bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of combination therapy (steroids, immunosuppressives, and plasmapheresis) on 5 mixed cryoglobulinemia patients with renal, neurologic, and vascular involvement
Authors: Geltner David , Kohn Robert W. , Gorevic Peter , Franklin Edward C.
Published: February 2007

A prospective clinical study evaluated the effects of combined chemotherapy, steroids, and plasmapheresis on 5 patients with mixed cryoglobulinemia with renal or neurologic and vasculitic manifestations. Treatment included prednisone (1 mg/kg/day), chlorambucil (white blood cell count at > 3,000/mm3), and plasmapheresis (1 to 3 liters/week). There was healing of cutaneous uleers (3/3), improvement in renal function (4/4), and diminution of purpura (2/2), but little improvement in peripheral neuropathy. Complications included leukopenia, perineal ulcers, and osteomyelitis.
Specificity of hidden 19s igm rheumatoid factor in patients with juvenile rheumatoid arthritis
Authors: Moore Terry L. , Dorner Robert W. , Weiss Terry D. , Baldassare Andrew R. , Zuckner Jack
Published: February 2007

Hidden 19S IgM rheumatoid factors (RF)—i.e., RF detected in the IgM‐containing fraction after separation of the serum at an acid pH—have been found in 68% of patients with seronegative juvenile rheumatoid arthritis (JRA). Inhibition studies utilizing a hemolytic assay for RF were performed to determine the specificity of hidden 19S IgM RF. Sera from 14 children with JRA were separated by gel filtration at pH 4.05. Two were seropositive for RF and 12 were seronegative; the latter had high titer hidden 19S IgM RF. The IgM‐containing fractions were preincubated with monomeric human IgG, rabbit IgG, or bovine IgG, and the complement‐dependent hemolytic assay was performed. The RF in the IgM fraction from the 2 seropositive patients were inhibited most strongly by rabbit IgG, whereas hidden RF in the IgM fraction of 9 seronegative patients were inhibited markedly by human IgG (homologous IgG equal to autologous IgG), poorly by rabbit IgG, and not at all by bovine IgG. Further inhibition studies with the hidden 19S IgM RF demonstrated inhibition by the human IgG1 subclass in all patients and only minimal inhibition by the IgG3 subclass in 3 patients. Inhibition with IgG1 Fc fragments produced by papain and thermolysin digestion demonstrated inhibition by only those fragments that contained the G1m (a) antigenic area which is found in the Cγ3 homology area of the IgG1 molecule. These data indicate that hidden 19S IgM RF possibly circulate as immune complexes bound to the IgG1 molecule and the binding chiefly occurs in the G1m (a) homology area.
Human synovial fibroblast plasminogen activator. modulation of enzyme activity by antiinflammatory steroids
Authors: Hamilton John A. , Bootes Alison , Phillips Paul E. , Slywka J.
Published: February 2007

Human synovial fibroblasts in culture have been shown to have low plasminogen activator (PA) activity; however, conditioned medium from concanavalin A‐stimulated peripheral blood mononuclear cells (c‐MCCM) stimulates the cellular levels of this protease. The present study shows that low concentrations of a series of antiinflammatory steroids inhibit the PA activities of both unstimulated and c‐MCCM‐stimulated fibroblasts. Dexamethasone, the corticosteroid studied in greatest detail, suppresses both the extracellular and cell‐associated enzyme activities; this inhibition is rapid, reversible, and is not due to the inhibition of cellular RNA, protein, or DNA synthesis. PA has been invoked as possibly being generally important for the processes of cell migration, tissue remodeling, and inflammation. These in vitro observations suggest that physiologic and/or pharmacologic control of the PA levels in synovial fibroblasts might also be achieved in vivo by the interacting effects of mutually antagonistic agents, namely, a product from stimulated mononuclear cells and glucocorticoids.
Experimentally Induced Osteoarthritis in Guinea Pigs
Authors: Schwartz Edith R. , Oh Won H. , Leveille Cynthia R.
Published: February 2007

Developing osteoarthritis, surgically induced in the right hind knee joint of guinea pigs by different procedures (A or B), was studied in animals maintained on either minimal or supplemented levels of dietary vitamin C. Procedure A, consisting of transecting the anterior cruciate and major portion of the medial collateral ligaments, resulted in a slower developing and less severe form of the disease than procedure B which also included a partial menisectomy. Regardless of the surgical procedure used, animals on minimal levels of ascorbate always exhibited more severe pathology than those on high levels. When compared with controls, a significant enhancement of acid phosphatase characterized arthritic cartilage in both supplemented and minimal diet groups, although the increase was 2‐fold greater in the latter. In addition, a significant elevation of arylsulfatase A and B activities was observed only in the minimal diet group. Early stages of pathology in both diet groups were characterized by formation of repair cartilage which stained strongly with Safranin O on histologic sections. As the disease progressed, pitting, ulcerations, and eburnation occurred in the minimal diet group. Cartilage weight in normal joints was greater for guinea pigs kept on high levels of vitamin C. It is likely that this stimulated synthesis of cartilage in the supplemented animals protected against the erosion of the articular cartilage which characterized the more severe disease process in the guinea pigs on minimal levels of ascorbate.
Autoimmunity to Collagen
Authors: Trentham David E. , Kammer Gary M. , Mccune W. Joseph , David John R.
Published: February 2007

