bluuebunny/crossref_metadata_2025 huggingface dataset:
Scleromyxedema with systemic involvement mimics rheumatic diseases
Authors: Fudman Edward J. , Golbus Joseph , Ike Robert W.
Published: February 2007

Scleromyxedema is an infiltrative skin disease produced by hyaluronic acid deposition in the dermis. A benign monoclonal gammopathy is usually present. We report 2 patients with scleromyxedema and systemic illnesses. Both patients had muscle weakness, dysphagia, and weight loss in addition to the skin changes. One also had sclerodactyly, telangiectasias, and Raynaud's phenomenon. Scleromyxedema with systemic involvement may mimic rheumatic diseases.
Influence of age, gender, and obesity on salicylate kinetics following single doses of aspirin
Authors: Greenblatt David J. , Abernethy Darrell R. , Boxenbaum Harold G. , Matlis Rita , Ochs Hermann R. , Harmatz Jerold S. , Shader Richard I.
Published: February 2007

Salicylate kinetics following single, 650‐mg intravenous and oral doses of aspirin were evaluated in humans in 2 studies. Complete conversion of aspirin to salicylate was assumed. The first study involved 25 young (25–40 years) and 21 elderly (66–89 years) healthy male and female volunteers. Mean salicylate clearance was lower in elderly females compared with that in young females; however, the difference between young men and elderly men was not significant. Salicylate free fraction in plasma increased significantly with age in men and women. After correction for free fraction, unbound mean clearance was reduced in elderly men compared with young men, and in elderly women compared with young women. Peak plasma salicylate concentrations after taking oral aspirin were not significantly influenced by age, and systemic availability of salicylate in all groups was complete. The second study compared 20 obese subjects (mean weight 113 kg) with 20 normal weight controls (mean weight 67 kg) matched for age, sex, height, and smoking habits. Small differences between obese and control groups were observed in total salicylate volume of distribution (Vd), unbound Vd, and mean clearance of total or unbound salicylate. Following normalization for total weight, however, values of total Vd and mean clearance were significantly smaller in obese subjects than in normal weight subjects. Rate and completeness of salicylate absorption were not influenced by obesity when aspirin was ingested, although peak levels were lower in obese subjects. If applied to multiple doses, the reduced unbound clearance of salicylate in the elderly would imply increased accumulation unless doses are appropriately adjusted downward. During long‐term therapy, salicylate dosage for obese individuals should not be adjusted upward in proportion to total weight.
The contribution of pain to disability in experimentally induced arthritis
Authors: Dardick Samuel J. , Basbaum Allan I. , Levine Jon D.
Published: February 2007

We examined the differential effects of disease severity and pain on morbidity (as measured by weight loss and decrease in activity) in rats with adjuvant‐induced arthritis. We found that eliminating nociceptive messages from affected extremities, although not significantly affecting the course of the disease, attenuated the morbidity observed in arthritic rats. When pain was factored out, the severity of the arthritis had no significant effect on the same measures of morbidity. These findings suggest that treatment of pain may reduce morbidity, and thereby may have significant benefits beyond that provided by slowing of the disease process.
Lipid microspherule–associated acute monarticular arthritis
Authors: Trostle David C. , Schumacher H. Ralph , Medsger Thomas A. , Kapoor Wishwa N.
Published: February 2007

We describe the fifth reported case of acute monarthritis associated with lipid microspherules. A 33‐year‐old obese man developed acute knee arthritis with a synovial fluid white blood cell count of 11,700/mm3 (97% polymorphonuclear leukocytes). The fluid contained numerous strongly positively birefringent intra‐ and extracellular spherules that measured 2–6 μm in diameter and had the appearance of Maltese crosses. No systemic lipid disorder or local trauma could account for the attack, which responded promptly to the administration of colchicine.
Molecular forms of IgA rheumatoid factor in serum and synovial fluid of patients with rheumatoid arthritis
Authors: Schrohenloher Ralph E. , Koopman William J. , Alarcón Graciela S.
Published: February 2007

The distribution of molecular forms of serum IgA rheumatoid factor (IgA‐RF) in 42 patients with rheumatoid arthritis was examined by solid‐phase radioim‐munoassay following fractionation by gel chromatography or ultracentrifugation in acidic buffer. Analysis of the fractions using phosphate buffered saline indicated that the IgA‐RF in each serum was mainly polymeric. However, monomeric IgA‐RF was detected in sera from approximately two‐thirds of the patients, after dilution of chromatographic or ultracentrifugal fractions in diluent containing mouse monoclonal anti‐human α chain antibody. The levels of monomeric IgA‐RF (mean ± SD 38 ± 86 μg/ml) and the ratios of monomeric to polymeric IgA‐RF (mean ± SD 0.29 ± 0.41) varied over a wide range. Paired synovial fluids from 9 of the patients were also examined. Monomeric IgA‐RF was detected in each, although 2 samples demonstrated only minimal quantities. Neither form of IgA‐RF was detected in serum from healthy adults when analyzed under the same conditions. Thus, both monomeric and polymeric IgA‐RF can occur in serum and synovial fluid from patients with rheumatoid arthritis, and their proportions vary widely among patients.
Metabolism of a cartilage matrix glycoprotein in normal and osteoarthritic canine articular cartilage
Authors: Fife Rose S. , Palmoski Marshall J. , Brandt Kenneth D.
Published: February 2007

