Ra Activity Research Articles

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

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

Effect of Mediterranean diet versus low caloric diet on rheumatoid arthritis disease activity

Abstract Background Rheumatoid arthritis Is a systemic connective tissue disease affecting predominantly joints. The disease develops in a course of autoimmune inflammatory process triggered by environmental factors in genetically predisposed person .One such environmental factors is the diet . A basic explanation of a low calorie diet is described as a diet that provides fewer than 1,200 calories per day. .Low calorie diets are known for getting individuals mind excited about losing the weight without the actual motivation to exercise. The Mediterranean diet is not a single prescribed diet, but rather a general food-based eating pattern, which is marked by local and cultural differences throughout the Mediterranean region.Diet is generally characterized by a high intake of plant-based foods (e.g. fresh fruit and vegetables, nuts, and cereals) and olive oil. Also it is characterized by moderate intake of fish and poultry, and low intakes of dairy products (mostly yoghurt and cheese), red and processed meats, and sweets. Objectives To assess the effect of Mediterranean diet versus low caloric diet on disease activity of rheumatoid arthritis Patient and methods The present study included 30 patients with Rheumatoid Arthritis diagnosed according to 2010 ACR\EULAR criteria every patient is subjected to full clinical examination ;BMI DAS28, CDAI, laboratory investigations, ESR, CRP, CBC, lipid profile, ALT, AST and serum creatinine. Patients were randomly assigned into one of two groups ; group 1 included 15 patients who received low caloric diet and group 2 included 15 patients who received Mediterranean diet for 6 weeks to be reassessed at the end of study. Results Both groups ;low caloric diet group and Mediterranean diet had significant improvement on BMI, number of tender joints, DAS and CDAI mHAQ, ESR CRP,TC p < 0.05 There was non significant change between both groups as regard previously mentioned parameters however regarding percent of change between both groups. There was significant difference regarding only BMI with more reduction in group 2 versus group 1 Conclusion both regimens are effective in lowering RA activity. Both have positive impacts on quality of life of RA patients,

Dynamics of the level of calprotectin in patients with rheumatoid arthritis during rituximab biosimilar (Acellbia “Biocad”) therapy

Objective.To study the relationship between the level of calprotectin (CP) and RA activity, the level of acute phase reactants, proinflammatory cytokines, chemokines and growth factors, to assess its dynamics during rituximab (RTM) biosimilar therapy.Material and methods.20 patients with RA were examined. All patients received 2 intravenous infusions of RTM (Acellbia®) at a dose of 600 mg with an interval of 2 weeks against the background of methotrexate therapy. The level of CP in blood serum was measured by ELISA.Results.Before starting DAS28 (5.6 [4.9–6.8]), SDAI (27.17 [23.08–39.9]) and CDAI (26.6 [22.25–37.0]) corresponded to the high disease activity. A decrease in disease activity was noted after 12 and 24 weeks of therapy: the DAS28 value was 4.28 [3.24–4.75] and 4.14 [3.11–4.66], respectively (p<0.05). Before the start of therapy, patients with RA had a higher CP level compared with healthy donors 9.68 (4.5–21.5) and 2.39 (1.52–4.45) μg/ml, respectively (p<0.05). Against the background of RTM therapy, there was a decrease in the CP level 12 weeks after the first infusion of the drug in the group as a whole by 26.5% from the initial level, among patients with moderate/no effect of therapy – by 32.7% from the initial level.Conclusion.The CP level significantly decreases during therapy and can be used to monitor the effectiveness of therapy. The predictive value of this laboratory parameter requires further study.