Thirty‐one patients with seronegative psoriatic arthritis, 27 patients with rheumatoid arthritis, 10 with psoriasis alone, and 20 normal volunteers were studied for autoimmunity to human collagens. Cellular and humoral responses were frequently observed in the 2 groups with arthritis, but the subjects without arthritis did not display reactivity to native collagens. These data demonstrate that collagens function as autoantigens in both psoriatic and rheumatoid arthritis.
Natural Cell‐Mediated Cytotoxicity in Sjögren's Syndrome and Rheumatoid Arthritis
Authors: Goto Makoto , Tanimoto Kiyoaki , Chihara Tadao , Horiuchi Yoshihiko
Published: February 2007

Natural cell‐mediated cytotoxicity (NCMC) was measured in 7 patients with Sjögren's syndrome without complication of connective tissue disease, 5 patients with Sjögren's syndrome associated with connective tissue disease other than rheumatoid arthritis (RA), 13 patients with Sjögren's associated with RA, and 29 patients with RA without Sjögren's. All 25 patients with Sjögren's syndrome showed a significantly suppressed NCMC. In the patients with RA but without Sjögren's, the NCMC for 21 female patients was rather enhanced when compared with controls, while 8 male patients did not differ from controls. The reduced NCMC in the Sjögren's patients did not seem to correlate with the presence of antilymphocyte antibody. A more accelerated rate of NCMC was demonstrated in the patients with RA who were receiving gold therapy.
Human Postthymic Precursor Cells in Health And Disease
Authors: Alarcón–Segovia Donato , Palacios Ronald
Published: February 2007

Human T cells are capable of forming rosettes with autologous erythrocytes (Tar cells) and behave as postthymic precursors. Thus, they generate Tγ and Tμ cells as well as suppression and spontaneous cytotoxicity and participate in a pokeweed mitogen‐driven system akin to that of feedback inhibition in which murine postthymic precursors participate. Tar cells were increased in 7 patients with mixed connective tissue disease (MCTD) compared to normal age/sex‐matched controls. Despite this increase of precursor cells, decreased Tγ cells and abrogation in the generation of suppression and of feedback inhibition were noted. These functional defects were not correctable with serum thymic factor but could be corrected by the addition of either allogenic Tμ or mononuclear cells depleted of Tar cells. Our findings suggest that the immunoregulatory T cell circuits in MCTD may be adequate both in postthymic precursor cells and in the thymic factor prompting. They are probably abnormal either at the site of Tμ signaling to Tar cells in feedback inhibition or in the Tμ reception of suppressor signals from Tγ cells. The decrease of Tγ cells in MCTD could be due to the decreased stimulus from feedback inhibition and/or to the penetration of anti‐ribonucleoprotein antibody. Abnormalities of immunoregulatory T cell circuits in MCTD are quite different from those found previously in systemic lupus erythematosus, scleroderma, and rheumatoid arthritis. These differences support the notion that MCTD is a distinct entity.
Defective monocyte cytotoxicity in rheumatoid arthritis
Authors: Barada Franc A. , O'Brien William , Horwitz David A.
Published: February 2007

The cytotoxic activities of human blood mononuclear cells against certain established cell lines were evaluated prospectively in 17 patients with rheumatoid arthritis before and after treatment with low (150 mg per week) and moderate doses (300 mg per week) of levamisole. Spontaneous or “natural” killer activity (NK) and antibody‐dependent cellular cytotoxicity (ADCC) of plastic adherent cells (“monocytes”) and lymphocytes were studied. We report a selective cytotoxic defect in monocyte NK and a correlation of this defect with severely active disease. The patients with the most severe defect responded to low‐dose levamisole, but others with normal values did not respond as well to treatment. This cytotoxic defect may be an important pathogenetic factor in rheumatoid arthritis and this new assay may be helpful in selecting candidates who are most likely to respond to levamisole.
Different molecular forms of fibronectin in rheumatoid synovial fluid
Authors: Clemmensen Inge , Bach Andersen R.
Published: February 2007

The concentration of fibronectin in rheumatoid synovial fluid was found to be 2–3 times higher than in the corresponding plasma. Normal plasma revealed a homogeneous precipitate by cross‐immunoelectrophoresis using antifibronectin, while rheumatoid plasma and rheumatoid synovial fluid exhibited a heterogeneous precipitate. The heterogeneous precipitate in rheumatoid plasma was found to be a complex between fibronectin and fibrinogen as evidenced by cross‐immunoelectrophoresis. Synovial fluid fibronectin demonstrated a lower molecular weight by gelfiltration on Sepharose CL6B than did normal plasma fibronectin. We suggest that the presence of degraded fibronectin in rheumatoid synovial fluid may be the result of either the degradation of fibrin–fibronectin complexes or the destruction of matrix fibronectin from the synovial tissue.
Free versus bound salicylate concentration in adults and children with chronic inflammatory joint disease
Authors: Costello Patrick B. , Green Floyd A. , Jung Chan Y.
Published: February 2007

Salicylate (SA) binding to albumin in purified human serum albumin (HSA) solutions was found to be predictably dependent on the concentrations of albumin and total SA. The influence of the presence of other ligands on SA binding in HSA solutions was measured and, in the case of bound fatty acids, free fractions of SA were increased by up to 100%. In sharp contrast, the free fraction of SA present in sera from patients with arthritis who were on long‐term aspirin (ASA) therapy was roughly twice that found in HSA solutions. A correlation between serum concentrations of free SA and albumin was evident in sera from one group of children with juvenile rheumatoid arthritis (r = −0.75) but was not seen in sera from the other patients. This would indicate that in vivo, the albumin level is not the sole, or, in some patients, even the dominant determinant of the free fraction of SA. Additional factors such as fatty acids and other hydrophobic ligands, both endogenous and exogenous, should be studied further, especially in adults.
Correction of a suppressor cell deficiency and amelioration of familial mediterranean fever by hemodialysis
Authors: Ilfeld David , Weil Shulamit , Kuperman Oded
Published: February 2007