We have recently described a 550,000‐dalton noncollagenous cartilage matrix glycoprotein (CMGP), with subunits of 130,000, which is present in hyaline cartilage and fibrocartilage. Biosynthetic studies indicated that CMGP was synthesized by short‐term organ cultures of normal canine articular cartilage, representing approximately 9% of the total 3H‐leucine incorporated into protein in 24‐hour cultures. There was no incorporation of 35S‐sulfate or 3H‐mannose into CMGP under these conditions, but the protein did incorporate 32P‐phosphate. The majority of the 3H‐leucine‐labeled CMGP was removed after 24 hours of chase with unlabeled leucine, and only a small amount remained at 72 hours, which suggests that there was rapid metabolism of the protein. CMGP was not detected in cartilage after addition of cycloheximide to the culture medium; this confirms its short half‐life. Cultures of osteoarthritic cartilage obtained from dogs 8–10 weeks after anterior cruciate ligament transection revealed no difference in the metabolism of CMGP in this tissue compared with that found in cultures of normal articular cartilage.
Arthropathy and cutaneous calcinosis in hemodialysis oxalosis
Authors: Reginato Antonio J. , Seoane Jose Luis Ferreiro , Alvarez Ceferino Barbazan , Piferrer Jorge Mitja , Meijon Lino Vidal , Turon Raul Pascual , Vasconez Fernando , Rivera Exequel R. , Clayburne Gilda , Rothfuss Susan
Published: February 2007

Recently, calcium oxalate crystals have been identified in the synovial fluid of patients with arthritis and end‐stage renal failure. We describe 4 patients who, during the course of long‐term hemodialysis, developed calcium oxalate crystal deposits in the synovium and skin. Clinical manifestations included podagra, teno‐synovitis, olecranon bursitis, and acute and chronic synovitis of the large joints that were associated with chondrocalcinosis or subchondral bone erosions. Diffuse involvement of the hand, with chondrocalcinosis of the finger joints, miliary calcified deposits in the skin, and artery calcifications, was observed in 3 patients. The fourth patient had erosive arthropathy. Oxalosis secondary to end‐stage renal failure in patients treated with long‐term hemodialysis can present with articular manifestations that resemble those of gout, pseudogout, and apatite deposition disease. Other characteristic features of the synovitis associated with oxalosis secondary to end‐stage renal disease were: predominant involvement of the hand, mild inflammatory changes in the synovial fluid and synovium, and poor response to administration of nonsteroidal antiinflammatory agents.
Monosodium urate crystals in the knee joints of patients with asymptomatic nontophaceous gout
Authors: Bomalaski John S. , Lluberas Geronimo , Schumacher H. Ralph
Published: February 2007

We aspirated synovial fluid from the knees of 50 patients with asymptomatic, nontophaceous gout, in whom synovial fluid monosodium urate (MSU) crystals had previously been documented in the knees or other joints. Fifty‐eight percent of these asymptomatic patients had MSU crystals in their knee joints. Serum uric acid levels, serum creatinine levels, volume of synovial fluid aspirated, and cell counts of the aspirated fluid did not differentiate the MSU crystal‐positive group from the group without MSU crystals. Clinical factors such as alcohol abuse, coronary heart disease, hypertension, duration of gout, duration of the intercritical period, and drug therapy did not differentiate the 2 groups. Nineteen patients consented to aspiration of their other knee. Seven of these patients (37%) had MSU crystals bilaterally, and 6 patients (32%) had them unilaterally. The implications of the persistence of MSU crystals (including those in intracellular locations) in many patients, despite normalization of serum uric acid levels, should be determined. Knee joint aspiration is a sensitive method for the demonstration of MSU crystals in asymptomatic patients. The procedure might also be useful in documenting these crystals in patients who have had attacks of arthritis with features consistent with a diagnosis of gout, but in whom MSU crystals have not been documented.
Multiple unusual manifestations of Wegener's granulomatosis: Breast mass, microangiopathic hemolytic anemia, consumptive coagulopathy, and low erythrocyte sedimentation rate
Authors: Jordan Joanne M. , Manning Michael , Allen Nancy Bates
Published: February 2007

We describe a patient who presented with multiple unusual manifestations of Wegener's granulomatosis, including a breast mass, microangiopathic hemolytic anemia, and consumptive coagulopathy. Erythrocyte sedimentation rate (Westergren), usually elevated in the course of this disease, persistently remained low in this patient. We found that C‐reactive protein levels were, in this case, a more sensitive gauge of disease activity.
Changes in cell surface antigen expression on human articular chondrocytes induced by gamma‐interferon
Authors: Jahn Beatrice , Burmester Gerd R. , Schmid Hansjörg , Weseloh Gerd , Rohwer Peter , Kalden Joachim R.
Published: February 2007

Ia antigens (class II HLA molecules) have been detected on cells eluted from affected human cartilage in certain disease states, but not on normal cartilage cells. Because the presence of Ia antigens on chondrocytes may play an important role in rheumatic diseases, we investigated the induction of these molecules by γ‐interferon (γ‐IFN), a potent Ia‐inducing lymphokine. Human articular chondrocytes were incubated with recombinant γ‐IFN, and the expression of Ia antigens was studied by cell sorter analysis, using a panel of reagents that detect monomorphic and polymorphic specificities of the DR and DQ Ia antigen families. While the induction of DR antigens, including polymorphic DR specificities, was readily obtained with γ‐IFN (50–95% positive cells), DQ antigens were negative or were displayed only on a lower percentage of chondrocytes (5–60%). In addition, incubation with γ‐IFN led to an increased expression of HLA class I antigens. The expression of various other surface markers either remained unchanged (as in 4F2 and BA‐2) or showed tendencies toward decreased percentages (as in 83c2) or increased percentages (as in MøR‐17). No apparent change in cell morphology or growth pattern was observed.
An Open, Controlled, Randomized Comparison of Cyclosporine and Azathioprine in the Treatment of Rheumatoid Arthritis: A Preliminary Report
Authors: FØRre ØYstein , Bjerkhoel Frithjof , Salvesen Christian F. , Berg Knut J. , Rugstad Hans E. , Saelid Gunnar , Mellbye Ove J. , KÅSs Erik
Published: February 2007