Exploring the role of monocyte chemoattractant protein-1 in fibroblast-like synovial cells in rheumatoid arthritis

BackgroundRheumatoid arthritis (RA) is a chronic systemic inflammatory disease with persistent synovitis. In the present study, the impact of monocyte chemoattractant protein-1 (MCP-1) was explored to determine methods for the diagnosis and treatment of RA.MethodsFirst, fibroblast-like synoviocytes (FLSs) were obtained from a collagen-induced rat RA model. Next, MCP-1-overexpression plasmid and small interfering RNA were transfected into human and rat FLSs. Cell Counting Kit-8 (CCK-8), Transwell migration and flow cytometry assays were used to analyze cell proliferation, migration and apoptosis of FLSs following MCP-1 transfections, respectively. Furthermore, western blotting was used to analyze the expression levels of p-P38, p-PI3K, PI3K, CD31, VEGF, TNF-α and IL-β in FLSs following MCP-1 transfection. In addition, reverse transcription-quantitative PCR and ELISAs were used to analyze the expression levels of C-reactive protein (CRP), estrogen receptor, MCP-1 and pentraxin-3 in patients with clinical RA, followed by correlation analysis of clinical data. Finally, expression validation, diagnostic and protein-protein interaction (PPI) network analysis of MCP-1 were performed.ResultsMCP-1 promoted FLS proliferation and migration, and affected the apoptosis of FLSs. In addition, the expression levels of p-P38, p-PI3K, PI3K, CD31, VEGF, TNF-α and IL-β were also affected by MCP-1. In patients with clinical RA, the expression level of MCP-1 was increased. Moreover, CRP expression level was significantly up-regulated in RA. Clinically, MCP-1 was strongly correlated with tender joint count, swollen joint count, visual analog scale for general health and disease activity score 28 (DAS28)-MCP-1, and was moderately correlated with DAS28 and DAS28-CRP. PPI analysis showed that MCP-1 mainly interacted with other inflammatory cytokines.ConclusionIn conclusion, MCP-1 may play a significant regulatory role in RA, and could be used as a measurement index of clinical RA activity.

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

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

Capabilities of ultrasonography in the diagnosis of early rheumatoid arthritis and hand osteoarthritis

Objective: to compare results of ultrasound examination (US) of the wrist joints (WJ) and small joints of hands with the clinical signs in patients with early rheumatoid arthritis (eRA) and hand osteoarthriti (OAH).Patients and methods. The study included 42 patients with eRA (group 1) and 38 patients with OAH (group 2). The average age of patients with eRA was 48.60±14.86 years, the duration of clinical manifestations was 7.45±1.77 months, of patients with OAH – 54.97±12.45 years and 8.26±1.83 months, respectively. The ratio of men and women in both groups was approximately the same, the majority were women. All patients with eRA had clinical and instrumentally confirmed signs of OA: I, II, and III radiological stages of OA according to Kellgren–Lawrence were detected in 10 (23.80%), 23 (54.76%) and 9 (21.43%) patients respectively. In erosive OA II and III X-ray stage was diagnosed in 16 (42.10%) and 22 (57.90%) patients, respectively. All patients underwent ultrasound of the joints, as well as a general clinical examination, which included an assessment of the number of painful joints, the number of swollen joints, and a general assessment of pain intensity using a visual analogue scale (100 mm). RA activity was determined using the DAS28 index. We also studied laboratory parameters – the levels of CRP, rheumatoid factor and antibodies to cyclic citrullinated peptide in blood serum.Results and discussion. Comparison of the two groups of patients showed that ultrasound in B-mode and power Doppler mode with eRA and OAH showed more pronounced inflammatory and destructive changes in the wrist joints and small joints of the hands, with the exception of the distal interphalangeal joints (DIPJ). In addition, only in patients of the 1st group there was a close correlation between the enhancement of the Doppler signal and levels of inflammatory markers. Conclusion. eRA compared with OAH is characterized by more pronounced ultrasound signs of inflammatory and destructive changes in the wrist joins and small joints of the hands, with the exception of DIPJ.

