scholarly journals Ethnic variation in the clinical manifestations of rheumatoid arthritis: Role of HLA–DRB1 alleles

2003 ◽  
Vol 49 (2) ◽  
pp. 200-208 ◽  
Author(s):  
Inmaculada del Rincón ◽  
Daniel F. Battafarano ◽  
Ramón A. Arroyo ◽  
Frederick T. Murphy ◽  
Michael Fischbach ◽  
...  
2020 ◽  
Vol 58 (3) ◽  
pp. 294-303
Author(s):  
A. D. Peshkova ◽  
T. A. Evdokimova ◽  
T. B. Sibgatullin ◽  
F. I. Ataullakhanov ◽  
R. I. Litvinov

Autoimmune diseases, including rheumatoid arthritis (RA), are risk factors for thrombotic events. Understanding the pathogenetic role of hemostatic changes in RA can assist in developing measures for prevention, prognosis, early diagnosis, and treatment of immune thromboses. Objective: to investigate the state of platelet and plasma hemostasis in patients with RA, as compared to other laboratory parameters and clinical manifestations of the disease. Subjects and methods. Hemostasis was investigated using two relatively new laboratory tests: thrombodynamics and kinetics of blood clot contraction (BCC). Examinations were made in 60 patients with RA and in 50 apparently healthy individuals of the control group. Results and discussion. In patients with RA, the parameters of thrombodynamics and BCC were found to be significantly different from the normal values. According to thrombodynamics, there was an increase in plasma clot growth rate, size, and density, which indicates chronic hypercoagulation. The rate and completeness of BCC were substantially reduced due to platelet dysfunction in patients with RA compared to healthy individuals. The changes in the parameters of thrombodynamics and BCC correlated with the laboratory signs of systemic inflammation and depended on the radiographic stage of the disease. Conclusion. The results of this investigation confirm that hemostatic disorders are present in RA and indicate the informative value of thrombodynamics and BCC tests as indicators of a pre-thrombotic state, including autoimmune pathology.


2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
John L. Gillick ◽  
John Wainwright ◽  
Kaushik Das

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease affecting a significant percentage of the population. The cervical spine is often affected in this disease and can present in the form of atlantoaxial instability (AAI), cranial settling (CS), or subaxial subluxation (SAS). Patients may present with symptoms and disability secondary to these entities but may also be neurologically intact. Cervical spine involvement in RA can pose a challenge to the clinician and the appropriate role of surgical intervention is controversial. The aim of this paper is to describe the pathology, pathophysiology, clinical manifestations, and diagnostic evaluation of rheumatoid arthritis in the cervical spine in order to provide a better understanding of the indications and options for surgery. Both the medical and surgical treatment options for RA have improved, so has the prognosis of the cervical spine disease. With the advent of disease modifying antirheumatic drugs (DMARDs), fewer patients are presenting with cervical spine manifestations of RA; however, those that do, now have improved surgical techniques available to them. We hope that, by reading this paper, the clinician is able to better evaluate patients with RA in the cervical spine and determine in which patients surgery is indicated.


2019 ◽  
Vol 64 (1) ◽  
pp. 53-56 ◽  
Author(s):  
T. Z. Kvlividze ◽  
B. V. Zavodovsky ◽  
Yu. R. Akhverdyan ◽  
Yu. V. Polyakova ◽  
L. E. Sivordova ◽  
...  

The purpose of this study was to determine the level of nesfatin-1 (NF-1) in the blood serum of healthy volunteers and patients with rheumatoid arthritis (RA) to establish the threshold for normal values of this parameter and to reveal the relationship between the level of NF-1 and clinical manifestations of RA. We examined 170 people, of which 110 patients with RA and 60 donors who made up the comparison group. The mean level of serum nesfatin-1 in healthy subjects was 31.61 ± 3.17 ng/ml (M ± σ). The level of normal values of nesfatin-1 in healthy individuals, defined as M ± 2σ, was from 25.27 to 37.95 ng/ml. These studies showed the relationship between the concentration of NF-1 and the severity of clinical manifestations of RA. We found that a higher serum level of NF-1 was characteristic of patients with a more severe clinical course of the disease. The data obtained indicate that high level of NF-1 positively correlates with higher concentrations of C-reactive protein and ESR. This data indirectly proves the pro-inflammatory effect of NF-1 and confirms the hypothesis about the primary role of systemic inflammation in the pathogenesis of RA.


Reumatismo ◽  
2016 ◽  
Vol 68 (4) ◽  
pp. 167 ◽  
Author(s):  
G. Cafaro ◽  
A. Alunno ◽  
V. Valentini ◽  
M. Comasia Leone ◽  
E. Marcucci ◽  
...  

