Type Of Rheumatoid Arthritis Research Articles

Specific Association of HLA-DRB1*03 With Anti-Carbamylated Protein Antibodies in Patients With Rheumatoid Arthritis.

Recognition of a new type of rheumatoid arthritis (RA)-specific autoantibody, the anti-carbamylated protein antibodies (anti-CarP), has provided an opportunity to improve the management and understanding of RA. The current study was undertaken to assess the relationship between anti-CarP antibodies and HLA-DRB1 alleles in RA. Serum samples were obtained from 3 different collections, comprising a total of 1,126 RA patients. Serum reactivity against in vitro carbamylated fetal calf serum proteins was determined by enzyme-linked immunosorbent assay. HLA-DRB1 alleles were determined using either hybridization techniques or imputation from HLA-dense genotypes. Results of these analyses were combined in a meta-analysis with data from 3 previously reported cohorts. The carrier frequencies of the common HLA-DRB1 alleles were compared between the antibody-positive RA subgroups and the double-negative subgroup of RA patients stratified by anti-citrullinated protein antibody (ACPA)/anti-CarP antibody status, and also between the 4 RA patient strata and healthy controls. Meta-analysis was conducted with 3,709 RA patients and 2,305 healthy control subjects. Results revealed a significant increase in frequency of HLA-DRB1*03 carriers in the ACPA-/anti-CarP+ subgroup as compared to ACPA-/anti-CarP- RA patients and healthy controls; this was consistently found across the 6 sample collections. This association of HLA-DRB1*03 with ACPA-/anti-CarP+ RA was independent of the presence of the shared allele (SE) and any other confounders analyzed. No other allele was specifically associated with the ACPA-/anti-CarP+ RA patient subgroup. In contrast, frequency of the SE was significantly increased in the ACPA+/anti-CarP- and ACPA+/anti-CarP+ RA patient subgroups, without a significant distinction between them. Furthermore, some alleles (including HLA-DRB1*03) were associated with protection from ACPA+ RA. These findings indicate a specific association of HLA-DRB1*03 with ACPA-/anti-CarP+ RA, suggesting that preferential presentation of carbamylated peptides could be a new mechanism underlying the contribution of HLA alleles to RA susceptibility.

FORMULATION DEVELOPMENT AND EVALUATION OF LIPOSOME FOR TOPICAL DELIVERY

and side effects. So the objective of the present research work is to reduce the side effects, Topical administration of drug is better for local action and the efficiency of the topically administered drug is increased with vesicles like Liposomes. Liposomes were prepared by rotator evaporation method and optimized on the basis of average vesicle size, % drug entrapment and polydispersity index. The optimized formulation was further encorpoated with gel base (carbapol gel) and characterized for their viscosity, extrudability, spreadability and drug release study. The NSAIDs is mainly used for the treatment of rheumatoid arthritis and osteoarthritis. Sulfasalazine is non steroidal anti inflammatory drug with analgesic, antipyretic and anti inflammatory activity and it is commonly used in the treatment of acute mild to moderate pain, as well as inflammation of the joints caused by certain type of rheumatoid arthritis. The sulfasalazine drug has less bioavailability(10-30%), more dose frequency dose frequency, increase the bioavailability and therapheutic efficacy. So sulfasalazine is chosen for development of liposome preparation.
 Keywords: Liposomes, rheumatoid arthritis, sulfasalazine

Association of Boron, Copper, Germanium, Magnesium, Selenium and Zinc with Incidence of Rheumatoid Arthritis