Cyclosporine (10 mg/kg/day) and azathioprine (2.5–3 mg/kg/day) were compared for 26 weeks in an open, controlled, randomized study of 24 patients with rheumatoid arthritis. Each treatment group consisted of 12 patients. Those patients who took cyclosporine improved significantly in the 50‐foot walk time, circumferences of proximal interphalangeal joints, Ritchie articular index, global assessment by investigator, and grip strength, when compared with baseline findings. In the azathioprine group, there was improvement only in grip strength.
Cytomegalovirus Retinitis in Rheumatic Disease: A Case Report
Authors: Winkler Anne , Finan Michael J. , Pressly Thomas , Roberts Randy
Published: February 2007

We describe a 67‐year‐old white man with Wegener's granulomatosis who was treated with cyclophosphamide, then with azathioprine, and who subsequently developed cytomegalovirus retinitis. The patient initially improved on a course of adenine arabinosine, but his retinitis has progressed, despite discontinuation of immunosuppressive therapy. We show that cytomegalovirus retinitis does occur in patients with rheumatic diseases who receive immunosuppressive therapy.
Subset specificity of antilymphocyte antibodies in systemic lupus erythematosus
Authors: Winfield John B. , Shaw Melody , Yamada Akira , Minota Seiji
Published: February 2007

Using indirect immunofluorescence and flow cytometry, we determined the proportion and number of T3+, T4+, and T8+ cells in the peripheral blood of patients with systemic lupus erythematosus whose sera were positive for cold‐reactive antilymphocyte antibodies versus values in patients whose sera were negative for these antibodies. There was a disproportionate reduction in T4+ peripheral lymphocytes when cold‐reactive antilymphocyte antibodies preferentially cytotoxic for this subpopulation were present in autologous serum. The decrease in this subset was responsible for a reduction in the T4:T8 ratio; variation in the number and proportion of T8+ cells was insignificant. A similar, but autoantibody‐independent, alteration in the T4+ subpopulation was found in patients who were receiving prednisone therapy. A relationship between T cell population abnormalities and systemic lupus erythematosus disease activity, per se, was not observed.
The interaction of antibody/dna immune complexes with complement
Authors: Taylor Ronald P. , Edberg Jeffrey C. , Kujala Gregory A. , Sloman Andrew J. , Wilson Cara C. , Cronin Mary E.
Published: February 2007

In 28 serum and plasma samples from patients with systemic lupus erythematosus, we examined the importance of antibody class with respect to complement‐mediated binding to human red blood cells (RBC) of antibody/DNA immune complexes (IC) prepared with anti‐DNA antibodies. We used both 3H–double‐stranded DNA and 3H–single‐stranded DNA (ssDNA). Generally, double‐stranded DNA IC showed considerably higher binding than did ssDNA IC in the RBC binding assay. Further analysis indicated that although ssDNA IC fix complement, it is necessary that these IC contain IgM anti‐DNA antibodies in order for them to bind to RBC. The results suggest that the mechanisms of clearance and pathogenic potential of these IC may depend upon both the DNA conformation and antibody class. In particular, complement‐fixing IC which contain IgG anti‐DNA antibodies and ssDNA may not be cleared via the erythrocyte clearance mechanism, and therefore, could be more likely to deposit in certain tissues and initiate inflammatory reactions.
Hereditary amyloidosis: description of a new american kindred with late onset cardiomyopathy
Authors: Benson Merrill D. , Wallace Margaret R. , Tejada Eduardo , Baumann Hal , Page Burnestine
Published: February 2007

A family with hereditary amyloidosis characterized by peripheral neuropathy and cardiomyopathy is described. Lack of eye involvement sets their disease apart from the Indiana/Swiss familial amyloidotic polyneuropathy type II. The disease is of late onset; affected members die of cardiomyopathy after age 60. The late onset and lack of clinically significant neuropathy in several family members has led to misdiagnosis of the cardiomyopathy. Immunohistochemistry using antiprealbumin antiserum showed staining of amyloid deposits in nerve and heart.
Creatine kinase activity inhibitor in sera from patients with muscle disease
Authors: Kagen Lawrence J. , Aram Sirarpi
Published: February 2007

Sera from patients with muscle disease contain an inhibitor of creatine kinase (CK) which may lead to underestimation of CK activity. The inhibitor was dialyzable, but was not related to previously described low molecular weight inhibitors of CK. In a small group of patients with myositis, the amount of inhibitor present in serum was correlated with the severity of the illness. Our findings suggest that the CK inhibitor may be released into serum from injured muscle.
Immunity to soluble retinal antigen in patients with uveitis accompanying juvenile rheumatoid arthritis
Authors: Petty R. E. , Hunt D. W. C. , Rollins D. F. , Schroeder M.‐L. , Puterman M. L.
Published: February 2007