The etiopathogenesis of rheumatoid arthritis (RA) is not yet fully elucidated and the site of inflammation onset is still a matter of debate. The presence of autoantibodies as well as clinical manifestations, such as interstitial lung disease, before the onset of arthritis seems to be in favour of the hypothesis that initial pathogenic events take place in tissues other than the joint. In this review article we summarize the most recent literature on extra-synovial autoimmunity triggers eventually leading to RA, with particular focus on the role of the lung. To date, anti-cyclic citrullinated peptide antibodies (ACPAs) are considered central players in RA pathogenesis and represent the gold-standard for disease diagnosis. Lungs and mucosae are exposed to environmental stimuli such as dusts and smoke which have been shown to foster citrullination of peptides in lungs thereby triggering the production of ACPA. In addition, other mechanisms of disease pathogenesis independent of citrullination play an important role. Deeper knowledge of these processes could represent a huge step forward in the management of RA, with dramatic impact on diagnosis, prevention, prognostic stratification and treatment of the disease.


2021 ◽  
Vol 35 ◽  
pp. 205873842110150
Author(s):  
Liberato Giardullo ◽  
Addolorata Corrado ◽  
Nicola Maruotti ◽  
Daniela Cici ◽  
Natalia Mansueto ◽  
...  

We performed a systematic literature review to summarize the underlying pathogenic mechanisms by which adipokines influence rheumatological diseases and the resulting clinical manifestations. Increasing evidence display that numerous adipokines may significantly influence the development or clinical course of various rheumatological diseases. Despite the normal anti- or pro-inflammatory role of the cytokines, the serum level varies enormously in various rheumatological diseases. The expression of high levels of pro-inflammatory cytokines such as leptin or visfatin, respectively in systemic lupus erythematosus and in rheumatoid arthritis, represents a negative prognostic factor; other adipokines such as adiponectin, broadly known for their anti-inflammatory effects, showed a correlation with disease activity in rheumatoid arthritis. In the near future pro-inflammatory cytokines may represent a potential therapeutic target to restrain the severity of rheumatological diseases. Further studies on adipokines may provide important information on the pathogenesis of these diseases, which are not yet fully understood. The mechanisms by which adipokines induce, worsen, or suppress inflammatory and degenerative musculoskeletal pathologies and their clinical significance will be discussed in this review.


2011 ◽  
Vol 39 (1) ◽  
pp. 6-9 ◽  
Author(s):  
FERNANDA LETICIA MARTINY ◽  
TIAGO DEGANI VEIT ◽  
CLAITON VIEGAS BRENOL ◽  
JOÃO CARLOS TAVARES BRENOL ◽  
RICARDO MACHADO XAVIER ◽  
...  

Objective.Rheumatoid arthritis (RA) is a disease with unknown etiology but it is probably multifactorial. RA susceptibility is related to genetic, hormonal, immunologic, and environmental factors. Mannose-binding lectin (MBL) is an important protein of the human innate immune system, encoded by the MBL2 gene. Polymorphisms in MBL2 were associated with several diseases, and may be an important factor in RA susceptibility. We analyzed 3 MBL2 gene polymorphisms in 322 Brazilian patients with RA and 345 ethnically matched healthy controls.Methods.MBL2 gene variants were analyzed through polymerase chain reaction sequencing.Results.Considering MBL2 B, C, and D alleles separately, a significant difference in both genotypic and allelic frequencies, particularly concerning frequency of the C allele, was observed comparing European-derived and African-derived individuals (European-derived patients 0.022 vs African-derived patients 0.205; European-derived controls 0.029 vs African-derived controls 0.144; both p < 0.001). We also analyzed MBL2 genotype in relation to extraarticular manifestations. Considering MBL2 variants together, we found an increased frequency of the OO genotype among patients with rheumatoid nodules (p = 0.031), although this association lost significance after Bonferroni correction.Conclusion.Our findings suggest an association of MBL2 genotypes with some clinical manifestations of RA, but more studies are needed to clarify the actual role of MBL in RA.


2019 ◽  
Vol 1 (7) ◽  
pp. 65-71
Author(s):  
O. A. Egorova ◽  
K. A. Novikov

Presented current data on the etiology of rosacea, the main aspects of pathogenesis, clinical forms of the disease. Reflects trigger factors leading to rosacea, as well as complicating its course. Modern methods of treatment are described, including the use of new safe preparations of ivermectin and brimonidine, providing a good, lasting effect of clinical manifestations of rosacea. The role of laser technology, actively occupying a leading place in the choice of physiotherapeutic treatment method, is noted. The need for an individual approach in the choice of therapy for each patient with rosacea is emphasized.


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