INFLUENCE OF BASIC AND EXTRACORPOREAL THERAPY ON THE LEVEL OF THYROID HORMONES AND ANTITHYROID ANTIBODIES IN PATIENTS WITH RHEUMATOID ARTHRITIS WITH THYROID INVOLVEMENT

Objective: to study the effect of treatment on the dynamics of antibodies to thyroid hormones in patients with rheumatoid arthritis with thyroid involvement. Methods: 27 people were selected with a diagnosis of rheumatoid arthritis, with a different cjndition of thyroid gland, tread with basic therapy (methotrexate or leflunomide). The patients were divided into three groups, depending on additional anti-inflammatory therapy: group 1 - NSAIDs, group 2 - NSAIDs and glucjcjrticoids (GC), group 3 - NSAIDs, GC and plasmapheresis (7, 15 and 5 patients, respectively). Concentrations of TSH, T3 and T4 were measured using ELISA, antibodies to T3 and T4 - by indirect ELISA using antigens immobilized on magnetic polyacrylamide beads. Marker levels were measured at admission to the hospital and at the time of discharge. Results. By the end of hospitalization of RA patients with autothyroid pathology in the hospital, there was a significant decrease in the content of antibodies in the blood to thyroid hormones. The level of antibodies to thyroid hormones in RA patients with concomitant autothyroid pathology demonstrated significant differences between the indicators before and after treatment in patients in the third group. The levels of antibodies to thyroid hormones in subgroup No. 3 after treatment significantly decreased by 75 % from the initial values. The other two subgroups also showed reductions in antibody levels, but these were not statistically significant. Conclusion. Thus, the basic therapy of RA, as well as additional methods of reducing RA activity using NSAIDs, GC, plasmapheresis, can affect the levels of thyroid hormones in patients with thyroid lesions. The most pronounced effect on the concentration of antibodies to thyroid hormones was found in patients who received a course of plasmapheresis in addition to other methods of treatment. T4 level after treatment was proportionally reduced in patients of all three groups, while remaining within the normal range. For T3, there were no distinct dynamics after treatment. The results obtained indicate a predominantly autoimmune genesis of thyroid lesions in RA.

Galectin-9 expression correlates with therapeutic effect in rheumatoid arthritis

Galectin-9 (Gal-9) is a multifunctional immunomodulatory factor highly expressed in RA. This study aimed to investigate the expression of Gal-9 and its correlation with disease activity and therapeutic response in RA patients. Active RA patients were enrolled and treated with tacrolimus (TAC) alone or in combination therapy for 12 weeks in a prospective cohort study. Clinical and immunological parameters were recorded at baseline and week 12. We measured Gal-9 expression in different T cell subsets and in plasma. The disease activity of RA patients decreased after treatment. At baseline, the Gal-9 expression percentage was higher in the group with severe disease than in mild or moderate groups. After treatment, the Gal-9 expression in CD3+, CD4+, CD8+ and CD4-CD8− cell subsets decreased, as well as Gal-9 mean fluorescence intensity in CD3+, CD4+ and CD8+ T cells. Similarly, plasma Gal-9 levels were lower at week 12 than at baseline. Good responders showed significantly lower Gal-9 expression on CD3+ and CD4+ T cell subsets and lower plasma Gal-9 levels than poor responders. Gal-9 expression positively correlates with disease activity in RA patients. Gal-9 can be regarded as a new biomarker for evaluating RA activity and therapeutic effect, including TAC.

Effect of CRABP1 expression on the proliferation and the sensitivity to retionoic acid of breast cancer cells of different origin

Background.Retinoic acid (RA), by modulation of the transcription of a number of retinoid-responsive genes, is involved in the regulation of cell differentiation and proliferation. The mechanisms by which the RA-binding proteins, molecular chaperones CRABP1 and CRABP2 (Cellular Retinoic Acid Proteins-1 and -2), participate in the realization of RA activity, as well as their precise role in tumor progression are still not fully understood. Recent data indicate that functional differences of CRABP proteins with respect to malignization of breast cancer cells could be determined by different sensitivity of tumor cells to RA and with the receptor status of the tumor.Materials and methods.The CRABP1 coding sequence was overexpressed in breast cancer cells without endogenous expression of this protein, with different levels of RA sensitivity and receptor status – SKBR3 (RA-sensitive, ER(–) / HER2(+) cells) and MDA-MB-231 (RA-resistant, triple negative status). The growth of CRABP1(+) derivatives and control cells was evaluated under standard culture conditions and in the presence of various concentrations of RA.Results.The effect of CRABP1 expression in RA-sensitive and RA-resistant breast cancer cells with different receptor status on the growth rate and sensitivity of cells to RA was studied. The expression of CRABP1 in RA-sensitive SKBR3 cells enhances proliferation in the absence of RA and decreases the antiproliferative effect of RA, while in RA-resistant triple-negative MDA-MB-231 cells, the expression of CRABP1 does not affect the studied characteristics.Conclusion.CRABP1 stimulates growth and suppresses the RA-sensitivity of HER2(+) RA-sensitive cells, but does not have a similar effect on highly aggressive triple-negative RA-resistant cells.

