#x0D; The aim: to identify predictors ofpyelonephritis manifestation in patients with rheumatoid arthritis.&#x0D; Materials and methods. The authors examined 31 patients with RA with presence of chronic pyelonephritis (CP), 31 patients with RA without presence of CP and 20 healthy individuals. Was used clustering and classification methods of Data Mining on indicators of lipid peroxidation of blood and urine, р2–microglobulin blood and urine, immune factors, that defined progressive CKD on the results of our previous studies (IL–1p,IL–10, TGF–р).&#x0D; Results. Found that patients with diagnosed RA only, mainly are included in the cluster «1» (18patients). Some of them (3 persons) classified as belonging to the cluster «2». Thus, these individuals should have two signs of disease, RA and CP, despite the fact that they have only diagnosed RA. It means that these patients are at risk of developing CP. This analysis gives grounds to consider that RA may be signs of a factor that causes manifestation of CP.&#x0D; It is proved that the main factor that characterizes the individuals belonging to the cluster of healthy is 2– microglobulin in the urine with the same threshold value, but factor in determining membership of a type of disease is a factor MDA of urine.&#x0D; Conclusion. The main predictors of pyelonephritis manifestation in patients with rheumatoid arthritis were 2– microglobulin and MDA in urine and TGF– 1 in blood. A new method of diagnosing ofprognostic factors of CP manifestation in patients with RA which is based on cluster and classification analysis makes it possible to establish the interrelation between a diagnosis of RA and caused by it manifestation of CP.&#x0D;

Correlación de la escala de Tarplay y el diagnóstico de pacientes con sospecha de tener síndrome de Sjögren del Centro Médico Nacional «La Raza»

AimTo establish any existing correlation between Tarplay’s grading system and patients with positive diagnosis of Sjögren’s syndrome. Methods321 cases of patients suspected to be afflicted with Sjögren’s syndrome were reviewed at the Highly Specialized Medical Units (UMAE), Centro Médico Nacional «La Raza» («La Raza» National Medical Center). These patients had been referred to the said center between January 2001 and December 2005. Patients had been referred as part of their study protocol. Patients were subjected to labial salivary gland biopsy. The procedure was undertaken under local anesthesia and using the technique described by Daniels. Evaluation was achieved using light microscopy and patients were graded according to Tarplay’s grading system. Sjögren’s syndrome diagnosis was established based on criteria proposed in 2002 by the Group of American and European Consensus. The main objective criterion used was histopathology of labial salivary glands. ResultsDirect association was found between Tarplay’s index increase of labial salivary gland biopsies and Sjögren’s syndrome positive diagnosis. Fisher exact test was used with p<0.001. OR = 0.13, with 95% confidence interval (CI) and 0.004–0.045 rank. No association was found between the degree of fibrosis and positive diagnosis of Sjögren’s syndrome. Presence of rheumatoid arthritis and systemic lupus erythematosus was directly associated with secondary positive Sjögren’s syndrome (p<0.001, OR = 3.25 with CI 95% = 1.8–5.6 and p=0.004, OR = 4.0 with CI 95% = 1.4–10.9 respectively). ConclusionsHistological evaluation of labial salivary glands using Tarplay’s grading system is a reliable test to establish diagnosis of Sjögren’s syndrome.

THU0410 When Does the Female Predominance in RA Start – Does Sex Influence the Risk of ACPA Development?

BackgroundRheumatoid factor and several other autoantibodies occur more often among women, but the role of female sex for anti-citrullinated peptide antibodies (ACPA) occurrence and concentration have not previously been explored...

