http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2013 , Hindawi Publishing Corporation . All rights reserved. Wed, 15 May 2013 13:51:51 +0000 http://www.hindawi.com/journals/arth/2013/818037/ Introduction. To compare the diagnostic values of laboratory variables, to present evaluations of the diagnostic test for asymmetric dimethyl arginine (ADMA), rheumatoid factor (RF), C-reactive protein (CRP), and DAS28 index, and to define the effect of untreated rheumatoid arthritis on endothelial function. In order to determine whether ADMA changes depending on the disease evolution, ADMA was used as an indicator for endothelial dysfunction. Methods. Using an ELISA technology of DLD-Diagnostika-GMBH for the detection of ADMA, the samples of serum and urine have been examined in 70 participants (35 RA who were not treated, 35 healthy controls). RF was defined with the test for agglutination (Latex RF test) in the same participants. Results. Out of 35 examined patients with RA, RF appeared in 17 patients (sensitivity of the test, 51.42%). In 20 of the 35 examined patients with RA, we found the presence of ADMA (sensitivity of the test, 57.14%). Anti-CCP antibody was present in 24 examined patients with RA (sensitivity of the test, 68.57%). Conclusion. ADMA has equal or very similar sensitivity and specificity to RF in untreated RA (sensitivity of 57.14% versus 48.57%, specificity of 88.57% versus 91.42%) in the detection of asymptomatic endothelial dysfunction in untreated RA. Dejan Spasovski, Arif Latifi, Bashkim Osmani, Svetlana Krstevska-Balkanov, Irena Kafedizska, Maja Slaninka-Micevska, Beti Dejanova, Sonja Alabakovska, and Trajan Balkanov Copyright © 2013 Dejan Spasovski et al. All rights reserved. Tue, 14 May 2013 11:18:53 +0000 http://www.hindawi.com/journals/arth/2013/256493/ Juan-Manuel Anaya, Adriana Rojas-Villarraga, Rubén Darío Mantilla, and Claudio Galarza-Maldonado Copyright © 2013 Juan-Manuel Anaya et al. All rights reserved. Wed, 24 Apr 2013 16:12:18 +0000 http://www.hindawi.com/journals/arth/2013/517803/ Janice Lin, Manish Parikh, and Jonathan Samuels Copyright © 2013 Janice Lin et al. All rights reserved. Thu, 28 Mar 2013 13:56:40 +0000 http://www.hindawi.com/journals/arth/2013/878126/ Objectives. To investigate associations of selected single-nucleotide polymorphisms (SNPs) in ADAM12 gene with radiographic knee osteoarthritis (rKOA) in Estonian population. Methods. The rs3740199, rs1871054, rs1278279, and rs1044122 SNPs in ADAM12 gene were genotyped in 438 subjects (303 women) from population-based cohort, aged 32 to 57 (mean 45.4). The rKOA features were evaluated in the tibiofemoral joint (TFJ) and patellofemoral joint. Results. The early rKOA was found in 51.4% of investigated subjects (72% women) and 12.3% of participants (63% women) had advanced stage of diseases. The A allele of synonymous SNP rs1044122 was associated with early rKOA in TFJ, predominantly with the presence of osteophytes in females (OR 1.57; 95% CI 1.08–2.29, ). The C allele of intron polymorphism rs1871054 carried risk for advanced rKOA, mostly to osteophyte formation in TFJ in males (OR 3.03; 95% CI 1.11–7.53, ). Also the CCAA haplotype of ADAM12 was associated with osteophytosis, again mostly in TFJ in males (). For rs3740199 and rs1278279, no statistically significant associations were observed. Conclusion.  ADAM12 gene variants are related to rKOA risk during the early and late stages of diseases. The genetic risk seems to be predominantly associated with the appearance of osteophytes—a marker of bone remodelling and neochondrogenesis. Irina Kerna, Kalle Kisand, Ann E. Tamm, Jaanika Kumm, and Agu O. Tamm Copyright © 2013 Irina Kerna et al. All rights reserved. Mon, 25 Mar 2013 13:34:55 +0000 http://www.hindawi.com/journals/arth/2013/673401/ Gout is an ancient disease. Last decade has brought about significant advancement in imaging technology and real scientific growth in the understanding of the pathophysiology of gout, leading to the availability of multiple effective noninvasive diagnostic imaging options for gout and treatment options fighting inflammation and controlling urate levels. Despite this, gout is still being sub-optimally treated, often by nonspecialists. Increased awareness of optimal treatment options and an increasing role of ultrasound and dual energy computed tomography (DECT) in the diagnosis and management of gout are expected to transform the management of gout and limit its morbidity. DECT gives an accurate assessment of the distribution of the deposited monosodium urate (MSU) crystals in gout and quantifies them. The presence of a combination of the ultrasound findings of an effusion, tophus, erosion and the double contour sign in conjunction with clinical presentation may be able to obviate the need for intervention and joint aspiration in a certain case population for the diagnosis of gout. The purpose of this paper is to review imaging appearances of gout and its clinical applications. Gandikota Girish, David M. Melville, Gurjit S. Kaeley, Catherine J. Brandon, Janak R. Goyal, Jon A. Jacobson, and David A. Jamadar Copyright © 2013 Gandikota Girish et al. All rights reserved. Sun, 03 Mar 2013 17:15:20 +0000 http://www.hindawi.com/journals/arth/2013/689236/ Several biomechanics treatments for knee osteoarthritis (OA) have emerged with the goal of reducing pain and improving function. Through this, researchers have hoped to achieve a transition from the pathological gait patterns to coordinated motor responses. The purpose of the study was to determine the long-term effects of a therapy using a biomechanical device in patients with knee OA. Patients with knee OA were enrolled to active and control groups. The biomechanical device used in therapy (AposTherapy) was individually calibrated to each patient in the active group. Patients in the control group received standard treatment. Outcomes were the Western Ontario and McMaster Osteoarthritis Index (WOMAC), Aggregated Locomotor Function (ALF), Short Form 36 (SF-36), and Knee Society Score assessments. The active and control groups were similar at the baseline (group difference in all scores ). The active group showed a larger improvement over time between groups in all three WOMAC categories (, 21.7, and 18.1 for pain, stiffness, and function; all ), SF-36 Physical Scale (; ), Knee Society Knee Score (; ), and Knee Society Function Score (; ). At the two-year endpoint, the active group showed significantly better results (all ). The groups showed a difference of 4.9, 5.6, and 4.7 for the WOMAC pain, stiffness, and function scores, respectively, 10.8 s in ALF score, 30.5 in SF-36 Physical Scale, 16.9 in SF-36 Mental Scale, 17.8 in Knee Society Knee Score, and 25.2 in Knee Society Function Score. The biomechanical therapy examined was shown to significantly reduce pain and improve function and quality of life of patients with knee OA over the long term. Yaron Bar-Ziv, Eytan M. Debbi, Yuval Ran, Shaike Benedict, Nahum Halperin, and Yiftah Beer Copyright © 2013 Yaron Bar-Ziv et al. All rights reserved. Wed, 20 Feb 2013 11:03:08 +0000 http://www.hindawi.com/journals/arth/2013/631959/ Purpose. This study has researched the affect of different methodologies of harvesting and analysing the samples in determining the mediators emerging after the rat articular cartilage injury. Materials and Methods. One hundred and forty-four male wistar rats were divided into 2 groups. Synovial fluid samples were taken from all of the rats. We entered into the right knees of the rats in group I under anaesthesia and took cartilage tissue samples from their distal femur. Samples were taken as reference values for enzyme linked immunosorbent assay (ELISA) and histopathological evaluations. We entered into the right knees of the rats in group II and formed complete layer of cartilage injury in their medial femoral condyles. At the end of the 15th day, the rats were sacrificed after taking synovial fluid samples from their right knees creating defect in the rats in group II. The molecular markers in the synovial fluid and cartilage tissue samples which were taken from the experimental and control groups (MMP-9, MMP-13, TIMP-1, TNF-α, and NO) were analysed by direct or indirect methodologies. SPSS 18.0 Package program was used in the statistical evaluation. Students t-test where the measurement variables between the experimental and control groups were compared was applied. Receiver Operating Characteristics (ROC) curves were used in the determination of the diagnostic sufficiency from the tissue. Results. No difference was found between TIMP-1 and MMP-9 levels in synovial fluid and cartilage tissue. From the molecular markers, when MMP-9, MMP-13, NO, TIMP-1, TNF-α′, the area under ROC curve, and P values were examined, MMP-13 (, 95% CI: 0.70–0.85), NO (, 95% CI: 0.72–0.86), and TNF-α (, 95% CI: 0.91–0.98) results were found to be statistically significant. Inferences. The indirect ELISA protocol which we apply for the cartilage tissue as an alternative to synovial lavage fluid is a reliable method which can be used in the determination of articular cartilage injury markers. Ibrahim Yilmaz, Nevzat Selim Gokay, Rifat Bircan, Gamze V. Saracoglu, Sergulen Dervisoglu, and Alper Gokce Copyright © 2013 Ibrahim Yilmaz et al. All rights reserved. Thu, 14 Feb 2013 18:02:24 +0000 http://www.hindawi.com/journals/arth/2013/762921/ Background. Widespread pain from fibromyalgia syndrome (FMS) is observed in patients with psoriatic arthritis (PsA). We hypothesized that there is increased frequency of FMS in patients with PsA that contributes to fatigue and pain. Method. We prospectively enrolled patients with PsA based on the Classification criteria for Psoriatic Arthritis and healthy subjects were used as controls. The frequency of FMS was determined using London Fibromyalgia Epidemiologic Study Screening Questionnaire (LFESSQ) and Symptoms Intensity scale (SIs). Results. 34 PsA patients and 44 controls fulfilled the inclusion criteria. Median age of PsA patients was 52 years with 53.33% females. Median age of controls was 50.5 years with 59% females. FMS was present in 53.33% of PsA patients compared to 4.54% of the controls (), based on LFESSQ. 37.50% of PsA had FMS compared to 6.66% of controls () based on SIs. There was a significant correlation between LFESSQ and SIs in the psoriatic group (). 