We tested the clinical and immunoregulatory effects of peritoneal dialysis and hemodialysis on a patient with familial Mediterranean fever (FMF), amyloidosis, and chronic renal failure. His frequency of FMF attacks during maintenance hemodialysis (no attacks in 21 months) was significantly less than during conservative medical therapy (10 attacks in 14 months, P < 0.00002) or during intermittent peritoneal dialysis (3 attacks in 4 months, P < 0.004). His mean (±SE) percentage suppressor cell function was significantly (P < 0.001) higher during hemodialysis (53 ± 5) than during conservative medical therapy (4 ± 3) or during peritoneal dialysis (2 ± 7) and was similar to the healthy untreated volunteers (46 ± 3). This suggests that his suppressor cell deficiency may be associated with the pathogenesis of his disease. One possible mechanism by which hemodialysis ameliorates FMF may be the correction of a suppressor cell abnormality.
Immunohistochemical findings in cranial arteritis
Authors: Gallagher Patrick , Jones Karen
Published: February 2007

The cause of cranial arteritis is unknown, but the demonstration of immunoglobulin and complement in temporal artery biopsies by immunofluorescence suggests that it may be a disease of disordered immunity. Because of the inevitable problems of histologic interpretation associated with the fluorescent technique, 15 temporal artery biopsies from patients with active arteritis were examined by an immunoperoxidase method. Varying amounts of IgA, IgG, and IgM were identified in plasma cells and macrophages. Extracellular IgG was identified in 1 case, but there was no staining for complement. These findings provide no support for the concept of cranial arteritis as a form of immune complex vasculitis.
T cell leukemia presenting as chronic polyarthritis
Authors: Van Soesbergen Renée M. , Feltkamp‐Vroom Thea M. , Feltkamp Constance A. , Somers Reinier , Van Beek Wim P.
Published: February 2007

T cell leukemia was detected in a woman who suffered from chronic polyarthritis. The peripheral blood leukocytes were increased in number and consisted of lymphocytes, 95% of which could be identified as T lymphocytes. T cell infiltration was found in the bone marrow, the synovial fluid, and tissue, and in nodules macroscopically resembling rheumatoid skin lesions. Further investigation of these cells by enzyme chemistry, immunohistochemistry, electron microscopy, and cytochemistry revealed that they had irregularly indented nuclei, no alpha‐naphthyl acetate esterase activity, and only faint granular acid‐phosphatase activity. The cells were negative for Ia‐like antigen and surface immunoglobulin. Analysis of the cell surface glycopeptides showed the presence of abnormally enlarged carbohydrate structures. These data suggest that these leukemic T cells are a malignant equivalent of immature T cells.
In vitro conditions affecting the synthesis of sulfated proteoglycans by normal and rheumatoid synovial cells in culture
Authors: Marsh Joanne M. , Roback David W. , Ross Garry T.
Published: February 2007

In vitro conditions affecting synthesis of sulfated proteoglycans by cell suspensions derived from monolayer cell cultures of normal and rheumatoid synovial tissue were examined. The capacity of cells to synthesize proteoglycans was estimated by the incorporation of 35S–sulfate into cetylpyridinium chloride–precipitable material. Synthesis of sulfated proteoglycans was maximal during log phase, and after 2–3 hours of recovery from disaggregation. Normal synovial cells appeared to be more sensitive to changes in serum concentration than were rheumatoid synovial cells, but rheumatoid synovial cells were more sensitive to changes in cell density. The proportion of newly synthesized extracellular proteoglycans increased with the duration of incubation in 35S–sulfate.
Immunity to homologous type III collagen after partial meniscectomy and sham surgery in rabbits
Authors: Champion Brian R. , Poole A. Robin
Published: February 2007

Cellular immunity to rabbit types I, II, and III collagen was detected after both partial medial meni‐scectomy and sham operations in rabbits when an in vitro 3H‐thymidine incorporation assay was used. The blastogenic responses were commonly directed toward peptides derived from collagens by cyanogen bromide cleavage used to mimic proteinase degradation products. The responses to type III collagen peptides were by far the strongest and were seen in most rabbits that were operated on. We suggest that the responses to types I and II collagen were caused by a cross‐reaction with type III collagen peptides. This conclusion was supported by the observation that spleen cells from rabbits directly immunized with homologous type III collagen peptides in Freund's complete adjuvant responded strongly to the immunizing peptides and also cross‐reacted with types I and II collagen peptides. Immunity to cartilage proteoglycans was observed primarily in rabbits that had undergone meniscectomy and had severe cartilage degeneration. These results indicated that immunity to collagens will develop merely as a result of joint surgery, whereas immunity to proteoglycans is largely dependent upon an osteoarthritic lesion.
Palindromic onset of rheumatoid arthritis. Clinical, synovial fluid, and biopsy studies
Authors: Schumacher H. Ralph
Published: February 2007