Elevated radium levels in Nubian Aquifer groundwater of Northeastern Africa

The Nubian Sandstone Aquifer System in Northeast Africa and the Middle East is a huge water resource of inestimable value to the population. However, natural radioactivity impairs groundwater quality throughout the aquifer posing a radiological health risk to millions of people. Here we present measurements of radium isotopes in Nubian Aquifer groundwater from population centers in the Western Desert of Egypt. Groundwater has 226Ra and 228Ra activities ranging from 0.01 to 2.11 and 0.03 to 2.31 Bq/L, respectively. Most activities (combined 226Ra + 228Ra) exceed U.S. EPA drinking water standards. The estimated annual radiation doses associated with ingestion of water having the highest measured Ra activities are up to 138 and 14 times the WHO-recommended maxima for infants and adults, respectively. Dissolved Ra activities are positively correlated with barium and negatively correlated with sulfate, while barite is approximately saturated. In contrast, Ra is uncorrelated with salinity. These observations indicate the dominant geochemical mechanisms controlling dissolved Ra activity may be barite precipitation and sulfate reduction, along with input from alpha-recoil and dissolution of aquifer minerals and loss by radioactive decay. Radium mitigation measures should be adopted for water quality management where Nubian Aquifer groundwater is produced for agricultural and domestic consumption.

The distribution and sources of radium isotopes in Da Qaidam salt lake

为了查明大柴旦湖周围水体相互作用过程，2016年3月和7月分别采集了大柴旦周围多种水体样品、悬浮颗粒物和湖底沉积物.测试了大柴旦盐湖、深部地下热水、表层地下水热水、浅层地下水、河流水体中镭同位素的活度值，通过解吸和扩散实验，获得了河流悬浮颗粒物和湖底沉积物扩散的镭同位素活度值.结果表明：河口区（3L10、3L11、3L12）²²³Ra、²²⁴Ra、²²⁶Ra和²²⁸Ra活度比湖中心的活度值高，湖水中²²³Ra、²²⁴Ra、²²⁶Ra和²²⁸Ra活度先随着盐度的增加而升高，当盐度大于168.99‰时，则随着盐度的增加而降低，这表明镭同位素在进入湖体是先发生解吸，后发生镭同位素的共沉淀.深部地下热水²²³Ra、²²⁴Ra和²²⁸Ra的活度值是表层地下热水²²³Ra、²²⁴Ra和²²⁸Ra活度值的3~4倍，而²²⁶Ra活度值正好相反，表层地下热水中²²⁶Ra的活度值比深部地下热水中²²⁶Ra的活度值高，在表层具有明显的积累现象.这是由于短半衰期²²³Ra、²²⁴Ra和²²⁸Ra发生衰减，而长半衰期²²⁶Ra得到积累的原因，从而表明镭同位素的运移方向是从深部往上涌的过程.大柴旦盐湖中的镭同位素主要来源于深部地下热水、浅层地下水和河流.大柴旦周围水循环过程是雨和冰雪融水下渗补给深部和浅层地下水以及地表径流；深部地下热水一部分上涌至表层，经过出山口之后全部转化为浅层地下水，一部分通过深大断裂汇集到大柴旦湖；浅层地下水直接汇集到湖盆；地表径流在山区下渗补给浅层地下水，丰水期汇入到湖盆.;In order to understand hydrologic cycle around Da Qaidam salt lake, water and suspended particulate matter (SPM) and sediments samples were collected in March and July in 2016. The activities of radium isotopes of brine water, deep hot spring water, shallow spring water and river water were measurement. Moreover, the radium isotopes activities from SPM and sediment were obtained by experiments of desorption and diffusion. The results showed that the activities of ²²³Ra, ²²⁴Ra, ²²⁶Ra and ²²⁸Ra of lake water in estuary were higher than those of in lake centre, and they increase with the salinity, and then decrease with the salinity when salinity is greater than 168.99‰, suggesting that radium were desorbed when groundwater or river water met salt lake water at beginning at low salinity, and radium were co-precipitation with Ca or Ba at high salinity. The activity value of ²²³Ra, ²²⁴Ra and ²²⁸Ra in deep hot spring water are about 3-4 times as much as those in shallow hot spring water. However, ²²⁶Ra activity values in shallow hot spring water are higher than that of deep hot spring water,which show an obvious accumulation phenomenon at the surface. This is because half-life of ²²³Ra, ²²⁴Ra and ²²⁸Ra is very short, it is easy to attenuate, while the long half-life ²²⁶Ra easy to accumulate, indicating that the migration direction of Radium is from deep to upwelling. The sources of radium in Da Qaidam salt lake are mainly from deep hot spring water, shallow groundwater and river water. The infiltration of rain and melt snow water to recharge deep and shallow groundwater and surface runoff. A part of the deep hot water rises to the surface, and then converted into shallow groundwater after passing through the mountain pass. The other part of deep hot water were flowed into Da Qaidam salt lake by the deep fault. The shallow groundwater entering into the lake basin. Surface runoff supply shallow groundwater by infiltration at and inflow into the lake basin during wet season.

