Repeatability and Reliability of the Rheumatoid Arthritis Foot Disease Activity Index in Spanish Patients: A Transcultural Adaptation

Background: The Rheumatoid Arthritis Foot Disease Activity Index (RADAI-F5) questionnaire, based on five questions, is used to assess the severity of rheumatoid arthritis disease in the foot. Nowadays, RADAI-F5 has been validated in different languages; however a Spanish version was lacking. Therefore, the purpose of this research was to translate and validate the Spanish version (RADAI-F5-es). Methods: A cross-cultural translation of the RADAI-F5 questionnaire was performed from English to Spanish. To validate its use, 50 subjects with rheumatoid arthritis who responded to the translated questionnaire two times in an interval of less than 3 months were selected in order to verify the psychometric properties. Results: Excellent agreement between the two versions according to the Cronbach’s α was shown. Five domains with regards to arthritis activity in foot joint tenderness and swelling, foot arthritis pain, general foot health and joint stiffness were added together to obtain the total score. Excellent retest reliability was shown for the total score. Test/retest reliability was excellent for joint stiffness on awakening and foot arthritis pain domains. There were no significant differences among any domains (p > 0.05). There were no statistically significant differences (p = 0.000) for the mean ± standard deviations (SD) between pre- and post-tests (98.09 ± 15.42) [93.75–102.43] and 97.96 ± 13.88 [94.5–101.86] points, respectively). Bland–Altman plots or clinically pertinent variations were not statistically significantly different. Conclusions: The RADAI-F5-es is considered a valid and strong tool with adequate repeatability in the Spanish community.

Micro RNA-23b as a potential biomarker in rheumatoid arthritis disease activity and severity: clinical, laboratory, and radiological cross-sectional study

Background Rheumatoid arthritis (RA) is an autoimmune inflammatory disease. It is characterized by an inflammatory polyarthritis that preferentially affects the small joints leading to joint damage and eventual deformity and disability, and can also present with extra-articular manifestations. Micro RNA (miRNA) is a class of non-coding RNAs which negatively regulate messenger RNA (mRNA) expression. Several studies had shown that miRNA-23b has a close relationship with inflammation and autoimmune diseases. An increasing evidence has suggested that miRNA-23b is closely associated with many inflammatory and autoimmune diseases. The current study aimed to evaluate the plasma expression of miRNA-23b in rheumatoid arthritis (RA) patients and to explore its potential association with diseases activity. Results RA patients had a significantly higher plasma miRNA-23b expression than controls (P < 0.001). The miRNA-23b plasma expression was significantly associated with the clinical and laboratory indices of RA activity as well as with the DAS28-ESR score (P = 0.009) and grades (P < 0.001). The miRNA-23b plasma expression was significantly correlated with the radiological severity of RA (P = 0.002). Conclusions Plasma expression of miRNA-23b is significantly increased in patients with RA than controls. In RA patients, plasma expression of miRNA-23b was significantly correlated with the activity and radiological severity of RA. miRNA-23b may represent a potential therapeutic target that can retard progression of RA.

Apelin Promotes Endothelial Progenitor Cell Angiogenesis in Rheumatoid Arthritis Disease via the miR-525-5p/Angiopoietin-1 Pathway

Angiogenesis is a critical process in the formation of new capillaries and a key participant in rheumatoid arthritis (RA) pathogenesis. The adipokine apelin (APLN) plays critical roles in several cellular functions, including angiogenesis. We report that APLN treatment of RA synovial fibroblasts (RASFs) increased angiopoietin-1 (Ang1) expression. Ang1 antibody abolished endothelial progenitor cell (EPC) tube formation and migration in conditioned medium from APLN-treated RASFs. We also found significantly higher levels of APLN and Ang1 expression in synovial fluid from RA patients compared with those with osteoarthritis. APLN facilitated Ang1-dependent EPC angiogenesis by inhibiting miR-525-5p synthesis via phospholipase C gamma (PLCγ) and protein kinase C alpha (PKCα) signaling. Importantly, infection with APLN shRNA mitigated EPC angiogenesis, articular swelling, and cartilage erosion in ankle joints of mice with collagen-induced arthritis. APLN is therefore a novel therapeutic target for RA.