Vitamin D status of patients with early inflammatory arthritis

The present study aimed to investigate the vitamin D status in patients with early inflammatory arthritis (EIA). We conducted a retrospective study among patients who presented with EIA at the outpatient rheumatology clinic of a tertiary referral center between March 2012 and February 2013. In total, 101 subjects with EIA (≥1 swollen joint and symptom duration of ≤6 months, not explained by another disease) and 101 healthy controls matched for age, sex, and the month of serum vitamin D measurements were enrolled. Serum 25-hydroxy vitamin D (25-OHD) concentrations were assessed by radioimmunoassay. Vitamin D "deficiency" and "severe deficiency" were defined as serum 25-OHD levels <20 and <10 ng/mL, respectively. Among EIA patients, rheumatoid arthritis (RA) was classified according to the 2010 American College of Rheumatology/European League against Rheumatism criteria. Vitamin D deficiency was highly prevalent among EIA patients, but no significant differences in the frequency of vitamin D deficiency of EIA patients and controls were observed (75.2 vs 65.3%, p = 0.106). Additionally, in spring and summer, EIA patients had significantly lower serum 25-OHD concentrations than controls, but the opposite trend was observed in autumn. Among 101 EIA patients, 38 (37.1%) were classified as having RA. Severe vitamin D deficiency in EIA patients was significantly associated with the higher likelihood of being classified as having RA. In conclusion, the frequency of vitamin D deficiency in EIA patients was comparable to that in controls, but severe vitamin D deficiency was associated with the presence of RA among EIA patients.

Relation between rheumatoid arthritis and periodontal diseases: Using the Fifth Korea National Health and Nutrition Examination Survey

Objectives: Rheumatoid arthritis (RA) has been associated with systemic diseases, such as periodontal diseases. Periodontal diseases and RA appear to share many pathologic features. The etiology of the two diseases may differ, but they share similar pathological characteristics. Therefore, the aim of this study was to evaluate the correlation between RA and periodontal diseases. Methods: Data from the Fifth Korea National Health and Nutrition Examination Survey (KNHNES) were used to analyze periodontal status according to the presence of RA. Demographics and oral behaviors were analyzed using the complex chi-square test to compare participants with RA with those without RA. Complex logistic regression was used to analyze relationships of periodontal diseases with RA and other covariates. Results: The odds ratio for periodontal diseases was 1.91 (95% confidence interval: 1.05-3.48) in participants with RA compared with participants without RA. Conclusions: The results of this study provide evidence of a significant association between periodontal diseases and RA.

PADI2 Is Significantly Associated with Rheumatoid Arthritis

Citrullination, a posttranslational modification of peptidyl arginine to citrulline, plays an essential role in rheumatoid arthritis (RA). Citrullination is catalyzed by a group of peptidylarginine deiminases (PADs) including PADI 1, 2, 3, 4 and 6. Many studies have indicated that the gene encoding PADI4 is a factor in susceptibility to RA. Some studies have detected PADI2 expression in RA synovial tissues, suggesting that PADI2 also plays an important role in the disease. This study evaluated the possible association between the PADI2-encoding gene and RA. Seventeen tag SNPs across the PAD locus were genotyped using a custom-designed Illumina 96-SNP VeraCode microarray. Peripheral blood samples were collected from patients with RA (n = 267), ankylosing spondylitis (AS, n = 51) and healthy controls (n = 160). The results of genotyping were verified using Sequenom MassARRAY in an independent cohort of 307 patients with RA, 324 patients with AS and 509 healthy controls. A western blot analysis was performed using synovial tissue from patients with RA (n = 7), osteoarthritis (OA, n = 7) and AS (n = 5) to determine the levels of expression of PADI2. A microarray analysis revealed a significant association between three selected PADI2 SNPs (rs2235926, rs2057094, rs2076616) and the presence of RA. The increased susceptibility to RA associated with rs2235926 (OR = 1.706733, 95% CI = [1.576366–1.866587], p = 0.000839) and rs2057094 (OR = 1.360432, 95% CI = [1.065483–1.869482], p = 0.003291) was further confirmed by the Sequenom MassARRAY. No tag SNPs in the PADI2 locus showed a significant association with AS. Increased expression of PADI2 was detected in RA synovial tissues compared with samples from patients with OA and AS. PADI2 is significantly associated with RA and may be involved in the pathogenesis of the disease.

