Bibliography January 2003
- CAIRNS AP, TAGGART AJ: Anti-tumour necrosis factor therapy for severe inflammatory arthritis: two years of experience in Northern Ireland. Ulster Med.J. 2002, 71:101-105.
Organism:Department of Rheumatology, Musgrave Park Hospital, Stockman's Lane, Belfast BT9 7JB
Abstract: Etanercept and infliximab are novel biological agents targeted against tumour necrosis factor alpha (TNFalpha), a key cytokine in the pathogenesis of rheumatoid arthritis (RA). We report the results of their use over a two year period in 94 patients with severe inflammatory arthritis. Eighty-eight adults with active inflammatory arthritis (82 with RA), unresponsive to all conventional treatment, received biological therapy in one of five specialist centres in Northern Ireland. 69 adult patients (78%) had a good response to treatment, four a partial response, and seven no response. The results of treatment could not be assessed in eight patients because they had only recently commenced therapy. Four patients had a mild allergic reaction to treatment but one patient developed fulminant lung fibrosis which may have been due to drug therapy and eventually proved fatal. There were four cases of major infection requiring hospitalisation. Two patients responded to treatment, but one succumbed to bacterial pneumonia, and another to bacterial meningitis. Six children with juvenile idiopathic arthritis (JIA) received etanercept. Four achieved a good response, one a partial response, and one no response to treatment. This study shows that the impressive response to anti-TNF therapies extends beyond the realm of clinical trials to everyday clinical practice. These agents represent a major advance in the treatment of severe inflammatory arthritis but they should be used with caution, particularly in the elderly and in patients who are predisposed to infection
Internet : PM:12513005 - CAMERON ML, KOCHER MS, BRIGGS KK, HORAN MP, HAWKINS RJ: The prevalence of glenohumeral osteoarthrosis in unstable shoulders. Am.J.Sports Med. 2003, 31:53-55.
Organism:Steadman-Hawkins Sports Medicine Foundation, Vail, Colorado 81657, USA
Abstract: BACKGROUND: Glenohumeral osteoarthritis has been a well-described complication of open procedures to correct shoulder instability. What remains unknown is whether chondral injuries sustained during instability episodes contribute to osteoarthritis or whether the cause is primarily the stabilization procedure itself. PURPOSE: To determine the prevalence of osteoarthrosis in a large database of patients with acute and chronic shoulder instability before primary stabilization surgery. STUDY DESIGN: Retrospective review of prospectively collected data. METHODS: Surgical and demographic data were collected on 422 patients with a diagnosis of shoulder instability who underwent arthroscopic examination and shoulder stabilization. RESULTS: There was a significant association between the grade of osteoarthrosis and the presence of osteoarthritis (grade III or IV chondral damage) with time from injury to surgery. Patients with osteoarthritis were significantly older than those without (34.9 versus 29.6 years). Multivariate analysis identified older age and time from injury to surgery as independent predictors of osteoarthritis. We found no association between direction of instability and the presence of osteoarthritis. CONCLUSION: The overall prevalence of glenohumeral osteoarthrosis was low. Predictors of osteoarthritis included time from injury to surgery and age
Internet : PM:12531757 - DAWSON J, MILTZ W, MIR AK, WIESSNER C: Targeting monocyte chemoattractant protein-1 signalling in disease. Expert.Opin.Ther.Targets. 2003, 7:35-48.
