scholarly journals The Results of Fetal Chondrocytes Transplantation in Patients with Rheumatoid Arthritis

2014 ◽  
Vol 3 ◽  
Author(s):  
Natalya Krivoruchko ◽  
Saltanat Tuganbekova ◽  
Gulnar Rakhimbekova ◽  
Karlygash Kuzembaeva ◽  
Lina Zaripova
Keyword(s):  
Rheumatoid Arthritis ◽  
Morphological Changes ◽  
Control Cell ◽  
Clinical Manifestations ◽  
Bone Destruction ◽  
Human Embryos ◽  
Control Group ◽  
X Ray ◽  
Donor Cells

Introduction. Nowadays anti-inflammatory and immunosuppressive therapy has significantly improved the quality of life and prognosis of rheumatoid arthritis (RA). Nevertheless, there are still many patients with progressive rheumatoid inflammation, resulting in the destruction of joints. Cell therapy seems like a promising direction in rheumatology. The aim of our research was to evaluate the efficacy of fetal chondrocyte transplantation in patients with RA.Methods. We examined 60 patients with rheumatoid arthritis (I - III stages) between 20 and 63 years of age. They were divided into 2 groups: the first group underwent the fetal chondrocytes transplantation (n = 40), and the second was a control group who got conservative therapy (n = 20). Donor cells were taken from the chondrogenic layer of the humerus or femur heads and hip condyles of human embryos in gestation for 17-20 weeks. A suspension of fetal chondrocytes injected into affected areas of the articular surfaces under X-ray control. Cell viability was determined before the injection. Efficacy of the therapy was assessed by clinical, instrumental, and laboratory tests. This clinical trial was allowed by The Ministry of Public Health and Ethics Committee. All of our patients gave informed consent for the fetal chondrocytes transplantation.Results. Evaluation of the clinical manifestations of RA in the first group of patients showed 3.7 times decrease in pain and 1.6 times relief of synovitis. Complete reduction of contracture was observed in 82% of patients in the first group. Morphometric changes in X-ray demonstrated inhibition of the destruction in articular cartilage and surfaces of bones after transplantation of fetal chondrocytes. The dynamics of morphological changes in synovium showed 2.5 times reduction of the inflammatory reaction. Transplantation of fetal chondrocytes led to a significant reduction in ESR, CRP, fibrinogen , γ-globulin after a period of 12 months (p < 0.03). Furthermore, patients in the second group had 2.7 times higher risk of ankylosis compared to the first group. We did not observe any complications of fetal chondrocytes transplantation.Conclusions. Application of fetal chondrocytes therapy had the desired clinical effect, which was confirmed by reduction of the RA activity and decrease of cartilage and bone destruction. 

scholarly journals From Rheumatoid Factor to Anti-Citrullinated Protein Antibodies and Anti-Carbamylated Protein Antibodies for Diagnosis and Prognosis Prediction in Patients with Rheumatoid Arthritis

2021 ◽  
Vol 22 (2) ◽  
pp. 686
Author(s):  
Chao-Yi Wu ◽  
Huang-Yu Yang ◽  
Shue-Fen Luo ◽  
Jenn-Haung Lai
Keyword(s):  
Rheumatoid Arthritis ◽  
Treatment Options ◽  
Clinical Manifestations ◽  
Bone Destruction ◽  
Response To Therapy ◽  
Current Evidence ◽  
Prognosis Prediction ◽  
Diagnosis And Prognosis ◽  
Systemic Inflammatory Disease ◽  
Citrullinated Protein

Rheumatoid arthritis (RA) is a chronic systemic inflammatory disease mainly involving synovial inflammation and articular bone destruction. RA is a heterogeneous disease with diverse clinical presentations, prognoses and therapeutic responses. Following the first discovery of rheumatoid factors (RFs) 80 years ago, the identification of both anti-citrullinated protein antibodies (ACPAs) and anti-carbamylated protein antibodies (anti-CarP Abs) has greatly facilitated approaches toward RA, especially in the fields of early diagnosis and prognosis prediction of the disease. Although these antibodies share many common features and can function synergistically to promote disease progression, they differ mechanistically and have unique clinical relevance. Specifically, these three RA associating auto-antibodies (autoAbs) all precede the development of RA by years. However, while the current evidence suggests a synergic effect of RF and ACPA in predicting the development of RA and an erosive phenotype, controversies exist regarding the additive value of anti-CarP Abs. In the present review, we critically summarize the characteristics of these autoantibodies and focus on their distinct clinical applications in the early identification, clinical manifestations and prognosis prediction of RA. With the advancement of treatment options in the era of biologics, we also discuss the relevance of these autoantibodies in association with RA patient response to therapy.

