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Abstract Background This study aimed to assess the association between social factors, demographic parameters, and disease activity among rheumatoid arthritis (RA) patients. Methods The University of Pittsburgh Rheumatoid Arthritis Comparative Effectiveness Research (RACER) registry was used for this study and included patients meeting 1987 ACR criteria for RA enrolled between 2010–2015. The registry collected clinical and laboratory data at each visit, permitting the calculation of disease activity measures that included Disease Activity 28-C Reactive Protein (DAS28-CRP). The current study was conducted as a cross-sectional study in which baseline data were used to construct multiple logistic regression models assessing the relationship between disease activity measures (DAS28-CRP), functional capacity (health assessment questionnaire (HAQ)), selected demographic and social factors (occupation, education, income, marital status, race, gender, age, and BMI), and clinical/laboratory variables. Results The analyses included 729 patients with baseline DAS28-CRP and social/demographic data. The mean age at enrollment was 59.5 (Standard Deviation (SD) = 12.7) years, 78% were female, and the median RA disease duration was 9.8 (Interquartile Range (IQR): 3.7, 19.1) years. We dichotomized the DAS28-CRP score and defined scores above or below 3.1 as high versus low RA disease activity. Most patients with high RA disease activity (N = 326, 45%) had less than a college degree (70%), were not working/retired/disabled (71%), and had an annual income under $50 K (55%). We found that higher body mass index (BMI) (Odds Ratio (OR) = 1.04, 95% CI: 1.01—1.08), longer disease duration (> 2 and

Objectives: To investigate an optimal composite score for disease activity in adult JIA from the viewpoint of the subsequent changes in physical function. Methods: Patients with JIA under the following conditions were enrolled: 1) disease onset < 18 years; 2) registered in the database by Tokyo Women’s Medical University for the first time between 2000 and 2020; and 3) ≥18 years old at the time of registration. Patients were stratified according to mean disease activity scores in SDAI, DAS28, and JADAS-27 during the first year from baseline. Trends of estimated mean change in Japanese-HAQ score ( ΔJ-HAQ) from baseline to 2 years later was examined across the stratified groups of each index. Results: We included 294 eligible individuals (median age at onset, 14.0 years; RF positive in 64.7%). A significant increasing trend of the estimated mean ΔJ-HAQ at 2 years after baseline was observed along with an increase in the mean disease activity during the first year measured using DAS28 (푝 = 0.01) and SDAI (푝 = 0.018), but not using JADAS-27. Conclusions: Disease activity measured using SDAI and DAS28, but not using JADAS27, was significantly associated with subsequent changes in physical function in adult patients with JIA. [ABSTRACT FROM AUTHOR]

Abstract Background We conducted a single-center cohort study of rheumatoid arthritis (RA) patients from 2011 to 2020 to understand their real world treatment and outcomes, especially changes in physical function and quality of life (QOL) in elderly patients, including those aged ≥ 80 years. Methods For RA patients attending our outpatient clinic, we annually recorded tender and swollen joint counts, laboratory findings, therapeutic drugs, and scores from the Japanese Health Assessment Questionnaire and EuroQoL-5 Dimensions questionnaire. We examined changes in treatment and outcomes over time, by age group, in patients enrolled over a 10-year period, from 2011 to 2020. Results One thousand eight hundred thirty RA patients were enrolled and data were recorded once a year, and a total of 9299 patient records were evaluated. The average age of patients increased by 3.7 years during the study period; the patients aged rapidly. Intensive pharmacological treatment was more frequent in younger patients. Disease activity, physical function, and QOL showed improvement in all age groups over the study period. Physical function and QOL showed greater changes with aging, compared with disease activity. This may be due to the effects of accumulated RA damage, disability due to aging, and depression. Conclusions Intensive pharmacological treatment contributes to not only control of disease activity but also the improvement of physical activity and QOL, even in elderly patients. Relieving age-related physical impairment and depression may improve the QOL of very elderly RA patients.