Renal dysfunction among rheumatoid arthritis patients: A retrospective cohort study

BackgroundRheumatoid arthritis (RA) is a common rheumatological disease which can involve a variety of different renal manifestations. This may be explained by disease effect itself or by medications used for treatment that may lead to renal dysfunction and its complications.We aimed to identify the prevalence and factors that played a role in renal dysfunction among RA Jordanian patients. Method285 patients with RA visiting outpatient clinic between March 2016 and March 2017 were included in a retrospective study design. Age, gender, comorbidities, duration of the disease, medications and laboratory results were gathered and scoring of RA activity was done. ResultsData gathered from the 285 patients showed a female predominance with 88.4% female and 11.6% male. The average disease duration was 6.7 years. Age, DM, HTN, and serum CRP were associated with worse renal function on univariate analysis. 44 patients (18.8%) presented with microscopic hematuria, 16 (6.9%) with proteinuria and only 5 (2.1%) patients presented with both microscopic hematuria and proteinuria. Patients with eGFR <60 ml/min had longer disease duration with a mean of 11 years (±7.7) in comparison to 6.4 years (±6.1) for those with eGFR>90 ml/min (P = 0.001). ConclusionRenal dysfunction is not common in RA Jordanian population and has variable presentations. Age and the duration of illness play a major role in the progression of CKD if present. Future prospective studies evaluating renal biopsies in RA patients are needed.

Impact of disease activity and treatments on ovarian reserve in patients with rheumatoid arthritis in the ESPOIR cohort.

Patients with RA have a higher prevalence of infertility than the general population. This study sought to examine the impact of RA disease activity and treatments on ovarian reserve measured by serum anti-Müllerian hormone (AMH) levels in the ESPOIR cohort. We sought to better define the indications for fertility preservation. Patients and serum analysis data were derived from the French national cohort ESPOIR. Enrolled patients (n = 102; 18-37-year-olds) fulfilled ACR/EULAR 2010 criteria for RA. Serum AMH levels were measured at T0, T6, T12, T24 and T36 months post-diagnosis. The impacts of RA activity (DAS28 and CRP level) and treatments (MTX only or with other medications) were evaluated at each study visit. A gradual decrease in patients' serum AMH levels was observed over time, in line with the descending curve described for healthy women. Serum AMH levels of RA patients in comparison with the values considered normal for age did not reveal any significant differences (P > 0.05). We did not observe any impact of RA treatments. We demonstrated an inverse correlation between AMH variation and disease activity (DAS28: r = -0.27, P = 0.003; CRP: r = -0.16, P = 0.06). This is the first study to determine serum AMH levels of a large cohort of RA patients over 36 months. Rapid disease activity control appears to be required to limit changes in the ovarian reserve. Fertility preservation is not likely to be necessary if inflammation is promptly controlled. NCT03666091.

