Bibliography May 2007

  1. BARASH Jet GOLDZWEIG O: Possible role of streptococcal infection in flares of juvenile idiopathic arthritis, Arthritis Rheum., Vol. 57(5), 877-880., 2007
    Organism:Kaplan Medical Center, Rehovot, Hebrew University and Hadassa, Jerusalem, Israel
    Abstract:

  2. BECHTOLD S, RIPPERGER P, POZZA RD, BONFIG W, HAFNER R, MICHELS Het SCHWARZ HP: Growth hormone increases final height in patients with juvenile idiopathic arthritis: Data from a randomized controlled study, J.Clin.Endocrinol.Metab., Vol. ., 2007
    Organism:University Children's Hospital, Division of Endocrinology and Diabetology, Munich, Germany; Children's Hospital for Rheumatology, Garmisch-Partenkirchen, Germany
    Abstract:    Background: Growth hormone (GH) treatment stimulates growth in short children with juvenile idiopathic arthritis (JIA). The extent to which this therapy increases final height is not known. Methods: 31 growth retarded children with systemic and polyarticular idiopathic arthritis were enrolled in this controlled study. After a mean observational time of 8.4 years final height was reached in 13 patients (7f, 6m) treated with GH for a mean of 6.7 years in a dose of 0.33 mg/kg bodyweight per week. 18 patients (12f, 6m) served as an untreated control group. Results: Mean increment in height in the treatment group was 1.6 +/- 0.8 SD whereas the patients of the control group lost 0.7 +/- 1.8 SD. Overall, mean final height in the treatment group was -1.6 SD and in the control group -3.4 SD. More GH treated patients reached a final height within target height than untreated patients (11/13 vs. 4/18). Disease activity markers had a significant influence on height outcome. After adjustment for baseline and average disease activity the difference between treatment and control group was still significant (mean 1.5 SD). Patients with a moderate overall disease activity profited most from GH treatment. No adverse events were noted throughout the study. Conclusion: Our data suggest that long-term growth hormone therapy has a beneficial effect on growth and final height in the majority of growth retarded children with severe forms of JIA

  3. CAPELL HA, MADHOK R, PORTER DR, MUNRO RA, MCINNES IB, HUNTER JA, STEVEN M, ZOMA A, MORRISON E, SAMBROOK M, WUI PF, HAMPSON R, MCDONALD F, TIERNEY A, HENDERSON Net FORD I: Combination therapy with sulfasalazine and methotrexate is more effective than either drug alone in patients with rheumatoid arthritis with a suboptimal response to sulfasalazine: results from the double-blind placebo-controlled MASCOT study, Ann.Rheum.Dis., Vol. 66(2), 235-241., 2007
    Organism:Centre for Rheumatic Diseases, Glasgow Royal Infirmary, 84 Castle Street, Glasgow G4 0SF, UK hilarycapell@northglasgowscotnhsukFAU - Capell, Hilary A
    Abstract:    BACKGROUND: Optimal use of disease-modifying antirheumatic drugs (DMARDs) in rheumatoid arthritis is vital if progression of disease is to be reduced. Methotrexate (MTX) and sulfasalazine (SASP) are widely used inexpensive DMARDs, recently often combined despite no firm evidence of benefit from previous studies. Aim: To establish whether a combination of SASP and MTX is superior to either drug alone in patients with rheumatoid arthritis with a suboptimal response to 6 months of SASP. METHODS: A randomised controlled study of step-up DMARD treatment in early rheumatoid arthritis. In phase I, 687 patients received SASP for 6 months. Those with a disease activity score (DAS) > or =2.4 were offered additional treatment in phase II (SASP alone, MTX alone or a combination of the two). The primary outcome measure was change in DAS. RESULTS: At 6 months, 191 (28%) patients had a DAS <2.4, 123 (18%) were eligible but did not wish to enter phase II, 130 (19%) stopped SASP because of reversible adverse events and 165 (24%) entered phase II. DAS at 18 months was significantly lower in those who received combination treatment compared with those who received either SASP or MTX: monotherapy arms did not differ. Improvement in European League Against Rheumatism and American College of Rheumatology 20, 50 and 70 scores favoured combination therapy. CONCLUSIONS: In this "true-to-life" study, an inexpensive combination of DMARDs proved more effective than monotherapy in patients with rheumatoid arthritis with a suboptimal response to SASP. There was no increase in toxicity. These results provide an evidence base for the use of this combination as a component of tight control strategies

  4. CARLENS C, BRANDT L, KLARESKOG L, LAMPA Jet ASKLING J: The inflammatory reflex and risk for rheumatoid arthritis: a case-control study of human vagotomy, Ann.Rheum.Dis., Vol. 66(3), 414-416., 2007
    Organism:Rheumatology Unit, Department of Medicine, Karolinska University Hospital and Institute, Stockholm, Sweden ceciliacarlens@kiseFAU - Carlens, Cecilia
    Abstract:    Recent data suggest remarkable effects of vagus stimulation (reduction) and vagotomy (exacerbation) on acute inflammation in rats, the so-called "inflammatory reflex". Its role in humans remains unknown. Therefore, the aim was to explore whether surgical vagotomy in humans would affect the risk of a prototype inflammatory disease, rheumatoid arthritis. This was a case-control study. Assessment of the relative risk (RR) of developing rheumatoid arthritis after surgical vagotomy during 1964-2001 in 63,092 prevalent rheumatoid arthritis cases versus 125,404 matched controls from the general population and in 2548 incident rheumatoid arthritis cases versus 24,357 matched controls from the general population, respectively, was done. For comparison, we assessed RRs for hospitalisation for gastric disorders not including vagotomy. Data on exposures and rheumatoid arthritis were retrieved from population-based and prospectively recorded Swedish registers. A pre-rheumatoid arthritis vagotomy was not significantly associated with an increased risk for rheumatoid arthritis (RR = 1.17, 95% CI 0.97 to 1.40). RRs in the same range were observed for several other pre-rheumatoid arthritis gastric conditions that do not include vagotomy (eg, gastric ulcer RR = 1.21, 95% 1.11 to 1.33). Vagotomy has no specific effect on the risk of developing rheumatoid arthritis in humans. Gastroduodenal ulcers occur more often than expected even before the occurrence of rheumatoid arthritis

  5. CAROLI F, PONTILLO A, D'OSUALDO A, TRAVAN L, CECCHERINI I, CROVELLA S, ALESSIO M, STABILE A, GATTORNO M, TOMMASINI A, MARTINI Aet LEPORE L: Clinical and genetic characterization of Italian patients affected by CINCA syndrome, Rheumatology (Oxford)., Vol. 46(3), 473-478., 2007
    Organism:Department of Molecular Genetics, IRCCS G Gaslini, Genoa, ItalyFAU - Caroli, F
    Abstract:    OBJECTIVE: We report the experience of the Italian Registry of patients affected by chronic infantile neurological, cutaneous, articular (CINCA) syndrome. The clinical and genetic features of 12 unrelated Italian patients with CINCA syndrome are described, focusing on the possible influence of the presence of CIAS1/cryopyrin mutations on the phenotype of the disease and on its prognosis. METHODS: The clinical features of 12 Italian CINCA patients were evaluated. Genomic DNA of the patients was sequenced using specific primers for CIAS1 and ASC genes. RESULTS: Our patients shared typical CINCA characteristics and, sometimes, remarkable perinatal events, peculiar of CIAS1-mutated patients. Seven patients carried CIAS1 missense mutation, localized within the nucleotide binding domain of cryopyrin. Four previously described mutations and three new heterozygous CIAS1 missense mutations were identified. ASC gene, encoding for a direct interactor of cryopyrin, was not mutated in Italian CINCA patients. Finally, we reported the efficacy and safety of anti-IL1 therapy (Anakinra) in seven patients with a particularly severe CINCA phenotype. CONCLUSION: Despite some common signs-used as syndrome hallmarks-we observed a high variability in symptoms, genetic results and outcomes in Italian CINCA patients. In contrast with other authors, we cannot find out any correlation between mutations in CIAS1 and CINCA severity, but we underlined the concomitance of perinatal events and mental retardation only in CIAS1 mutated subjects. Finally, we confirmed the efficacy of Anakinra treatment, both in CIAS1-mutated and non-mutated patients