Organism:Arthritis and Bone Metabolism Research, Novartis Pharma AG, Basel, Switzerland
Abstract: Monocyte chemoattractant protein-1 (MCP-1) has been implicated in many inflammatory and autoimmune diseases. The G-protein-coupled receptor CCR-2B is probably the most important MCP-1 receptor in vivo, and loss of MCP-1 effector function alone is sufficient to impair monocytic trafficking in inflammation models. MCP-1 signalling appears to be a relevant target, especially in rheumatoid arthritis (RA). In RA patients, MCP-1 is produced by synovial cells and infiltrating monocytes, plasma MCP-1 concentrations correlate with swollen joint count, and elevated serum MCP-1 concentrations were found in juvenile RA in patients with active disease. Modulation of MCP-1 signalling in experimental RA showed beneficial effects on inflammation and joint destruction. With respect to chronic neuroinflammation, a critical role for MCP-1 has been established in animal models for multiple sclerosis. In acute neuroinflammation, experimental evidence for a detrimental role of MCP-1 in stroke and excitotoxic injury has been found. Several selective small molecular weight CCR-2B antagonists and MCP-1-blocking antibodies have been described. The proof for the validity of targeting MCP-1 signalling in disease, however, has yet to be established in clinical trials
Internet : PM:12556201 - DE JAGER W, TE VH, PRAKKEN BJ, KUIS W, RIJKERS GT: Simultaneous detection of 15 human cytokines in a single sample of stimulated peripheral blood mononuclear cells. Clin.Diagn.Lab Immunol. 2003, 10:133-139.
Organism:Department of Pediatric Immunology, University Medical Center Utrecht, Wilhelmina Children's Hospital, 3584 EA Utrecht Sanquin Research at Central Laboratory of The Netherlands Red Cross, Department of Reagents, 1066 CX Amsterdam, The Netherlands
Abstract: Cytokines secreted by cells of the immune system can alter the behavior and properties of immune or other cells. At a site of inflammation, sets of cytokines interact with immune cells, and their combined effect is often more important than the function of one isolated component. Conventional techniques, such as enzyme-linked immunosorbent assays, generally require large quantities of cells to characterize a complete cytokine profile of activated lymphocytes. The Bio-Plex system from Bio-Rad Laboratories combines the principle of a sandwich immunoassay with the Luminex fluorescent-bead-based technology. We developed a multiplex cytokine assay to detect different cytokines simultaneously in culture supernatant of human peripheral blood mononuclear cells stimulated with antigen and with mitogen. Fifteen human cytokines (interleukin 1alpha [IL-1alpha], IL-1beta, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12p70, IL-13, IL-15, IL-17, IL-18, gamma interferon, and tumor necrosis factor alpha) were validated with a panel of healthy individuals, rheumatoid arthritis patients, and juvenile idiopathic arthritis patients. Comparing the multiplex assay with a regular enzyme-linked immunosorbent assay technique with this donor panel resulted in correlation coefficients for all cytokines ranging from 0.75 to 0.99. Intra-assay variance proved to be less then 10%, whereas interassay variability ranged between 10 and 22%. This multiplex system proved to be a powerful tool in the quantitation of cytokines. It will provide a more complete picture in differences between activated lymphocyte cytokine profiles from healthy individuals and those from patients with chronic inflammatory diseases
Internet : PM:12522051 - FALCINI F, BINDI G, SIMONINI G, STAGI S, GALLUZZI F, MASI L, CIMAZ R: Bone status evaluation with calcaneal ultrasound in children with chronic rheumatic diseases. A one year followup study. J.Rheumatol. 2003, 30:179-184.