Total Flavonoids of Bidens pilosa Ameliorates Bone Destruction in Collagen-Induced Arthritis

Planta Medica ◽  
2021 ◽  
Author(s):  
Mengqin Hong ◽  
Xingyu Fan ◽  
Shengxiang Liang ◽  
Wang Xiang ◽  
Liting Chen ◽  
...  
Keyword(s):  
Rheumatoid Arthritis ◽  
Proinflammatory Cytokines ◽  
Bone Destruction ◽  
Nuclear Factor Κb ◽  
Total Flavonoids ◽  
Nuclear Factor ◽  
Collagen Induced Arthritis ◽  
Bidens Pilosa ◽  
X Ray ◽  
Receptor Activator

AbstractRheumatoid arthritis is a chronic autoimmune disease characterized by the infiltration of synovial inflammatory cells and progressive joint destruction. Total flavonoids of Bidens pilosa have been used against inflammation in rheumatoid arthritis, but its role in bone destruction remains to be explored. The aim of this paper was to study whether total flavonoids of B. pilosa relieve the severity of collagen-induced arthritis in rats, particularly whether it regulates the production of proinflammatory cytokines and the receptor activator of nuclear factor-κB/receptor activator of nuclear factor-κB ligand/osteoprotegerin signaling pathway. In this research, a collagen-induced disease model was induced in adult rats by subcutaneous injection of collagen II. Total flavonoids of B. pilosa at different doses (40, 80, and 160 mg/kg/d) were administered intragastrically, while methotrexate (1 mg/kg/w) was injected intraperitoneally as a positive control. Paw swelling, arthritis score, and body weight were assessed and evaluated. The severity of joint damage was determined using X-ray and confirmed by histopathology. The expression levels of receptor activator of nuclear factor-κB ligand, osteoprotegerin, IL-1β, IL-17, and TNF in the serum and tissue were assayed using ELISA and immunohistochemistry. We found that total flavonoids of B. pilosa attenuated collagen-induced arthritis at the macroscopic level, and total flavonoids of B. pilosa-treated rats showed reduced paw swelling, arthritis scores, and X-ray appearance of collagen-induced arthritis in addition to improved histopathological results. These findings were consistent with reduced serum and tissue receptor activator of nuclear factor-κB ligand, TNF, IL-1β, and IL-17 levels but increased osteoprotegerin levels. Our data suggest that total flavonoids of B. pilosa attenuate collagen-induced arthritis by suppressing the receptor activator of nuclear factor-κB ligand/receptor activator of nuclear factor-κB/osteoprotegerin pathway and the subsequent production of proinflammatory cytokines. In addition, total flavonoids of B. pilosa may be a promising therapeutic candidate for the management of rheumatoid arthritis.

Strengthening the pharmacological potential of drug therapy in treatment of patients with chronic pancreatitis by using therapeutic physical factors

2020 ◽  
pp. 8-14
Author(s):  
R. M. Mallaeva ◽  
A. N. Makhinko ◽  
M. B. Uzdenov
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Drug Therapy ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Pharmacological Potential

The purpose of the study is to improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG, 39 people) received standard drug therapy; 1st comparison group (GC1; 38 people) additionally received TPF; GC2 (40 people) in addition to treatment in GC1 had drinking mineral water «Slavyanovskaya»; in main group (42 people) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78,2% (p<0,01), in GC1 — by 71,5% (p<0,01), GC2 — by 62,3% (p<0,01), CG — by 57,2% (p<0,01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34,4% (p<0,01), after 12 months — by 24,0% (p<0,05); mental — by 32,3% (p<0,01) and 22,5% (p<0,05), respectively. In both comparison groups, positive dynamics was 10–12% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

scholarly journals Twelve Weeks of Strengthening Exercise for Patients with Rheumatoid Arthritis: A Prospective Intervention Study

2020 ◽  
Vol 9 (9) ◽  
pp. 2792
Author(s):  
Bomi Sul ◽  
Kyoung Bo Lee ◽  
Young Bin Joo ◽  
Bo Young Hong ◽  
Joon-Sung Kim ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Rheumatoid Arthritis ◽  
Lower Limb ◽  
Exercise Group ◽  
Activity Level ◽  
Control Group ◽  
Intervention Period ◽  
Sf 36 ◽  
Strengthening Exercise