  6. DE JAGER W, HOPPENREIJS EP, WULFFRAAT NM, WEDDERBURN LR, KUIS Wet PRAKKEN BJ: Blood and synovial fluid cytokine signatures in patients with juvenile idiopathic arthritis: a cross-sectional study, Ann.Rheum.Dis., Vol. 66(5), 589-598., 2007
    Organism:Department of Pediatric Immunology, University Medical Center Utrecht, Utrecht, The NetherlandsFAU - de Jager, Wilco
    Abstract:    BACKGROUND: Juvenile idiopathic arthritis (JIA) consists of a heterogeneous group of disorders with, for the most part, an unknown immunopathogenesis. Although onset and disease course differ, the subtypes of JIA share the occurrence of chronic inflammation of the joints, with infiltrations of immunocompetent cells that secrete inflammatory mediators. OBJECTIVE: To identify a panel of cytokines specifically related to the inflammatory process in JIA. METHODS: Using a new technology, the multiplex immunoassay, 30 cytokines were measured in plasma of 65 patients with JIA, of which 34 were paired with synovial fluid. These data were compared with plasma of 20 healthy controls and 9 patients with type I diabetes, a chronic inflammatory disease. RESULTS: Patients with JIA had, irrespective of their subclassification, significantly higher levels of tumour necrosis factor alpha, macrophage inhibitory factor (MIF), CCL2, CCL3, CCL11, CCL22 and CXCL9 in plasma than controls. In paired plasma and synovial fluid samples of patients with JIA, significantly higher levels of interleukin (IL)6, IL15, CCL2, CCL3, CXCL8, CXCL9 and CXCL10 were present in synovial fluid. Cluster analysis in all patients with JIA revealed a predominant pro-inflammatory cytokine cluster during active disease and a regulatory/anti-inflammatory-related cytokine cluster during remission. Whether a discrimination profile of various cytokines could help in the determination of disease classification was tested. CONCLUSION: It is suggested that several cytokines (IL18, MIF, CCL2, CCL3, CCL11, CXCL9 and CXCL10) may correspond to the activation status during inflammation in JIA and could be instrumental in monitoring disease activity and outcomes of (new) immunotherapies

  7. DHILLON S, LYSENG-WILLIAMSON KAet SCOTT LJ: Etanercept: a review of its use in the management of rheumatoid arthritis, Drugs., Vol. 67(8), 1211-1241., 2007
    Organism:Wolters Kluwer Health | Adis, Auckland, New Zealand, an editorial office of Wolters Kluwer Health, Conshohocken, Pennsylvania, USAFAU - Dhillon, Sohita
    Abstract:    Etanercept (Enbrel((R))), a soluble fusion protein that binds specifically to the cytokine human tumour necrosis factor (TNF), is approved for subcutaneous use in the treatment of patients with moderate to severe active rheumatoid arthritis, juvenile rheumatoid arthritis, psoriatic arthritis, ankylosing arthritis and plaque psoriasis in the US, Italy, the rest of the EU and other countries worldwide. Subcutaneous etanercept was efficacious and generally well tolerated in several large, well designed, clinical trials and in the clinical-practice setting in adult patients with rheumatoid arthritis, including methotrexate-naive patients with early disease and those with long-standing, treatment-resistant active disease. Etanercept plus methotrexate combination therapy was generally superior to either monotherapy in reducing disease activity and structural joint damage, as well as improving health-related quality of life (HR-QOL). Furthermore, etanercept monotherapy was superior to placebo and at least as effective as methotrexate therapy in reducing disease activity and improving HR-QOL in patients with early or refractory disease. The beneficial effects of etanercept monotherapy or combination therapy were sustained in the long term (</=9 years). Some pharmacoeconomic analyses suggest that etanercept is a cost-effective option in the treatment of patients with rheumatoid arthritis. Direct head-to-head comparisons with other biological agents would help to definitively position etanercept with respect to these agents. Nevertheless, extensive clinical experience indicates that etanercept is a valuable treatment option in adult patients with long-standing moderate to severe active rheumatoid arthritis and an emerging option in those with early disease

  8. DIAZ-GONZALEZ F, ALTEN RH, BENSEN WG, BROWN JP, SIBLEY JT, DOUGADOS M, BOMBARDIERI S, DUREZ P, ORTIZ P, DE MIQUEL G, STAAB A, SIGMUND R, SALIN L, LELEDY Cet POLMAR SH: Clinical trial of a leucotriene B4 receptor antagonist, BIIL 284, in patients with rheumatoid arthritis, Ann.Rheum.Dis., Vol. 66(5), 628-632., 2007
    Organism:Service of Rheumatology, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Canary Islands, SpainFAU - Diaz-Gonzalez, Federico
    Abstract:    BACKGROUND: Several clinical and experimental lines of evidence suggest that leucotriene B4 (LTB4), an arachidonic acid derivative with potent proinflammatory properties, plays a key role in the pathophysiology of rheumatoid arthritis (RA). OBJECTIVE: To evaluate the efficacy and safety of BIIL 284, an oral long-acting LTB4 receptor antagonist, as monotherapy for the treatment of patients with active RA. METHODS: This was a multi-centre, randomised, double-blind, placebo-controlled trial of patients with active RA of 3 months' duration. A total of 342 patients were randomised to receive 5 mg, 25 mg or 75 mg of BIIL 284 or placebo. The primary end point was the percentage of patients achieving an American College of Rheumatology (ACR) 20. RESULTS: Although a higher percentage of ACR 20 responders was observed in the groups treated with 25 mg and 75 mg of BIIL 284 compared with those treated with placebo, no statistically significant differences were found between any of the three active treatment groups compared with the placebo group with regard to the primary or secondary end points. All trial treatments were safe and well tolerated. CONCLUSIONS: This clinical trial demonstrates that treatment of patients with active RA with a potent oral long-acting LTB4 receptor antagonist produced only modest improvements in disease activity. The results of this trial support the conclusion that LTB4 is not a major contributor to the inflammatory process in RA

  9. EASTELL T, HINKS Aet THOMSON W: SNPs in the FOXP3 gene region show no association with Juvenile Idiopathic Arthritis in a UK Caucasian population, Rheumatology (Oxford)., Vol. ., 2007
    Organism:Arthritis Research Campaign Epidemiology Unit, University of Manchester, Manchester, M13 9PT, UK
    Abstract:    Objective. A region on the short arm of the X-chromosome, Xp11, has previously been linked to childhood-onset polyarthritis. Mapping to the linked region is FOXP3, a transcription factor that regulates regulatory T cell (T(reg)) development and function. The objective of this study was to determine whether single nucleotide polymorphisms (SNPs) in the FOXP3 gene region contribute to JIA susceptibility. Method. Nine FOXP3 SNPs were genotyped in 761 JIA cases and 402 controls using the Sequenom(R) MassARRAY(R) system. Association was measured using either chi(2) or Fisher's exact test at the allelic and genotypic level. Furthermore, cases and controls were stratified by gender and association measured for each stratum. Results. None of the SNPs showed an association with JIA. Similarly, the lack of association was also evident in both the female and male cohorts. Conclusion. Although FOXP3 presents itself as a good candidate for contributing to JIA susceptibility, this study, which was powered to detect associations with genotypic relative risk >2 in the female cohort, has failed to find an association between SNPs in the FOXP3 gene region and JIA