Radium Mass Balance Sensitivity Analysis for Submarine Groundwater Discharge Estimation in Semi-Enclosed Basins: The Case Study of Long Island Sound

Estimation of submarine groundwater discharge (SGD) to semi-enclosed basins by Ra isotope mass balance is herein assessed. We evaluate 224Ra, 226Ra and 228Ra distributions in surface and bottom waters of Long Island Sound (CT-NY, USA) collected during spring 2009 and summer 2010. Surface water and bottom water Ra activities display an apparent seasonality, with greater activities during the summer. Long-lived Ra isotope mass balances are highly sensitive to boundary fluxes (water flux and Ra activity). Variation (50%) in the 224Ra, 226Ra and 228Ra offshore seawater activity results in a 63 – 74% change in the basin-wide 226Ra SGD flux and a 58 – 60% change in the 228Ra SGD flux, but only a 4 – 9% change in the 224Ra SGD flux. This highlights the need to accurately constrain long-lived Ra activities in the inflowing and outflowing water, as well as water fluxes across boundaries. Short-lived Ra isotope mass balances are sensitive to internal Ra fluxes, including desorption from resuspended particles and inputs from sediment diffusion and bioturbation. A 50% increase in the sediment diffusive flux of 224Ra, 226Ra and 228Ra results in a ~30% decrease in the 224Ra SGD flux, but only a ~6 – 10% decrease in the 226Ra and 228Ra SGD flux. When boundary mixing is uncertain, 224Ra is the preferred tracer of SGD if sediment contributions are adequately constrained. When boundary mixing is well-constrained, 226Ra and 228Ra are the preferred tracers of SGD, as sediment contributions become less important. A three-dimensional numerical model is used to constrain boundary mixing in Long Island Sound, with mean SGD fluxes of 1.2 ± 0.9 *1013 L y-1 during spring 2009 and 3.3 ± 0.7 *1013 L y-1 during summer 2010. The SGD flux to Long Island Sound during summer 2010 was one order of magnitude greater than the freshwater inflow from the Connecticut River. The maximum marine SGD-driven N flux is 14 ± 11 *108 mol N y-1 and rivals the N load of the Connecticut River.

The impact of disease severity and duration on cost, early retirement and ability to work in rheumatoid arthritis in Europe: an economic modelling study.

ObjectiveRA is a progressive, chronic autoimmune disease. We summarize the impact of disease activity as measured by the DAS in 28 joints (DAS28-CRP scores) and pain on productivity and ability to work using the Work Productivity and Activity Impairment questionnaire (WPAI) scores, in addition to the impact of disease duration on the ability to work.MethodsData were drawn from the Burden of RA across Europe: a Socioeconomic Survey (BRASS), a European cross-sectional study in RA. Analyses explored associations between DAS28-CRP score and disease duration with stopping work because of RA, and regression analyses assessed impacts of pain and DAS28-CRP on early retirement and WPAI.ResultsFour hundred and seventy-six RA specialist clinicians provided information on 4079 adults with RA, of whom 2087 completed the patient survey. Severe disease activity was associated with higher rates of stopping work or early retirement attributable to RA (21%) vs moderate/mild disease (7%) or remission (8%). Work impairment was higher in severe (67%) or moderate RA (45%) compared with low disease activity [LDA (37%)] or remission (28%). Moreover, patients with severe (60%) or moderate pain (48%) experienced increased work impairment [mild (34%) or no pain (19%)]. Moderate to severe pain is significant in patients with LDA (35%) or remission (22%). A statistically significant association was found between severity, duration and pain vs work impairment, and between disease duration vs early retirement.ConclusionResults demonstrate the high burden of RA. Furthermore, subjective domains, such as pain, could be as important as objective measures of RA activity in affecting the ability to work.