Rheumatoid arthritis (RA) patients may benefit from exercise for several reasons. However, whole-limb strengthening exercises for such patients remain poorly studied. We hypothesized that systemic strength training that includes the upper and lower extremities would improve strength per se and enhance the quality of life. Here, we investigated the effects of 12 weeks of upper- and lower-limb strengthening exercise on the strength and quality of life of RA patients using the International Classification of Functioning, Disability, and Health model. This was a prospective, interventional controlled trial. Forty female RA patients were recruited and assigned to two groups not based on willingness to exercise, with 20 patients in the exercise group and 20 in the control group. All patients in the exercise group received once-weekly training sessions of 60 min over 12 weeks. All participants were assessed before and after the 12-week intervention period. We measured the hand grip strength and isometric quadriceps contraction, the cross-sectional area of the rectus femoris (CSA-RF) (via ultrasonography), and performed the 30 s sit-to-stand test and the 6 min walk test (6MWT). We derived the Borg scale score after the 6MWT and assessed the extent of social participation and quality of life using a Korean version of the 36-Item Short Form Health Survey (SF-36). A total of 35 subjects completed the experiment (18 in the exercise group, 17 in the control group). After the 12-week intervention period, the lower-limb strength and the CSA-RF were significantly increased in the exercise group. The activity level did not change significantly in either group. The exercise group exhibited significant improvements in the SF-36 mental health domain scores. Thus, strengthening exercise is useful for patients with RA.

Study of the effect of menopausal hormone therapy in women with psoriasis type 2 in postmenopause

2016 ◽  
Vol 19 (5) ◽  
pp. 296-300
Author(s):  
Evgeniya P. Opruzhenkova ◽  
O. A Sidorenko ◽  
L. A Anisimova ◽  
V. V Starostenko
Keyword(s):  
Hormone Therapy ◽  
Clinical Manifestations ◽  
Menopausal Hormone Therapy ◽  
Control Group ◽  
Study Group ◽  
Hormonal Status ◽  
Basic Therapy ◽  
Basic Treatment

The results of comparative analysis of the hormonal status from 75 women aged from 49 to 60 years old (average age 54.04 ± 1.28 year) in postmenopause with psoriasis type 2 (study group) and 50 women of control group of the same age and menstrual status without psoriasis are presented. There were two subgroups in the main group: subgroup 1 received basic therapy in combination with menopausal hormone therapy (MHT) (estradiol 1 mg + drospirenone 2 mg), subgroup 2 - basic therapy. Psoriatic process was assessed according to PASI index and was evaluated by the dermatology quality of the life index (DIQL) and the content of gonadotropic and sex hormones before treatment and after 3 and 6 months of starting treatment in patients of both subgroups. More pronounced clinical efficacy in combination with reduced FSH level is 13.2% (p < 0.001), increased content of estradiol 69.3% (p < 0.001) was observed in patients from 1 subgroup. MHT supplement to the basic treatment decreased the PASI index after 3 months of starting treatment for 50.9% (p fter 6 months - at 94% (p < 0.001), and reduced DIQL in subgroup 1 compared to 2 subgroup after 3 months - 15.3% (p < 0.05) and after 6 months - 20.8% (p < 0.05). In postmenopausal women with psoriasis favorable changes of indexes reflecting the clinical manifestations of the disease were associated with the correction of hormonal status in MHT estradiol 1 mg + drospirenone 2 mg.

Transplantion of autologous cells of stromal vascular fraction of adipose tissue in severe local radiation injuries of skin caused by x-ray

2017 ◽  
Vol 62 (1) ◽  
pp. 5-11 ◽  
Author(s):  
Бушманов ◽  
Andrey Bushmanov ◽  
Самойлов ◽  
Alyeksandr Samoylov ◽  
Добрынина ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Clinical Manifestations ◽  
Stromal Vascular Fraction ◽  
Control Group ◽  
Tissue Cell ◽  
X Rays ◽  
Radiation Injuries ◽  
X Ray ◽  
Local Radiation ◽  
Radiation Ulcers