Studies of immunity to bovine soluble retinal antigen (antigen S) were carried out using serum and peripheral blood lymphocytes from children with juvenile rheumatoid arthritis and chronic anterior uveitis (JRA‐uveitis), children with JRA alone, children with nonrheumatic diseases, and controls who had no ocular or rheumatic disease. Enzyme‐linked immunosorbent assay and the lymphocyte transformation assay were used to determine immunity. Antibody to antigen S was present significantly more frequently in children with JRA‐uveitis than in children with JRA alone, children with nonrheumatic disorders, or controls. These latter groups did not differ in positivity for this antibody. Lymphocyte transformation occurred more frequently in children with JRA–uveitis than in children with JRA alone or controls. Children with JRA alone and controls had similar frequencies of lymphocyte transformation positivity. Enzyme‐linked immunosorbent assay positivity and lymphocyte transformation positivity tended to occur in different children. Children with JRA–uveitis who had HLA–B35 had the highest frequency of antibody to antigen S. Immunity to antigen S may be the result of ocular damage by mechanisms other than a pathogenic mechanism per se.
Failure Of klebsiella pneumoniae antibodies to cross‐react with peripheral blood mononuclear cells from patients with ankylosing spondylitis
Authors: Cameron Fiona H. , Russell Pamela J. , Easter Joan F. , Wakefield Denis , March Lyn
Published: February 2007

Cross‐reactivity between antibodies to 2 strains of Klebsiella pneumoniae (K43 and F77) and the peripheral blood lymphocytes of patients with ankylosing spondylitis (AS) was examined in 3 separate antibody binding and cytotoxicity assays. Using K pneumoniae antisera in a chromium release cytotoxicity assay, we found no difference in the reactions of cells from AS patients and those from control subjects. This result contrasts with the results of previous studies. Similarly, using an enzyme‐linked immunosorbent assay, we detected no significant increase in antibody binding to peripheral blood mononuclear cells (PBMC) in HLA–B27 positive patients with AS. Low levels of antibody binding were detected by a fluoresceinated antibody binding assay; however, normal rabbit serum, which was used as a control, was shown to have a binding affinity for PBMC that was significantly greater than that of specific K pneumoniae antisera. The results of our present study do not support the concept of a specific cross‐reactivity between antibodies to K pneumoniae and the PBMC of patients with AS who are HLA–B27 positive.
Intravenous pulse methylprednisolone treatment of juvenile dermatomyositis
Authors: Laxer Ronald M. , Stein Leonard D. , Petty Ross E.
Published: February 2007

Recent observations that juvenile dermatomyositis (JDMS) may be a heterogenous disorder, in both its clinical course and prognosis, suggest that subgroups of patients with this disease may respond to various modes of therapy. Therefore, current treatment recommendations of daily, long‐term oral corticosteroid treatment, with its attendant side effects, may not be necessary for all children with JDMS. We report the results of treatment with high‐dose, pulse intravenous methylprednisolone in 7 children with JDMS, 3 of whom had an excellent response with complete remission and no need for daily steroid therapy. We suggest that patients with early, mild JDMS may be candidates for therapy with intravenous methylprednisolone.
Transient fall in serum salicylate levels following intraarticular injection of steroid in patients with rheumatoid arthritis
Authors: Baer Philip A. , Shore Abraham , Ikeman Robert L.
Published: February 2007

Our study of 13 hospitalized patients with rheumatoid arthritis examined the effect of intraarticular injection of steroid on serum salicylate levels. A mean decrease in serum salicylate levels of 42 ± 14.5% was observed in 12 patients within 12–36 hours post‐injection (P <0.005). This interaction, though transient, may be very significant clinically. It may lead to erroneous conclusions concerning patient compliance, unwarranted increases in salicylate dosage and resultant toxicity, and delay of appropriate therapeutic maneuvers.
Synovial fluid analysis for diagnosis of amyloid arthropathy
Authors: Lakhanpal Sharad , Li Chin Y. , Gertz Morie A. , Kyle Robert A. , Hunder Gene G.
Published: February 2007

To detect the presence of amyloid, we studied synovial fluid samples from 7 patients who had biopsyproven amyloidosis and clinical arthropathy and from 98 patients who had other forms of arthritis. Centrifuged sediments from synovial fluids of all 7 patients with amyloid and clinical arthropathy were positive on staining with Congo red, whereas the 98 others were negative. Under polarized microscopy, the amyloid appeared as an amorphous material with strong Congo red uptake and typical apple‐green birefringence. These findings indicate that analysis of synovial fluid sediments with Congo red may represent a simple, yet sensitive, test for the diagnosis of amyloid arthropathy.
Interleukin‐1β and interleukin‐1α stimulate the plasminogen activator activity and prostaglandin E2 levels of human synovial cells
Authors: Leizer Tali , Clarris Barry J. , Ash Patricia E. , Damme Joseph Van , Saklatvala Jeremy , Hamilton John A.
Published: February 2007

Monocyte—macrophage polypeptides (monokines) cause synovial cells to increase the levels of putative mediators of destruction and inflammation. This interaction may account for some of the properties of rheumatoid pannus. We report here that samples of purified human interleukin‐1β(IL‐1β) and recombinant IL‐1β stimulate both the plasminogen activator activity and prostaglandin E2 levels of human synovial fibroblast‐like cells. The same holds true for purified pig IL‐1 (catabolin) and recombinant murine IL‐1. The elevation in plasminogen activator activity was inhibited by indomethacin, and this suggests that endogenous prostanoids are important in the IL‐1‐mediated stimulation of proteinase activity.
Articular indices of joint inflammation in rheumatoid arthritis. Correlation with the acute‐phase response
Authors: Thompson Paul W. , Silman Alan J. , Kirwan John R. , Currey Harry L. F.
Published: February 2007