Joint inflammation tends to recur in the same joints during the rheumatoid arthritis disease course

ObjectivesWe investigated whether local joint swelling recurs in the same joints over time in patients with rheumatoid arthritis (RA) who are treated to target.MethodsPatients with newly diagnosed RA participating in the Behandel-Strategieën, “treatment strategies” (BeSt) study (n=508) were followed for median 10 years while receiving Disease Activity Score (DAS) ≤2.4 steered treatment. Every 3 months 68 joints were assessed for the presence of swelling. We evaluated whether baseline local joint swelling was predictive for swelling in the same joint during follow-up using a multilevel mixed-effect logistic regression model. Different strategies were used to account for missing data. A permutation test was performed to assess if joint swelling was better predicted by baseline swelling of the joint itself than by baseline swelling of randomly selected other joints.ResultsIn 46% of the joints that were swollen at baseline, joint swelling later recurred at least once during follow-up. Joint swelling at baseline was statistically significantly associated with swelling in the same joint during follow-up (OR 2.37, 95% CI 2.30 to 2.43, p<0.001), and also specifically with recurrent swelling in the same joint (OR 1.73, 95% CI 1.37 to 1.59, p<0.001). Local joint swelling was better predicted by baseline swelling of that particular joint than by baseline swelling of other joints (p<0.001).ConclusionJoint swelling tends to recur locally in the joints swollen at RA onset. This suggests that local factors influence the manifestation of joint inflammation over time.

Formulation, Optimization and Evaluation of Niosomes Containing Leaf Extract of Moringa oleifera and Pharmacological Screening of the Extract against Rheumatoid Arthritis

This research is formulated on the basis of the Rheumatoid Arthritis of a niosome that contains leaf extract of the herb. Therefore, in this part along with the medication system of the herb on the body, the pharmacologic testing procedure is clarified. In the following part, we will explore a thorough assessment of the condition, called rheumatoid arthritis and how the medicinal plant is used as a release agent. While focusing on rheumatoid arthritis throughout the discussion, the research discussion section has made it clear how effectively this paper has tried to meet the formation of niosome with Moringa extract and its effectiveness to reduce the pain. Furthermore, the entire analysis has been illustrated by focusing on the effect of Moringa oleifera over rheumatoid arthritis disease.

Acquisition of New Migratory Properties by Highly Differentiated CD4+CD28null T Lymphocytes in Rheumatoid Arthritis Disease

Expanded CD4+CD28null T lymphocytes are found in the tissues and peripheral blood of patients with many autoimmune diseases, such as rheumatoid arthritis (RA). These highly differentiated cells present potent inflammatory activity and capability to induce tissue destruction, which has been suggested to predispose to the development of more aggressive disease. In fact, preferential migration to inflammatory sites has been proposed to be a contributing factor in the progression of autoimmune and cardiovascular diseases frequently found in these patients. The functional activity of CD4+CD28null T lymphocytes is largely dependent on interleukin 15 (IL-15), and this cytokine may also act as a selective attractor of these cells to local inflammatory infiltrates in damaged tissues. We have analysed, in RA patients, the migratory properties and transcriptional motility profile of CD4+CD28null T lymphocytes compared to their counterparts CD28+ T lymphocytes and the enhancing role of IL-15. Identification of the pathways involved in this process will allow us to design strategies directed to block effector functions that CD4+CD28null T lymphocytes have in the target tissue, which may represent therapeutic approaches in this immune disorder.