76.66% of PsA patients complained of fatigue compared to 40.90% of controls, but the mean fatigue score between the two groups was comparable (5.03 versus 5.18). Conclusion. FMS-associated pain and fatigue are significantly more frequent in patients with PsA compared to controls. Marina N. Magrey, Maria Antonelli, Neena James, and Muhammad Asim Khan Copyright © 2013 Marina N. Magrey et al. All rights reserved. Thu, 31 Jan 2013 08:28:33 +0000 http://www.hindawi.com/journals/arth/2013/487615/ Background. Primary osteoarthritis of the elbow is a debilitating disease with an overall incidence of about 2%. Pain and reduced motion (ROM) lead to disability and loss of functional independence. Purpose. To critically review the literature on patient-related important functional outcomes (pain, ROMs and functional recovery) after surgery for primary OA of the elbow, utilizing the 2011 OCEBM levels of evidence. Design. A literature synthesis. Results. Twenty-six articles satisfied the inclusion and exclusion criteria; 25 of the studies were at level IV evidence, and 1 at level III. All three surgical techniques led to improvement in pain, ROM, and functional recovery in the short- and medium-term follow-up. Long-term follow-up results, available only for open joint debridement, showed recurrence of osteoarthritic signs on X-ray with minimal loss of motion. Recently, there seems to be an increased focus on arthroscopic debridement. Conclusion. The quality of research addressing surgical interventions is very low, including total elbow arthroplasty (TEA). However, the evidence concurs that open and arthroscopic joint debridement can improve function in patients with moderate-to-severe OA of the elbow. TEA is reserved for treating severe joint destruction, mostly for elderly individuals with low physical demands when other intervention options have failed. Joshua I. Vincent, Anthony A. Vandervoort, and Joy C. MacDermid Copyright © 2013 Joshua I. Vincent et al. All rights reserved. Tue, 15 Jan 2013 10:05:46 +0000 http://www.hindawi.com/journals/arth/2013/563268/ Many musculoskeletal disorders (MDs) are associated with irreversible bone and cartilage damage; this is particularly true for osteoarthritis (OA). Therefore, a clinical need exists for modalities which can detect OA and other MDs at early stages. Optical coherence tomography (OCT) is an infrared-based imaging, currently FDA approved in cardiology and ophthalmology, which has a resolution greater than 10 microns and acquisition rate of 120 frames/second. It has shown feasibility for imaging early OA, identifying changes prior to cartilage thinning both in vitro and in vivo in patients and in OA animal models. In addition, OCT has shown an ability to identify early rheumatoid arthritis (RA) and guide tendon repair, but has the potential for an even greater impact. Clinical trials in OA are currently underway, as well as in several other MDs. Christopher Rashidifard, Christopher Vercollone, Scott Martin, Bin Liu, and Mark E. Brezinski Copyright © 2013 Christopher Rashidifard et al. All rights reserved. Thu, 10 Jan 2013 13:21:00 +0000 http://www.hindawi.com/journals/arth/2013/370231/ Osteoarthritis (OA) is the most frequent cause of disability in the USA, affecting up to 32.8% of patients over the age of sixty. Treatment of shoulder OA is often controversial and includes both nonoperative and surgical modalities. Nonoperative modalities should be utilized before operative treatment is considered, particularly for patients with mild-to-moderate OA or when pain and functional limitations are modest despite more advanced radiographic changes. If conservative options fail, surgical treatment should be considered. Although different surgical procedures are available, as in other joints affected by severe OA, the most effective treatment is joint arthroplasty. The aim of this work is to give an overview of the currently available treatments of shoulder OA. Claudio Chillemi and Vincenzo Franceschini Copyright © 2013 Claudio Chillemi and Vincenzo Franceschini. All rights reserved. Mon, 31 Dec 2012 20:02:33 +0000 http://www.hindawi.com/journals/arth/2012/560634/ Low-grade inflammation and oxidative stress underlie chronic osteoarthritis. Although best-practice guidelines for osteoarthritis emphasize self-management including weight control and exercise, the role of lifestyle behavior change to address chronic low-grade inflammation has not been a focus of first-line management. This paper synthesizes the literature that supports the idea in which the Western diet and inactivity are proinflammatory, whereas a plant-based diet and activity are anti-inflammatory, and that low-grade inflammation and oxidative stress underlying osteoarthritis often coexist with lifestyle-related risk factors and conditions. We provide evidence-informed recommendations on how lifestyle behavior change can be integrated into “first-line” osteoarthritis management through teamwork and targeted evidence-based interventions. Healthy living can be exploited to reduce inflammation, oxidative stress, and related pain and disability and improve patients’ overall health. This approach aligns with evidence-based best practice and holds