The joints of 30 rheumatoid arthritis patients were assessed by one observer for signs of inflammation. Computer analysis was then used to calculate 70 different articular indices for each patient. Pearson correlation coefficients were calculated between serum C‐reactive protein levels and the articular indices. The results show that: 1) findings in a restricted set of examined joints were equivalent to those in a more complete set; 2) the simultaneous presence of joint tenderness and swelling yielded higher correlation than did either variable alone; and 3) joint ‘weighting’ for size yielded higher correlation than did simple counts.
Magnetic resonance imaging in the evaluation of patients with rheumatoid arthritis and subluxations of the cervical spine
Authors: Breedveld Ferdinand C. , Algra Paul R. , Vielvoye C. Jan , Cats Arnold
Published: February 2007

We used magnetic resonance imaging (MRI) to examine 21 patients with rheumatoid arthritis and vertebral subluxations of the cervical spine, in whom neurologic symptoms and signs indicated spinal cord compression. Based on neurologic signs, the patients were assigned to 1 of 3 classes: class I, no objective signs of cervical myelopathy (9 patients); class II, only 1 objective sign of cervical myelopathy (4 patients); or class III, 2 or more objective signs of cervical myelopathy (8 patients). Atlantoaxial subluxation (20 patients) and subluxations below C2 (6 patients) were detected equally well by MRI and radiography. MRI revealed physical distortion of the spinal cord in all class III patients with compressive myelopathy. This distortion was found less frequently in class II and class I patients (3 patients), and the difference was statistically significant (P < 0.005, class III versus class I and class II). No correlation was found between the vertebral dislocation (measured in millimeters) on plain radiographs and the presence of cord distortion on MRI. Myelography in class III patients showed that passage of contrast medium was blocked at the same level as the cord distortion seen on MRI. These findings suggest that MRI can serve as a useful, noninvasive procedure in the diagnosis and management of rheumatoid arthritis patients in whom compressive cervical myelopathy is suspected.
Myoadenylate deaminase deficiency and forearm ischemic exercise testing
Authors: Valen Peter A. , Nakayama Denny A. , Veum Judith , Sulaiman A. R. , Wortmann Robert L.
Published: February 2007

Myoadenylate deaminase (MADA) deficiency has been associated with symptoms of postexertional aches, cramps, weakness, and skeletal muscle dysfunction. Measurement of plasma lactate and ammonia concentrations after forearm ischemic exercise has been suggested as a screening test for this disorder. We performed forearm ischemic tests on 3 patients with histochemically defined MADA deficiency and 13 healthy control subjects, in a standardized fashion. Our results demonstrated that subject effort and/or performance during the exercise portion of testing is a critical variable. In addition to lactate and ammonia, plasma purine compounds (adenosine, inosine, and hypoxanthine) were measured. The finding of decreased purine release after exercise in MADA‐deficient patients compared with that in normal individuals increases the specificity of the test and supports the hypothesis that disordered purine metabolism occurs in MADA deficiency.
The immunologic relationship of human neutrophil and skin collagenases
Authors: Hasty Karen A. , Stricklin George P. , Hibbs Margaret S. , Mainardi Carlo L. , Kang Andrew H.
Published: February 2007

An understanding of the immunologic relationships between collagenases of various cellular origins is necessary to define the roles of various cell types in the pathologic tissue destruction seen in chronic inflammatory diseases, such as rheumatoid arthritis. We compared the immunologic cross‐reactivity of human neutrophil and skin fibroblast collagenases, utilizing polyclonal antisera prepared to purified enzymes. Polyclonal antisera from rabbits immunized with neutrophil collagenase recognized fibroblast collagenase, as well as the neutrophil enzyme, when analyzed by immunoblot techniques. The cross‐reactive epitopes constituted a major proportion of the antibody population, as shown by competitive inhibition enzyme‐linked immunosorbent assay; 50% of the antibody to neutrophil collagenase was inhibited by skin collagenase. Paradoxically, antisera to fibroblast collagenase failed to recognize the neutrophil enzyme, either by immunoblot techniques or competitive inhibition enzyme‐linked immunosorbent assay, an observation which supports the notion that there are unique immunodominant epitopes. The cross‐reactivity with skin fibroblast collagenase shown by the neutrophil antibody suggests a conservation of epitopes between collagenases of different cellular origins. The presence of epitopes unique for each enzyme, however, could lead to a feasible approach for investigating the differential contribution of various cell types to collagenolytic activity in inflamed tissues.
Persistent synovial lymphocyte responses to cytomegalovirus antigen in some patients with rheumatoid arthritis
Authors: Ford Denys K. , Roza Doreen M. Da , Schulzer Michael , Reid Graham D. , Denegri Jorge F.
Published: February 2007

Synovial lymphocytes from 6 of 40 patients with rheumatoid arthritis responded to cytomegalovirus antigen stimulation. 3H‐thymidine uptakes were more than 3 times greater than were those of the responses to 13 other microbial antigens. Similar results were obtained in 1 patient on 7 occasions over 17 months, and in the 5 other patients on each of 2 occasions. In 3 of the 6 patients, synovial lymphocyte responses to cytomegalovirus antigen were markedly different from simultaneous peripheral blood lymphocyte responses.
Monoclonal autoantibody from a (new zealand black x new zealand white)F1 mouse and some human scleroderma sera target an MTr 34,000 nucleolar protein of the U3 RNP particle
Authors: Reimer G. , Pollard K. M. , Penning C. A. , Ochs R. L. , Lischwe M. A. , Busch H. , Tan E. M.
Published: February 2007