Five patients had episodic arthritis consistent with palindromic rheumatism that evolved into definite or classic rheumatoid arthritis after 1 or more years. Synovial effusions during palindromic episodes had various leukocyte counts; mononuclear cells predominated in 4 patients. Neither these effusions nor needle synovial biopsies that showed subacute superficial inflammation and microvascular disease allowed any prediction that the disease would evolve into rheumatoid arthritis. Electron‐dense deposits in vessel walls suggested circulating immune complexes. There was also prominent, unidentified debris in vessel walls and in phagocytic vacuoles, which might also be important in pathogenesis.
Genetic predictors of patient response and side effects in the treatment of rheumatoid arthritis with a high dose nonsteroidal antiinflammatory drug regimen
Authors: Semble Elliott , Metcalf Douglas , Turner Robert , Agudelo Carlos , Pisko Edward , Johnson A. Myron , Heise Eugene
Published: February 2007

Clinical, laboratory, genetic, and radiologic studies were evaluated for 18 patients with rheumatoid arthritis who were treated for a mean of 16.6 months with a regimen involving supplementary aspirin and piroxicam, an investigational, nonsteroidal antiinflammatory agent. Although improvement in disease activity was seen, progression was evident on successive radiographs. Disease activity was not associated with the presence of any of the genetic markers. Peptic ulcers developed in 33% of patients, all of whom had type O blood. ABO blood typing may therefore be useful in patients with rheumatoid arthritis before consideration of therapy with potentially ulcerogenic drugs.
Use of monoclonal antibodies to analyze peripheral blood and salivary gland lymphocyte subsets in sjögren's syndrome
Authors: Fox Robert I. , Carstens Scott A. , Fong Sherman , Robinson Charles A. , Howell Frank , Vaughan John H.
Published: February 2007

Using monoclonal antibodies to cell surface antigens, we studied lymphocyte subsets in 15 patients with primary Sjögren's syndrome. The absolute number of OKT8‐positive cells (reactive with T suppressor/cytotoxic cells) was significantly decreased in such patients (353 ± 186/mm3) compared to age‐matched controls (631 ± 150/mm3) (P<0.001). The number of OKT4‐positive cells (reactive with T helper/inducer cells) was comparable in both groups (932 ± 588/mm3 versus 1.073 ± 290/mm3). The ratio of OKT4/OKT8‐reactive peripheral blood lymphocytes was increased (>2.4) in 67% of these patients and ranged from 1.0 to 6.4 (normal = 1.8 ± 0.3). OKT4‐positive cells were the predominant subset in lip biopsy specimens stained with immunofluorescence or immunoperoxidase techniques; the OKT4/OKT8 ratio exceeded 3.0 in all 5 patients examined. In 1 patient with pseudolymphoma, a lymph node biopsy specimen contained 80% T cells with an OKT4/OKT8 ratio of 3.2. Thus, OKT4‐positive cells predominated in the peripheral blood lymphocytes as well as in sites of inflammation in primary Sjögren's syndrome. The decreased number of OKT8‐positive cells in primary Sjögren's syndrome was probably not caused by circulating autoantibody, since patients' sera did not react with normal OKT8‐positive cells. Functional studies using pokeweed mitogen demonstrated that T helper cell activity for immunoglobulin synthesis was contained in the OKT4‐positive subset in both normal and patients' peripheral blood lymphocytes. Removal of OKT8‐positive cells by complement‐mediated lysis did not lead to increased immunoglobulin synthesis or production of rheumatoid factor. The identification of peripheral blood lymphocyte subsets by use of monoclonal antibodies and the relationship of these subsets to tissue infiltrates and autoantibody production provide further insight into the pathogenesis of primary Sjögren's syndrome.
Oropharyngeal epstein‐barr virus excretion in rheumatoid arthritis
Authors: Depper Joel M. , Zvaifler Nathan J. , Bluestein Harry G.
Published: February 2007

We hypothesized that the defective cellular regulation of Epstein‐Barr virus (EBV) in rheumatoid arthritis (RA) might be reflected in an increased rate of oropharyngeal virus excretion, but we found that the prevalence of excretion in 45 RA patients (22%) did not differ from 45 age‐ and sex‐matched non‐RA patients (24%) who were taking similar medications. Increased excretion rates correlated with corticosteroid therapy and male sex, but not with age or serum levels of EBV antibodies.
An analysis of the american rheumatism association criteria for rheumatoid arthritis
Authors: Mitchell Donald M. , Fries James F.
Published: February 2007

When a community‐derived population of 840 rheumatoid arthritis patients was used to test the American Rheumatism Association's 11 diagnostic criteria for rheumatoid arthritis, these criteria divided patients into 3 reasonably distinct classifications (probable, definite, and classic). The severity of disease increased in direct proportion to the number of positive criteria. Three criteria involve invasive procedures that are rarely performed; they are unnecessary for effective use of the other 8 criteria. Although 256 possible combinations of these 8 criteria exist, the criteria function principally to classify patients into only 7 major clinical syndromes, each of which corresponds to a major clinical presentation. By identifying the logical interrelationships between criteria in this report, we have confirmed their applicability and provided insight into the manner by which criteria classify patients.
Further characterization of a neutral metalloprotease isolated from human articular cartilage
Authors: Sapolsky Asher I. , Howell David S.
Published: February 2007

The neutral metalloprotease extracted from 1,200 gm of human articular cartilage was purified 1,400‐ to 2,400‐fold by diethylaminoethyl‐ and carboxymethyl‐Sephadex chromatography. Disc electrophoresis and an isoelectric focusing method resolved the neutral enzyme activity into 4 bands. All bands had a similar amino acid analysis and a similar molecular weight by sodium dodecylsulfate electrophoresis and gel filtration: 24,000–27,000 daltons. The enzyme degraded proteoglycan subunit and proteoglycan aggregate to products with a sedimentation coefficient of 3S, but at low dilutions the enzyme produced 19.3S fragments. It is postulated that this protease may contribute to the development of osteoarthritis from within the cartilage matrix.
Reproducibility studies for anti‐DNA antibody detection in systemic lupus erythematosus and related diseases. Fiax fluorometric immunoassay and farr radioimmunoassay
Authors: Berne Bernard H. , Deblock Kathryn T. , Lawless Oliver J.
Published: February 2007

