Progression Of Erosion Research Articles

Sustained improvements in MRI outcomes with abatacept following the withdrawal of all treatments in patients with early, progressive rheumatoid arthritis

ObjectivesTo assess structural damage progression with subcutaneous abatacept (ABA) in the Assessing Very Early Rheumatoid arthritis Treatment (AVERT) trial following abrupt withdrawal of all rheumatoid arthritis (RA) medication in patients...

A 4 year prospective longitudinal study of progression of dental erosion associated to lifestyle in 13–14 year-old Swedish adolescents

ObjectivesTo evaluate the progression of dental erosion in 13–14 year-olds after 4 years, and its association with lifestyle and oral health. Methods227 randomly selected 13–14 year-olds from a Public Dental Clinic, Örebro, Sweden, were investigated. A clinical examination was performed which included dental caries/gingival/plaque status, as well as grading of dental erosion at the tooth surface and participant levels in “marker teeth”, including buccal/palatal surfaces of 6 maxillary anterior teeth (13–23), and occlusal surfaces of first molars. An interview and a questionnaire regarding drinking habits and other lifestyle factors were completed. All investigations were repeated at follow-up. The participants were divided into high and low progression erosion groups and logistic regression statistics were applied. Results175 individuals participated at follow-up. Progression occurred in 35% of the 2566 tooth surfaces. 32% of the surfaces had deteriorated by one severity grade (n=51 individuals) and 3% by two grades (n=2 individuals). Boys showed more severe erosion than girls at the follow-up. Among the variables predicting greater progression, a lower severity of erosive wear at baseline had the highest OR (13.3), followed in descending order by a “retaining” drinking technique, more frequent intake of drinks between meals, low GBI and lesser sour milk intake, with reference to the baseline recording. Using these five variables, sensitivity and specificity were 87% and 67% respectively, for predicting progression of erosion. ConclusionsProgression of erosive lesions in Swedish adolescents aged 13–14 years followed up to age 17–18 years was common and related to certain lifestyle factors. Clinical SignificanceIn permanent teeth, dental erosion may develop early in life and its progression is common. Dental health workers should be made aware of this fact and regular screenings for erosion and recording of associated lifestyle factors should be performed.

RANKL-Independent Osteoclastogenesis: A Long-Standing Controversy.

RANKL-Independent Osteoclastogenesis: A Long-Standing Controversy.

River bank erosion and channel evolution in sand-bed braided reach of River Chenab: role of floods during different flow regimes

Braided reaches of large rivers in alluvial plains show major morphological changes, particularly the external bank erosion, due to the flood events. This paper highlights the bank erosion and channel evolution induced by eleven different flood events in a 7-km long reach of the River Chenab, Pakistan. The impact of floods on river bank erosion and channel evolution is analyzed under low and high flow conditions. Flood-induced changes, for river’s external banks and channel evolution, were assessed by processing Landsat ETM+ images in ArcGIS tool, and their inter-relationship is evaluated through regression analysis. The results revealed that the major morphological changes were triggered by the flood events occurred during the high flow or Monsoon season (July–September), whereas the flood events of similar magnitude occurring during low flow season (October–March) did not induce such changes. Mostly, the erosion remained limited to the middle part of the reach, where the branch channel flows along the bank. The average annual bank erosion rates are much higher as compared with a global scale. Data analysis showed a strong correlation between the mean high flows and total bank erosion indicating that Monsoon seasonal flows and floods are responsible for bank erosion. The present study further identifies the river bank locations highly susceptible to erosion by developing the correlation between bank erosion and branch channel progression. Strong correlation for bank erosion could be established with the shift of branch channels position flowing along the banks in braided reaches of sand bed rivers. However, the presence of sand bars along the river banks resulted in reduced erosion that weakens this relationship. The findings of the present study can help develop better understanding about the bank erosion process and constitute a key element to inform and improve river bank management.

An Assessment of Gully Erosion Progression and Vulnerability in Auchi Area in Edo State

An Assessment of Gully Erosion Progression and Vulnerability in Auchi Area in Edo State

Treat-to-target therapy does not prevent excessive progression of carotid intima media thickness during the first year of therapy in early rheumatoid arthritis.