  10. EUSTACE Net O'HARE B: Use of nonsteroidal anti-inflammatory drugs in infants. A survey of members of the Association of Paediatric Anaesthetists of Great Britain and Ireland, Paediatr.Anaesth., Vol. 17(5), 464-469., 2007
    Organism:Department of Anaesthesia and Critical Care Medicine, Our Lady's Hospital for Sick Children, Crumlin, Dublin, IrelandFAU - Eustace, Nicholas
    Abstract:    BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used as perioperative analgesics. Many are currently used off label. Diclofenac is currently licensed for use in children over 1 year of age for the treatment of juvenile rheumatoid arthritis, while ibuprofen is licensed for use in children weighing over 7 kg. The dose and interval in children is currently extrapolated from adult studies, as the pharmacokinetic (PK) and pharmacodynamic (PD) data are lacking in infants. METHODS: A postal questionnaire was sent to members of the Association of Paediatric Anaesthetist of Great Britain and Ireland seeking to clarify members' prescribing patterns of NSAIDs, especially in infants. Information regarding the choice of NSAIDS, route of administration, lower age limit, dose interval, dose and practice in two specific perioperative contexts (adenotonsillectomy and open heart surgery) was sought. RESULTS: The response rate was 80%. NSAIDs are used by 86% of responders in infants. Diclofenac is most commonly used intraoperatively (78%); while ibuprofen (73%) was used more frequently postoperatively. NSAIDs are used by 21% of respondents in ICU. Commonest routes of administration were oral (81%) and rectal (80%), rarely intravenously (9%). The commonest dose for diclofena is 1 mg x kg(-1) (59%); the dosing schedule employed being 8 hourly in 53% of cases. NSAIDs are used by 57% of responders as part of their analgesic regime for adenotonsillectomies. CONCLUSION: Members of the Association of Paediatric Anaesthetists of Great Britain and Ireland commonly prescribe NSAIDs in infants. This is despite the dearth of PK and PD data in this age group

  11. FLEDELIUS HC, NIELSEN SM, NISSEN KR, PEDERSEN FKet ZAK MS: [Anti-TNFalpha treatment of juvenile uveitis], Ugeskr.Laeger., Vol. 169(14), 1309-1312., 2007
    Organism:Rigshospitalet, Ojenafdelingen, Kobenhavn OFAU - Fledelius, Hans Callo
    Abstract:    INTRODUCTION: To present our experience with anti-TNFalpha treatment of juvenile idiopatic arthritis (JIA) associated uveitis. MATERIALS AND METHODS: All 11 children with severe uveitis were monitored between 2001 and 2005. Nine of the children had JIA and a set of twins had a rare hereditary granulomatous disease, Blau's syndrome. The patients were selected and the reason for starting anti-TNFalpha treatment was an insufficient response in the arthritis or uveitis to previous therapy. RESULTS: In all patients the anti-TNFalpha treatment reduced the activity of uveitis. The response to treatment was related to 1) visual acuity and 2) the reduction of systemic immune-suppressing agents. All 11 children are still on anti-TNFalpha treatment. CONCLUSION: Anti-TNFalpha was effective in treating uveitis in all 11 patients. In patients with active uveitis associated JIA not responding to corticosteroids and methotrexate and with declined vision the trend is to start anti-TNFalpha treatment early in the inflammatory disease to prevent long term complications to the eyes. The results indicate a superiority of infliximab over Eternacept in the treatment of uveitis

  12. GANNOTTI ME, NAHORNIAK M, GORTON GE, III, SCIASCIA K, SUELTENFUSS M, SYNDER Met ZANIEWSKI A: Can exercise influence low bone mineral density in children with juvenile rheumatoid arthritis?, Pediatr.Phys.Ther., Vol. 19(2), 128-139., 2007
    Organism:University of Hartford (MEG, KS, MS, MS, AZ), Hartford, Connecticut and Shriners Hospital for Children (MN, GEG), Springfield, MassachusettsFAU - Gannotti, Mary E
    Abstract:    PURPOSE:: Low bone mineral density (BMD) is a common secondary condition associated with juvenile idiopathic arthritis (JIA). The purpose of this review was evaluate the literature pertinent to designing an effective, safe weight-bearing exercise program to reduce the risk of low BMD in children with JIA. SUMMARY OF KEY POINTS:: Thirty-seven articles on the risk of low BMD and children with JIA, weight-bearing interventions to improve BMD in healthy children, or safety and efficacy of exercise interventions with children with JIA were critiqued on the basis of their design. Three highly rated studies confirmed the multifactorial nature of low BMD in children with JIA, two highly rated studies support the efficacy of weight-bearing interventions for increasing BMD in children who are healthy, and one moderately rated study demonstrated the safety of low impact exercise by children with JIA. STATEMENT OF CONCLUSIONS AND RECOMMENDATIONS FOR CLINICAL PRACTICE:: Weight-bearing activities should be included in exercise programs for individuals with JIA, although more research is needed to determine the amount, duration, and frequency of weight-bearing activity needed to reduce the risk for low BMD

  13. GONZALEZ B, LARRANAGA C, LEON O, DIAZ P, MIRANDA M, BARRIA Met GAGGERO A: Parvovirus B19 May Have a Role in the Pathogenesis of Juvenile Idiopathic Arthritis, J.Rheumatol., Vol. ., 2007
    Organism:From the Immunology Unit, Luis Calvo Mackenna Hospital; Virology Program and Pathophysiology Program, ICBM, Faculty of Medicine, University of Chile; and Rheumatology Unit, San Juan de Dios Hospital, Santiago, Chile
    Abstract:    OBJECTIVE: To determine the prevalence of human parvovirus B19 infection in patients with juvenile idiopathic arthritis (JIA) by detection of specific IgM, IgG, and viral DNA. METHODS: Serum samples of 50 patients with diagnosis of JIA and 39 healthy controls were analyzed by ELISA to detect IgG and IgM anti-B19-specific antibodies. The parvovirus B19 genome was detected by nested polymerase chain reaction (PCR). The average age of the patients was 9.6 years (2-14 yrs); 30 were female (60%) and 20 male (40%). The definitive diagnoses of these patients corresponded to 19 systemic forms (38%), 11 to the oligoarticular variety (22%) and 20 to the polyarticular (40%). The average age of the control group was 7.8 years (2-16 yrs); the distribution by sex was 25 females (64%) and 14 males (36%). RESULTS: IgM against parvovirus B19 was detected in 20% of the cases (10 patients) and B19 DNA genome by PCR in 48% (24 patients); in 10% of the cases (5 patients), both markers were detected. IgG was found in 32% (16 patients). In the control group neither IgM nor the viral genome was detected. However, 43.5% of the controls (17/39) had IgG against parvovirus B19, indicating past infection by the virus. CONCLUSION: Our study confirms recent observations regarding a high prevalence of viral DNA in JIA patients and a possible role of this viral infection in JIA pathogenesis

  14. HARDIN DS, KEMP SFet ALLEN DB: Twenty years of recombinant human growth hormone in children: relevance to pediatric care providers, Clin.Pediatr.(Phila)., Vol. 46(4), 279-286., 2007
    Organism:Ohio State University and Columbus Children's Hospital, Columbus, OH 43205, USA hardind@pediatricsohio-stateeduFAU - Hardin, Dana S
    Abstract:    Recombinant human growth hormone has revolutionized the management of children and adolescents with growth hormone deficiency and other growth disorders, but clinical and ethical controversies remain regarding diagnostic approach, optimal recombinant human growth hormone dose and duration, and expected outcomes. Management of pubertal and transitioning patients with growth hormone deficiency has also commanded increased attention. Recent clinical studies that demonstrate the positive health benefits of recombinant human growth hormone in children with cystic fibrosis, inflammatory bowel disease, and juvenile rheumatoid arthritis have not yet clarified issues about patient selection and appropriate long-term use. An understanding of current recombinant human growth hormone indications and controversies can facilitate patient evaluation and expedite referral for potential treatment. This review summarizes current indications for recombinant human growth hormone use, discusses clinical challenges, and provides recommendations for pediatricians caring for children who may be appropriate candidates for recombinant human growth hormone therapy