We compared the FIAX fluorometric immunoassay for antiDNA antibodies with a Farr radio‐immunoassay. Neither was precise; coefficients of variation usually exceeded 10%. The 2 assays correlated well (r = 0.87). Both were almost completely specific for systemic lupus erythematosus and identified similar numbers of sera with elevated antiDNA levels. FIAX was faster, simpler, and safer. It appears preferable to the Farr assay and probably to all other antiDNA assays currently used in clinical situations, although its reproducibility needs improvement.
Immunopathology of rheumatic pericarditis
Authors: Persellin Scott T. , Ramirez German , Moatamed Farhad
Published: February 2007

Immunologic mechanisms have been implicated in the endocarditis, myocarditis, and arthritis of acute rheumatic fever. However, pericarditis, a major manifestation of acute rheumatic fever with a clinical incidence of 5–10%, has not been studied. We have evaluated a patient who had this febrile disease with arthritis and pericarditis. Pericardial tissue showed extensive deposition of IgG, IgM, and C3 both on the pericardial surface and within the walls of pericardial blood vessels. Our findings of immunoglobulins and complement within the inflamed pericardium suggest an immune‐mediated mechanism for the pericarditis of acute rheumatic fever.
Partial reversal by beta‐d‐xyloside of salicylate‐induced inhibition of glycosaminoglycan synthesis in articular cartilage
Authors: Palmoski Marshall J. , Brandt Kenneth D.
Published: February 2007

While net 35S‐glycosaminoglycan synthesis in normal canine articular cartilage was suppressed by 10−3M sodium salicylate to about 70% of the control value, addition of xyloside (10−6M–10−3M) to the salicy‐late‐treated cultures led to a concentration‐dependent increase in glycosaminoglycan synthesis, which rose to 120–237% of controls. Similar results were obtained when 3H‐glucosamine was used to measure glycosaminoglycan synthesis, confirming that salicylate suppresses and xyloside stimulates net glycosaminoglycan synthesis, and not merely sulfation. Salicylate (10−3M) did not affect the activity of xylosyl or galactosyl transferase prepared from canine knee cartilage, and net protein synthesis was unaltered by either salicylate or xyloside. The proportion of newly synthesized proteoglycans existing as aggregates when cartilage was cultured with xyloside was similar to that in controls, although the average hydrodynamic size of disaggregated proteoglycans and of sulfated glycosaminoglycans was diminished.
COMPARISON of five assays for immune complexes in the RHEUMATIC DISEASES. An Assessment of Their Validity for Rheumatoid Arthritis
Authors: McDougal J. Steven , Hubbard Marjorie , Mcduffie Frederic C. , Strobel Phyllis L. , Smith S. Jay , Bass Noah , Goldman John A. , Hartman Sanford , Myerson Gary , Miller Stephen , Morales Rafael , Wilson C. H.
Published: February 2007

Clinical assessment (disease activity, severity, and extraarticular manifestations) of 101 rheumatoid arthritis patients was correlated with several laboratory tests, including 5 immune complex assays: the bovine conglutinin, 125I–C1q binding, monoclonal rheumatoid factor inhibition, Raji cell, and staphylococci binding assays. Elevated disease activity indices were most closely associated with the presence of immune complexes detected by the 125I–C1q and staphylococci binding assays. There were significant but weak correlations between the level of disease activity and the level of immune complexes as measured by the bovine conglutinin, 125I–C1q binding, Raji cell, and staphylococci binding assays. Articular disease severity, as measured by anatomic stage, was best discriminated by the bovine conglutinin, monoclonal rheumatoid factor inhibition, and staphylococci binding assays. Extraarticular manifestations were best discriminated by the Raji cell and staphylococci binding assays. We concluded that the sensitivity, specificity, predictive value, and overlap of the associations were not sufficient to warrant their wide use for the diagnosis and management of rheumatoid arthritis in individual patients. Conversely, the 125I–C1q and staphylococci binding assays were as good as the erythrocyte sedimentation rate and the IgG rheumatoid factor test (the 2 best tests of many examined) in assessing disease activity. Further prospective studies with these assays will determine their usefulness in following rheumatoid arthritis for a prolonged period.
The 1982 revised criteria for the classification of systemic lupus erythematosus
Authors: Tan Eng M. , Cohen Alan S. , Fries James F. , Masi Alfonse T. , Mcshane Dennis J. , Rothfield Naomi F. , Schaller Jane Green , Talal Norman , Winchester Robert J.
Published: February 2007

The 1971 preliminary criteria for the classification of systemic lupus erythematosus (SLE) were revised and updated to incorporate new immunologic knowledge and improve disease classification. The 1982 revised criteria include fluorescence antinuclear antibody and antibody to native DNA and Sm antigen. Some criteria involving the same organ systems were aggregated into single criteria. Raynaud's phenomenon and alopecia were not included in the 1982 revised criteria because of low sensitivity and specificity. The new criteria were 96% sensitive and 96% specific when tested with SLE and control patient data gathered from 18 participating clinics. When compared with the 1971 criteria, the 1982 revised criteria showed gains in sensitivity and specificity.
Molecular characterization of ribonucleoprotein antigens bound by antinuclear antibodies. A diagnostic evaluation
Authors: Matter L. , Schopfer K. , Wilhelm J. A. , Nyffenegger T. , Parisot R. F. , De Robertis E. M.
Published: February 2007