Organism:Department of Pediatrics, University of Florence, Florence, Italy
Abstract: OBJECTIVE: To evaluate at baseline and after one year the bone status in children with chronic rheumatic diseases (CRD) using quantitative ultrasound techniques. METHODS: We evaluated bone status in 67 children, 52 female, 15 male, age range 2.80 to 18.10 years; 46 juvenile idiopathic arthritis, 11 juvenile dermatomyositis, and 10 systemic lupus erythematosus. Twenty-seven of 67 patients were taking only nonsteroidal antiinflammatory drugs (NSAID), 11 were given NSAID and methotrexate (MTX), 15 were also receiving steroids (prednisone), and 14 patients were given steroids and alendronate. Broadband ultrasound attenuation (BUA) by bone was determined at the left calcaneus using two 12.5 mm diameter, 1 MHz transducers mounted in hand-held calipers linked to a pediatric contact ultrasound bone analyzer. RESULTS: At baseline in the whole patient group mean BUA values and Z scores were significantly lower than in controls: 41.84 +/- 21.64 vs 61.69 +/- 17.42 dB/MHz (p < 0.001); Z score -0.91 +/- 1.07 vs 0.09 +/- 0.62 in controls (p < 0.001). At one year followup in the patient group BUA values were significantly increased compared to baseline (BUA 46.43 +/- 21.51 dB/MHz; p = 0.002); no significant difference was found in Z score. The 15 children receiving steroids in addition to NSAID and MTX showed a decrease in BUA value at one year (NS), while Z scores were significantly reduced compared to baseline (-1.45 +/- 1.40 vs -1.08 +/- 1.11; p < 0.05). The 14 patients in the group receiving NSAID and MTX who also received alendronate showed significant increases in BUA (56.93 +/- 19.32 vs 44.21 +/- 15.67; p < 0.001) and Z score (-0.87 +/- 1.19 vs -1.56 +/- 0.82; p < 0.002). CONCLUSION: Contact ultrasound bone analysis at the calcaneus is a useful tool in the assessment and monitoring of bone status in children with CRD
Internet : PM:12508409 - FLORENSA R, NOBOA R, MUNOZ J, COLET S, CLADELLAS JM, RODRIGUEZ MA, LEY A: [Results of C1-C2 transarticular screw fixation in a series of 20 patients]. Neurocirugia.(Astur.) 2002, 13:429-435.
Organism:Servicio de Neurocirugia Hospital Universitari Germans Trias i Pujol Badalona Barcelona Espana
Abstract: OBJECTIVE: C1-C2 transarticular fixation is an increasingly used surgical method of treating atlantoaxial instability. When properly performed, it can safely provide fusion rates near 100%, but techniques of fixation in this region allow only a small margin of error. We here report the results of C1-C2 transarticular fixation in a series of 20 patients in which different procedures were selected according to the presenting disorder in each case. METHODS: The study group included 9 men and 11 women with a mean age of 48 years (range 17 to 68 years). The causes of instabilities were rheumatoid arthritis in nine patients, type II and III Hangman's fracture of traumatic origin in nine (in association with other lesions in three cases), pseudoarthrosis after type II odontoid fracture in one, and type III complex C1 fracture in a patient with ankylosing spondylitis. Preoperative assessment included flexion and extension plain radiographs and computed tomography (CT) and magnetic resonance imaging (MRI) scans. Operations included transarticular screw fixation in all cases; in patients with rheumatoid arthritis it was associated with sublaminar fixation and bone grafting following Sonntag's technique in all but two cases. Postoperative results were evaluated in relation to the biomechanical stability and fusion was studied by flexion and extension radiographs and CT scans. Pain relief in patients with rheumatoid arthritis patients was assessed using a 0-10 visual analogic scale (V.A.S.). RESULTS: In the traumatic group, a consolidation of the fracture and radiologic stability was achieved in all cases. In patients with rheumatoid arthritis, pain improved in all but not the neurological deficit, and in all cases a C1-C2 biomechanical stability was reached despite interlaminar graft resorption in two (25%) cases. With respect to complications, a lesion of the vertebral artery occurred in one case, deviation of the screw in two cases, and breakage of the screw without clinical repercussion in two other cases. CONCLUSION: C1-C2 transarticular screw fixation was a useful technique to achieve satisfacory biomechanical stability in patients with atlatoaxial instability of both inflammatory and traumatic origin with a low rate of complications
Internet : PM:12529771 - HIERHOLZER J, MIDIRI M, IOVANE A, SPARACIA G, VENZ S, LAGALLA R: [Detection of extra-articular soft-tissue involvement in rheumatoid arthritis: value of color-coded Doppler sonography]. Ultraschall Med. 2002, 23:392-396.
Organism:Diagnostische und Interventionelle Radiologie, Klinikum Ernst von Bergmann, Potsdam,Germany
Internet : PM:12514756 - HILL J, BIRD H: The development and evaluation of a drug information leaflet for patients with rheumatoid arthritis. Rheumatology (Oxford) 2003, 42:66-70.