the promise of eliminating or reducing chronic low-grade inflammation, attenuating disease progression, reducing weight, maximizing health by minimizing a patient’s risk or manifestations of other lifestyle-related conditions hallmarked by chronic low-grade inflammation, and reducing the need for medications and surgery. This approach provides an informed cost effective basis for prevention, potential reversal, and management of signs and symptoms of chronic osteoarthritis and has implications for research paradigms in osteoarthritis. Elizabeth Dean and Rasmus Gormsen Hansen Copyright © 2012 Elizabeth Dean and Rasmus Gormsen Hansen. All rights reserved. Mon, 31 Dec 2012 15:20:32 +0000 http://www.hindawi.com/journals/arth/2012/505842/ This study aimed at determining if synovial cell cultures from rheumatoid arthritis (RA), osteoarthritis (OA), and healthy controls (HC) differ and are suitable disease models in pharmacological studies, and tested their response to some anti-inflammatory drugs. Synovial cells were isolated from synovial membrane or joint fluid. Cells were cultivated and exposed to no or TNF-α stimulation without, or in the presence of, betamethasone, ibuprofen, or a standardized ginger extract. Concentrations of a panel of cytokines, growth factors, and chemokines were mapped for each culture and condition. Our cells secreted an increased amount of the cytokines IL-1β, IL-6, and IL-8 in response to TNF-α stimulation in all conditions. OA cells showed a higher IL-6 and IL-8 and a lower IL-1β production, when not stimulated, than RA and HC cells, which were similar. TNF-α stimulation caused similar IL-1β, IL-6, and IL-8 release in all groups. Ibuprofen showed no effect on cytokine production, while ginger extract was similar to betamethasone. Ginger extract was as effective an anti-inflammatory agent as betamethasone in this in vitro model. Cultured fibroblast-like synoviocytes from OA and RA subjects promise to be a useful pharmacological disease model, but further studies, to support results from such a model are needed. Søren Ribel-Madsen, Else Marie Bartels, Anders Stockmarr, Arne Borgwardt, Claus Cornett, Bente Danneskiold-Samsøe, and Henning Bliddal Copyright © 2012 Søren Ribel-Madsen et al. All rights reserved. Sun, 30 Dec 2012 18:38:06 +0000 http://www.hindawi.com/journals/arth/2012/648537/ Background. Besides its involvement in the cardiovascular system, the renin-angiotensin-aldosterone (RAS) system has also been suggested to play an important role in inflammation. To explore the role of this system in cartilage damage in arthritis, we investigated the expression of angiotensin II receptors in chondrocytes. Methods. Articular cartilage was obtained from patients with osteoarthritis, rheumatoid arthritis, and traumatic fractures who were undergoing arthroplasty. Chondrocytes were isolated and cultured in vitro with or without interleukin (IL-1). The expression of angiotensin II receptor types 1 (AT1R) and 2 (AT2R) mRNA by the chondrocytes was analyzed using reverse transcription-polymerase chain reaction (RT-PCR). AT1R expression in cartilage tissue was analyzed using immunohistochemistry. The effect of IL-1 on AT1R/AT2R expression in the chondrocytes was analyzed by quantitative PCR and flow cytometry. Results. Chondrocytes from all patient types expressed AT1R/AT2R mRNA, though considerable variation was found between samples. Immunohistochemical analysis confirmed AT1R expression at the protein level. Stimulation with IL-1 enhanced the expression of AT1R/AT2R mRNA in OA and RA chondrocytes. Conclusions. Human articular chondrocytes, at least partially, express angiotensin II receptors, and IL-1 stimulation induced AT1R/AT2R mRNA expression significantly. Yuki Kawakami, Kosuke Matsuo, Minako Murata, Kazuo Yudoh, Hiroshi Nakamura, Hiroyuki Shimizu, Moroe Beppu, Yutaka Inaba, Tomoyuki Saito, Tomohiro Kato, and Kayo Masuko Copyright © 2012 Yuki Kawakami et al. All rights reserved. Thu, 27 Dec 2012 09:10:27 +0000 http://www.hindawi.com/journals/arth/2012/764621/ Knee osteoarthritis remains a tremendous public health concern, both in terms of health-related quality of life and financial burden of disease. Translational research is a critical step towards understanding and mitigating the long-term effects of this disease process. Animal models provide practical and clinically relevant ways to study both the natural history and response to treatment of knee osteoarthritis. Many factors including size, cost, and method of inducing osteoarthritis are important considerations for choosing an appropriate animal model. Smaller animals are useful because of their ease of use and cost, while larger animals are advantageous because of their anatomical similarity to humans. This evidence-based review will compare and contrast several different animal models for knee osteoarthritis. Our goal is to inform the clinician about current research models, in order to facilitate the transfer of knowledge from the “bench” to the “bedside.” Martin H. Gregory, Nicholas Capito, Keiichi Kuroki, Aaron M. Stoker, James L. Cook, and Seth L. Sherman Copyright © 2012 Martin H. Gregory et al. All rights reserved. Wed, 19 Dec 2012 10:05:00 +0000 http://www.hindawi.com/journals/arth/2012/137635/ Objective. To assess the relationship between work productivity with disease activity, functional capacity, life quality and radiological damage in patients with rheumatoid arthritis (RA). Methods. The study included consecutive employed patients with RA (ACR'87), aged over 18. Demographic, disease-related, and work-related variables were determined. The reduction of work productivity was assessed by WPAI-RA. Results. 