The eye and inflammatory rheumatic diseases: The eye and rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis

2016 ◽  
Vol 30 (5) ◽  
pp. 802-825 ◽  
Author(s):  
Philip Ian Murray ◽  
Saaeha Rauz
2021 ◽  
Vol 12 ◽  
Author(s):  
Milena Iwaszko ◽  
Joanna Wielińska ◽  
Jerzy Świerkot ◽  
Katarzyna Kolossa ◽  
Renata Sokolik ◽  
...  

ObjectiveRheumatoid arthritis (RA), ankylosing spondylitis (AS), and psoriatic arthritis (PsA) belong to inflammatory rheumatic diseases, the group of conditions of unknown etiology. However, a strong genetic component in their pathogenesis has been well established. A dysregulation of cytokine networks plays an important role in the development of inflammatory arthritis. Interleukin 33 (IL-33) is a recently identified member of the IL-1 family. To date, the significance of IL-33 in inflammatory arthritis has been poorly studied. This research aimed to investigate the potential of IL-33 gene polymorphisms to serve as biomarkers for disease susceptibility and TNF inhibitor response in RA, AS, and PsA patients.Materials and MethodsIn total, 735 patients diagnosed with RA, AS, and PsA and 229 healthy individuals were enrolled in the study. Genotyping for three single nucleotide polymorphisms (SNPs) within the IL-33 gene, namely, rs16924159 (A/G), rs10975519 (T/C), and rs7044343 (C/T), was performed using polymerase chain reaction amplification employing LightSNiP assays.ResultsIn the present study, the IL-33 rs10975519 CC genotype was associated with a decreased risk of developing RA in females, while the IL-33 rs16924159 polymorphism was associated with the efficacy of anti-TNF therapy and clinical parameters for RA and AS patients. The IL-33 rs16924159 AA genotype correlated with higher disease activity and worse clinical outcomes in RA patients treated with TNF inhibitors, and AS patients carrying the IL-33 rs16924159 AA genotype had higher disease activity and a worse response to anti-TNF therapy. That indicates a deleterious role of the IL-33 rs16924159 AA genotype in the context of RA, as well as AS.ConclusionsThe obtained results suggest that IL-33 gene polymorphisms might be potential candidate biomarkers of disease susceptibility and anti-TNF treatment response in patients with inflammatory rheumatic diseases.


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1931.3-1931
Author(s):  
M. M. Castañeda-Martínez ◽  
G. Figueroa-Parra ◽  
D. Vega-Morales ◽  
B. R. Vázquez Fuentes ◽  
Y. G. Ordoñez Azuara ◽  
...  

Background:Primary care physicians (PCP) are usually the first contact of people with inflammatory rheumatic diseases, and find the early symptoms of Rheumatoid Arthritis (RA) difficult to distinguish from those of other rheumatic diseases. A time-delay in the reference to Rheumatology is a health issue in several countries. The clinical aspects that general practitioner took into account in hand arthralgia patients are important to make the reference. In particular the Squeeze Test (ST) - which is simple to perform and rapidly done, ST is useful for identifying progression to RA in patients with undifferentiated arthritis. The ST has been described as not reliable because is clinician-dependent.Objectives:To identify the required force that needs to be applied in order to obtain a positive Automatized Squeeze Test (AST) in a cohort of patients with hand arthralgia.Methods:Ninety-seven patients were recruited in Family Medicine Consultation and in Rheumatology Consultation of the Hospital Universitario “Dr. José Eleuterio González” in Monterrey, Nuevo León, México. Eligible patients were adults (aged≥18 years) with hand arthralgia (that wasn’t caused by trauma) as their chief complaint. After obtaining informed consent and after a questionnaire application, patients were submitted to AST maneuver, using an automated compressor with different forces already predetermined in the interface of the software used for compression.Results:In this cohort of 98 patients, 79 (80.6%) were women. The mean age was 51.14 years (SD 14.66). Ninety-six (97.9%) patients were right handed. The diagnoses were Osteoarthritis (OA) (16.3%), RA (5.1%), Undifferentiated arthritis (1.2%), Psoriatic arthritis (1.2%) and Fibromyalgia (2%). Force measures according to diagnoses are reported in Table 1.Table 1.Diagnoses and mean forcesDiagnosisn (%)Right hand force mean (kg/s2) (SD)Left hand force mean (kg/s2) (SD)OA16 (16.3)3.53 (2.74)3.18(2.73)RA5 (5.1)3.60 (2.53)3.16(1.36)UA1 (1.2)7.60(0)8.70(0)PsA1 (1.2)7.60(0)7.80(0)FM2 (2.0)4.11(4.40)1.75(1.06)OA, Osteoarthritis;RA, Rheumatoid Arthritis;UA, Undifferentiated Arthritis;PsA, Psoriatic Arthritis;FM, Fibromyalgia;SD, Standard DeviationConclusion:In the cases of RA and OA, the means of force to obtain a positive AST was lower than in the rest of the diagnoses.References:[1]Stack R, Nightingale P, Jinks C, Shaw K, Herron-Marx S, Horne R et al. Delays between the onset of symptoms and first rheumatology consultation in patients with rheumatoid arthritis in the UK: an observational study. BMJ Open. 2019;9(3):e024361.Disclosure of Interests:None declared