  15. HORNEFF G: [Biologics for treatment of juvenile idiopathic arthritis. Consensus statement of the 7th Worlitzer Expertengesprache 2004 for the German Arbeitsgemeinschaft Kinder- und Jugendrheumatologie], Z.Rheumatol., Vol. 65(2), 152-6, 158., 2006
    Organism:Universitatsklinik und Poliklinik fur Kinder und Jugendmedizin, Halle gerdhorneff@medizinuni-halledeFAU - Horneff, G
    Abstract:    The group of biologics for the treatment of rheumatic diseases is continuously growing. They have become an important option not only for treatment of so far untreatable chronic inflammatory or rheumatic disease, but also for juvenile idiopathic arthritis. In addition, the velocity and the degree of improvement is better than with to conventional therapies. Furthermore, toxicity and risks seem to be lower with higher safety and compatibility. Although the data are scarce, they are widely used. Therefore, the German Arbeitsgemeinschaft Kinder- und Jugendrheumatologie is updating the current recommendation for the treatment of juvenile idiopathic arthritis using biologics

  16. IKIZ AO, UNSAL E, KIRKIM G, ERDAG TKet GUNERI EA: Hearing loss and middle ear involvement in patients with juvenile idiopathic arthritis, Int.J.Pediatr.Otorhinolaryngol., Vol. 71(7), 1079-1085., 2007
    Organism:Dokuz Eylul University School of Medicine, Department of Ear Nose Throat and Head & Neck Surgery, 35340 Izmir, TurkeyFAU - Ikiz, Ahmet Omer
    Abstract:    OBJECTIVE: Evaluation of the hearing status and middle ear function of patients with juvenile idiopathic arthritis. METHODS: The study group was comprised of 38 ears of 19 patients (6 males, 13 females) aged between 5 and 23 years. The control group was comprised of 30 ears of 15 healthy subjects (5 males, 10 females) aged between 5 and 22 years. All subjects were examined audiologically using tympanometry, stapedial reflex, acoustic reflex decay, pure-tone audiometry, high frequency audiometry and transient evoked otoacoustic emission tests. RESULTS: There were statistically significant (p<0.05) number of ears (32%) with abnormal tympanograms in the patient population while all tympanograms were normal, type A in the control group. Seven type As, 2 type Ad, and 3 type C tympanograms were seen in the patient population. In pure tone audiometry tests there was no subject having neither a conductive nor sensorineural hearing loss individually in both groups. But as a group, patients with juvenile idiopathic arthritis showed statistically significant elevation of air conduction thresholds at frequencies of 250, 500, 6000, 14,000 and 16,000Hz for right ears; and at 500, 2000, 12,500 and 16,000Hz for left ears; and larger air-bone gaps at 500 and 2000Hz for right ears; and at 500Hz for left ears (p<0.05). Comparison of bone conduction thresholds and otoacoustic emission tests between both groups did not reveal any statistically significant difference (p>0.05). CONCLUSION: This study suggests a dual effect of disease on both the middle and inner ear of patients with juvenile idiopathic arthritis. Presence of abnormal tympanograms together with worse air conduction thresholds at lower frequencies as well as larger air bone gaps at frequencies of 500 and 2000Hz suggest subclinical middle ear involvement; while hearing losses at 6000Hz and very high frequencies of 12,500, 14,000 and 16,000Hz suggest inner involvement at an early stage

  17. KEMPER KJ, ROUSTER-STEVENS K, SINAL Set ARCURY T: Complementary therapies in juvenile idiopathic arthritis, Lancet., Vol. 369(9573), 1602, 2007
    Organism:

  18. KIM HY, RENSHAW-GEGG LW, BALCIUNAS AMet KOHNO T: Construction and Purification of the Murine p75-murine IgG1 Fusion Protein, J.Investig.Dermatol.Symp.Proc., Vol. 12(1), 48-49., 2007
    Organism:1Department of Protein Science, Amgen Inc, Thousand Oaks, California, USAFAU - Kim, Helen Y
    Abstract:    Etanercept (Amgen Inc, Thousand Oaks, CA) is a human soluble p75 tumor necrosis factor (TNF) receptor-human-IgG1 (hup75 TNFR-huIgG1) fusion protein used in the treatment of chronic inflammatory diseases in humans, including rheumatoid arthritis, juvenile rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, and psoriasis. To be able to study the effects of the soluble receptor fusion protein in mouse models, including those that mimic human granulomatous infections, a murine soluble p75-TNF receptor-murine IgG1 (murine p75-murine IgG1) fusion protein had to be constructed. This article discusses the generation, large-scale production, and purification of this molecule.Journal of Investigative Dermatology Symposium Proceedings (2007) 12, 48-49. doi:10.1038/sj.jidsymp.5650035

  19. LOPEZ-ARBESU R, BALLINA-GARCIA FJ, ALPERI-LOPEZ M, LOPEZ-SOTO A, RODRIGUEZ-RODERO S, MARTINEZ-BORRA J, LOPEZ-VAZQUEZ A, FERNANDEZ-MORERA JL, RIESTRA-NORIEGA JL, QUEIRO-SILVA R, QUINONES-LOMBRANA A, LOPEZ-LARREA Cet GONZALEZ S: MHC class I chain-related gene B (MICB) is associated with rheumatoid arthritis susceptibility, Rheumatology (Oxford)., Vol. 46(3), 426-430., 2007
    Organism:Department of Functional Biology, Universidad de Oviedo, Oviedo, SpainFAU - Lopez-Arbesu, R
    Abstract:    OBJECTIVES: Several recent studies have shown that the MHC class III region, located telomeric to HLA-DRB1, contains an additional genetic factor that predisposes to rheumatoid arthritis (RA). In this study, we investigate whether inhibitor of kappaB-like (IkappaBL), MICB or MICA located in the MHC class III region are the second susceptibility gene associated with RA. METHODS: A total of 154 healthy controls and 140 RA patients were genotyped for HLA-DRB1, MICA, MICB and the polymorphism -62 of the IkappaBL gene. RESULTS: A significant increase of HLA-DRB1 shared epitope (SE) alleles was detected in RA patients (61.4 vs 43.5%, P(c) = 0.01, OR = 2.1, 95% CI = 1.3-3.3). Among SE alleles, the HLA-DRB1*0401 (13.5 vs 5.1%, P(c) = 0.04, OR = 3.2, 95% CI = 1.3-8.1) and HLA-DRB1*0404 (6.4 vs 1.2%, P = 0.02, P(c) = NS) showed the most significantly association with RA. No increase of risk was associated with HLA-DRB1*01. Remarkably, the allele MICB*004 was also significantly associated with RA susceptibility (40.7 vs 23.3%, P(c) = 0.01, OR = 2.2, 95% CI = 1.3-3.7). MICB*004 was in linkage disequilibrium with HLA-DRB1*0404 (lambda(s) = 0.33) and HLA-DRB1*0405 (lambda(s) = 0.34). However, MICB*004 was also increased in HLA-DRB1 SE negative patients (37 vs 21.5%, P = 0.04). No significant association between IkappaBL and MICA with RA was found. CONCLUSIONS: MICB*004 allele was associated with RA susceptibility. This allele was in linkage disequilibrium with HLA-DRB1*0404 and DRB1*0405. The association of MICB with RA susceptibility and the functional role of MIC genes in the pathogenesis of RA converts MICB into a candidate to be an additional MHC gene associated with RA susceptibility