90 patients were evaluated, 71% women. Age average is 50 years old, DAS28 4, and RAQoL 12. Median SENS is 18 and HAQ-A 0.87. Mean absenteeism was of 14%, presenting an average of 6.30 work hours wasted weekly. The reduction in performance at work or assistance was of 38.4% and the waste of productivity was of 45%. Assistance correlated with DAS28 (r = 0.446; P < 0.001), HAQ-A (r = 0.545; P < 0.001) and RAQoL (r = 0.475; P < 0.001). Lower total productivity was noticed in higher levels of activity and functional disability. Patients with SENS > 18 showed lower work productivity than those with SENS < 18 (50 versus 34; ). In multiple regression analysis, variables associated with reduction of total work productivity were HAQ-A and RAQoL. Conclusion. RA patients with higher disease severity showed higher work productivity compromise. Rafael Chaparro del Moral, Oscar Luis Rillo, Luciana Casalla, Carolina Bru Morón, Gustavo Citera, José A. Maldonado Cocco, María de los Ángeles Correa, Emilio Buschiazzo, Natalia Tamborenea, Eduardo Mysler, Guillermo Tate, Andrea Baños, and Natalia Herscovich Copyright © 2012 Rafael Chaparro del Moral et al. All rights reserved. Mon, 03 Dec 2012 19:15:20 +0000 http://www.hindawi.com/journals/arth/2012/601763/ Nontraumatic osteonecrosis continues to be a challenging problem causing debilitating major joint diseases. The etiology is multifactorial, but steroid- and alcohol-induced osteonecrosis contribute to more than two thirds of all cases with genetic risk factors playing an important role in many other cases, especially when they contribute to hypercoagulable states. While the exact mechanisms remain elusive, many new insights have emerged from research in the last decade that have given us a clearer picture of the pathogenesis of nontraumatic osteonecrosis of the femoral head. Progression to end stage osteonecrosis of the femoral head appears to be related to four main factors: interactions involving the differentiation pathway of osteoprogenitor cells that promote adipogenesis, decreased angiogenesis, direct suppression of osteogenic gene expression and proliferation of bone marrow stem cells, and genetic anomalies or other diseases that promote hypercoagulable states. Jesse Seamon, Thomas Keller, Jamal Saleh, and Quanjun Cui Copyright © 2012 Jesse Seamon et al. All rights reserved. Mon, 03 Dec 2012 08:47:09 +0000 http://www.hindawi.com/journals/arth/2012/504189/ Studies have shown that osteoarthritis (OA) is highly associated with obesity, and individuals clinically defined as obese (BMI > 30.0 kg/m2) are four times more likely to have knee OA over the general population. The purpose of this research was to examine if isolated weight loss improved knee symptoms in patients with osteoarthritis. Adult patients (; age 18–70; BMI > 35 kg/m2) with clinical and radiographic evidence of knee OA participated in a one-year trial in which WOMAC and KOOS surveys were administered at a presurgery baseline and six and twelve months postsurgery. Statistical analysis was performed using Student's and Wilcoxon Signed Rank tests. Weight loss six and twelve months following bariatric surgery was statistically significant compared to presurgery measurements. All variables from both KOOS and WOMAC assessments were significantly improved when compared to baseline. Isolated weight loss occurring via bariatric surgery resulted in statistically significant improvement in patient’s knee arthritis symptoms at both six and twelve months. Further research will need to be done to determine if symptom relief continues over time, and if the benefits are also applicable to individuals with symptomatic knee arthritis that are overweight but not obese. Christopher Edwards, Ann Rogers, Scott Lynch, Tamara Pylawka, Matthew Silvis, Vernon Chinchilli, Timothy Mosher, and Kevin Black Copyright © 2012 Christopher Edwards et al. All rights reserved. Mon, 19 Nov 2012 10:38:40 +0000 http://www.hindawi.com/journals/arth/2012/984060/ Objectives. The aim of this study was to investigate the relationships between pain, disability, and radiographic findings in patients with knee osteoarthritis (OA). Patients and Methods. A total of 114 patients with knee OA who attended the physical medicine and rehabilitation outpatient clinic were included in this study. The diagnosis was based on the American College of Rheumatology (ACR) criteria for knee OA. Age, duration of disease, and body mass index (BMI) of the patients were recorded. Radiographic features on the two-sided knee radiography were assessed with the Kellgren-Lawrence scale. The severity of knee pain, stiffness, and disability were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC). Results. The mean age of