The specificity of antinuclear antibodies in sera from 54 patients with various rheumatic diseases was analyzed by immunoprecipitation of 32P‐ or 35S‐methionine‐labeled HeLa cell extracts. Of 35 sera giving a speckled and/or homogeneous immunofluorescence pattern in rat liver nuclei, 20 contained antibodies to nuclear ribonucleoproteins, which are defined by their ribonucleic acid and protein components. Four sera reacted with a nuclear antigen (Ga) which has not been described so far. Of 19 sera with antinucleolar antibodies, 18 did not react with nuclear or nucleolar ribonucleoproteins. Correlation of these molecularly defined antinuclear antibody specificities with immunofluorescence patterns and rheumatic diseases is discussed.
Hla antigens in yakima indians with rheumatoid arthritis. lack of association with hla–dw4 and hla–dr4
Authors: Willkens Robert F. , Hansen John A. , Malmgren Judith A. , Nisperos Brenda , Mickelson Eric M. , Watson Margaret A.
Published: February 2007

Women of the Yakima Indian Nation, a northwest Native American population, are known to have an increased prevalence of a rheumatoid arthritis–like disease characterized by erosive arthritis, frequent involvement of metacarpophalangeal and wrist joints, and positive rheumatoid factor. These patients are frequently positive for antinuclear antibodies and often demonstrate adverse reactions to gold therapy. HLA antigens were determined for 29 Yakima Indians with this disease, but there was no increased frequency of either HLA–Dw4 or HLA–DR4, in contrast to other populations with rheumatoid arthritis. There was, however, a trend toward an increase in HLA–B40 and a decrease in HLA–DR8. The relative risk for rheumatoid arthritis in Yakima Indians was 2.53 in the presence of B40 and 0.28 in the presence of DR8.
Enzyme immunoassay for antibodies to native DNA
Authors: Eaton Roger B. , Schnneider Graciela , Schur Peter H.
Published: February 2007

An enzyme immunoassay was developed to detect antibodies to native DNA; DNA coating conditions that maximized sensitivity, specificity, and reproducibility were selected. Sera of patients with systemic lupus erythematosus (SLE) were positive more frequently by this immunoassay than by the Crithidia luciliae assay or by counterimmunoelectrophoresis. By enzyme immunoassay, 94% of sera with active SLE and 70% of sera from patients with inactive SLE were positive, as were 16% from those suspected of having SLE, and 2.5% of normal persons. Specificity for native DNA was shown for both SLE and normal sera by inhibition studies and by S1 nuclease treatment of polystyrene‐bound native DNA. The enzyme immunoassay correlated more with serum hemolytic complement levels than did the other 2 assays, suggesting that it detects biologically more relevant anti‐DNA antibodies than do the other 2 tests.
Trends in serum uric acid levels
Authors: Glynn Robert J. , Campion Edward W. , Silbert Jeremiah E.
Published: February 2007

Uric acid levels of adult male volunteers in a longitudinal study of human aging rose steadily between 1961 and 1978. In the 1,141 men with 3 serial physical examinations, who developed no diseases and who took no drugs known to affect uric acid levels, levels rose from means below 5.5 mg/dl in 1961–1963 to means above 6.5 mg/dl in 1975–1978. The best predictor of a longitudinal increase in uric acid level was a gain in weight, but this, and other significant predictors, explained only a small portion of the increase in this population. Preliminary data available from a fourth examination indicate that the rising trend has leveled off.
Ia specific antilymphocyte antibodies in rheumatoid arthritis
Authors: Searles Robert P. , Okudaira Kunio , Savage Susan M. , Goodwin James S.
Published: February 2007

Antilymphocyte antibodies (ALA) in rheumatoid arthritis (RA) have increased reactivity with phytohemagglutinin (PHA) activated lymphoblasts which are known to have increased expression of Ia antigen. The present experiments suggest that part of this reactivity represents an Ia specificity of ALA. Fifteen of 18 RA sera tested were able to inhibit the binding of monoclonal anti‐Ia antibodies as measured by a rosette method. RA sera did not inhibit the binding of other monoclonal antibodies: anti‐OKT3, anti‐OKT4, and anti‐OKT8. The ability of RA sera to inhibit the binding of anti‐Ia antibody was eliminated after absorption of the RA sera with an Ia positive human cell line (B35M) but not by an Ia negative line (MOLT4). Blocking of anti‐Ia binding was greater in the IgG fraction of the RA sera but also occurred in the IgM fraction. Experiments including ultracentrifugation, pepsin digestion of RA sera, and preincubation of lymphoblasts with aggregated IgG demonstrated that Fc binding by RA sera was not a factor. Both monoclonal anti‐Ia and anti‐Ia heteroantiserum also had increased reactivity with lymphoblast target cells. Pepsin digested Fab fragments of the anti‐Ia heteroantiserum were able to block the activity of cytotoxic RA serum. However, ALA cytotoxic to lymphoblasts did not correlate with anti‐Ia by rosette method. Ia‐specific ALA by rosette method was associated with donor variability but did not appear to be HLA‐DR restricted. Ia‐specific ALA did correlate with disease activity. These data suggest that anti‐Ia activity is present in RA sera and may play an immunoregulatory role in this disease.
Capillary Microscopy in Eosinophilic Fasciitis
Authors: Rozboril Michael B. , Maricq Hildegard R. , Rodnan Gerald P. , Jablonska Stephania , Bole Giles G.
Published: February 2007