A monoclonal IgG2a antinucleolar autoantibody (72B9) was obtained by fusion of spleen cells from a (New Zealand black x New Zealand white)F1 mouse with myeloma cells (P3x63Ag8.653). Antibody 72B9 recognized a highly conserved nucleolar antigen present in both animal and plant cells. The staining pattern produced by antibody 72B9 in different cell substrates was identical with those obtained by scleroderma antibodies reactive with a basic (pi 8.5) nucleolar protein of Mr 34,000, which is associated with the U3 RNP particle. Western blotting further confirmed its reactivity with this scleroderma‐related U3 RNP protein.
Reaction of antipolynucleotide antibody from systemic lupus erythematosus patient serum with double‐stranded DNA complexed to protein
Authors: Faiferman Isidore , Koffler David
Published: February 2007

Antipolynucleotide antibody from systemic lupus erythematosus patient serum was found to interact with common determinants of double‐stranded DNA (dsDNA) complexed to protein within nucleosomes, and with protein‐free denatured DNA. In contrast, purified dsDNA isolated from nucleosomes manifested decreased reactivity with antipolynucleotide antibody. These data suggest that immunoassays using denatured DNA antigen substrate are useful for identifying a broad spectrum of antipolynucleotide antibodies that are reactive with dsDNA complexed to protein.
Inhibition of neutrophil‐mediated degradation of isolated basement membrane collagen by nonsteroidal antiinflammatory drugs that inhibit degranulation
Authors: Neal Teresa M. , Vissers Margret C. M. , Winterbourn Christine C.
Published: February 2007

The ability of nonsteroidal antiinflammatory drugs to inhibit neutrophil‐mediated degradation of type IV collagen in an in vitro tissue injury model using glomerular basement membrane (GBM) containing immune complexes was investigated. Auranofin (2.5–10 μM), phenylbutazone (50–250 μM), sulfasalazine (250–1,000 μM), and 4‐bromophenacyl bromide (5–20 μM) each inhibited up to 70% of the collagen degradation, in parallel with almost complete inhibition of the release of azurophil and specific granule enzymes. These drugs had much less an effect on gelatinase release. Indomethacin and the antimalarials, which inhibited the neutrophil oxidative burst but not degranulation, had little effect on GBM collagen degradation. Our results do not necessarily imply that inhibition of neutrophil‐mediated degradation of connective tissue is relevant to the action of nonsteroidal antiinflammatory drugs in vivo; however, using the GBM model system, we have shown that when a drug inhibits granule enzyme release, there is an associated decrease in collagen degradation, whereas inhibition of the oxidative burst has relatively little effect.
Computer‐based patient education for older persons with osteoarthritis
Authors: Rippey Robert M. , Bill Dee , Abeles Micha , Day John , Downing Deborah S. , Pfeiffer Carol A. , Thal Sara E. , Wetstone Scott L.
Published: February 2007

A program of 8 lessons on various aspects of osteoarthritis (OA), its treatment, and patient self‐care was prepared on an Apple IIc computer. The courses were then field‐tested and evaluated by 72 older (age range 52–88) OA patients in community centers for senior citizens. Statistical analysis of the findings showed significant increases in knowledge and significant self‐reported, beneficial behavior changes, including increased exercise, use of heat, and rest. Our findings demonstrate that older persons can use the computer to learn to cope with OA when a thoughtfully planned program is made available in a community setting.
Medical management of pneumococcal arthritis involving a knee prosthesis
Authors: Sublett Kevin L. , Katz Arnold L.
Published: February 2007

Septic arthritis involving prosthetic joints has been frequently reported, with Staphylococcus species being the pathogen most commonly noted. We report a case of septic arthritis of a prosthetic knee caused by Pneumococcus, a previously unreported pathogen in this condition, which uniquely responded to treatment with antibiotics.
Wegener's granulomatosis presenting with erosive arthritis
Authors: Jacobs Robert P. , Moore Marianne , Brower Anne
Published: February 2007

We describe a patient with Wegener's granulomatosis who presented with erosive arthritis. The patient's multisystem disease responded to cyclophosphamide treatment, and the erosions healed. Our findings suggest that Wegener's granulomatosis should be added to the differential diagnosis of diseases associated with erosive arthritis.
Complement C3b receptors on erythrocytes in patients with juvenile rheumatoid arthritis
Authors: Thomsen Bjarne S. , Heilmann Carsten , Jacobsen Svend E. H. , Pedersen Freddy K. , Morling Niels , Jakobsen Bodil K. , Svejgaard Arne , Nielsen Henrik
Published: February 2007

Forty patients with juvenile rheumatoid arthritis (JRA) were examined for C3b receptor (CR1) levels on erythrocytes (by an enzyme‐linked immunosorbent assay), levels of circulating immune complexes (IC) (by a polyethylene glycol precipitation–complement consumption method), C3d split products (by intermediate gel rocket immunoelectrophoresis), and HLA–A, B, and C (by microdroplet lymphocytotoxicity test). Lower CR1 levels were found predominantly among patients with JRA (mean 57%) compared with 40 age‐matched controls (mean 68%) (P = 0.008). The CR1 levels differed when the JRA patients were grouped by mode of disease onset and by clinical state at the time of testing (levels in patients with pauciarticular disease were higher than those in patients with polyarticular disease, and levels in patients with polyarticular disease were higher than those in patients with systemic disease) or by sex (girls had higher levels than boys; P = 0.01). The levels of circulating IC and C3d were elevated in 25% and 40% of JRA patients, respectively, and were mutually correlated (P < 0.05, τ = 0.20). A negative correlation was found between levels of C3d and the numbers of CR1 (P < 0.01, τ = ‐0.28), but concentrations of circulating IC did not correlate with CR1 values. CR1 levels were the same in 6 HLA–B27 positive and 25 HLA–B27 negative patients. These findings do not represent conclusive evidence that the number of CR1 on erythrocytes serves as a predictor of disease severity or as an indicator of disease activity in patients with JRA.
2,000‐Centigray total lymphoid irradiation for refractory rheumatoid arthritis
Authors: Trentham David E. , Belli James A. , Bloomer William D. , Anderson Ronald J. , Lane Heather , Reinherz Ellis L. , Austen K. Frank
Published: February 2007