Immunological and Biochemical Peculiarities of the Rheumatoid Arthritis

The article presents the results of studies of immunological and biochemical characteristics of diseases of the osteoarticular system among residents of Bishkek. The studies were carried out on residents of Bishkek, men and women aged 21–74, in the spring of 2019, in the fall of 2019 and in the fall of 2020. A total of 1358 people were examined for ACCP, of which 282 residents of Bishkek were found to have an ACCP content higher than the norm, among which 238 were women and 44 were men. The level of antibodies to cyclic citrullinated peptide (ACCP) was determined in blood serum by immunochemiluminescence analysis. Biochemical studies aimed at identifying the activity of the process and immune inflammation consisted of determining the levels of rheumatoid factor (RF), C-reactive protein (CRP), Antistreptolysin-O (ASL-O) and uric acid (MC) according to generally accepted methods. Out of the selected 282 Bishkek residents, 17 men and 82 women belong to the confirmation group, while 27 men and 156 women are in the group of people with increased levels of ACCP were first established. ACCPs mainly belong to the IgG class and are found in the blood at the earliest stages of rheumatoid arthritis disease (1–2 years before the onset of the first symptoms) and their specificity in rheumatoid arthritis is about 97%. They are detected at very early stages of the disease, which explains the distribution of the surveyed residents of Bishkek by groups. Analysis by sex distribution showed that in all groups women prevail than men, since it is known from scientific literature source that diseases of the osteoarticular system, in particular rheumatoid arthritis, are more susceptible to women than men. Women get sick more often than men 2–5 times more, which was found in our studies, the ratio of men and women is on average 1:3.4–5.6. It has been proven that damage to the osteoarticular system can occur at any age. According to our data, 47.7% of the total number of surveyed men were aged 35–60 years, 45.5% were men aged 61–74 years. At the same time, among women, 37% were aged 35–60 years, 36.3% were women aged 61–74 years. According to scientific literature sources, the incidence of rheumatoid arthritis increases with age, over 60 years old reaches its maximum value (more than 2%), the population is aging when RA grows. Gender differences are also lost, the ratio of women to men is 2:1 or less. At the same time, rheumatoid arthritis can develop at any age, most often from 35 to 50 years, but it can also be in childhood and in the elderly. According to our results, among women under 35 years of age in the confirmation group, the prevalence of RA was 28.3%, at the age of 36-60 years 58.8%, and at the age of over 61 years — 43.6%. And in the group of primary confirmation, women under 35 years old accounted for 16.7%, at the age of 36-60 they make up 20.4% and over 60 years old — 28.5%. As you know, ACCP can be detected in 30% of cases of seronegative rheumatoid arthritis (negative for rheumatoid factor), which is advisable in the diagnosis of early seronegative RA, in differential diagnosis with other rheumatic diseases. Elevated ACCP levels in healthy individuals indicate a significant increase in the risk of developing RA. Rheumatoid factor is an autoimmune antibody, an immunoglobulin protein (IgM) produced by the body's immune system. Autoantibodies attack their own tissues, mistaking them for foreign ones. Although the nature of rheumatoid factor is still poorly understood, its presence is an indicator of inflammatory and autoimmune processes. With rheumatoid arthritis symptoms, high rheumatoid factor levels are likely to indicate seropositive rheumatoid arthritis. However, even a negative test result does not exclude that the patient has these diseases. Antibodies to cyclic citrullinated peptide and RF are currently recognized as an informative serological marker of rheumatoid arthritis. Based on studies carried out at different times of the year (spring, autumn 2019, autumn 2020), it was found that the season does not have a significant effect on the content of the ACCP level, although residents of Bishkek (men and women) often complain of pain in the joints in the fall. than in the spring. This is confirmed by the highest content of ACCP among women, as well as men over 35 years old to 74 years old.

Predominant Bacterial Diversity in Rheumatoid Arthritis Rat After Treated with Caprine CSN1S2 Protein

Rheumatoid arthritis (RA) is an autoimmune and systemic inflammatory disease that is affected to microbial abnormalities in the gut and altered the metabolism and immune system. Bioactive peptides have many functions in the body that related to health. This study aimed to investigate the effect of caprine CSN1S2 protein and to identify the predominant bacterial diversity in rheumatoid arthritis rats through fecal analysis based on PCR-DGGE and phylogenetic analysis. The animals were divided into 6 groups with 2 types of the rat model, namely control rats (untreated (C), treated with caprine CSN1S2 protein from milk (CM), and treated with caprine CSN1S2 protein from yogurt (CY)) and rheumatoid arthritis rats (rheumatoid arthritis (RA), treated with caprine CSN1S2 protein from milk (RAM), and treated with caprine CSN1S2 protein from yogurt (RAY). Predominant cultivable bacteria were obtained by direct culture and analyzed using PCR-DGGE with several specific primers. The DNA sequences were analyzed and aligned using bioinformatics software to construct the phylogenetic tree. The results showed that bacterial composition in all control groups was dominated by Lactobacillus group but in the rheumatoid arthritis rat (RA) group was dominated by Enterococcus group, particularly Enterococcus faecium and Enterococcus faecalis. Meanwhile, Bacillus coagulans dominated in rheumatoid arthritis rats after treated with caprine CSN1S2 protein. The caprine CSN1S2 protein has effects in rheumatoid arthritis rats with the emergence of predominant bacteria that can promote the growth of B. coagulans and it might be suppressed pathogenic bacteria in the development of rheumatoid arthritis disease.

Multi-criteria Decision Making on the Best Drug for Rheumatoid Arthritis

The theory of Multi-Criteria Decision Making (MCDM) was introduced in the second half of the twentieth century and aids the decision maker to resolve problems when interacting criteria are involved and need to be evaluated. In this paper, we apply MCDM on the problem of the best drug for rheumatoid arthritis disease. Then, we solve the MCDM problem via -Sugeno measure and the Choquet integral to provide realistic values in the process of selecting the most appropriate drug. The approach confirms the proper interpretation of multi-criteria decision making in the drug ranking for rheumatoid arthritis.