  20. LUQUE C, CISTERNAS FAet ARAYA M: [Changes in the patterns of disease after the epidemiological transition in health in Chile, 1950-2003], Rev.Med.Chil., Vol. 134(6), 703-712., 2006
    Organism:Programa de especializacion en Gastroenterologia Pediatrica, Universidad de Chile, Santiago, ChileFAU - Luque, Cecilia
    Abstract:    BACKGROUND: During the twentieth century there was a change in the pattern of diseases in Europe, with an increase in the incidence of allergies and autoimmune disorders, that paralleled a decrease of infectious conditions. The Hygiene hypothesis proposes that these phenomena are causally related. Aim: To evaluate the epidemiological changes of allergic, autoimmune, and infectious diseases in Chile between 1950 and 2003. MATERIAL AND METHODS: Search for the incidence and prevalence of these diseases in the national records published by the Ministry of Health, as well as through a systematic search of national literature using PubMed and Scielo as search engines. RESULTS: The annual incidence of tuberculosis, rheumatic fever, measles, and typhoid fever has progressively diminished in Chile since 1970. Figures for the national prevalence for asthma, rheumatoid arthritis, and type I diabetes are scarce and difficult to compare, but clearly show an increasing epidemiological trend in the last 20 years. CONCLUSIONS: The national figures suggest that, although the country has only recently gone through an epidemiological transition in health problems, there are detectable changes that show the same trends described in Europe

  21. OGILVIE EM, KHAN A, HUBANK M, KELLAM Pet WOO P: Specific gene expression profiles in systemic juvenile idiopathic arthritis, Arthritis Rheum., Vol. 56(6), 1954-1965., 2007
    Organism:University College London, London, UK
    Abstract:    OBJECTIVE: Patients with systemic juvenile idiopathic arthritis (JIA) have arthritis, quotidian fevers, and other extraarticular features. This disease often remains severe and debilitating. The purpose of this study was to compare gene expression profiles in peripheral blood mononuclear cells (PBMCs) from patients with active and inactive systemic JIA to define and better understand the cause of active disease. METHODS: Gene expression profiles of PBMCs were determined in cells from 9 patients with active systemic JIA and 8 patients with inactive systemic JIA. Unsupervised clustering and significance analysis were performed. We compared the systemic JIA profile with data from patients with polyarticular JIA, chronic infantile neurologic, cutaneous, articular syndrome, Kawasaki disease, and systemic lupus erythematosus to identify disease-specific genes. Quantitative reverse transcription-polymerase chain reaction of selected genes was performed on negatively selected B cells, T cells, and monocytes. RESULTS: Unsupervised clustering of expressed genes resulted in 2 groups that corresponded to the clinical status of the patients (active and inactive disease) and was independent of their medications. A total of 286 genes were identified as significantly up-regulated in patients with active disease and 86% of them were specific to systemic JIA. Interleukin-6 (IL-6) was expressed in monocytes and B cells, IL-10 in monocytes, and suppressor of cytokine signaling 3 in monocytes and T cells from patients with active disease. CONCLUSION: Gene expression profiles in PBMCs identified disease-specific genes in patients with systemic JIA. Cell type analyses should allow further insight into the mechanisms of the disease

  22. PUSZCZEWICZ MJ, TUCHOCKA-PIOTROWSKA A, MAJEWSKI Det KOLCZEWSKA A: [Coincidence of juvenile idiopathic arthritis and multiple sclerosis: case report], Ann.Acad.Med.Stetin., Vol. 52 Suppl 2, 85-88., 2006
    Organism:Katedra i Klinika Reumatologiczno-Rehabilitacyjna i Chorob Wewnetrznych Akademii Medycznej im K Marcinkowskiego ul 28 Czerwca 1956 roku 135/147, 61-545 PoznanFAU - Puszczewicz, Mariusz J
    Abstract:    INTRODUCTION: Juvenile idiopathic arthritis is a systemic pathology of connective tissue characterized by a chronic inflammatory process with an autoimmune background whereas multiple sclerosis is a demyelination disease with an important role of immune disorders in its pathogenesis. The etiology in both cases remains unknown. The coincidence of juvenile idiopathic arthritis and multiple sclerosis was described a just a few patients. MATERIAL AND METHODS: We now report on a 31-year-old woman with juvenile idiopathic arthritis and multiple sclerosis. In the present case, the main problem was to find the right proper medication for a very, aggressive course of multiple sclerosis and for arthritis. RESULT: Treatment with interferon-beta and methylprednisolone led to remission with just minor side-effects

  23. REICHERT S, STEIN J, FUCHS C, JOHN V, SCHALLER HGet MACHULLA HK: Are there common human leucocyte antigen associations in juvenile idiopathic arthritis and periodontitis?, J.Clin.Periodontol., Vol. 34(6), 492-498., 2007
    Organism:University School of Dental Medicine, Department of Operative Dentistry and Periodontology, Martin-Luther University, Halle-Wittenberg, GermanyFAU - Reichert, Stefan
    Abstract:    Aim: The aim of this study was to evaluate common human leucocyte antigen (HLA) associations in patients with juvenile idiopathic arthritis (N=110), in patients with generalized aggressive periodontitis (N=50) and in patients with chronic periodontitis (N=102) in comparison to healthy controls (no periodontitis, no arthritis N=102). Material and methods: HLA-class I and II markers were determined using microlymphocytotoxicity test and polymerase chain reaction with sequence specific primers. Statistical analyses were carried out by chi(2)-test and Yates' correction. If n<5 Fisher's exact test was performed. In the arthritis group the influence of HLA on attachment loss was determined by using backwards logistic regression considering age, gender, smoking, plaque level, and the duration of the disease. Results: In comparison with the controls HLA-DRB3(*) occurred more frequently in both females suffering from juvenile idiopathic arthritis (74.58%versus 54.54%, p=0.024) and females suffering from chronic periodontitis (73.02%versus 54.54%, p=0.035). Furthermore, among patients with juvenile idiopathic arthritis an increased odds ratio (OR) for attachment loss was found in subjects who expressed HLA-A(*)01 (OR=4.6, p=0.014) or HLA-A(*)01:DRB3(*) (OR=4.3, p=0.031). Conclusion: HLA-DRB3(*) could be a common putative risk indicator for juvenile idiopathic arthritis and chronic periodontitis among females

  24. ROBINSON RF, NAHATA MC, HAYES JR, RENNEBOHM Ret HIGGINS G: Quality-of-Life Measurements in Juvenile Rheumatoid Arthritis Patients Treated with Etanercept, Clin.Drug Investig., Vol. 23(8), 511-518., 2003
    Organism:The Ohio State University and Children's Hospital, Columbus, Ohio, USA
    Abstract:    OBJECTIVE: The aims of this study were: (1) to assess functional status, emotional well-being and quality of life in patients with polyarticular and systemic juvenile rheumatoid arthritis (JRA) treated with etanercept, and (2) to determine the prevalence and significance of adverse events associated with etanercept therapy. PATIENTS AND METHODS: All JRA patients (n = 21) who received etanercept in our rheumatology clinic over a 14-month period were evaluated. Patient demo-graphics, type of arthritis, dosing regimens, family history, measures of joint function and laboratory parameters were obtained for each patient. A questionnaire that comprised validated functional assessment and quality-of-life measures (the Childhood Health Assessment Questionnaire [CHAQtrade mark], the Juvenile Arthritis Function Assessment Report [JAFAR 5trade mark] and the Pediatric Quality of Life Inventory Version 4 [PedsQL Generic Scaletrade mark] scales) was administered to patients and parents to assess physical and emotional function, pain, adverse drug events and quality of life at each clinic visit. RESULTS: Functional status and quality of life improved in patients with poly-articular and systemic disease. A significant difference between pre- and post-etanercept functional assessment (JAFARtrade mark and CHAQtrade mark) and quality-of-life assessment by parents and patients was found (p = 0.009, p = 0.002, p </= 0.001, p </= 0.001, respectively). The JAFARtrade mark results concurred with those of the CHAQtrade mark test, and did not distinguish between patients with polyarticular and systemic disease. Laboratory parameters indicative of toxicity did not differ between patients with polyarticular and systemic JRA and the number of adverse events reported was low. Underlying disease did not appear to predict improvement. CONCLUSION: Etanercept appeared to improve functional status, emotional well-being, quality of life and activity level with minimal toxicity in patients with polyarticular and systemic JRA