IntroductionThe aim of the study was to investigate the presence of subclinical atherosclerosis and predictors of change in carotid intima-media measures in early rheumatoid arthritis patients (eRA) as compared to chronic RA patients and patients without arthritis.Material and methodsFifty-five consecutive eRA patients were assessed at the time of diagnosis and after 1 year of therapy. Fifty-five sex- and age-matched chronic RA patients and 29 patients without inflammatory disease were used as controls. Carotid artery intima-media thickness (CIMT) and carotid plaques were measured at baseline and after follow-up. In eRA patients ultrasound assessment of hand joints was performed before and after treatment. Carotid artery intima-media thickness was assessed again after 2 years in 44 eRA patients.ResultsCarotid artery intima-media thickness progression after 1 year of therapy was higher in eRA patients compared to both control groups (p = 0.017) and correlated with symptoms duration (p = 0.017) and DMARD monotherapy (p = 0.015). Ultrasound progression of hand joint erosions was associated with longer symptoms duration (p = 0.006). After 2 years of observation CIMT progression was similar in all examined groups.ConclusionsWe observed rapid CIMT progression during the first year of RA therapy. Longer symptoms duration and less aggressive therapy were associated with CIMT increase.

Effect of denosumab on Japanese patients with rheumatoid arthritis: a dose–response study of AMG 162 (Denosumab) in patients with RheumatoId arthritis on methotrexate to Validate inhibitory effect on bone Erosion (DRIVE)—a 12-month, multicentre, randomised, double-blind, placebo-controlled, phase II clinical trial

ObjectivesTo evaluate efficacy and safety of three different regimens of denosumab, a fully human monoclonal antibody to receptor activator of nuclear factor kappa B (RANK) ligand (RANKL), for Japanese patients...

Laboratory Test for Evaluating Crack Filling During Internal Erosion in Zoned Dams

Abstract A new laboratory test, the crack-filling erosion test (CFET), was developed to study crack filling during the progression of internal erosion in the embankment of zoned dams. Crack filling involves the transport of eroded material from an upstream zone, through a flaw in the core, which is then retained by a downstream granular layer. In the CFET, the specimen comprises a core, an upstream shell material, and a downstream filter layer. These are compacted inside a test apparatus made up of several pieces. The specimen is subjected to water flow through a predrilled hole in the core to simulate a concentrated leak. Seven granular upstream materials, two core soils, and two granular filters are examined. Following an extensive testing program, experimental observations and physical descriptions are presented. Three main types of pattern behaviors are identified: rapid crack filling with almost “no erosion” of the core; filtering after “some erosion” or “excessive erosion” of the core and/or upstream material; and “continuing erosion” of the core and upstream material. When the core has moderate-to-high resistance to erosion, crack filling is mainly governed by grading properties of the upstream zone and of the filter. Crack filling is more likely to occur the finer the filter layer, the higher the fine-sand content of the upstream soil, and the lower the fines content of the upstream soil. Test results are checked against the subjective guidelines on crack-filling action available in the literature.

Clinical and radiographic outcome of a treat-to-target strategy using methotrexate and intra-articular glucocorticoids with or without adalimumab induction: a 2-year investigator-initiated, double-blinded, randomised, controlled trial (OPERA)

ObjectivesTo study clinical and radiographic outcomes after withdrawing 1 year's adalimumab induction therapy for early rheumatoid arthritis (eRA) added to a methotrexate and intra-articular triamcinolone hexacetonide treat-to-target strategy (NCT00660647).MethodsDisease-modifying antirheumatic...

The effect of enamel proteins on erosion.

Enamel proteins form a scaffold for growing hydroxyapatite crystals during enamel formation. They are then almost completely degraded during enamel maturation, resulting in a protein content of only 1% (w/v) in mature enamel. Nevertheless, this small amount of remaining proteins has important effects on the mechanical and structural properties of enamel and on the electrostatic properties of its surface. To analyze how enamel proteins affect tooth erosion, human enamel specimens were deproteinated. Surface microhardness (SMH), surface reflection intensity (SRI) and calcium release of both deproteinated and control specimens were monitored while continuously eroding them. The deproteination itself already reduced the initial SMH and SRI of the enamel significantly (p < 0.001 and p < 0.01). During the course of erosion, the progression of all three evaluated parameters differed significantly between the two groups (p < 0.001 for each). The deproteinated enamel lost its SMH and SRI faster, and released more calcium than the control group, but these differences were only significant at later stages of erosion, where not only surface softening but surface loss can be observed. We conclude that enamel proteins have a significant effect on erosion, protecting the enamel and slowing down the progression of erosion when irreversible surface loss starts to occur.