Organism:Clinical Pharmacology Unit (Rheumatism Research, University of Leeds), Chapel Allerton Hospital, Chapeltown Road, Leeds, West Yorkshire LS7 4SA, UK jhill@leedsacuk
Abstract: OBJECTIVES: To develop and assess the effectiveness of a drug information leaflet (DIL) for D-penicillamine (DPA) and determine whether additional verbal information provides enhanced benefit. METHODS: Three preliminary studies were undertaken: a reading age study; the development of a DIL for DPA; and a DPA knowledge questionnaire. The primary study assessed the effect of the DIL on the knowledge of 30 patients at weeks 0 and 24 after commencing DPA. A follow-up study of 100 patients randomly assigned to receive the DIL alone (control group) or with additional verbal backup (experimental group) determined the effects of additional verbal information by comparison of DPA knowledge questionnaire scores at weeks 0 and 24. RESULTS: The reading study showed that 12% of the sample had difficulty reading and so the DPA DIL was designed to be easy to read using the Flesch Reading Index. An assessment of knowledge of DPA prior to reading the DIL resulted in scores ranging from 0 to 13 with a median of 2 (maximum possible 14). By week 24 the median score was 10 (range 6-14), which was significant at P < 0.0001. The assessment of additional verbal backup showed that both the control group and the experimental group knew little about DPA on study entry, with a median score 2 in each group. On study exit, both groups knew significantly more (P < 0.001) about the drug; the control group scored 9 and the experimental group 11 (not significantly different; P=0.109). CONCLUSIONS: A large minority of patients have poor reading skills, but when a DIL is designed to be easy to read patients gain significant amounts of knowledge from it. Providing additional verbal explanations did bring about increases in knowledge but these were not significant
Internet : PM:12509615 - HOOTMAN JM, HELMICK CG, SCHAPPERT SM: Magnitude and characteristics of arthritis and other rheumatic conditions on ambulatory medical care visits, United States, 1997. Arthritis Rheum. 2002, 47:571-581.
Organism:National Center for Chronic Disease Prevention and Health Promotion, Centers for Disease Control and Prevention, Atlanta, Georgia, USA jhootman@cdcgov
Abstract: OBJECTIVE: To describe ambulatory medical care utilization, defined to exclude injury-related visits, for persons with arthritis and other rheumatic conditions. METHODS: National estimates, rates, and other characteristics of ambulatory care visits were calculated from a national sample of patient visits to physician offices and acute care hospital outpatient and emergency departments. RESULTS: An estimated 36.5 million ambulatory care visits were related to arthritis and other rheumatic conditions. Visit rates increased with age and, overall, were twice as high among women as men. Rates of visits by race varied by ambulatory care setting. Soft tissue disorders (9.3 million), osteoarthritis (7.1 million), nonspecific joint pain/effusion (7.0 million), and rheumatoid arthritis (3.9 million) were the most common diagnoses. CONCLUSIONS: Arthritis and other rheumatic conditions account for about as many ambulatory care visits as cardiovascular disease or essential hypertension. These visits serve as excellent opportunities to counsel patients regarding prevention messages for arthritis
Internet : PM:12522829 - HUNT RH, HARPER S, CALLEGARI P, YU C, QUAN H, EVANS J, JAMES C, BOWEN B, RASHID F: Complementary studies of the gastrointestinal safety of the cyclo-oxygenase-2-selective inhibitor etoricoxib. Aliment.Pharmacol.Ther. 2003, 17:201-210.
Organism:Division of Gastroenterology, McMaster University Medical Center, Hamilton, Ontario, Canada huntr@mcmasterca
Abstract: BACKGROUND: Cyclo-oxygenase-2-selective non-steroidal anti-inflammatory drugs are intended to preserve cyclo-oxygenase-1-mediated gastroprotection and platelet function, whilst inhibiting cyclo-oxygenase-2-mediated inflammation. AIM: To assess the gastrointestinal safety of the cyclo-oxygenase-2-selective inhibitor etoricoxib vs. non-selective non-steroidal anti-inflammatory drugs. METHODS: Two randomized, double-blind, pla
Internet : PM:12534404 - KARI JA, BAMASHMOUS H, MAHAN JD: Steroid-sensitive nephrotic syndrome and juvenile idiopathic arthritis. Pediatr.Nephrol. 2002, 17:975-976.