Because toxicity with the use of 3,000 centiGray (cGy) of total lymphoid irradiation (TLI) was observed in an earlier study, 2,000‐cGy treatments were delivered in a 2‐portal format to 7 patients and in a modified 3‐portal fashion to 6 patients, as part of a randomized, investigator‐blinded trial of TLI treatment for refractory rheumatoid arthritis. Analysis of combined data from the 13 patients revealed statistically significant improvement in 5 clinical indicators of disease activity at the end of TLI and 6 and 12 months later, accompanied by T4‐specific immunosuppression. Management considerations resulted in the introduction of prednisone therapy in 5 patients, methotrexate in 4, and azathioprine in 1 during the interval of 8–12 months post‐TLI. Herpes zoster occurred in 5 patients prior to the initiation of this additional therapy. These data indicate that, in patients with rheumatoid arthritis, a TLI dose of 2,000 cGy is sufficient to produce measurable benefit that lasts for 6 months, and that the improvement can be maintained at 12 months by the use of prednisone and methotrexate.
Meclofenamate sodium monohydrate inhibits chemotactic factor–induced human polymorphonuclear leukocyte function. a possible explanation for its antiinflammatory effect
Authors: Perez H. Daniel , Elfman Fred , Marder Shelley
Published: February 2007

Meclofenamate sodium monohydrate (MSM), a potent nonsteroidal antiinflammatory agent, specifically inhibits chemotactic factor‐induced human polymorphonuclear leukocyte functions: chemotaxis, degranulation, and generation of superoxide anion radicals. These effects of MSM were found to be dependent upon the concentrations of drug not bound to albumin (free drug), and were caused by its ability to interfere at both a receptor and post‐receptor (i.e., a step distal to mobilization of polymorphonuclear leukocyte intracellular Ca2+) level. These unique actions of MSM may provide a partial explanation for its potent antiinflammatory effect.
Felty's syndrome: long‐term followup after treatment with auranofin
Authors: Bellelli Anna , Veneziani Maura , Tumiati Bruno
Published: February 2007

Five patients who had Felty's syndrome were treated with auranofin, 6 mg/day, for a period that ranged from 4 months to 2 years. All patients experienced both an improvement in articular symptoms and a normalization of the leukocyte count. Auranofin appears to be an effective treatment for Felty's syndrome, and to have a lower degree of toxicity than parenteral gold.
Increase in okm1 + granular lymphocytes in patients with rheumatoid arthritis
Authors: Cooper Sheldon M. , Roessner Karen , Ferriss John A. , Baigent Gregory , Bakke Antony C.
Published: February 2007

Patients with very active rheumatoid arthritis that was being treated only with nonsteroidal antiinflammatory drugs had increased numbers of peripheral blood OKM1 + lymphocytes. In 3 patients, 90° light scatter analysis revealed a double lymphocyte peak. When sorted, the high scatter peak contained a large percentage of granular lymphocytes. Patients with mild‐to‐moderately active rheumatoid arthritis had normal levels of OKM1 + lymphocytes, but when the drugs were discontinued, the activity of the disease and the numbers of OKM1 + cells increased. Administration of piroxicam was associated with clinical improvement and a decrease in levels of OKM1 + cells. OKM1 + granular lymphocytes are increased in some rheumatoid arthritis patients, and their numbers may correlate with clinical disease activity and/or therapy.
Avidity of anti‐yersinia antibodies in yersiniosis patients with and without yersinia‐triggered reactive arthritis
Authors: Lahesmaa‐Rantala Riitta , Lehtonen Olli‐Pekka , Granfors Kaisa , Toivanen Auli
Published: February 2007

Avidity of IgM, IgG, and IgA class anti‐Yersinia antibodies was compared in sera of 22 patients with yersiniosis and subsequent reactive arthritis versus sera of 22 patients without postinfection complications. An enzyme‐linked immunosorbent assay was used for antibody determination. Less than 2 months after onset of the infection, the patients with arthritis had fewer high‐avidity IgM antibodies against the bacterial lipopolysaccharide (P = 0.035) and more high‐avidity IgA antibodies against bacterial cell extract (P = 0.039) than did the patients without arthritis. This difference increased with time.
Subclinical lung inflammation in primary sjögren's syndrome. relationship between bronchoalveolar lavage cellular analysis findings and characteristics of the disease
Authors: Hatron Pierre‐Yves , Wallaert Benoît , Gosset Didier , Tonnel Andréa‐Bernard , Gosselin Bernard , Voisin Cyr , Devulder Bernard
Published: February 2007