2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 1133.2-1134
Author(s):  
D. Freier ◽  
E. Wiebe ◽  
R. Biesen ◽  
T. Buttgereit ◽  
S. Hermann ◽  
...  

Background:The prevalence of osteoporosis in inflammatory rheumatic diseases such as psoriatic arthritis (PsA) has not been sufficiently clarified yet, and the data in the literature are heterogeneous. In addition, it is still unclear to what extent patients with PsA differ in terms of bone density from patients with other forms of spondyloarthritis such as ankylosing spondylitis (AS).Objectives:In an interim analysis of the Rh-GIOP Study (ClinicalTrials.gov IdentifierNCT02719314), we observed that PsA patients demonstrated more frequently normal bone density than any other patient group analyzed (suffering from e.g. rheumatoid arthritis or systemic sclerosis). The main objective of this investigation was to compare bone density data from patients with PsA and AS, as both diseases belong to the spondyloarthritis group. 1100 patients with inflammatory rheumatic diseases provided the basis of Rh-GIOP, a prospective study monitoring glucocorticoid (GC)-induced osteoporosis in patients with rheumatic diseases. Rh-GIOP was established in 2015 at the Charité University Hospital. Bone mineral density data were measured by dual x-ray absorptiometry (DXA).Methods:92 patients with PsA (65% female) were compared with 51 patients suffering from AS (35% female). Potential risk and protective factors (e.g. data on GC treatment, anti-rheumatic therapy), laboratory parameters (e.g. Vitamin D, alkaline phosphatase, calcium and inflammatory markers) and functional status (e.g. Health Assessment Questionnaire, sporting activities, back pain) were compared between these groups. Statistical analysis was performed descriptively using mean and standard deviation, t-tests for metric variables, and chi-square tests for nominal variables. Due to the heterogeneous gender distribution, an additional statistical matching was performed to compare patients matched by age and gender.Results:Patients with PsA displayed significantly higher minimal T-scores than patients with AS (p=0.003) even though patients with AS were younger and more often male (p<0.001). AS patients showed a higher frequency of osteopenic bone densities (p<0.05), however, no differences in the frequency of osteoporotic bone densities were found. Body-mass-index (BMI) was significantly higher (p<0.001) in PsA patients. PsA patients demonstrated a higher frequency of csDMARD use (p<0.001). Additional analyses among PsA patients with and without csDMARDs revealed also significantly higher minimal T-scores in PsA patients taking csDMARDs (90% Methotrexate), and both groups showed the same average of age and gender distribution. Furthermore, AS patients complained significantly more often of back pain (96 % vs. 74%, p=0.001) than PsA patients. No differences in GC use or cumulative GC dose were found. All results could be confirmed when groups were matched by age and gender.Conclusion:Our results demonstrate that patients with PsA display higher bone density compared to age and gender matched patients with ankylosing spondylitis. Possible influencing factors could be the higher frequency of csDMARD use, higher BMI or the lower frequency of back pain in PsA patients. Multivariate tests and additional biomarker investigations in larger cohorts are necessary to corroborate these findings and to identify underlying pathogenic differences which could serve for an explanation.Disclosure of Interests:Desiree Freier: None declared, Edgar Wiebe: None declared, Robert Biesen: None declared, Thomas Buttgereit: None declared, Sandra Hermann: None declared, Timo Gaber: None declared, Frank Buttgereit Grant/research support from: Amgen, BMS, Celgene, Generic Assays, GSK, Hexal, Horizon, Lilly, medac, Mundipharma, Novartis, Pfizer, Roche, and Sanofi.