the patients was 56.98 (±8.28) years and the mean disease duration was 4.14 (±4.15) years. Kellgren-Lawrence grading scale and age or disease duration were positively and significantly associated, whereas none of the WOMAC subscores were found to be related with Kellgren-Lawrence grading scale (). On the other hand, WOMAC disability scores were significantly associated with WOMAC pain and WOMAC stiffness (). Conclusions. Knee pain, stiffness, and duration of disease may affect the level of disability in the patients with knee OA. Therefore treatment of knee OA could be planned according to the clinical features and functional status instead of radiological findings. Duygu Cubukcu, Ayse Sarsan, and Hakan Alkan Copyright © 2012 Duygu Cubukcu et al. All rights reserved. Sun, 18 Nov 2012 08:21:23 +0000 http://www.hindawi.com/journals/arth/2012/864907/ Objective. To determine the prevalence and impact of autoimmune thyroid disease (AITD) in patients with rheumatoid arthritis (RA). Methods. Eight-hundred patients were included. The association between AITD and RA was analyzed was analyzed by bivariate and multivariate analysis. In addition, a literature review was done focusing on geographical variations. Results. In our cohort the prevalence of AITD was 9.8% while the presence of antibodies was 37.8% for antithyroperoxidase enzyme (TPOAb) and 20.8% for antithyroglobulin protein (TgAb). The presence of type 2 diabetes, thrombosis, abnormal body mass index, and a high educational level was positively associated with AITD. The literature review disclosed a geographical variation of AITD in RA ranging from 0.5% to 27%. Autoantibody prevalence ranges from 6% to 31% for TgAb, 5% to 37% for TPOAb, and from 11.4% to 32% for the presence of either of the two. Conclusion. AITD is not uncommon in RA and should be systematically assessed since it is a risk factor for developing diabetes and cardiovascular disease. These results may help to further study the common mechanisms of autoimmune diseases, to improve patients’ outcome, and to define public health policies. An international consensus to accurately diagnose AITD is warranted. Jorge Cárdenas Roldán, Jenny Amaya-Amaya, Juan Castellanos-de la Hoz, Juliana Giraldo-Villamil, Gladys Montoya-Ortiz, Paola Cruz-Tapias, Adriana Rojas-Villarraga, Rubén D. Mantilla, and Juan-Manuel Anaya Copyright © 2012 Jorge Cárdenas Roldán et al. All rights reserved. Wed, 14 Nov 2012 11:40:46 +0000 http://www.hindawi.com/journals/arth/2012/670579/ Rheumatoid arthritis (RA) is a common autoimmune disease that affects all ethnic groups. Genetic factors, mainly HLA alleles, are highly associated with increased risk to develop RA. However, there are few available data about the role of these genetic polymorphisms in the prevalence or severity of RA in the Afrodescendant population, who have evolutionarily and by natural selection developed mutations that allowed them to acquire resistance to infectious diseases like malaria. Some of the mechanisms, by which this resistance was developed as a product of natural selection, are involved in different forms of immunological response, many of them of a well-known importance in the pathophysiology of RA. This paper focuses on presenting the known mechanisms of resistance to malaria and their possible contribution to the pathophysiology of RA, including “loss-of-function” mutations, lack of expression of chemokine receptors, decrease of immune complexes clearance by asplenia, or increase of immune reactivity mediated by B cells, among other mechanisms in this special group of patients. Fabio Bonilla-Abadía, Gabriel J. Tobón, and Carlos A. Cañas Copyright © 2012 Fabio Bonilla-Abadía et al. All rights reserved. Tue, 13 Nov 2012 13:41:38 +0000 http://www.hindawi.com/journals/arth/2012/176298/ Psoriatic arthritis is a debilitating condition, which affects approximately one-quarter of psoriasis patients. Recent findings have furthered our understanding of the complex pathophysiology of PsA. There have been major advances in the identification of genes associated with joint involvement but not with cutaneous disease alone. The elucidation of key immunologic pathways has allowed the development of novel targeted therapies that are in the research pipeline. Currently, good screening tests and biomarkers to diagnose early PsA and to guide therapy are limited. In this paper, we present recent findings with regard to the immunopathogenesis and genetics of PsA, biomarkers, and screening tools and review the targeted therapies currently in clinical trials. Peter Lloyd, Caitriona Ryan, and Alan Menter Copyright © 2012 Peter Lloyd et al. All rights reserved. Wed, 07 Nov 2012 11:32:17 +0000 http://www.hindawi.com/journals/arth/2012/239310/ Rheumatoid arthritis (RA) is a chronic, autoimmune, and complex inflammatory disease leading to bone and cartilage destruction, whose cause remains obscure. Accumulation of genetic susceptibility, environmental factors, and dysregulated immune responses are necessary for mounting this self-reacting disease. Inflamed joints are infiltrated by a heterogeneous population of cellular and soluble mediators of the immune system, such as T cells, B