Relationship of multi-biomarker disease activity score and other risk factors with radiographic progression in an observational study of patients with rheumatoid arthritis.

Objectives. To evaluate the multi-biomarker disease activity (MBDA) score as a predictor of radiographic progression and compare it with other risk factors among patients with established RA receiving non-biologic DMARDs.Methods. For 163 patients with RA, we assessed 271 visits for MBDA score (scale of 1−100), clinical data and subsequent 1-year radiographic progression (change in Sharp−van der Heijde score [SHS]). Scatter plot and non-parametric quantile regression curves evaluated the relationship between the MBDA score and change in SHS. Changes in joint space narrowing and erosions were compared among MBDA categories with Wilcoxon rank-sum tests. The ability of the MBDA score to independently predict progression was determined by multivariate models and cross-classification of MBDA score with other risk factors. Generalized estimating equation methodology was used in model estimations to adjust for same-patient visits, always ≥1 year apart.Results. Patient characteristics included 67% female, 66%/67% RF+/anti-CCP+; mean age 55 years, MBDA score 43 (moderate = 30−44); median disease duration 4.6 years, SHS 23. Radiographic progression was infrequent for low MBDA scores. Relative risk for progression increased continuously as the MBDA score increased, reaching 17.4 for change in SHS >5 with MBDA scores ≥60. Joint space narrowing and erosion progression were associated with MBDA score. MBDA score was associated with radiographic progression after adjustments for other risk factors. MBDA score significantly differentiated risk for progression when swollen joint count, CRP or DAS28–CRP was low, and among seropositive patients.Conclusion. MBDA score enhanced the ability of conventional risk factors to predict radiographic progression in patients with established RA receiving non-biologic DMARDs.

Effect of Nd:YAG laser irradiation and fluoride application in the progression of dentin erosion in vitro.

Nd:YAG laser and its association with fluoride have been proposed as an option for the prevention of dental erosion. This study evaluated the progression of existing dentin erosive lesions after treatment with different Nd:YAG laser (1064 nm) protocols, associated or not with fluoride. Erosive lesions were created with 1 % citric acid for 10 min in human dentin specimens. They were randomly assigned into eight groups (n = 15): no treatment (control), 1-min application of 2 % sodium fluoride gel (NaF), Nd:YAG1 (Nd:YAG laser irradiation 0.5 W; 50 mJ; ~41.66 J/cm(2); 10 Hz; 40 s; in contact), Nd:YAG2 (0.7 W; 70 mJ; ~62.50 J/cm(2); 10 Hz; 40 s; in contact), Nd:YAG3 (1 W; 100 mJ; ~54,16 J/cm(2); 10 Hz; 40 s; 1 mm unfocused), NaF + Nd:YAG1, NaF + Nd:YAG2, and NaF + Nd:YAG3. After treatment, the specimens were submitted to a 5-day erosion-remineralization cycling model, 6×/day. Dentin surface loss (SL) was evaluated with optical profilometry after the formation of the initial lesion; after treatment; and after days 1, 3, and 5. Data were statistically analyzed (alpha = 0.05). Significant differences were observed among the groups in all testing times (p < 0.001), except after initial lesion formation. Loss of dentin surface was observed after irradiation with all Nd:YAG laser protocols (p < 0.05). The association fluoride and laser did not differ significantly from laser alone. NaF showed the lowest values of SL and Nd:YAG2 and NaF + Nd:YAG2, the highest. Within the limitations of an in vitro study, it was concluded that laser irradiation, according to the parameters used, was not an appropriated approach to prevent dentin erosion progression, even when it was associated with fluoride.