  25. ROTH J, BECHTOLD S, BORTE G, DRESSLER F, GIRSCHICK Het BORTE M: [Diagnosis, prophylaxis and therapy of osteoporosis in juvenile idiopathic arthritis : Consensus statement of the German Association for Pediatric Rheumatology.], Z.Rheumatol., Vol. ., 2007
    Organism:Padiatrische Pneumologie und Immunologie, SPZ Rheumatologie, Charite Virchow Klinikum, Augustenburger Platz 1, 13353, Berlin, Deutschland, johannesroth@charitede
    Abstract:    In all subgroups of juvenile idiopathic arthritis (JIA), a pathologic loss of bone or the lack of increase in bone mass has been described in a high percentage of cases, even with new therapeutic approaches. The decrease in bone mass is correlated with the duration of active disease and the number of affected joints (cytokines, inactivity). In several studies, muscle mass was the strongest predictor of bone mass. A standardized diagnostic approach to the musculoskeletal system including measures of prophylaxis and therapy therefore seems to be mandatory for all children with JIA who do not achieve rapid remission. In this review, the diagnostic and therapeutic options are described and summarized in an algorithm

  26. ROTH J, LINGE M, TZARIBACHEV N, SCHWEIZER Ret KUEMMERLE-DESCHNER J: Musculoskeletal abnormalities in juvenile idiopathic arthritis--a 4-year longitudinal study, Rheumatology (Oxford)., Vol. ., 2007
    Organism:Charite Virchow Klinikum, Berlin and University Children's Hospital, Tuebingen, Germany
    Abstract:    Objectives. Bone density in juvenile idiopathic arthritis (JIA) is largely normal whereas geometric parameters of bone are abnormal. The most prominent changes are a reduction in muscle cross sectional area (CSA) and muscle force. The aim of this study was to assess the evolution of these changes throughout the course of the disease. Methods. Twenty-five JIA patients were assessed by peripheral quantitative computed tomography longitudinally with a median of 48 months between measurements. At the non-dominant forearm, parameters of bone density and geometry as well as muscle CSA were recorded. The strength-strain index (SSI) as an indicator of bone strength was determined. Results. Muscle CSA improved from a median Z-score of -1.94 to -1.10 at follow-up. Cortical thickness increased from -1.55 to -0.97 whereas marrow area remained enlarged at 0.96 vs 1.05. Cortical density remained normal at 0.34 vs 0.69 and trabecular density improved from -0.75 to -0.36. The SSI increased from -0.79 to -0.13. Conclusions. JIA patients show some improvement in muscle CSA and an increase in cortical thickness. The marrow area remains enlarged but by increasing the cortical thickness, area and diameter, bone strength increases. These geometric adaptations, for the first time shown in this study, nevertheless represent a disturbance in skeletal development. In addition to efficient disease control, training modalities to improve muscle strength and subsequent bone development have to be included in therapeutic approaches

  27. RUSSELL AS, WALLENSTEIN GV, LI T, MARTIN MC, MACLEAN R, BLAISDELL B, GAJRIA K, COLE JC, BECKER JCet EMERY P: Abatacept improves both the physical and mental health of patients with rheumatoid arthritis who have inadequate response to methotrexate treatment, Ann.Rheum.Dis., Vol. 66(2), 189-194., 2007
    Organism:562 Heritage Medical Research Centre, University of Alberta, Edmonton, AB, T6G 2S2 Canada asr@gpusrvualbertacaFAU - Russell, A S
    Abstract:    OBJECTIVE: To examine the impact of added abatacept treatment on health related quality of life (HRQoL) in patients with rheumatoid arthritis (RA) who have inadequate response to methotrexate (MTX). METHODS: The impact of abatacept treatment on HRQoL was examined in a longitudinal, randomised double blind, placebo controlled clinical trial. Effects of treatment on HRQoL were examined using repeated measures analysis of covariance and comparing rates of change in HRQoL across treatment groups. The relationship between American College of Rheumatology (ACR) clinical markers and disease duration with changes in HRQoL indicators was also examined. Finally, a responder analysis was used to examine the percentage of patients who improved by 0.5 SD in 12 months or who reached the normative levels seen in the US general population. RESULTS: Statistically significant improvements in the abatacept group relative to controls were observed across a range of HRQoL measures, including physical function, fatigue, all eight domains of the SF-36, and the physical and mental component summaries (PCS and MCS). Improvements were seen as early as day 29 for fatigue and for five out of eight SF-36 domains. By day 169, all HRQoL measures were significantly better with abatacept than with placebo. HRQoL gains were associated with greater ACR clinical improvement, and the effects were consistent for patients with different disease duration. A significantly greater percentage of patients treated with abatacept reached normative levels of PCS, MCS, physical functioning, and fatigue compared with patients treated with MTX alone. CONCLUSION: Combined abatacept and MTX treatment produces significant improvements across a wide range of HRQoL domains in patients with RA

  28. SAURENMANN RK, ROSE JB, TYRRELL P, FELDMAN BM, LAXER RM, SCHNEIDER Ret SILVERMAN ED: Epidemiology of juvenile idiopathic arthritis in a multiethnic cohort: Ethnicity as a risk factor, Arthritis Rheum., Vol. 56(6), 1974-1984., 2007
    Organism:Zurich University Children's Hospital, Zurich, Switzerland, and The Hospital for Sick Children and University of Toronto, Toronto, Ontario, Canada
    Abstract:    OBJECTIVE: To study the influence of ethnicity on the risk of developing juvenile idiopathic arthritis (JIA) in a multiethnic community of patients with unrestricted access to health care. METHODS: A questionnaire on ethnicity was distributed to all patients with JIA being followed up at the Hospital for Sick Children in Toronto, Ontario, Canada. Of 1,082 patients, 859 (79.4%) responded to the questionnaire. To calculate the relative risk (RR) of developing JIA in this study cohort, the results were compared with data from the age-matched general population of the Toronto metropolitan area (TMA) as provided in the 2001 census from Statistics Canada. RESULTS: European descent was reported by 69.7% of the patients with JIA compared with a frequency of 54.7% in the TMA general population, whereas a statistically significantly lower than expected percentage of the patients with JIA reported having black, Asian, or Indian subcontinent origin. Children of European origin had a higher RR for developing any of the JIA subtypes except polyarticular rheumatoid factor (RF)-positive JIA, and were particularly more likely to develop the extended oligoarticular and psoriatic subtypes. A higher frequency of enthesitis-related JIA was observed among patients of Asian origin, while those of black origin or native North American origin were more likely to develop polyarticular RF-positive JIA. CONCLUSION: In this multiethnic cohort, European descent was associated with a significantly increased risk of developing JIA, and the distribution of JIA subtypes differed significantly across ethnic groups

  29. SCHNEIDER S, MOHNEN SM, SCHILTENWOLF Met RAU C: Comorbidity of low back pain: representative outcomes of a national health study in the Federal Republic of Germany, Eur.J.Pain., Vol. 11(4), 387-397., 2007
    Organism:Stiftung Orthopadische Universitatsklinik Heidelberg, Forschungsgruppe Epidemiologie und Biometrie, Schlierbacher Landstrasse 200, D-69118 Heidelberg, Germany sschneider@dkfzdeFAU - Schneider, Sven
    Abstract:    BACKGROUND: Unlike other biopsychosocial risk factors, the role of comorbidity in low back pain is largely unknown. AIMS: The purpose is (1) to generate prevalence data on back pain in the total adult population and (2) to identify the most common physical comorbidities in subjects with back pain. This paper also (3) analyses the gender-specific and age-specific comorbidity structure. METHODS: The National German Health Survey is the first study to provide the basis for a representative nationwide analysis of back pain prevalence and the associated comorbidities. The net sample comprises a total of 7124 Germans aged 18-79. RESULTS: One in three Germans (34%) experienced back pain during the seven days prior to being interviewed. The one-year prevalence rate is 59%. All the morbidities investigated by us are more common in subjects with back pain than in individuals without back pain. The most common comorbidities associated with back pain are musculoskeletal disorders like rheumatoid arthritis, osteoarthritis and osteoporosis, followed by cardiovascular and cerebrovascular disease. CONCLUSIONS: The present study investigating 31 physical diseases is the most extensive analysis to date on the topic of back pain and comorbidity. This is an attempt to cast light on the tangled relationships involved in developing and coping with back pain. In view of the large percentage of unspecific back pain, we believe it is important for physicians treating back pain to extend their history and diagnostic analysis skills to embrace comorbidities related to the back pain