To directly evaluate whether a subclinical alveolar inflammation is associated with primary Sjögren's syndrome (SS), we evaluated the distribution of cells obtained by bronchoalveolar lavage (BAL) from the lower respiratory tract in 29 patients who had primary SS, but who were free of clinical pulmonary symptoms and had normal findings on chest roentgenograms. There was no difference in total cell counts of specimens from patients versus those of controls. An abnormal differential cell count was noted in 16 patients (55%). Two patterns of alveolitis were observed: a pure lymphocyte alveolitis (>18% lymphocytes, present in 11 patients) and a neutrophil alveolitis (>4% neutrophils, present in 5 patients). There was associated lymphocytosis in 4 of the patients with neutrophil alveolitis. All patients had normal results on pulmonary function tests. Patients with abnormal BAL findings showed clinical and biologic indexes of more severe disease than did those with normal BAL results, as demonstrated by greater extraglandular extension of the disease, higher mean values of serum gamma globulins and serum β2‐microglobulin, and higher prevalence of rheumatoid factor and of antinuclear antibody. Thus, our data demonstrate that BAL permitted the detection of subclinical inflammatory alveolitis in 55% of our patients with primary SS. A long‐term followup is required to determine whether these patients will develop obvious pulmonary involvement.
The Autoimmune Antigen me is Distinct and Related to Undifferentiated Connective Tissue Disease
Authors: Treadwell Edward L. , Boak Andra M. , Kovacs SHIRLEY A. H. , Chen Jintao , Wang Richard J. , Sharp Gordon C. , Agris Paul F.
Published: February 2007

Using prototype Me serum, a new autoantibody‐antigen system has been identified by Ouchterlony immunodiffusion and indirect immunofluorescence. Although immunologically distinct, the Me antigen has physiochemical and biochemical properties similar to those of the Sm antigen. Immunoblot assays indicate that Me sera commonly recognize 4 peptides of molecular weights approximating 100K, 65K, 21K, and 16K. The last of these may be identical to the D peptide recognized by Sm antibodies. The Me antigen may be associated with the RNP‐Sm macromolecular complex. Me‐positive patients have few clinical symptoms, and the most common diagnosis is undifferentiated connective tissue disease.
Cloning of a complementary dna for rabbit proactivator. a metalloproteinase that activates synovial cell collagenase, shares homology with stromelysin and transin, and is coordinately regulated with collagenase
Authors: Fini M. Elizabeth , Karmilowicz Michael J. , Ruby Peggy L. , Beeman Anne M. , Borges Kimberly A. , Brinckerhoff Constance E.
Published: February 2007

Rabbit proactivator is a neutral metalloproteinase that activates another metalloproteinase, procollagenase, and degrades noncollagenous matrix. We describe the construction of an activator complementary DNA (cDNA) clone, which is 1.9 kb, that selects a 2.1‐kb messenger RNA (mRNA) in Northern blot hybridizations. Nucleic acid sequence studies of the activator cDNA indicate 1) that it encodes protein Mr 53,881, 2) that this protein exhibits ˜80% homology with rat transin, an oncogene‐induced protein with a previously unknown function, and 3) that, in the first 172 residues, it is virtually identical to the rabbit metalloproteinase, stromelysin. Homology between rabbit activator and human skin collagenase is approximately 50%. Activator and collagenase mRNA are coordinately regulated; untreated cultures of rabbit synovial fibroblasts produce low levels of each protein, but addition of phorbol myristate acetate (10–8M) results in an increase in mRNA for both proteins by 2.5–5 hours. Adding all‐trans‐retinoic acid (10–6M) or dexamethasone (10–7M) to phorbol‐stimulated cells coordinately suppresses both activator and collagenase mRNA. Our data suggest the existence of coordinately regulated metalloproteinases that are important in the modulation of connective tissue metabolism.
Imaging of experimental amyloidosis with 131i‐labeled serum amyloid p component
Authors: Caspi Dan , Zalzman Samuel , Baratz Mimi , Teitelbaum Zvi , Yaron Michael , Pras Mordechai , Baltz Marilyn L. , Pepys Mark B.
Published: February 2007

131I‐labeled human serum amyloid P component, which was injected into mice with experimentally induced systemic AA amyloidosis and into controls, became specifically localized and was retained in amyloidotic organs. In comparison, it was rapidly and completely eliminated from unaffected tissues and from control animals. Distinctive images of this amyloid‐specific deposition of labeled serum amyloid P component were derived from whole body scanning, in vivo, of amyloidotic mice. These findings suggest that such imaging may have applications for the diagnosis and quantitation of amyloid deposits in humans.
Connective tissue activation. xxxi. identification of two molecular forms of a human mesenchymal cell—derived growth factor, connective tissue activating peptide—V
Authors: Cabral A. R. , Castor C. W.
Published: February 2007

We previously identified, in normal urine, a growth factor that stimulated monolayer cultures of human synovial, cartilage, and dermal fibroblasts to synthesize incremental amounts of hyaluronic acid, proteoglycans, and DNA. An isolation procedure guided by bioassays and immunologic methods disclosed 2 anionic bioactive polypeptides with Mr of 28,000 and 16,000, respectively, as judged by single bands with sodium dodecyl sulfate—polyacrylamide gel electrophoresis in reduced and nonreduced samples. Rabbit antibodies raised against each purified protein were shown to react, on immunodiffusion and Western blot, with both antigens. Immunohistochemical and immunobinding studies detected the protein in normal human synovial, dermal, and cartilage fibroblasts and in human saphenous vein endothelial cells. The mesenchymal cell—derived growth factor is now designated connective tissue activating peptide—V (CTAP‐V). Monospecific polyclonal anti—CTAP‐V antibodies were used in a radial immunodiffusion assay for quantitative determination of the antigen in biologic fluids. In normal human plasma the concentration of CTAP‐V was below the limit of detection. The CTAP‐V concentration in normal urine was 4.5 ± 2.0 m̈g/ml, calculated from measurements of 5—18‐fold concentrated samples. Joint fluid from patients with rheumatic diseases and normal renal function had CTAP‐V levels similar to those found in plasma; 2—15‐fold increases were detected in plasma and joint fluid of patients with chronic renal failure. Immunodiffusion or dot‐blot analysis revealed a CTAP‐V—like material in the plasma or serum of 10 mammalian species. It was not detectable in 2 avian species.