Development of Reduced Kidney Function in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is associated with a variety of kidney disorders. However, it is unclear whether the development of reduced kidney function is higher in patients with RA compared to the general population. Retrospective review. Incident adult-onset RA cases (813) and a comparison cohort of non-RA individuals (813) in Olmsted County, MN, in 1980-2007. Baseline demographic and clinical variables. Reduced kidney function: (1) estimated glomerular filtration rate (eGFR)<60mL/min/1.73m(2) and (2) eGFR<45mL/min/1.73m(2) on 2 consecutive occasions at least 90 days apart; cardiovascular disease (CVD); and death. The cumulative incidence of reduced kidney function was estimated adjusting for the competing risk of death. Of 813 patients with RA and 813 non-RA individuals, mean age was 56±16 (SD) years, 68% were women, and 9% had reduced kidney function at baseline. The 20-year cumulative incidence of reduced kidney function was higher in patients with RA compared with non-RA participants for eGFR < 60mL/min/1.73m(2) (25% vs 20%; P=0.03), but not eGFR<45mL/min/1.73m(2) (9% vs 10%; P=0.8). The presence of CVD at baseline (HR, 1.77; 95% CI, 1.14-2.73; P=0.01) and elevated erythrocyte sedimentation rate in patients with RA (HR per 10-mm/h increase, 1.08; 95% CI, 1.00-1.16; P=0.04) was associated with increased risk of eGFR<60mL/min/1.73m(2). eGFR<60mL/min/1.73m(2) was not associated with increased risk of CVD development in patients with RA (HR, 0.99; 95% CI, 0.63-1.57; P=0.9), however, a greater reduction in GFR (eGFR<45mL/min/1.73m(2)) was associated with increased risk of CVD (HR, 1.93; CI, 1.04-3.58; P=0.04). Reduced kidney function was defined by estimating equations for kidney function. We are limited to deriving associations from our findings. Patients with RA were more likely to develop reduced kidney function over time. CVD and associated factors appear to play a role. The presence of RA in individuals with reduced kidney function may lead to an increase in morbidity from CVD development, for which awareness may provide a means for optimizing care.

Uncommon ocular and visual signs of relapsing remitting multiple sclerosis

Uncommon ocular and visual signs of relapsing remitting multiple sclerosis

Rheumatoid arthritis and amyotrophic lateral sclerosis association: A case report and literature review

Rheumatoid arthritis and amyotrophic lateral sclerosis association: A case report and literature review

Prosthetic joint-associated infections treated with DAIR (debridement, antibiotics, irrigation, and retention)

Background and purpose For prosthetic joint-associated infection (PJI), a regimen of debridement, antibiotics, irrigation, and retention of the prosthesis (DAIR) is generally accepted for acute infections. Various risk factors associated with treatment success have been described. The use of local antibiotic carriers (beads and sponges) is relatively unknown. We retrospectively analyzed risk factors in a cohort of patients from 3 hospitals, treated with DAIR for PJI.Patients and methods 91 patients treated with DAIR for hip or knee PJI in 3 Dutch centers between 2004 and 2009 were retrospectively evaluated. The mean follow-up was 3 years. Treatment success was defined as absence of infection after 2 years, with retention of the prosthesis and without the use of suppressive antibiotics.Results 60 patients (66%) were free of infection at follow-up. Factors associated with treatment failure were: a history of rheumatoid arthritis, late infection (> 2 years after arthroplasty), ESR at presentation above 60 mm/h, and infection caused by coagulase-negative Staphylococcus. Symptom duration of less than 1 week was associated with treatment success. The use of gentamicin sponges was statistically significantly higher in the success group, and the use of beads was higher in the failure group in the univariate analysis, but these differences did not reach significance in the logistic regression analysis. Less surgical procedures were performed in the group treated with sponges than in the group treated with beads.Interpretation In the presence of rheumatoid arthritis, duration of symptoms of more than 1 week, ESR above 60 mm/h, late infection (> 2 years after arthroplasty), and coagulase-negative Staphylococcus PJI, the chances of successful DAIR treatment decrease, and other treatment methods should be considered.