Abstract Background and objective To identify the clinical patterns and consequences of post-chikungunya arthritis was the study's objective. Methods This longitudinal study was carried out among 143 Chikungunya virus (CHIKV) infected adult patients at the rheumatology department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during the outbreak of CHIKV infection in 2017. The disease was categorized into three phases: acute or febrile (lasting up to 10 days), subacute (11–90 days), and chronic (> 90 days). Patients who progressed towards the chronic phase were followed up to 1-year. Post-CHIKV de novo chronic inflammatory rheumatisms (CIRs) were characterized by persistent mono or oligoarthritis, undifferentiated polyarthritis, or meet the criteria rheumatoid arthritis (RA) or Spondyloarthritis (SpA). In addition, functional status was assessed by the validated Bangla version of the Health Assessment Questionnaire (HAQ). Results Mean age was 43.3 ± 11.5 years, and 51.0% were male. Within 1-year follow-up, 60 (41.9%) patients were suffering from arthralgia/ arthritis. Of them 52 patients did not have any pre-existing arthralgia/arthritis. 35 (65.3%) had undifferentiated arthritis, 10 (19.2%) had SpA, and 7 (13.5%) had RA. Patients with pre-existing rheumatological disorders, 6(4.2%) had SpA, 1(0.7%) had RA and 1(0.7%) had osteoarthritis. Polyarthralgia (n = 33, 55.0%) and polyarthritis (n = 20, 33.3%) were the main presentations. Female gender (OR: 0.45; CI: 0.21–0.96), positive IgG (OR: 0.30; CI: 0.12–0.76), and moderate to severe functional disability (OR: 3.46; CI: 1.62–7.40) were independent predictors of developing chronic post-CHIKV rheumatism. Conclusions At 1-year follow-up, more than one-third of the patients remained symptomatic. Female gender, positive IgG, and moderate to severe functional disability contributed to the development of chronicity.

Background and objective: To identify the clinical patterns and consequences of post-chikungunya arthritis was the study's objective. Methods: This longitudinal study was carried out among 143 Chikungunya virus (CHIKV) infected adult patients at the rheumatology department, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh, during the outbreak of CHIKV infection in 2017. The disease was categorized into three phases: acute or febrile (lasting up to 10 days), subacute (11–90 days), and chronic (> 90 days). Patients who progressed towards the chronic phase were followed up to 1-year. Post-CHIKV de novo chronic inflammatory rheumatisms (CIRs) were characterized by persistent mono or oligoarthritis, undifferentiated polyarthritis, or meet the criteria rheumatoid arthritis (RA) or Spondyloarthritis (SpA). In addition, functional status was assessed by the validated Bangla version of the Health Assessment Questionnaire (HAQ). Results: Mean age was 43.3 ± 11.5 years, and 51.0% were male. Within 1-year follow-up, 60 (41.9%) patients were suffering from arthralgia/ arthritis. Of them 52 patients did not have any pre-existing arthralgia/arthritis. 35 (65.3%) had undifferentiated arthritis, 10 (19.2%) had SpA, and 7 (13.5%) had RA. Patients with pre-existing rheumatological disorders, 6(4.2%) had SpA, 1(0.7%) had RA and 1(0.7%) had osteoarthritis. Polyarthralgia (n = 33, 55.0%) and polyarthritis (n = 20, 33.3%) were the main presentations. Female gender (OR: 0.45; CI: 0.21–0.96), positive IgG (OR: 0.30; CI: 0.12–0.76), and moderate to severe functional disability (OR: 3.46; CI: 1.62–7.40) were independent predictors of developing chronic post-CHIKV rheumatism. Conclusions: At 1-year follow-up, more than one-third of the patients remained symptomatic. Female gender, positive IgG, and moderate to severe functional disability contributed to the development of chronicity. [ABSTRACT FROM AUTHOR]

Aim: Nitric oxide (NO) is a molecule known to play a role in many physiological and pathological events in the body. It is thought to play an active role in inflammation. Rheumatoid arthritis (RA) is the most common chronic inflammatory autoimmune disease worldwide. In this study, we aimed to evaluate the serum NO levels of RA patients and their relation with parameters that are indicators of disease activity. Material and Method: Thirty patients with RA (7 males/ 23 females, mean age 48.80±7.88 years old) and 30 healthy control groups were included in the study. Both groups were compared with erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), rheumatoid factor (RF), anti cyclic citrullinated peptide antibody (anti CCP) and serum NO levels and clinically with Visual Analog Scale (VAS), Disease Activity Score-28 (DAS-28) and Health Assessment Questionnaire (HAQ) scales. Results: ESR, CRP and NO levels in the patient group were significantly higher than the control group (p 3.2, inactive disease DAS-28

Aim of the work To assess the impact of metabolic syndrome (MetS) on the pattern and clinical presentation of rheumatoid arthritis (RA), and its relation to disease activity and functional status of the patients. Patients and Methods Sixty RA patients were equally grouped into those with MetS (group A) and those without (group B). The disease activity score (DAS-28) was assessed and functional status was measured using health assessment questionnaire (HAQ). Results The 30 patients with MetS had a mean age of 46.3 ± 9.9 years (27–66 years), disease duration of 5 (3–10) years and the 30 without were of matched age and sex. Joint deformities were detected in 8 patients (26.7%) in group A and in 10 patients (33.3%) in group B. While bone erosions were in 6 (20%) in group A, and 7 (23.3%) in group B. As regards the functional capacity; it was found to be more impaired in patients with MetS shown by the significantly higher HAQ in group A than group B (p = 0.007). While no significant differences were detected regarding the DAS28 and visual analogue scale (VAS)(p = 0.26 and 0.13 respectively). In patients with MetS (group A), body weight and waist circumference were significantly increased in those with an increased frequency of joint deformities (p = 0.047 and p = 0.018 respectively). A significant correlation was found between fasting blood glucose and both joint deformities and erosions (p = 0.016 and p = 0.004 respectively). Conclusion MetS might have a negative impact on RA disease activity and functional status. Regular screening for MetS in RA patients is recommended. [ABSTRACT FROM AUTHOR]