Internet : PM:12506913 - KUHNKE A, BURMESTER GR, KRAUSS S, BUTTGEREIT F: Bioenergetics of immune cells to assess rheumatic disease activity and efficacy of glucocorticoid treatment. Ann.Rheum.Dis. 2003, 62:133-139.
Organism:Department of Rheumatology and Clinical Immunology, Charite University Hospital, Humboldt University, Schumannstrasse 20/21, 10117 Berlin, Germany
Abstract: OBJECTIVE: To investigate whether activity and glucocorticoid treatment of rheumatic diseases are reflected by selected parameters of cellular energy metabolism of peripheral blood mononuclear cells (PBMC). METHODS: PBMC were obtained from 30 healthy volunteers, 28 patients (16 inactive; 12 active) with rheumatoid arthritis, systemic lupus erythematosus, vasculitis, or other autoimmune diseases, and five patients with infectious diseases. Patients with active rheumatic diseases were examined before and 4-5 days after starting, restarting, or increasing the dose of glucocorticoids. Cellular oxygen consumption (as a measure of ATP production), bioenergetic ability to be stimulated, and major ATP consuming processes were measured amperometrically with a Clark electrode. RESULTS: A normal value for oxygen consumption of 3.84 (SEM 0.1) (all data in nmol O(2)/min/10(7) cells) independent of sex was found. In patients with inactive disease the respiration rate was slightly higher, but was significantly increased in active patients to 4.82 (SEM 0.33) (p<0.001). PBMC from active patients showed a significantly lower bioenergetic response to a mitogenic stimulus than controls (p<0.05). In stimulated cells from active patients there was a significant reduction in cation transport and protein synthesis. All parameters above were almost normalised within 4-5 days upon optimised treatment with glucocorticoids. For comparison, PBMC from patients with active infectious diseases also showed an increased respiration rate; their response to mitogenic stimulation was even higher. CONCLUSIONS: This study shows for the first time that parameters describing the cellular function of PBMC in bioenergetic terms are suitable for (a) describing semiquantitatively the activity of a rheumatic disease and (b) assessing the therapeutic effect on the disease
Internet : PM:12525382 - LAIHO K, MAENPAA H, KAUPPI M, KAUTIAINEN H, BELT E: Short-term serum C-reactive protein response after shoulder replacement. Joint Bone Spine 2002, 69:622-623.
Internet : PM:12537274 - LOVELL DJ, GIANNINI EH, REIFF A, JONES OY, SCHNEIDER R, OLSON JC, STEIN LD, GEDALIA A, ILOWITE NT, WALLACE CA, LANGE M, FINCK BK, BURGE DJ: Long-term efficacy and safety of etanercept in children with polyarticular-course juvenile rheumatoid arthritis: interim results from an ongoing multicenter, open-label, extended-treatment trial. Arthritis Rheum. 2003, 48:218-226.
Organism:Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio 45229-3039, USA daniellovell@cchmcorg
Abstract: OBJECTIVE: To evaluate the long-term efficacy and safety of etanercept in children with juvenile rheumatoid arthritis (JRA) participating in an ongoing multicenter, open-label, extended-treatment trial. All patients had been participants in an initial randomized efficacy and safety trial of etanercept. METHODS: Etanercept was administered at a dosage of 0.4 mg/kg (maximum 25 mg) subcutaneously twice each week. Safety and efficacy evaluations were performed every 3-4 months. The JRA 30% definition of improvement (DOI) was defined as improvement of > or =30% in at least 3 of 6 response variables used to assess disease activity, with no more than 1 variable worsening by more than 30%. RESULTS: At the time of analysis, 48 of the 58 patients (83%) were still enrolled in the study; 43 of them (74%) had completed 2 years of treatment. Of these 43 patients, 81% met the JRA 30% DOI, 79% met the JRA 50% DOI, and 67% met the JRA 70% DOI. Ten children started low-dose methotrexate after year 1. Of the 32 children taking prednisone, the dosage was decreased to <5 mg/day in 26 (81%). Two children had serious infections (varicella with aseptic meningitis in one and complicated sepsis in the other). In general, adverse events were of the types seen in a general pediatric patient population. CONCLUSION: Children with severe, longstanding, methotrexate-resistant polyarticular JRA demonstrated sustained clinical improvement with >2 years of continuous etanercept treatment. Etanercept was generally well-tolerated. There were no increases in the rates of adverse events over time. However, children taking etanercept should be monitored closely for infections
Internet : PM:12528122 - MEINEKE I, TURCK D: Population pharmacokinetic analysis of meloxicam in rheumatoid arthritis patients. Br.J.Clin.Pharmacol. 2003, 55:32-38.