FRI0537 Self-reported health status and effort-reward imbalance in patients with rheumatoid arthritis and systemic lupus erythematosus

BackgroundWork environment factors influence patients’ (life) satisfaction and well being. The model of effort-reward imbalance (ERI) was developed to identify health-adverse effects produced by a stressful psychosocial job-related environment. Research...

AB0246 Prevalence and risk factors of preclinical carotid atherosclerosis in patients with rheumatoid arthritis

BackgroundThe principal cause of death in patients with rheumatoid arthritis (RA) is the cardiovascular disease (CVD) associated with atherosclerosis. To improve the prognosis of living in RA patients an early...

AB0163 Factors associated with the expansion of TH17 cells in peripheral blood of ra patients: Possible different effect between anti-IL-6 and anti-TNF therapies

BackgroundTh17 cells play an important role in many animal models of autoimmune arthritis. However, pathophysiological roles of Th17 cells in patients with rheumatoid arthritis (RA), as well as the impact...

Erosive polyarthropathy in a Late Roman skeleton from northern France: A new case of rheumatoid arthritis from the pre-Columbian Old Word?

A skeleton from the Late Roman period, recovered in Amiens, northern France, exhibits multiple symmetrical marginal erosions, primarily involving the metacarpophalangeal and metatarsophalangeal joints. Other skeletal changes include erosions of several peripheral joints and some entheses, and severe osteoporosis. Macroscopic and radiological aspects of the lesions, as well as the absence of spinal and sacroiliac joints involvement, are consistent with a diagnosis of rheumatoid arthritis. Differential diagnosis includes other erosive arthropathies, in particular the diseases belonging to the spondyloarthropathy group. This case provides a new evidence of the presence of rheumatoid arthritis in Western Europe long before the colonisation of the Americas by Europeans.

Periodontitis and Rheumatoid arthritis – A Review

The periodontal disease is an inflammatory condition of the supporting structres of the teeth. The presence of rheumatoid arthritis or other systemic inflammatory disease may increase the severity of the periodontal disease. The studies published in the past reveals that the oral bacterial infections and inflammation seemed to be linked directly to the etiopathogenesis of rheumatoid arthritis. There are findings support the impact of periodontal pathogens, such as Porpyromonas gingivalis on citrullination, and the association of periodontitis in rheumatoid arthritis patients with serospecificity toward rheumatoid factor and the anti-cyclic citrullinated peptide antibody 1 .In this review the common etiology, pathogenesis and immunogenetics of two

Prevalence and incidence of rheumatoid arthritis in South Korea

Several studies of rheumatoid arthritis (RA) incidence and prevalence indicate that occurrence of the disease varies significantly among different populations. We aimed to estimate the prevalence and incidence of RA in South Korea. We used Korean National Health Insurance (NHI) claims data to estimate the prevalence of RA in 2007-2009 and the incidence of RA in 2008. On the basis of our previous validation study, the presence of RA was defined by the diagnostic code for RA with biologic or non-biologic disease-modifying anti-rheumatic drugs in the same claim in each year. To estimate the incidence of RA, we identified cases of RA in 2008 and set the 12-month period prior to 2008 as a disease-free period. Among the incident case of 2008, only patients who continued treatment in 2009 were defined as true incident case of RA in 2008. The corresponding prevalence estimates were 0.26 % (95 % CI 0.25-0.27) in 2006, 0.27 % (95 % CI 0.26-0.28) in 2007, and 0.27 % (95 % CI 0.26-0.28) in 2008. The incidence of RA in 2008 was estimated at 42/100,000 (95 % CI 29.3-54.7) in the general population of South Korea. Data gathered nationwide through the NHI yielded estimates of RA prevalence and incidence in South Korea. This study is the first report of nationwide prevalence and incidence of South Korea and those are comparable to values for other countries in Asia.