Background and Objectives: Trace elements have an important role in numerous metabolic processes. This study aimed to investigate the association between the levels of boron, copper, germanium, magnesium, selenium and zinc with the incidence of rheumatoid arthritis, and assess their relationship with other confounding factors, such as age, gender and type of rheumatoid arthritis (rheumatoid arthritis with rheumatoid factor positive or negative). This study also aimed to evaluate the correlation coefficient between all studied parameters. Methods: This case-control study was conducted on 56 men and women Iraqi patients with rheumatoid arthritis. An equal number of apparently healthy adults were also enrolled in this study as the control group. The patients were free from any diseases except rheumatoid arthritis, which was confirmed by clinical examination and laboratory estimations of biochemical and hematological tests. Serum levels of the investigated parameters were estimated using flame and flameless atomic absorption spectrophotometry. Results: Results showed that the serum levels of the investigated parameters significantly reduced in the patient groups compared with the control group. No significant age differences were observed in relation to the investigated parameters. In terms of the levels of boron, copper, magnesium and selenium a significant differences were observed between men and women. By contrast, no significant differences were observed between men and women in terms of the levels of germanium and zinc. Conclusion: The serum levels of the investigated elements were significantly reduced in patients with rheumatoid arthritis. Thus, supplementation with trace elements could be necessary for rheumatoid arthritis therapy, and even more important to individuals who are at high risk of developing rheumatoid arthritis. These findings prove the possible association between decreased serum levels of the studied parameters with the incidence of rheumatoid arthritis. Therefore, the estimation of these trace elements could be a useful complementary non-invasive diagnostic tool to determine trace elements status for early diagnosis and therapy of rheumatoid arthritis.

Cytotoxic T lymphocyte-Associated Antigen +49G Variant Confers Risk for Anti-CCP- and Rheumatoid Factor-Positive Type of Rheumatoid Arthritis Only in Combination with CT60∗G Allele

Controversial observations have been published on the association of the cytotoxic T lymphocyte associated antigen gene's variants with rheumatoid arthritis (RA). After genotyping 428 patients and 230 matched controls, the prevalence of the CT60∗G allele was more frequent in RF- and/or anti-CCP-seropositive RApatients, compared to the healthy controls (P < .001). Regression analysis revealed that the CT60∗G allele is a possible predisposing factor for RA in these subgroups. No accumulation of the +49∗G allele was found among patients, and this variant was not found to correlate with RA. Assaying the possible genotype variations, the +49∗G-C T60∗G allelic combination was accumulated in seropositive RA-subtypes, and was associated with the risk of RA (OR = 1.73, P = .001 for the whole RA-population). Although the +49∗G allele did not mean a predisposition to RA alone, in combination with C T60∗G it, also conferred risk, suggesting that the +49A/G variant is associated with the risk of RA only in certain haplotypes.

The definition and clinical features of the mutilans type of rheumatoid arthritis

The mutilans type of rheumatoid arthritis (RA) is refractory to several treatments and involves many types of surgical application. It is difficult to prevent its progress, and it has a poor functional prognosis. However, the definition is not always distinct. In this report, I attempt to clarify the clinical features of the mutilans type of RA and establish an accurate definition of the disease. Previous definitions have been divided into three groups: (1) the mutilans group (Mu-G), which has more than three joints showing severe resorptive bone destruction and joint instability; (2) the suspected mutilans group (sMu-G) which has one to two joints with joint instability or showing no instability but with highly resorptive bone destruction; (3) the Larsen V group (LV-G), which has radiological findings indicating Larsen grade V disease. Patients suffering from rheumatoid arthritis for over 10 years and who do not fall into any of the above groups are referred to as the control group. Among 337 patients who suffered from RA for more than 10 years, 58 were classified as being in the mutilans group, 59 in the suspected Mu-G, 47 in the LV-G, and 173 in the control group. The mutilans group had distinctive features which were different from those of the other groups, which had a radiological finding of Larsen grade V disease or severe resorptive bone destruction without instability. From these data, the definition of the mutilans type of RA should be specified as the Mu-G. Thus, the Mu-G shows a distinctive clinical picture which is unlike that in the other groups. It is important to define the mutilans type of RA clearly because it has a poor prognosis. Early identification will help in the establishment of a treatment plan.

The definition and clinical features of the mutilans type of rheumatoid arthritis

The definition and clinical features of the mutilans type of rheumatoid arthritis

Immunogenetic aspects of allotransplantation.