Purpose: To investigate the effectiveness of autologous cells of stromal vascular fraction of adipose tissue in severe local radiation skin injuries after the exposure of rats to X-rays. Material and methods: Experiments were performed on Wistar rats, weighing 200–230 g. Rats were exposed locally in iliolumbar region using X-ray machine LNC-268 (RAP 100-10) at a dose of 110 Gy (30 kV tube voltage, current 6.1 mA, thick Al filter 0.1 mm), dose rate: 17.34 Gy/min. Area of the irradiation field was 8.2–8.5 cm2. Transplantation of autologous cells of stromal vascular fraction (SVFC) of adipose tissue was carried out on 21st or 35th days after irradiation. SVFC isolation was performed by means of enzymatic treatment of adipose tissue. SVFC suspension was administered subcutaneously at a dose of 1×106 cells per injection around the radiation ulcers.The severity of radiation damage to the skin and the effects of cellular therapy were evaluated in the dynamics of clinical manifestations, with the help of plane geometry and pathomorphometry. Results: It was found that by the 17–25th day after irradiation radiation ulcers were formedon rat skin. In the control group of animalsulcers persisted throughout the observation period of more than 3 months. The area of ulcers was 1,87 ± 0,35 cm2 and 1.52 ± 0.24 cm2 at 83th and 90th days after irradiation, respectively. In animals of the experimental group, with autologous stromal vascular fraction of adipose tissue, was significant decrease in ulceration the area in comparison to control animals. In 80 % of the rats treated with SVFC on 21st day after exposure, to the 90th day after irradiation complete healing of ulcers occurred with the formation of atrophic scar at the site of radiation injuries. These clinical observations and planimetric were correlated with the results of histomorphometry. Conclusion: Transplantation autologous SVFC of adipose tissue contributes to accelerate the healing of radiation ulcers after local x-ray exposure in the experiment, indicating that the prospects of using adipose tissue cell products for the treatment of severe local radiation injuries.

scholarly journals Comparison of clinical manifestations of rheumatoid arthritis in patients with moderate or high disease activity depending on the presence or absence of symptoms of neuropathic pain

2021 ◽  
Vol 15 (6) ◽  
pp. 13-18
Author(s):  
E. Yu. Polishchuk ◽  
E. S. Filatova ◽  
A. E. Karateev ◽  
V. N. Amirdzhanova ◽  
V. A. Nesterenko
Keyword(s):  
Rheumatoid Arthritis ◽  
Neuropathic Pain ◽  
Disease Activity ◽  
Pain Intensity ◽  
Clinical Manifestations ◽  
High Disease Activity ◽  
Control Group ◽  
Disease Modifying Antirheumatic Drugs ◽  
Antirheumatic Drugs ◽  
Disease Modifying

Objective: to study the effect of neuropathic pain symptoms (SNP) on the clinical manifestations of rheumatoid arthritis (RA) in patients with moderate or high disease activity.Patients and methods. The 1st (main) group included 58 RA patients (84.5% of women, age 53.0±11.9 years), in whom SNP were identified using the DN4 (≥4) and PainDETECT (≥13) questionnaires. The 2nd (control) group included 43 patients with RA (79.1% women, age 48.8±14.4 years) who did not have SNP (DN4 ≤4 and PainDETECT ≤13). All patients received disease-modifying antirheumatic drugs (mainly methotrexate and leflunomide), 20% – biologic disease-modifying antirheumatic drugs. We compared groups 1 and 2 for RA activity (DAS28, CDAI, SDAI), pain intensity on a visual analogue scale (VAS, 0–100 mm), functional impairment (HAQ), patient global assessment (PGA, VAS), number of painful and swollen joints, quality of life (EQ-5D), signs of anxiety and depression (HADS), CRP level.Results and discussion. The RA activity in patients of the 1st and 2nd groups did not differ statistically significantly. Patients of the 1st group showed significantly higher indicators of the severity of pain, PGA and anxiety than patients of the control group: 71.0±12.5 and 54.7±17.5 mm, respectively (p<0.001); 61.0±13.1 and 53.7±15.3 mm (p=0.045); 62.1 and 28.6% (HADS ≥7; p<0.001), respectively.Conclusion. SNP are associated with higher rates of pain intensity, PGA, and anxiety in RA patients with moderate to high disease activity.

scholarly journals 1% ivermectin in combination therapy regimens for rosacea

2020 ◽  
pp. 17-23
Author(s):  
E. A. Khlystova ◽  
A. L. Savastenko
Keyword(s):  
Quality Of Life ◽  
Comparative Analysis ◽  
Combination Therapy ◽  
Combination Treatment ◽  
Clinical Manifestations ◽  
Life Quality ◽  
Clinical Results ◽  
Control Group ◽  
Before And After