cells, macrophages, cytokines, and prostaglandins (PGs). Prostaglandins are lipid inflammatory mediators derived from the arachidonic acid by multienzymatic reactions. They both sustain homeostatic mechanisms and mediate pathogenic processes, including the inflammatory reaction. They play both beneficial and harmful roles during inflammation, according to their site of action and the etiology of the inflammatory response. With respect to the role of PGs in inflammation, they can be effective mediators in the pathophysiology of RA. Thus the use of agonists or antagonists of PG receptors may be considered as a new therapeutic protocol in RA. In this paper, we try to elucidate the role of PGs in the immunopathology of RA. Mohammad Javad Fattahi and Abbas Mirshafiey Copyright © 2012 Mohammad Javad Fattahi and Abbas Mirshafiey. All rights reserved. Wed, 31 Oct 2012 14:09:52 +0000 http://www.hindawi.com/journals/arth/2012/371909/ Background. Cardiovascular disease (CVD) is the major predictor of poor prognosis in rheumatoid arthritis (RA) patients. There is an increasing interest to identify “nontraditional” risk factors for this condition. Latin Americans (LA) are considered as a minority subpopulation and ethnically different due to admixture characteristics. To date, there are no systematic reviews of the literature published in LA and the Caribbean about CVD in RA patients. Methods. The systematic literature review was done by two blinded reviewers who independently assessed studies for eligibility. The search was completed through PubMed, LILACS, SciELO, and Virtual Health Library scientific databases. Results. The search retrieved 10,083 potential studies. A total of 16 articles concerning cardiovascular risk factors and measurement of any cardiovascular outcome in LA were included. The prevalence of CVD in LA patients with RA was 35.3%. Non-traditional risk factors associated to CVD in this population were HLA-DRB1 shared epitope alleles, rheumatoid factor, markers of chronic inflammation, long duration of RA, steroids, familial autoimmunity, and thrombogenic factors. Conclusions. There is limited data about CVD and RA in LA. We propose to evaluate cardiovascular risk factors comprehensively in the Latin RA patient and to generate specific public health policies in order to diminish morbi-mortality rates. Juan Camilo Sarmiento-Monroy, Jenny Amaya-Amaya, Juan Sebastián Espinosa-Serna, Catalina Herrera-Díaz, Juan-Manuel Anaya, and Adriana Rojas-Villarraga Copyright © 2012 Juan Camilo Sarmiento-Monroy et al. All rights reserved. Wed, 24 Oct 2012 11:57:59 +0000 http://www.hindawi.com/journals/arth/2012/805875/ Rheumatoid arthritis (RA) is a common autoimmune disease and a systemic inflammatory disease which is characterized by chronic joint inflammation and variable degrees of bone and cartilage erosion and hyperplasia of synovial tissues. Considering the role of autoreactive T cells (particularly Th1 and Th17 cells) in pathophysiology of RA, it might be assumed that the regulatory T cells (Tregs) will be able to control the initiation and progression of disease. The frequency, function, and properties of various subsets of Tregs including natural Tregs (nTregs), IL-10-producing type 1 Tregs (Tr1 cells), TGF-β-producing Th3 cells, CD8+ Tregs, and NKT regulatory cells have been investigated in various studies associated with RA and collagen-induced arthritis (CIA) as experimental model of this disease. In this paper, we intend to submit the comprehensive information about the immunobiology of various subsets of Tregs and their roles and function in immunopathophysiology of RA and its animal model, CIA. Maryam Gol-Ara, Farhad Jadidi-Niaragh, Reza Sadria, Gholamreza Azizi, and Abbas Mirshafiey Copyright © 2012 Maryam Gol-Ara et al. All rights reserved. Wed, 24 Oct 2012 09:29:30 +0000 http://www.hindawi.com/journals/arth/2012/391567/ Primary biliary cirrhosis (PBC) is a progressive cholestatic liver disease characterized serologically by cholestasis and the presence of high-titre antimitochondrial antibodies and histologically by chronic nonsuppurative cholangitis and granulomata. PBC patients often have concomitant autoimmune diseases, including arthropathies. This raises the question as to whether there are shared features in the pathogenesis of those diseases with the pathogenesis of PBC. Epidemiological and large case studies have indicated that although the incidence of rheumatoid arthritis (RA) is not significantly raised in PBC patients, there appears to be a higher rate of RA in PBC patients and their relatives. Genetic studies have demonstrated that several genes implicated in PBC have also been implicated in RA. Epigenetic studies provided a wealth of data regarding RA, but the findings on epigenetic changes in PBC are very limited. As well, certain infectious agents identified in the pathogenesis of PBC may also play a role in the pathogenesis of RA. These data suggest that although RA is not significantly present in PBC, some individuals with certain genetic traits and environmental exposures may develop both conditions. This concept may also apply to other concomitant diseases found in PBC patients. Daniel S. Smyk, Dimitrios