It now appears unequivocal that three markers exist in a linkage group in chromosome 6 of man: HLA-A, HLA-B and PGM3 (Fig. 1.) Tentatively, two other HLA loci and one Ir gene have been mapped close to HLA-B. The probable map order is HLA-A - HLA-C - HLA-B - HLA-D - Ir. The biological functions of these loci are unknown. However, HLA-A, B and C are important in allograft rejection. Other closely linked loci (HDR, CML) appear to be important in the first events of the allograft rejection (first set) and in generation of killer cells. HLA-D might be important in cellular recognition and graft-versus-host reactions (matching at HLA-D decreases the incidence and severity of graft-versus-host disease), and the Ir genes in the defense against infections. HLA-B and HLA-D loci are important markers in studies of disease susceptibility. HLA-B locus antigens HLA-B27 and HLA-B8 are frequently associated with arthritic or autoimmune disorders. HLA-D determinants have been found in association with multiple sclerosis and C2 deficiency (HLA-DW2); juvenile diabetes and Addison's disease (HLA-DW3) and adult type of rheumatoid arthritis (HLA-DW4).

Synovectomy of the Knee

Summary Synovectomy of the knee is a useful procedure in diseases of the synovial membrane, which include synovial osteochondromatosis, pigmented villonodular synovitis, arborescent synovial lipoma, diffuse synovial hemangiomata, the unusual case of the synovial phase of tuberculosis, and coccidioidal synovitis. The most widespread usage of synovectomy today is in rheumatoid arthritis. Synovectomy should be performed in rheumatoid arthritis when the joint motion is good, there is no ligamentous instability, and the roentgenograms show little or no erosion. The white line of the subchondral plate of bone of the tibia and femur should be carefully examined for areas of indistinctness or breaks in continuity. Any such areas may represent erosions of bone. The type of rheumatoid arthritis that produces a synovial mass or proliferative synovitis responds well to synovectomy. The adhesive capsulitis or dry form of rheumatoid arthritis, which produces little synovitis, does not respond well to synovectomy. The best results from synovectomy of the knee can be achieved by early postoperative motion. Manipulation is not performed routinely. Relief of pain may be dramatic, and motion is usually maintained. The problem of recurrent synovitis has yet to be settled; it can be the result of either of two factors. One is the obvious recurrence of the rheumatoid disease process; the other is inflammatory synovitis as a result of incongruity of the joint surfaces already damaged by rheumatoid arthritis. It is not possible to distinguish between these two mechanisms at the present time. Synovectomy of the knee is a highly effective means of relieving pain in the patient with rheumatoid arthritis. It should be performed when the disease is progressive but before joint damage is severe, if the best results are to be obtained.

ARTHRITIS RHEUMATOIDES ADOLESCENTIUM.

SummaryRheumatoid arthritis with onset before 25 years of age seems to be a special type of rheumatoid arthritis characterized by good functional capacity inspite of advanced anatomical changes. The gamma-globulin level in serum is, as a rule, normal and the degree of inflammatory activity is slight. The name “arthritis rheumatoides adolescentium” is suggested for this variant of disease.

The intracutaneous Congo Red Test.

Summary The intracutaneous Congo Red test was studied in 30 subjects with the adult type of rheumatoid arthritis and in 24 patients with other collagen diseases. The rate of fading of the dye was compared with a control group of 40 subjects, some of whom were normal while the remainder suffered from a variety of general medical diseases.The fading rate in adults with rheumatoid arthritis did not differ significantly from the control group of non-collagen diseses.A marked and significant delay in absorption was observed in rheumatic fever. A small number of subjects with Still's Disease and systemic lupus erythematosus also exhibited delayed F. Rs. Possible causes for this are discussed.

DEGENERATIVE RHEUMATOID CHANGES

1. Three cases of a degenerative type of rheumatoid arthritis, with large cystic cavities filled with pus-like material, are described. They may arise from bursae or breaking-down nodules. 2. Four cases in which necrosis and subluxation complicated rheumatoid disease of the cervical column are recorded. 3. The pathogenesis of necrotic and cystic areas in rheumatoid arthritis is discussed.