Introduction. The article provides latest data on modern methods of treating rosacea. The results of own clinical observations of patients with moderate to severe papulopustular rosacea receiving combination treatment and a comparative analysis of the efficacy of various therapy regimens are presented.Objective of the study. The aim of the study was to conduct a comparative analysis of the therapeutic efficacy of combination therapy using the ivermectin 1% topical drug combined with systemic therapy drugs (doxycycline, minocycline, isotretinoin).Materials and methods. We observed 37 patients with moderate to severe papulo-pustular rosacea subtype. The patients were divided into 4 groups (A, B, C, D). Patients in the control group received monotherapy with 1% ivemectin topical drug, patients in the other groups received combination therapy (1% ivermectin combined with low-dose doxycycline, minocycline and isotretinoin). The efficacy of the therapy was evaluated by measuring rosacea severity on the Scale for Diagnostic Assessment of Rosacea (SDAR), clinical manifestations according to the IGA (Investigator Global Assessment) criteria, and by assessing the patients' quality of life using the DLQI (Dermatology Life Quality Index) questionnaire before and after 3-month treatment.Results. The comparative analysis of changes in severity indicators of the skin process and quality of life in patients with moderate to severe papulopustular rosacea after topical and combination therapy showed that the results of the treatment in patients receiving combination therapy were more significant than those in the group receiving monotherapy.Conclusion. The concomitant use of 1% ivermectin and systemic drugs is most effective in patients with severe papulopustular rosacea subtype. The combination treatment tailored to the clinical forms and severity of rosacea allows to optimize the clinical results of the therapy, which significantly affects the patients' quality of life and opens up potential for an individual approach in the algorithms for the treatment of rosacea.

scholarly journals Pharmacological potential strengthening of drug therapy in treating patients with chronic pancreatitis by using therapeutic physical factors

2021 ◽  
Vol 19 (5) ◽  
pp. 293-298
Author(s):  
Raziyat M. Mallaeva ◽  
Anna N. Makhinko ◽  
Marat B. Uzdenov
Keyword(s):  
Quality Of Life ◽  
Chronic Pancreatitis ◽  
Drug Therapy ◽  
Clinical Manifestations ◽  
Medical Rehabilitation ◽  
Control Group ◽  
Physical Factors ◽  
Standard Drug ◽  
Pharmacological Potential

Background. The steady increase in the incidence of chronic pancreatitis, its aggressive course in recent years, as well as the insufficient therapeutic effect of standard techniques determine the relevance of the search for new approaches to the treatment and medical rehabilitation of this category of patients. Aims. To improve rehabilitation treatment of patients with chronic pancreatitis (CP) at inpatient stage by strengthening pharmacological potential of drug therapy due to inclusion of therapeutic physical factors (TPF) in therapeutic programs. Materials and methods. 159 patients with acute CP were observed. By simple randomization, 4 groups were formed: the control group (MG; n=39) received standard drug therapy; 1st comparison group (GC1; n=38) additionally received TPF; (GC2, n=40) in addition to treatment in GC1 had drinking mineral water "Slavyanovskaya"; in main group (n=42) in addition to the treatment in GC2 got preformed peloidotherapy on the cervical-collar zone. All the patients underwent the evaluation of clinical score and quality of life before and after medical rehabilitation. Results. In MG, clinical symptomatology leveling was by 78.2% (р 0.01), in GC1 by 71.5% (р 0.01), GC2 by 62.3% (р 0.01), CG by 57.2% (р 0.01) on average immediately after the treatment, which was in a clear correlation with indicators of quality of life. In the long term (in 6 and 12 months), the advantage of combination therapy was noted with the same validity, the preservation of the achieved positive result was mostly noted in the MG: after 6 months the improvement in physical health compared to the initial values was noted by 34.4% (р 0.01), after 12 months by 24.0% (р 0.05); mental by 32.3% (р 0.01) and 22.5% (р 0.05), respectively. In both comparison groups, positive dynamics was 1012% lower, and in the control group, after 6 months, there was only a tendency to improve quality of life indicators. Conclusion. The inclusion of TPF in the programs of the inpatient stage of medical rehabilitation of patients with chronic pancreatitis by strengthening the pharmacological potential of drug therapy contributes to the leveling of clinical manifestations (abdominal pain, dyspepsia and diarrhea), the result of which is an improvement in the quality of life of this category of patients.

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