Organism:Department of Clinical Pharmacology, Georg August Universitat Gottingen, D-37075 Gottingen, Germany imeineke@meduni-goettingende
Abstract: AIM: To perform a nonlinear mixed effect modelling (NONMEM) population pharmacokinetic analysis of meloxicam plasma concentrations in rheumatoid arthritis (RA) patients participating in three clinical trials, and to evaluate the effects of age, weight, gender and concomitant medications on meloxicam pharmacokinetics. METHODS: Meloxicam was administered to RA patients once daily for 3 weeks or 6 months at doses between 7.5 and 60 mg. Plasma samples were obtained at least 7 days after the first dose and meloxicam plasma concentrations were quantified by h.p.l.c. RESULTS: NONMEM analysis was conducted on plasma samples derived from 586 patients. A one-compartmental model was found to describe the data adequately. For a typical subject in the population, a clearance of 0.377 l h-1 (95% confidence interval (CI) 0.0304-0.449) in males and 0.347 l h-1 (95% CI 0.274-0.419) in females was obtained. The volume of distribution was estimated to be 14.9 l. The findings were corroborated by subsequent analysis using WinBUGS. Analysis of covariates showed that age and gender both significantly (P < 0.005) affected clearance. The effect of age was relatively small and a dose adjustment of <10% was deemed unnecessary. Differences between males and females were attributed to differences in weight. No clinically relevant drug-drug interactions were found, although sulphasalazine and glucocorticoids both significantly (P < 0.005) affected meloxicam clearance (+19%
Internet : PM:12534638 - OBRADOR A, LOPEZ SR, MUNOZ P, FORTUN J, GASSULL MA: [Consensus guideline on tuberculosis and treatment of inflammatory bowel disease with infliximab. Spanish Working Group on Crohn Disease and Ulcerative Colitis]. Gastroenterol.Hepatol. 2003, 26:29-33.
Organism:Servicio de Digestivo Hospital Son Dureta Palma de Mallorca Espana
Internet : PM:12525326 - WIECHENS B, REICHELT JA, URBAT C, NOLLE B: [Pars plana vitrectomy in cystoid macular edema of different forms of chronic uveitis]. Ophthalmologe 2003, 100:33-43.
Organism:Augenklinik, Klinikum Hannover
Abstract: BACKGROUND. Cystoid macular edema (CME) is a common complication in different forms of chronic uveitis. In spite of immunosuppressive and anti-inflammatory therapy, chronic or relapsing courses can occur which may have a negative impact on visual prognosis. Pars plana vitrectomy (PPV) is known to positively influence chronic uveitis.This retrospective study was performed to investigate the role of PPV in the therapy refractive uveitic CME. PATIENTS AND METHODS. PPV for CME was performed in eyes with CME in intermediate uveitis (IMU, n=42), chronic iridocyclitis in juvenile rheumatoid arthritis (CIC, n=14) and multifocal chorioretinitis (MFC, n=12).In none of the eyes had immunosuppressive and/or anti-inflammatory therapy or antiedema treatment (e.g.acetazolamide) led to regression of the CME.After a postoperative follow-up period of 7 and 106 months all patients were re-examined. RESULTS. Postoperative complete or partial regression of CME was observed as follows: IMU: 25/42 (59.5%), CIC: 8/14 (57.1%),MFC: 5/12 (41.7%). A significant increase in visual acuity of 2 lines and more was observed in 50%,71.4% and 41.7% of eyes, respectively. In the long-term follow-up best functional results were achieved in eyes with IMU. CONCLUSIONS. Response to PPV was variable according to the type of underlying form of uveitis.The lowest success rate could be observed in eyes with MFC. Although the postoperative regression rate of CME was satisfactory in eyes with CIC, long-term visual acuity results were disappointing due to secondary complications of CIC in this young age group.Best results were achieved in patients with IMU (statistically not significant). A multicenter study in a larger series of patients is needed to investigate the exact role of PPV in different forms of chronic uveitis
Internet : PM:12557024 - YOKORO CM, TATSUO MA, PEREIRA LS, ALVES DL, FRANCISCHI JN: Role of endogenous glucocorticoids in hyperalgesia and edema in old arthritic rats. Braz.J.Med.Biol.Res. 2003, 36:77-83.