  30. SIMON D, PRIEUR AM, QUARTIER P, CHARLES RJet CZERNICHOW P: Early Recombinant Human Growth Hormone treatment in Glucocorticoid-Treated Children with Juvenile Idiopathic Arthritis: 3-Year Randomized Study, J.Clin.Endocrinol.Metab., Vol. ., 2007
    Organism:Department of Pediatric Endocrinology, Robert Debre Teaching Hospital, Paris, France; Department of Pediatric Rheumatology, National Reference Center for Rare Diseases, Necker-Enfants Malades Teaching Hospital, Paris, France; and Department of Radiology, Cochin Teaching Hospital, Paris, France
    Abstract:    Context: Long-term glucocorticoid therapy adversely affects growth and body composition in children with juvenile idiopathic arthritis (JIA). In previous studies, recombinant human growth hormone (rhGH) halted the progression of these complications without inducing catch-up growth. Objectives: The objective of the study was to evaluate the impact on growth and body composition of rhGH started early after glucocorticoid initiation and to record adverse effects, in children with JIA. Design: This is a 3-year randomized controlled study. Setting: This study was conducted in a teaching hospital. Patients: 30 children, 12-15 months into glucocorticoid therapy for severe JIA, were enrolled. Intervention: Patients received rhGH (0.46 mg/kg/week) in daily subcutaneous injections (n = 15) or no rhGH therapy (n = 15) for 3 years. Main Outcome Measure: Difference in height standard deviation score (SDS) change between the two groups was assessed. Height velocity, body composition and oral glucose tolerance were evaluated yearly. Results: Mean height SDS increase was larger with rhGH (+0.37 +/- 1.5 SDS) than without (-0.96 +/- 1.2 SDS) (P = 0.04). Mean height velocity returned to normal within the first year of rhGH treatment and remained normal thereafter. Mean lean mass increase was greater with rhGH-treatment (+7.3 +/- 2.9 kg vs. +4.4 +/- 2.8 kg; P = 0.03). Fat mass and bone mineralization were not significantly different in the two groups. Fasting serum insulin increased significantly in rhGH-treated patients (5.2 +/- 16 mIU/L) compared to untreated controls (-2.3 +/- 5 mIU/L) (P = 0.04); fasting glycemia was unchanged. Conclusions: rhGH started early in the course of JIA preserved normal growth velocity and height. Although rhGH was well tolerated, carbohydrate metabolism should be monitored closely

  31. TAKEYAMA J, UMEBAYASHI Het INAGAKI T: Renal involvement in a patient with juvenile idiopathic arthritis presenting after treatment for Hodgkin lymphoma, J.Pediatr.Hematol.Oncol., Vol. 29(5), 347, 2007
    Organism:

  32. THAPA R, MALLICK D, MANDAL Pet GHOSH A: Neuroblastoma masquerading as juvenile idiopathic arthritis, Indian J.Pediatr., Vol. 74(4), 421-422., 2007
    Organism:

  33. TYNJALA P, LINDAHL P, HONKANEN V, LAHDENNE Pet KOTANIEMI K: Infliximab and etanercept in the treatment of chronic uveitis associated with refractory juvenile idiopathic arthritis, Ann.Rheum.Dis., Vol. 66(4), 548-550., 2007
    Organism:Department of Pediatric Rheumatology, Research Unit, Hospital for Children and Adolescents, Helinski University Central Hospital, 00029 HUS, Finland pirjotynjala@husfiFAU - Tynjala, Pirjo
    Abstract:    OBJECTIVE: To evaluate the efficacy of anti-tumour necrosis factor (anti-TNF) treatment in juvenile idiopathic arthritis (JIA)-associated uveitis. METHODS: 24 patients with uveitis taking etanercept and 21 taking infliximab were studied. The endpoint ophthalmological evaluation was at 24 months or at the termination of the first biological agent. The ocular inflammatory activity was graded on the basis of the number of anterior chamber cells. RESULTS: Of the 45 patients, uveitis improved in 14 (31%), no change was observed in 14 (31%) and the activity of uveitis increased in 17 (38%). Inflammatory activity improved more frequently (p=0.047) in the patients taking infliximab than in those taking etanercept. The number of uveitis flares/year was higher (p=0.015) in the patients taking etanercept (mean 1.4, range 0-3.2) than in those taking infliximab (mean 0.7, range 0-2). Uveitis developed for the first time while taking anti-TNF treatment in five patients-4 taking etanercept (2.2/100 patient-years) and 1 taking infliximab (1.1/100 patient-years). CONCLUSIONS: During anti-TNF treatment, the ophthalmological condition improved in one-third of the patients with uveitis. In chronic anterior uveitis, associated with refractory JIA, infliximab may be more effective than etanercept

  34. VALENTINO LAet HAKOBYAN N: Histological changes in murine haemophilic synovitis: a quantitative grading system to assess blood-induced synovitis, Haemophilia., Vol. 12(6), 654-662., 2006
    Organism:The RUSH Hemophilia and Thrombophilia Center, The Department of Pediatrics, Rush Children's Hospital and Rush University Medical Center, Chicago, Illinois 60612-3833, USA lvalentino@rusheduFAU - Valentino, L A
    Abstract:    Haemophilia is a congenital disorder that results in frequent bleeding into joints, in which a chronic and debilitating arthritis develops. The presence of blood evokes an inflammatory and proliferative synovial reaction. Although the molecular mechanisms and biochemical pathways which underlie this disorder are not known, significant advances have been made by studying a murine model of human haemophilic synovitis. In order to better understand and correlate the pathological, molecular and biochemical changes, it has become necessary to grade the histological changes observed. Despite a search of the literature and review of relevant publications, none of the currently utilized schemes were appropriate, and therefore a novel grading scheme was developed. After review of over 1000 histological sections, six characteristic changes were identified: (i) synovial hyperplasia; (ii) vascularity; (iii) discolouration by haemosiderin; (iv) the presence of blood (erythrocytes); (v) villus formation; and (vi) cartilage erosion. Synovial hyperplasia and vascularity were present in variable amounts and were quantitatively scored (0-3), while the other changes were qualitatively scored as absent or present (0 or 1). Application of the grading scheme was tested and a high interobserver correlation (greater than 80%) was found. The scheme was easy to learn even by novices, with no prior experience. The availability of the histological grading scheme for murine synovitis will allow for precise evaluation of the pathological changes following joint bleeding, and facilitate correlations with molecular and biochemical changes that lead to these changes

  35. VAN HOLSBEECK MT: A role for US screening in juvenile idiopathic arthritis, Pediatr.Radiol., Vol. ., 2007
    Organism:Department of Radiology, Musculoskeletal Radiology, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI, 48202, USA, vanholsbeeck@comcastnet
    Abstract:

  36. VAN ROSSUM MA, VAN SOESBERGEN RM, BOERS M, ZWINDERMAN AH, FISELIER TJ, FRANSSEN MJ, TEN CATE R, SUIJLEKOM-SMIT LW, WULFFRAAT NM, VAN LUIJK WH, OOSTVEEN JC, KUIS Wet DIJKMANS BA: Long-term outcome of Juvenile Idiopathic Arthritis following a placebo controlled trial: sustained benefits of early sulfasalazine treatment, Ann.Rheum.Dis., Vol. ., 2007
    Organism:Emma Children's Hospital AMC and Jan van Breemen Instituut, Amsterdam, Netherlands
    Abstract:    OBJECTIVES: A previous 24-week randomised trial demonstrated that sulfasalazine (SSZ) treatment was superior to placebo (PLAC) in suppressing disease activity in patients with oligo- and polyarticular onset juvenile idiopathic arthritis (JIA). The current study determines the long-term outcome of the trial participants and evaluates whether the benefits of SSZ allocation are sustained over time. METHODS: Between 2001 and 2003, 32 SSZ and 29 PLAC patients (90% of all patients) were prospectively examined clinically and by chart review, median 9 years (range 7-10) after trial inclusion. In the follow-up assessment variables of the American College of Rheumatology Pediatric 30 (ACR Pedi 30) criteria were collected. The assessor was blinded to trial treatment allocation. RESULTS: After the trial patients had been routinely followed in rheumatology referral centres, and treated at the discretion of the attending physician. Almost all patients continued or started DMARDs (SSZ 91%, PLAC 93%; SSZ treatment in about 80%). DMARD treatment appeared less intensive in the SSZ group as evidenced by a significantly shorter duration of SSZ use (median 2.5 vs. 5.2 years; p = 0.02) and a trend towards less use of methotrexate and other DMARDs. More than one-third of the patients reported long periods of non-compliance with DMARD treatment in both groups. At follow up 74% of the patients had active joints and 30% showed active polyarthritis. Almost all outcome scores were better for SSZ compared to PLAC patients. Differences (often exceeding 50%) were significant for the number of active joints, patients' overall well-being, number of patients with episodes of clinical remission off medication (CROM) and duration of these episodes, patients in CROM and ACR Pedi 30 response at follow-up. Additional exploratory analyses performed to detect potential confounders related to patient characteristics or follow-up treatment showed that DMARD treatment compliance was positively correlated with an ACR Pedi 30 response (odds ratio 3.8, 95% confidence interval (CI) 1.1-13.4; p = 0.03). Adjusted for compliance, a SSZ patient was 4.2 times as likely as a PLAC patient to be an ACR Pedi 30 responder at follow-up (95% CI 1.3-14.3; p = 0.02). CONCLUSIONS: This follow-up study shows that effective suppression of disease activity by SSZ treatment early in active disease in JIA patients has beneficial effects that persist for many years. Given these results, compliance with DMARD treatment deserves serious attention

  37. VANNINI A, CHEUNG K, FUSCONI M, STAMMEN-VOGELZANGS J, DRENTH JP, DALL'AGLIO AC, BIANCHI FB, BAKKER-JONGES LE, VAN VENROOIJ WJ, PRUIJN GJet ZENDMAN AJ: Anti-cyclic citrullinated peptide positivity in non-rheumatoid arthritis disease samples: citrulline-dependent or not?, Ann.Rheum.Dis., Vol. 66(4), 511-516., 2007
    Organism:Department of Internal Medicine, Cardioangiology, Hepatology, University of Bologna, and Azienda Ospedaliero-Universitaria S Orsola-Malpighi, Bologna, Italy antoniovannini@tiscaliitFAU - Vannini, A
    Abstract:    BACKGROUND: Antibodies directed against citrullinated proteins (eg anti-cyclic citrullinated peptide (CCP)) have excellent diagnostic and good prognostic potential for rheumatoid arthritis. Type 1 autoimmune hepatitis (AIH-1) is a chronic liver disease characterised by a variety of serum autoantibodies. Recently, in a large group of patients with AIH-1 without clear rheumatoid arthritis overlap, a relatively high percentage (9%) of anti-CCP2 positivity was scored. OBJECTIVES: To characterise the citrulline-dependence of the observed anti-CCP2 positivity in AIH-1 sera as well as in other groups of patients without rheumatoid arthritis (mainly rheumatic diseases). METHODS: Serum samples of 57 patients with AIH-1 and 66 patients without rheumatoid arthritis, most of them reported as anti-CCP positive, were tested for citrulline-specific reactivity with a second generation anti-CCP kit, with the citrullinated and the corresponding non-citrullinated (arginine-containing) antigen. A subset of AIH-1 sera was also tested with a CCP1 ELISA (and arginine control). RESULTS: The anti-CCP2 reactivity of most non-rheumatoid arthritis rheumatic diseases samples (87-93%) was citrulline-specific, whereas a relatively high percentage of AIH-1 samples (42-50%) turned out to be reactive in a citrulline-independent manner. The use of citrullinated and non-citrullinated CCP1 peptides confirmed a high occurrence of citrulline-independent reactivity in AIH-1 samples. CONCLUSIONS: In rheumatoid arthritis and most non-rheumatoid arthritis rheumatologic disease sera, anti-CCP positivity is citrulline-dependent. However in some patients, particularly patients with AIH-1, citrulline-independent reactivity in the anti-CCP2 test can occur. A positive CCP test in a non-rheumatic disease (eg liver disease) should therefore be interpreted with care, and preferably followed by a control ELISA with a non-citrullinated antigen

  38. WATANABE R, FUJIMOTO M, YAZAWA N, NAKASHIMA H, ASASHIMA N, KUWANO Y, TADA Y, MARUYAMA N, OKOCHI Het TAMAKI K: Increased serum levels of a proliferation-inducing ligand in patients with bullous pemphigoid, J.Dermatol.Sci., Vol. 46(1), 53-60., 2007
    Organism:Department of Dermatology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo, Tokyo 113-8655, JapanFAU - Watanabe, R
    Abstract:    BACKGROUND: B cells have been demonstrated to have critical roles in developing autoimmune bullous diseases. Recently identified tumor necrosis factor-like molecules, B cell-activating factor of the TNF family (BAFF) and a proliferation-inducing ligand (APRIL) are essential molecules for B cell development, survival, and proliferation. Although the functions of APRIL have not been fully evaluated, recent studies suggest that circulating levels of APRIL are increased in various autoimmune diseases, including systemic lupus erythematosus and rheumatoid arthritis. OBJECTIVES: To determine serum APRIL levels in patients with pemphigus vulgaris (PV) and bullous pemphigoid (BP), and compare those with clinical findings and laboratory findings. PATIENTS/METHODS: Sera from 15 PV patients, 43 BP patients, and 15 normal controls were subjected to ELISA assays to measure serum APRIL, BAFF, Dsg3, and BP180 levels. RESULTS AND CONCLUSIONS: Circulating APRIL levels were significantly elevated in BP patients but not in PV patients, and correlated with serum BAFF levels. Our study revealed that serum APRIL levels tended to be increased in the quite early stage of disease. In conclusion, circulating APRIL levels may be a useful marker for early activation of autoimmune diathesis, and furthermore, an effective therapeutic target molecule in patients with BP

  39. ZAGOROV MY, DRAGANOV MM, ALIMANSKA SA, STAYKOVA ND, STEFANOV RS, TRAYANCHEVA M, KUZMANOVA SIet MURDJEVA MA: Indirect immunofluorescent assay for antinuclear antibodies on McCoy-Plovdiv serum-free cell line substrate, Comp Immunol.Microbiol.Infect.Dis., Vol. 30(3), 153-162., 2007
    Organism:Department of Microbiology and Immunology, Medical University-Plovdiv, 15A Vassil Aprilov Street, 4000 Plovdiv, BulgariaFAU - Zagorov, Marin Yordanov
    Abstract:    Indirect immunofluorescent assay for antinuclear antibodies (IIFA-ANA) on HEp-2 cell substrate is a widely used test for diagnosis of connective tissue diseases. Recently, serum-free fibroblast cell line McCoy-Plovdiv has been developed to provide an alternative substrate. The aim of the present study was to evaluate the diagnostic performance of IIFA-ANA on McCoy-Plovdiv cell substrate for systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA) and compare it with that of the standard HEp-2 cell substrate. Sera from 72 patients with RA and 23 patients with SLE were tested with IIFA-ANA on both substrates. The control group consisted of 100 sera from healthy individuals. The agreement (Cohen's kappa) and the diagnostic performance (ROC analysis) of both methods were evaluated. IIFA-ANA on McCoy-Plovdiv cells proved to be comparable with the standard IIFA-ANA on HEp-2 cell substrate