P. Bogdanos, Maria G. Mytilinaiou, Andrew K. Burroughs, and Eirini I. Rigopoulou Copyright © 2012 Daniel S. Smyk et al. All rights reserved. Tue, 23 Oct 2012 09:26:55 +0000 http://www.hindawi.com/journals/arth/2012/713618/ Psoriatic arthritis (PsA) is a clinical manifestation of psoriatic disease. Although the pathogenesis of PsA remains unknown, PsA can be managed by treatments similar to those used for rheumatoid arthritis (RA). Because interleukin-(IL-) 6 has been suggested to have a pathogenic role in PsA, a humanized anti-IL-6 receptor antibody tocilizumab treatment for PsA was recently tried. However, the efficacy of tocilizumab for PsA was not favorable. This suggests that the pathogenic roles of IL-6 in PsA and RA are different. In RA, tumor necrosis factor (TNF) primarily contributes to the arthritis effector phase and IL-6 contributes to the arthritis priming phase. In PsA, the TNF-related effector phase is similar to that in RA, but the IL-6-related priming phase might not be critical. This paper discusses the role of IL-6 in PsA. Atsushi Ogata, Atsushi Kumanogoh, and Toshio Tanaka Copyright © 2012 Atsushi Ogata et al. All rights reserved. Thu, 18 Oct 2012 11:47:30 +0000 http://www.hindawi.com/journals/arth/2012/604187/ Silicon is one of the most common chemicals on earth. Several compounds such as silica, asbestos, silicone or, nanoparticles are built from tetrahedral units with silicon as the central atom. Despite these, structural similarities, they have rarely been analyzed as a group. These compounds generate significant biological alterations that include immune hyperactivation, production of the reactive species of oxygen and tissue injury. These pathological processes may trigger autoimmune responses and lead to the development of rheumatoid arthritis. Populations at risk include those that constantly work in industrial process, mining, and agriculture as well as those that undergo silicone implants. Herein a review on the main features of these compounds and how they may induce autoimmune responses is presented. Cesar A. Speck-Hernandez and Gladis Montoya-Ortiz Copyright © 2012 Cesar A. Speck-Hernandez and Gladis Montoya-Ortiz. All rights reserved. Wed, 17 Oct 2012 08:35:40 +0000 http://www.hindawi.com/journals/arth/2012/185208/ This study retrospectively analysed the effects of obesity as described by Body Mass Index (BMI) on patient reported outcomes following total knee replacement. Participants (105 females and 66 males) who had undergone surgery under the care of a single surgeon were included in the review and were grouped according to their preoperative BMI into nonobese ( kg/m2), () obese ( kg/m2) (). Oxford Knee Score (OKS) and Short Form 12 scores (SF12) were taken preoperatively and 6 and 12 months after surgery to analyse differences between groups in the absolute scores as well as changes from before to after surgery. Preoperatively, the obese group had a significantly poorer OKS compared to non obese (44.7 versus 41.2, ). There were no statistically significant group effects on follow-up or change scores of the OKS and SF12. Correlations coefficients between BMI and follow-up and change scores were low (). There were no significant differences in the number of complications and revisions (local wound infection, 6.7% non obese, 11% obese, postoperative systemic complication, 8% non obese, 12% obese, revision, 4% nonobese, 3% obese). In conclusion, our findings indicate similar degrees of benefits from the surgery irrespective of patient BMI. Vandana Ayyar, Richard Burnett, Fiona J. Coutts, Marietta L. van der Linden, and Thomas H. Mercer Copyright © 2012 Vandana Ayyar et al. All rights reserved. Tue, 02 Oct 2012 11:06:01 +0000 http://www.hindawi.com/journals/arth/2012/698709/ Aims. To examine all relevant literature on the economic costs of osteoarthritis in the UK, and to compare such costs globally. Methods. A search of MEDLINE was performed. The search was expanded beyond peer-reviewed journals into publications by the department of health, national orthopaedic associations, national authorities and registries, and arthritis charities. Results. No UK studies were identified in the literature search. 3 European, 6 North American, and 2 Asian studies were reviewed. Significant variation in direct and indirect costs were seen in these studies. Costs for topical and oral NSAIDs were estimated to be £19.2 million and £25.65 million, respectively. Cost of hip and knee replacements was estimated to exceed £850 million, arthroscopic surgery for osteoarthritis was estimated to be £1.34 million. Indirect costs from OA caused a loss of economic production over £3.2 billion, £43 million was spent on community services and £215 million on social services for osteoarthritis. Conclusions. While estimates of economic costs can be made using information from non-published data, there remains a lack of original research looking at the direct or indirect costs of osteoarthritis in the UK. Differing methodology in calculating costs from overseas studies makes direct comparison with the UK difficult. A. Chen, C. Gupte, K. Akhtar, P. Smith, and J. Cobb Copyright © 2012 A. Chen et al. All rights reserved.