КЛИНИЧЕСКИЕ ОСОБЕННОСТИ НЕВРОТИЧЕСКИХ НАРУШЕНИЙ ПРИ РЕВМАТОИДНОМ АРТРИТЕ

When examining 168 patients with rheumatoid arthritis (113 women, 55 men), neurotic disorders were found in 72.6% of patients: 22.6% -mild, 35.1% –moderate, and 14.9%-severe. At low RA activity, neurotic disorders were diagnosed in 56.8% of patients, and at medium and high levels-in 73.9 and 84.3% of patients. The most common types of disorders were asthenic and vegetative disorders, the frequency of which was 60.7 and 63.1%. 24.4% of patients were diagnosed with emotional disorders, 12.5% with hypochondriacal disorders, 9.5% with hysterical disorders, and 4.8% with obsessive -compulsive disorders

Analysis of lncRNA expression profiles by sequencing reveals that lnc-AL928768.3 and lnc-AC091493.1 are novel biomarkers for disease risk and activity of rheumatoid arthritis.

This study aimed to analyze long non-coding RNA (lncRNA) expression profiles in synovium tissue of patients with RA using RNA sequencing, and to further assess the clinical values of dysregulated lncRNAs in RA diagnosis and monitoring. Thirty patients with RA who underwent knee arthroscopy and 30 controls with knee trauma who underwent surgery were consecutively enrolled and synovium tissue samples of both groups were obtained during surgery. In the exploration stage, lncRNA and mRNA expression profiles in three RA samples and three control samples were detected by RNA sequencing and bioinformatic analyses were then performed. In the validation stage, quantitative polymerase chain reaction (qPCR) was subsequently used to detect expression of five candidate lncRNAs in 30 patients with RA and 30 control patients. A total of 349 lncRNAs and 1582 mRNAs were upregulated and 806 lncRNAs and 1295 mRNAs were downregulated in patients with RA compared with controls. Enrichment analyses revealed that these dysregulated lncRNAs and mRNAs were mainly involved in regulating immune response, leukocyte migration, complement activation, and Bcell receptor signaling pathway. Subsequent qPCR validation discovered that lnc-AL928768.3 (P < 0.001) and lnc-AC091493.1 (P < 0.001) were elevated in patients with RA compared with controls and afford good predictive values for RA risk by receiver operating characteristic (ROC) curve analysis. Additionally, the two lncRNAs were positively associated with C-reactive protein level and disease activity score in 28 joints (ESR) (all P < 0.05). Analysis of lncRNA expression profiles by sequencing reveals that lnc-AL928768.3 and lnc-AC091493.1 are novel biomarkers for RA risk and activity.

Near-field hydrothermal plume dynamics at Brothers Volcano (Kermadec Arc): A short-lived radium isotope study

The naturally occurring radium (Ra) isotope quartet was measured for the first time at an intraoceanic arc hydrothermal setting along the Kermadec Island Arc (SW Pacific). 224Ra (3.7 d half life) and 223Ra (11.4 d half life) are assumed to be tracers solely originating from hydrothermal discharge and have been used to resolve near-field hydrothermal plume dynamics by applying both advection and eddy diffusion-based dispersion models. Assuming dominant advective processes, we identified different horizontal plume age structures at Brothers volcano, with a slow moving plume inside the caldera (0.060 cm/s) and a faster moving plume outside the caldera (0.323 cm/s), indicating a longer plume residence time within the caldera structure. The decreasing trend in Ra activity also allows the calculation of horizontal eddy diffusion coefficients inside and outside of the caldera, with 0.164 m2/s and 3.545 m2/s for 224Ra, respectively. These trends are in accordance with the radial horizontal eddy diffusion model. Our results reveal that net advection might not necessarily play a major role at Brothers, as radial horizontal eddy diffusion reproduces the observed Ra activity distribution to the same degree. Additional model simulations based on a combination of advection and diffusion, favor slow net advection to explain the Ra activity distribution. Within the rising non-buoyant plume, Ra isotopes suggested constant dilution along the first 170 m of the vertical water column and a vertical transport velocity on the order of 0.156 cm/s for altitudes up to 150 m above the vent and around 0.004 cm/s for altitudes above 150 m. When a common source of diffuse and focused venting is assumed and only small amounts of Ra are added to the ascending plume, due to recoil originating from high water to rock ratios, fluids from diffuse vents show a slower migration rate through the subsurface than fluids from focused vents. Our data imply that the fluids from diffuse vents needed approximately five days longer to percolate through the underlying subsurface to reach the water column plume, compared to the fluids from direct vents which emanate through chimney structures. This study demonstrates the potential of short-lived Ra isotopes as tracers of near-field plume dynamics, which will improve our understanding of hydrothermal vents as sources for various trace elements to the global ocean.