2010 ◽  
pp. 3603-3616 ◽  
Author(s):  
J. Braun ◽  
J. Sieper

The spondyloarthritides are a group of inflammatory rheumatic diseases with predominant involvement of axial and peripheral joints and entheses, together with other characteristic clinical features, including inflammatory back pain, sacroiliitis, peripheral arthritis (mainly in the legs), enthesitis, dactylitis, preceding infection of the urogenital/gastrointestinal tract, psoriatic skin lesions, Crohn-like gut lesions, anterior uveitis, and a family history of Spondyloarthritis. They are the second most frequent inflammatory rheumatic diseases after rheumatoid arthritis....


2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 822.2-822
Author(s):  
K. Bonek ◽  
E. Kuca-Warnawin ◽  
M. Ciechomska ◽  
P. Głuszko ◽  
E. Kontny

Background:Patients with rheumatic diseases such as rheumatoid arthritis (RA), psoriatic arthritis (PsA), and ankylosing spondylitis (AS) are at increased risk of developing dyslipidaemia and premature cardiovascular disease (CVD)(1).Objectives:To investigate the relationship between proinflammatory cytokines, microRNA, and lipid profile in patients with RA, AS, and PsA.Methods:A group of 65 patients (RA15/ AS25/ PsA25) with high disease activity (mean DAS28 5,98 / ASDAS-CRP 3,7/ DAPSA 38,5) and 25 healthy controls (HC) were compared. Lipid profile comprised triglycerides (TG), total cholesterol(TC), low (LDL), and high-density lipoprotein (HDL). Serum concentrations of IL-6, IL-21, IL-17, TNF and osteoprotegerine (OPG) were measured by commercially available enzyme-linked immunosorbent assays. Expression of miR-233-5p,miR-92-3p,miR-485-3p,miR-10b-5p,let-7d-5p, miR-26 -a-2-3p levels in sera was normalized to miR-16a internal control. The Mann-Whitney test was applied for intergroup comparison, the correlation was assessed using Spearman’s Rank test.Results:Patients with RA revealed mixed dyslipidemia (mean values:TC196; LDL 117; HDL, 48 TG; 124 mg/dl), PsA revealed hypertriglyceridemia (TC 175; LDL 100; HDL 50; TG137 mg/dl) and in AS no specific profile was found (TC 179; LDL98; HDL55; TG103 mg/dl). Higher expression of miR-485was observed in patients with PsA (4,8-fold) and AS (5,9-fold) compared to RA and HC groups (3,1 and 1,5-fold p=0,02). Similarly, miR-26a revealed higher expression in patients with PsA (28,4-fold) and AS (21,5-fold) than in RA and HC (3,5 and 2,9-fold p<0,00). PsA patients had higher expression of miR-146b than patients with RA, AS and HC (40,9-fold vs 12,6 vs 15,7 vs 3,4-fold p=0,002) and higher miR-10b (11,7 vs 1,4 vs 4,9 vs 1,7-fold p=0,004). Patients with RA showed higher expression of let7-d than patients with PsA, AS and HC (22-fold vs 1,8 vs 2,3 vs1,9 -fold p=0,002). In PsA miR-92b expression correlated negatively with HDL levels (r=-0,62 p=0,02) and positively with fasting glucose (r=0,71 p<0,00). TG levels negatively correlated with TNF (r=-0,47 p=0,01), IL-17 (r=-0,49 p=0,01) and OPG (r=-0,51 p=0,00) serum levels. Let-7d correlated negatively with TC (r=-0,58 p=0,03). In RA IL-21 positively correlated with LDL (r=0,71 p=0,00) and TC (r=0,75 p=0,001) concentrations. TG levels correlated positively with expressions of miR-92b (r=6,9 p=0,02) and miR-26a (r=0,69 p=0,03). In AS expression of let-7d was correlated positively with HDL (r=0,41 p=0,00) and TC (r=0,45 p=0,00) levels and negatively with ASDAS-CRP (r=-0,675 p=0,02) and CRP levels (r=-0,53 p=0,01). There were no significant differences in OPG, IL-21 concentrations or miR-146b, miR-92b,miR-233 expressions.Conclusion:Differences in proinflammatory profile in RA, PsA, and AS seem to be associated with different phenotypes of dyslipidemia. In PsA expression of miR-92b and higher levels of TNF, IL-17 and OPG are associated with altered lipid profile and hypertriglyceridemia. High activity of AS is associated with lowered expression of let-7d, possibly influencing TC and HDL levels. Therefore, measuring lipid profile in active disease might be misleading. In active RA increase of TC and LDL levels was associated with high IL-21 concentration, while hypertriglyceridemia with miR-92b and miR-26a expressions.References:[1]Bonek K,et al AB0775 Peripheral joint inflammation is associated with more proatherogenic cardiovascular risk profile in patients with psoriatic arthritis.Annals of the Rheumatic Diseases 2020;79:1685-1686Disclosure of Interests:None declared.