Capillary microscopy was performed on 19 patients with eosinophilic fasciitis. These patients were compared with 13 individuals with progressive systemic sclerosis (scleroderma). Capillary patterns were normal in 16 of 19 (84%) eosinophilic fasciitis patients; 3 exhibited either borderline or nonspecific changes, and none showed a definite scleroderma pattern. In contrast, characteristic nailfold capillary changes, consisting of both dilatation and loss of capillaries, were present in 11 of 13 (85%) scleroderma patients; the remaining 2 showed scleroderma‐type abnormalities of only 1 finger and were, therefore, classified as borderline. These results suggest that capillary microscopy may help to distinguish these 2 disorders.
The Educational Impact of a Rheumatology Elective
Authors: Goldenberg Don L. , Meenan Robert F. , Allaire Saralynn , Cohen Alan S.
Published: February 2007

We used a newly developed evaluation strategy to compare the performance of 12 medical residents who received ambulatory care rheumatology training and 12 who received inpatient consultative training. There was no significant difference in the cognitive test scores or the patient examination skills of the 2 groups. The ambulatory care residents saw more patients with common rheumatic diseases and performed more joint aspirations and injections. Both groups performed significantly better in all education impact measurements than did a control group of medical residents who received no formal rheumatology elective training. The control group of residents performed no better than did fourth‐year medical students who also had no formal rheumatology elective training. The study demonstrated that formal rheumatology training is essential if medical residents are to achieve adequate skills in rheumatology. This training can be provided through ambulatory care or inpatient‐oriented electives.
Gold Therapy in The Elderly Rheumatoid Arthritis Patient
Authors: Kean Walter F. , Bellamy Nicholas , Brooks Peter M.
Published: February 2007

Forty elderly (≥60 years old) and 101 young (<60 years old) rheumatoid arthritis patients receiving injectable gold therapy were followed prospectively between April 1971 and April 1982. The mean total gold compound received was 1,392 mg in the young group and 1,861 in the elderly group. Besides age, the only significant difference between the two groups was the increased gold compound received by the elderly. To determine efficacy and toxicity within and between certain age groups, the 141 patients were divided into 4 arbitrary age groups: group A (<30 years), group B (30—44 years), group C (45–59 years), and group D (≥60 years). The elderly responded to the gold therapy as well as the young patients did, at any time frame examined after 3 months of therapy. There was no difference in clinical benefit among groups A, B, C, and D. Nine patients in the elderly group and 15 in the young group had therapy discontinued because of no response. This difference was not significant among the groups A, B, C, and D. There was no difference in outcome of individual toxicity between the elderly and the young groups, and no difference in frequency of toxicity between the age groups A, B, C, and D. Serious hematologic toxicity occurred only in patients over 47 years of age, and nephrotic syndrome occurred only in patients over 52. In this study, gold therapy was found to be as clinically beneficial in the elderly as in the young patients, and the toxicity and drug failure rates were not significantly different.
Increased IgA‐producing cells in the blood of patients with active henoch‐schönlein purpura
Authors: Casanueva B. , Rodriguez‐Valverde V. , Merino J. , Arias M. , Garcia‐Fuentes M.
Published: February 2007

Peripheral blood lymphocytes (PBL) producing IgA, IgM, and IgG, both spontaneously and after pokeweed mitogen stimulation in cell culture, were determined by a protein A hemolytic plaque assay in 20 children with active Henoch‐Schönlein purpura (HSP), 42 with inactive disease, 22 normal controls of the same ages, and 18 children with upper respiratory tract infections (URTI). The geometric mean of circulating IgA‐producing cells in active HSP (1,016 \documentclass{article}\pagestyle{empty}\begin{document}$\[\begin{array}{l} \times \\ \div \\ \end{array}\] $\end{document}
1.55 cells/106 PBL) was increased when compared with the group with inactive disease (P < 0.001), normal controls (P < 0.001), and children with URTI (542 \documentclass{article}\pagestyle{empty}\begin{document}$ \[\begin{array}{l} \times \\ \div \\ \end{array}\] $\end{document}
2.03 cells/106 PBL, P < 0.05). The number of circulating IgM‐producing cells was slightly increased in active HSP (260 \documentclass{article}\pagestyle{empty}\begin{document}$ \[ \begin{array}{l} \times \\ \div \\ \end{array}\] $\end{document}
2.65 cells/106 PBL) and URTI (256 \documentclass{article}\pagestyle{empty}\begin{document}$ \[\begin{array}{l} \times \\ \div \\ \end{array}\] $\end{document}
3.16 cells/106 PBL). Both values were higher than those found in the group with inactive disease (113 \documentclass{article}\pagestyle{empty}\begin{document}$ \[\begin{array}{l} \times \\ \div \\ \end{array}\] $\end{document}
2.26 cells/106 PBL, P < 0.01). There were no significant differences among the 4 groups in the number of circulating IgG‐producing cells. The number of cells producing each type of immunoglobulin after in vitro stimulation with pokeweed mitogen was similar in patients with active HSP, normal controls, and the group with inactive disease. These data demonstrate a selective increase in the number of circulating IgA‐producing cells only during disease activity, and add further support to a possible pathogenic role of this immunoglobulin in HSP.
In vivo effect of aspirin on canine osteoarthritic cartilage
Authors: Palmoski Marshall J. , Brandt Kenneth D.
Published: February 2007