Polish Rheumatologists and Rheumatoid Arthritis Patients Differ in Their Opinions About Treatment Inefficacy

Objectives: This study aims to detect the differences of opinion between rheumatoid arthritis patients and rheumatologists concerning factors affecting escalation of disease modifying antirheumatic drugs (DMARDs). Materials and methods: The study included 82 rheumatoid arthritis patients (14 males, 68 females; mean age 61.4±11 years; range 35 to 84 years) and 85 rheumatologists (26 males, 59 females; mean age 49.7±11.7 years; range 33 to 77 years). All participants were asked to complete a survey which was composed of nine factors related to the ineffectiveness of RA treatment and the necessity of treatment change or DMARDs escalation. The patients were also asked to assess their satisfaction with current treatment and trust in their doctor. We collected demographic data of patients as well as their Disease Activity Score 28, erythrocyte sedimentation rate, and Health Assessment Questionnaire score. Results: Of the patients, 83% declared confidence in their doctor and 74.5% declared satisfaction with current therapy, while only 44% achieved low disease activity. The most important reasons for patients to escalate their therapy were persistent pain, functional impairment, progression of erosions, and rheumatologist’s decision. For rheumatologists, the most important issues were progression of erosions, joints’ swelling, high erythrocyte sedimentation rate, and morning stiffness. Radiological progression, joints’ swelling, and high erythrocyte sedimentation rate were considered more important for DMARD escalation by physicians than by patients. Middle-aged rheumatologists of 41-60 years of age and female rheumatologists were more inclined to consider patients’ opinion as a factor for treatment change. Conclusion: Different factors are important for rheumatologists and rheumatoid arthritis patients regarding DMARDs escalation. Treatment satisfaction is determined not only by disease activity indices but also by other patient-oriented factors. Improved communication between patients and physicians plays a significant role in achieving the therapeutic goal of tight control of the disease.

Notch1 targeting siRNA delivery nanoparticles for rheumatoid arthritis therapy

Notch pathway plays a pivotal role in synoviocytes involved in progression of rheumatoid arthritis (RA). Herein, we designed the Notch1 targeting siRNA delivery nanoparticles (siRNA-NPs) in order to confirm the anti-inflammatory effect in collagen-induced arthritis (CIA) model. The siRNA-NPs were successfully produced by encapsulating polymerized siRNA (poly-siRNA) into thiolated glycol chitosan (tGC) nanoparticles in aqueous condition. The in vitro Notch1 inhibition of siRNA-NPs in murine macrophage cell (RAW 264.7) was confirmed using confocal microscopy and real time PCR. Fluorescently labeled siRNA-NPs were successfully transfected in RAW 264.7 and modulated the expression of Notch1 in mRNA level. For in vivo study, siRNA-NPs exhibited the higher targeting efficiency in the arthritic joins of CIA mice, confirmed by the near-infrared fluorescence (NIRF) imaging. Furthermore, inhibition of Notch1 with siRNA-NPs resulted in retarded progression of inflammation, bone erosion, and cartilage damage in CIA mice. Novel Notch1 targeting siRNA delivery system of siRNA-NPs showed effective RA treatment by suppressing Notch1 signaling pathway without undesirable severe toxicity. Thus, Notch1 inhibiting siRNA-NPs demonstrated the great potential in RA therapeutics that was hard to be achieved using conventional drugs.

Radiographic Structural Damage Is Worse in the Dominant than the Non-Dominant Hand in Individuals with Early Rheumatoid Arthritis.

ObjectiveThe relationship between mechanical stress and radiographic progression in rheumatoid arthritis (RA) is unclear. The assumption is that mechanical stress is greater in the dominant hand. Therefore, the aim of the present study was to compare the presence and progression of erosions and joint space narrowing (JSN) in the dominant and non-dominant hand.MethodsData from 194 patients recently diagnosed with seropositive RA, and with hand radiographs taken at the time of diagnosis and at 2-year follow-up, were analyzed retrospectively. Radiographs were scored using the van der Heijde-modified Sharp Score (HSS) method. Each joint group within each hand was rated separately by two independent examiners in a double-blinded manner.ResultsOne hundred and ninety-four patients were enrolled (80% female, 88% positive rheumatoid factor, 92% positive anti-citrullinated protein antibody, and 95.4% right-handed). The baseline, follow-up erosion and JSN HSS were significantly higher in the dominant hand than in the non-dominant hand. The annual rate of radiographic progression was also higher in the dominant hand. The erosive progression in the wrist joints varied significantly according to handedness, but the erosion in the proximal interphalangeal joints and metacarpophalangeal joints was similar in both hands. The radiographic progression was associated with the dominant hand, an abnormal baseline C-reactive protein level, and joint damage at baseline. There was no significant difference in bone mineral density between the right and left hands.ConclusionRadiological damage was worse and progressed faster in the dominant hand, suggesting that mechanical stress is associated with radiographic joint damage in early and active RA.