Organism:Departamento de Farmacologia, Instituto de Ciencias Biologicas, Universidade Federal de Minas Gerais, Belo Horizonte, MG, Brasil
Abstract: We compared the intensity and frequency of arthritis in old (8-12 months, N = 12) and juvenile (2 months, N = 10) rats and determined the role played by adrenal glands in this disorder. Arthritis was induced by subcutaneous injection of Mycobacterium butyricum at the base of the tail of female Holtzman rats at day zero. Paw edema and hyperalgesia were monitored from day zero to day 21 after induction as signs of arthritis development. Some (N = 11) old animals were adrenalectomized bilaterally and treated with dexamethasone or celecoxib immediately following surgery. All bilaterally adrenalectomized old animals became susceptible to arthritis and the onset of disease was shortened from the 10th to the 5th day. Hyperalgesia and paw edema responses were less frequent in older animals (50 and 25% compared to control juvenile rats, respectively), although old responder animals showed responses of similar intensity to those of their juvenile counterparts: by the 14th day the data for hyperalgesia were juvenile = 0.8 +/- 0.07/old = 0.8 +/- 0.09, and for paw edema juvenile = 56.6 +/- 6.04/old = 32.24 +/- 12.7, reported as Delta% increase in paw edema. Chronic treatment of adrenalectomized old animals with dexamethasone (0.01 or 0.1 mg/kg) but not celecoxib (3 mg/kg), once daily for 21 days by gavage, abolished the effects of adrenalectomy, in particular those related to the hyperalgesia response (old = 0.95 +/- 0.03/dexamethasone = 0 +/- 0; 14th day), thus suggesting a specific participation of circulating corticosteroids in the modulation of pain in old arthritic rats
Internet : PM:12532230 - YOUNES M, KAHN MF, MEYER O: Hip involvement in patients with familial Mediterranean fever. A review of ten cases. Joint Bone Spine 2002, 69:560-565.
Organism:Rheumatology Department (Professor O Meyer), Bichat Teaching Hospital, 46, rue Henri-Huchard, 75018 Paris, France
Abstract: Hip involvement is uncommon in familial Mediterranean fever (FMF) and can result either from a process specific to this disease or from a coexisting chronic inflammatory joint disease, usually suggestive of ankylosing spondylitis (AS). We report ten cases of FMF with radiologically-documented inflammatory hip disease. Five patients had AS and one had juvenile idiopathic arthritis. There were six men and four women, with a mean age of 34.4 years +/- 17.6 (range, 15-70 years). Onset of the inflammatory hip disease occurred after bouts of acute hip symptoms in one of the patients with isolated FMF and after protracted hip arthritis in another; the two other patients had no history of hip symptoms. The HLA-B27 antigen was looked for in two of the five patients with FMF and AS, with negative results in both; another patient in this subgroup had severe ulcerative colitis. Total hip replacement or replacement of the acetabulum was required in six patients, including two with isolated FMF. Chronic joint disease has been estimated to contribute fewer than 5% of the joint manifestations in FMF. In previous studies, the hips and knees were affected in 75% of patients with chronic joint disease related to FMF. The association of FMF and AS (usually without the HLA-B27 antigen) has been well documented, although the pathogenic mechanisms that link these two conditions remain unknown
Internet : PM:12537263