The in vivo effect of aspirin on degeneration of knee cartilage in a canine model of osteoarthritis was examined. When dogs were fed aspirin daily after anterior cruciate ligament transection, the degeneration of articular cartilage in the unstable knee was more marked 9 weeks later than that in the operated knee of dogs which did not receive aspirin. Compared with samples from the contralateral knees, the thickness of articular cartilage in the operated knees of aspirin‐fed dogs was reduced, while it was increased in the operated knees of dogs not fed aspirin. In addition, the proteoglycan (uronic acid) content and the augmentation of proteoglycan synthesis in cartilage from the unstable knee were significantly lower when the dogs were fed aspirin than when they were not, and Safranin‐O staining of the matrix was less intense. However, cartilage from the contralateral knees of aspirin‐fed dogs was histochemically and biochemically normal in every respect. When metatarsal bones, with their overlying articular cartilage intact, were cultured in the presence of 10−4M and 10−5M salicylate, net glycosaminoglycan synthesis was suppressed by 25% and 15%, respectively. These concentrations of salicylate had previously been shown to have no effect on glycosaminoglycan metabolism in normal cartilage from the weightbearing region of the femoral condyle. Since the uronic acid content of metatarsal cartilage is lower than that of femoral cartilage, and that of osteoarthritic femoral cartilage is lower than that of normal femoral cartilage, the present results are consistent with the concept that cartilage is more permeable to aspirin when its matrix is depleted of proteoglycans.
Role of medullasin in granulocytes in the development of inflammation
Authors: Aoki Yosuke , Machinami Rikuo
Published: February 2007

Injection of a small amount of medullasin protease (20 μg) into the skin of guinea pigs or rabbits caused inflammation characterized by severe injury to endothelial cells in venules and by infiltration of a large number of macrophages. Medullasin inhibited macrophage chemotaxis in vitro, stimulated granulocyte chemotaxis, and potentiated the production of superoxide by macrophages. These results indicate that medullasin in granulocytes plays an important role in the development of inflammation.
Comparative rates of proteoglycan synthesis and size of proteoglycans in normal and osteoarthritic chondrocytes
Authors: Teshima Ryota , Treadwell Benjamin V. , Trahan Carol A. , Mankin Henry J.
Published: February 2007

Normal human and osteoarthritic cells were isolated from cartilage with clostridial collagenase. The cells were grown in media as a suspension culture in the presence of 35SO4. Osteoarthritic cartilage of moderate histologic grade (4–8) yielded chondrocytes which incorporated 35SO4 at a rate 3–4 times greater than did normal chondrocytes. The rate of incorporation, however, decreased to normal levels with chondrocytes isolated from mild (grade 0–3) or more advanced (grade 9–13) stages of the disease. These results corroborate those obtained in earlier studies using organ cultures and show that when osteoarthritic cells are isolated from their matrix environment, they continue to synthesize macromolecules at an increased rate. Analysis of the material synthesized by the isolated cells on sizing column demonstrated an inverse relationship between the size of the 35SO4 containing molecules and the severity of the disease.
Serum transfer of collagen‐induced arthritis.II. Identification and Localization of Autoantibody to Type II Collagen in Donor and Recipient Rats
Authors: Stuart John M. , Tomoda Koichi , Yo Md Tai June O. , Townes Alexander S. , Kang Andrew H.
Published: February 2007

Collagen‐induced arthritis can be transferred from immunized arthritic rats to unimmunized recipients by intravenous injection of an immunoglobulin concentrate of sera. This study identifies antibodies in the transfer concentrate which localize to the articular surface of cartilage in joints of recipients. Immunoglobulin can also be demonstrated in the same location in arthritic joints from rats after immunization. Antibody capable of transferring arthritis is present in donor rats over a period of at least 3 weeks and can be absorbed using homologous type II collagen. In addition, antitype II collagen antibodies can be eluted from arthritic joints of rats with early disease.
Phenotypic characterization of synovial tissue cells in situ in different types of synovitis
Authors: Lindblad Staffan , Klareskog Lars , Hedfors Eva , Forsum Urban , Sundstrom Christer
Published: February 2007

Immunohistochemical double‐staining was performed on frozen sections from synovial biopsies obtained at arthroscopy from 22 patients with different kinds of synovitis. Not only in specimens from patients with rheumatoid arthritis and seronegative chronic polyarthritis, but also in those from patients with synovitis due to psoriasis, trauma, or crystals, were seen many αLeu‐1‐positive T lymphocytes—in most cases predominantly of the αLeu‐3a‐positive T “helper” cell type—in close contact with HLA‐DR‐positive macrophages/dendritic cells. Presence of many HLA‐DR‐positive, often OKMI‐negative, and irregular sublining cells characterized all forms of chronic arthritis.
Hereditary chondrocalcinosis in a mexican‐american family
Authors: Richardson Bruce C. , Chafetz Neil I. , Ferrell Linda D. , Zulman Julian I. , Genant Harry K.
Published: February 2007

In a study of 45 adults in a family of Mexican‐Indian ancestry, it was found that 22 (49%) had joint symptoms resembling those of degenerative joint disease. Eleven family members had radiographic evidence of chondrocalcinosis, and 1 adult and 3 adolescents had clinical histories and examinations consistent with the familial arthropathy, but no radiographic evidence of disease. The cause of the arthritis in the affected family members is calcium pyrophosphate crystal deposition. The mode of inheritance appears to be autosomal dominant with a high degree of penetrance. The disease is characterized by onset in the second to fifth decades of either episodes of acute inflammatory arthritis or degenerative joint disease. A unique finding of this study was a “halo” surrounding chondrocytes in 1 patient's cartilage, demonstrating loss of the proteoglycans.