Effect of sodium fluoride and stannous chloride associated with Nd:YAG laser irradiation on the progression of enamel erosion.

This study evaluated the progression of enamel erosion after treatment with gels containing sodium fluoride (NaF; 9047 ppm F) and stannous chloride (SnCl2; 3000 ppm Sn), associated or not with Nd:YAG laser irradiation. Sixty enamel specimens were prepared from bovine incisors and protected by a tape, leaving an exposed surface area of 4 × 1 mm. The specimens were immersed in 1 % citric acid (pH = 2.3) for 10 min to create an initial erosion lesion. After, they were randomly divided into six groups: (C) control: gel without active ingredient; (F): NaF gel; (F + Sn): NaF + SnCl2 gel; (laser): Nd:YAG laser irradiation (0.5 W; 50 mJ; ∼41.66 J/cm(2); 10 Hz; 40 s); (F + laser): NaF gel + Nd:YAG; (F + Sn + laser): NaF + SnCl2 gel + Nd:YAG. All gels had pH = 4.5 and were applied for 1 min. Laser irradiation was performed after gel application. The specimens were then submitted to a 5-day erosion-remineralization cycling model using 1 % citric acid (pH = 2.3), six times per day. Enamel surface loss (SL) was analyzed by optical profilometry in the end of the cycling (in μm). Data were analyzed by one-way ANOVA and Holm-Sidak tests (alpha = 0.05). The control and the laser groups presented the highest enamel loss (means ± SD = 53.52 ± 3.65 and 53.30 ± 2.73, respectively), followed by F + Sn (44.76 ± 2.83). The groups F (36.76 ± 2.28), F + laser (36.25 ± 3.59), and F + Sn + laser (39.83 ± 4.62) showed the lowest enamel loss, with no significant difference among them (p > 0.05). In conclusion, NaF by itself or associated with SnCl2 and Nd:YAG laser was able to reduce enamel erosion progression. Nd:YAG laser alone did not show a protective effect.

Osteoprotegerin and tumor necrosis factor-related apoptosis-inducing ligand as prognostic factors in rheumatoid arthritis: results from the ESPOIR cohort.

IntroductionWe previously reported that low ratio of osteoprotegerin (OPG) to tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) was associated with Disease Activity Score in 28 joints (DAS28) remission at 6 months in patients with early rheumatoid arthritis (RA). Here, we aimed to evaluate the value of baseline OPG/TRAIL ratio in predicting clinical and radiological outcomes in patients with early RA in the ESPOIR cohort.MethodsOPG and TRAIL serum concentrations were assessed in the ESPOIR cohort patients. Patients with definite RA were included in this study. Patients were excluded if they had high erosion score at baseline (>90th percentile) or received biological therapy during the first 2 years of follow-up. Data were analyzed by univariate analysis and multivariate logistic regression to predict 1-year DAS28 remission and 2-year radiographic disease progression.ResultsOn univariate analysis of 399 patients, OPG/TRAIL ratio at baseline was significantly lower in patients with than without remission at 1 year (p = 0.015). On multivariate logistic regression including age, gender, body mass index and DAS28, low OPG/TRAIL ratio was independently associated with remission at 1 year (odds ratio 1.68 [95 % confidence interval 1.01–2.79]). On univariate analysis, high OPG/TRAIL ratio at baseline was associated with rapid progression of erosion at 2 years (p = 0.041), and on multivariate logistic regression including age, anti-citrullinated protein antibody positivity and C-reactive protein level, OPG/TRAIL ratio independently predicted rapid progression of erosion at 2 years.ConclusionsOPG/TRAIL ratio at baseline was an independent predictor of 1-year remission and 2-year rapid progression of erosion for patients with early rheumatoid arthritis. Thus, OPG/TRAIL ratio could be included in matrix prediction scores to predict rapid radiographic progression. Further confirmation in an independent cohort is warranted.