2021 ◽  
pp. 209-239
Author(s):  
Altaf Abdulkhaliq

AbstractBone is a target tissue in many inflammatory diseases including rheumatic diseases such as rheumatoid arthritis (RA), ankylosing spondylitis (AS), systemic lupus erythematosus (SLE), and psoriatic arthritis.


2020 ◽  
Vol 58 (5) ◽  
pp. 532-543
Author(s):  
E. L. Nasonov ◽  
A. M. Lila

The explanation of the mechanisms underlying the pathogenesis of rheumatoid arthritis (RA), along with the development of a wide range of biologics (bDMARDs), is among the major achievements of medicine in the 21st century. A new direction in the pharmacotherapy of inflammatory rheumatic diseases is associated with the development of “targeted” oral anti-inflammatory drugs, which include Janus kinase (JAK) inhibitors. One representative of the class of JAK inhibitors is upadacitinib (UPA), which has been registered for the treatment of RA and is undergoing clinical studies in patients with ankylosing spondylitis, psoriatic arthritis, and other inflammatory rheumatic diseases. This review presents new data on the efficacy and safety of UPA in RA.


2020 ◽  
pp. 83-94
Author(s):  
D. E. Karateev ◽  
E. L. Luchikhina

The treatment of immuno-inflammatory rheumatic diseases has advanced significantly in recent decades due to development of biological medications, which, however, are not without some weak points. They include immunogenicity, parenteral administration, and potentially insufficient stability of the composition of the drug. Great hopes are related to a relatively new class of targeted synthetic immunomodulatory drugs, currently represented in rheumatology by JAK kinase inhibitors (tofacitinib, baricitinib, upadacitinib) and phosphodiesterase 4 inhibitor (apremilast). The most actively developed group is JAK inhibitors that influence one of the most important signal pathway of immune system. This family includes 4 subtypes: JAK1, JAK2, JAK3 и tyrosine-kinase2 (TYK2). JAK-kinases selectively aggregate with cytoplasmic domains of different cytokine receptors, activation of which includes intracellular signal pathway JAK-STAT (Signal Transducer and Activator of Transcription). STAT proteins are responsible for transduction of the signals from more than 50 cytokines, hormones and growth factors that regulate key processes of survival, proliferation and differentiation of immune cells. The greatest practical experience achieved on tofacitinib. This medication approved inRussiafor several indications: rheumatoid arthritis, psoriatic arthritis, psoriasis, ulcerative colitis. Clinical trials of III phase of ORAL series in rheumatoid arthritis and OPAL series in psoriatic arthritis showed high efficacy of Tofacitinib in different clinical situations. In Russian strategic trial REMARKA after treatment with Tofacitinib very fast improvement of the signs of activity was observed, 68,8% patients achieved low disease activity or remission at 6th month of follow-up. Russian open multi-center observational study of Tofacitinib in 101 patients with rheumatoid arthritis and insufficient efficacy of basic and biologic drugs showed achievement of low disease activity or remission in 60% patients, as well as significant improvement of quality of life with a very low frequency of withdrawals due to adverse events (less than 2%).


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