Predictive factors related to the progression of periodontal disease in patients with early rheumatoid arthritis: a cohort study

BackgroundRheumatoid arthritis (RA) and periodontal disease are inter-related conditions. However, factors predictive of periodontal disease progression in patients with early rheumatoid arthritis (eRA) are lacking. The aim of this study was to identify factors associated with the progression of clinical attachment loss (CAL) in interproximal dental sites of eRA patients.MethodsTwenty-eight eRA patients were evaluated for the progression of CAL at 280 interproximal dental sites at 1 year of follow-up. Markers of RA activity (rheumatoid factor, erythrocyte sedimentation rate, and C-reactive protein), a marker of bone resorption (Dickkopf-related protein 1), Disease Activity Score 28 and Simple Disease Activity Index were included as potential systemic predictive factors. Plaque index, gingival index, pocket depth, clinical attachment level and Dickkopf-related protein 1 in crevicular fluid at baseline were included as potential local predictive factors. Data were analysed in a hierarchical structure using generalised linear mixed models for progression at each site (> 2 mm) during follow-up.ResultsC-reactive protein level was the most important predictive systemic factor for the progression of CAL. The mean CAL and a high degree of gingival inflammation in interproximal sites at baseline were important predictive local factors (p < 0.0001). Patients who received combined treatment with disease-modifying antirheumatic drugs and corticosteroids exhibited less CAL (p < 0.0001). The predictive value of the generalised linear mixed model for progression was 85%.ConclusionsSystemic factors, including RA disease activity and baseline periodontal condition, were associated with periodontal progression. Pharmacological treatment may affect periodontal progression in patients with early RA.

Hydrogeological processes and near shore spatial variability of radium and radon isotopes for the characterization of submarine groundwater discharge

Inadequate characterization of variability in natural tracers of submarine groundwater discharge (SGD) introduces large errors into tracer-derived SGD estimates. To address this gap, we investigated spatial variability in the natural SGD tracers 223Ra, 224Ra, 226Ra, 228Ra and 222Rn using a high-density array of piezometers and seepage meters over a nearshore area where discharging groundwater transitioned from fresh to saline. Seepage meters and piezometers were used to sample groundwater and to quantify fluxes and salinity. A series of spatial patterns was distinguished beyond the normal salinity impact on Ra activity. The discharge in the interface between saltwater and freshwater was characterized by higher activities of the longer-lived isotopes (226Ra and 228Ra), while areas dominated by benthic exchange had higher activities of the shorter-lived isotopes (223Ra and 224Ra). Spatial differences in Ra activities were associated with variation in salinity and residence time in the aquifer and were indicative of underlying hydrogeological processes. At the freshwater-saltwater interface, fresh discharge is driven by terrestrial hydraulic gradients and saline discharge is driven by density gradients; both result in long residence times in the aquifer. Benthic exchange of saltwater has shorter residence times, much less than required to enrich long-lived isotopes and reach secular equilibrium. The highest activities of 222Rn were detected in the fresh discharge zone, and the lowest activities in areas dominated by benthic exchange. Direct sampling at discharge points allowed comparison between groundwater collected from inland wells and the water discharging to the bay, and indicated significant differences in the activities despite the short distance from wells to the discharge area. Substantial spatial variability in Ra and Rn was observed on the meter scale, with trends that reflected groundwater origin and residence time. Inadequate characterization of variability, trends, and fluxes introduces large errors into tracer-derived estimates of submarine groundwater discharge. Thus, the study of submarine groundwater discharge with radioactive tracers requires adequate hydrogeological knowledge to identify processes that have strong impacts on Ra and Rn activities and associated fluxes to the ocean.