Automated three-dimensional registration of high-resolution peripheral quantitative computed tomography data to quantify size and shape changes of arthritic bone erosions.

To monitor size and shape changes of bone erosions and changes in BMD in the vicinity of the erosion and in the periarticular trabecular compartment of patients with RA using high-resolution peripheral quantitative CT (HR-pQCT) imaging and to compare an automated three-dimensional (3D) image processing technique with manual measurements of erosion width and depth. The shape of 40 bone erosions and composition of bone around the erosions were analysed in the MCP joints of 22 RA patients both manually and by semi-automated 3D image processing at two different time points. Periosteal segmentation was performed using volume growing and morphological operations. Image registration was applied for transfer of baseline segmentations to follow-up datasets. Eight erosions decreased in size, 6 increased and 28 remained stable. Increasing erosions were more spherical and smaller at baseline compared with decreasing or stable erosions. BMD in the vicinity of shrinking erosions increased, while it decreased next to expanding erosions. There was moderate agreement in the determination of erosion volume between semi-automated and manual measurements, but agreement was poor when assessing changes in volume over time. Longitudinal changes in erosion size and shape and of BMD in the vicinity of an erosion can be measured. BMD changes are associated with progression and regression of erosions. However, the semi-automated and manual approaches did not classify longitudinal changes of erosion volume in the same way. Further research is necessary to define the nature of these differences.

The role of matrix metalloproteinases and cysteine-cathepsins on the progression of dentine erosion

ObjectiveTo evaluate in vitro the effect of the inhibition of endogenous dentinal enzymes (matrix metalloproteinases-MMPs and cysteine cathepsins-CCs) on dentine erosion. DesignDentine blocks (4mm×4mm×2mm) from sound human teeth were randomly divided into 7 groups (n=17) according to the treatment: MMP- and CC-inhibitor chlorhexidine digluconate (CHX, 10mM); MMP-inhibitor galardin (G, 0.2mM); specific cathepsin B inhibitor (CCB, 0.2mM); non-specific CC inhibitor (CCE-64, 0.5μM); fluoride (F, 1.23% NaF); placebo (P) and untreated (UT). Inhibitors were applied as gels once for 1min. Specimens were submitted to 5 days of pH cycling including the erosive challenge (Coke, pH 2.64, 90s/day) and remineralisation (artificial saliva). Demineralised organic surface loss was determined profilometrically. Demineralised organic matrix (DOM) was removed with collagenase and the profile was re-evaluated in the absence of collagen fibrils. The differences in profilometric results and DOM thickness among the groups were analysed with ANOVA and Tukey's test (p<0.05). ResultsLoss of demineralised tissue (μm, mean±SD) was: CHX 8.4±1.7 b, G 8.6±1.9 b, CCB 9.6±1.4 a, CCE-64 9.9±1.3 a, F 9.9±1.7 a, P 10.9±2.2 a, UT 11.0±1.5 a. Loss of mineralised tissue was: CHX 15.4±2.2 b, G 16.0±1.8 b, CCB 17.6±2.4 a, CCE-64 17.6±2.0 a, F 17.3±2.8 a, P 19.1±2.1 a, UT 18.9±2.4 a. MMP-inhibitors significantly reduced organic matrix and mineral loss in comparison to all the other groups (p<0.05). No statistically significant differences were found in the thickness of the remaining DOM (p=0.845). ConclusionDentine endogenous MMPs seem to be the main enzymes responsible for DOM loss and erosion.

Validity of early MRI structural damage end points and potential impact on clinical trial design in rheumatoid arthritis

ObjectiveTo evaluate the construct validity of the rheumatoid arthritis MRI score (RAMRIS) erosion evaluation as structural damage end point and to assess the potential impact of incorporation in clinical trials.MethodsIn...