Objectives: To investigate an optimal composite score for disease activity in adult JIA from the viewpoint of the subsequent changes in physical function., Methods: Patients with JIA under the following conditions were enrolled: 1) disease onset < 18 years; 2) registered in the database by Tokyo Women's Medical University for the first time between 2000 and 2020; and 3) ≥18 years old at the time of registration. Patients were stratified according to mean disease activity scores in SDAI, DAS28, and JADAS-27 during the first year from baseline. Trends of estimated mean change in Japanese-HAQ score (ΔJ-HAQ) from baseline to 2 years later was examined across the stratified groups of each index., Results: We included 294 eligible individuals (median age at onset, 14.0 years; RF positive in 64.7%). A significant increasing trend of the estimated mean ΔJ-HAQ at 2 years after baseline was observed along with an increase in the mean disease activity during the first year measured using DAS28 (p = 0.01) and SDAI (p = 0.018), but not using JADAS-27., Conclusions: Disease activity measured using SDAI and DAS28, but not using JADAS27, was significantly associated with subsequent changes in physical function in adult patients with JIA., (© Japan College of Rheumatology 2022. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.)

BACKGROUND: The clinical disease activity index (CDAI) with 28 joint counts measures the activity of rheumatoid arthritis (RA) without laboratory tests. OBJECTIVE: To evaluate the CDAI in daily practice in RA patients at one year of the symptoms onset. MATERIAL AND METHOD: A prospective study was done with 120 consecutive patients with early RA ≤ 12 months (101 women, 19 men) seen in the rheumatology consult within 1 year of symptoms onset. The CDAI was divided into four categories: high or severe activity >22, moderate >10-22, mild <10 and remission ≤2.8. Functional disability (HAQ, health assessment questionnaire, 0-3 score) was also evaluated. A combination of methotrexate and sulfasalazine or chloroquine and low-dose prednisone 2.5-5.0 mg/d was administered. RESULTS: At baseline, 88 (73%) patients had high activity and 32 (27%) had moderate-mild activity. At 6 months 3% had high activity, whereas 96 (80%) were in remission (median 0, range 0-2.6). At 12 months, 110 patients (91%) were in remission and 6 (5%) had mild activity. The median score of HAQ was 1.4 (range 0.5-3.0) and at 12 months was 0 (range 0-1.2) There was a good correlation between HAQ and CDAI. CONCLUSION: The CDAI score is a clinical tool that omits laboratory tests. Remission, defined as a CDAI ≤2.8 was achieved so early as 6 months. This study also showed improvement in functional ability. [ABSTRACT FROM AUTHOR]

Background Programmed cell death-1 (PD-1) is an immunoreceptor that negatively regulates antigen receptor signaling and plays a critical role in the immunoregulation of autoimmune diseases. Aim of the work This study aimed to measure the plasma and synovial fluid levels of soluble programmed death-1(sPD-1) in rheumatoid arthritis (RA) patients and to correlate them with the clinical and laboratory characteristics, disease activity, functional status and radiological severity. Patients and methods We measured sPD-1 in the plasma ( n = 60) and synovial fluid (SF) samples ( n = 24) from 60 RA patients and in the plasma from healthy control ( n = 30). In the patients, disease activity score using 28 joint counts (DAS28) and the health assessment questionnaire (HAQ) score were assessed; immunoglobulin-M rheumatoid factor (IgM-RF) titer, anti-cyclic citrullinated peptide (anti-CCP) antibodies titer and C-reactive protein (CRP) levels were measured and total Sharp score calculated. Results In RA patients both plasma and SF sPD-1 levels (1416.9 ± 1037.9 pg/ml and 1503.9 ± 1129.48 pg/ml respectively) were highly significantly increased compared to its plasma level in the healthy control (165 ± 26.11 pg/mL) ( p < 0.001). In RA patients, the plasma and SF levels of sPD-1 significantly correlated with DAS28 ( r = 0.52 and 0.58 respectively, p < 0.05), HAQ scores ( r = 0.48 and 0.51 respectively, p < 0.05) and anti-CCP titers ( r = 0.55 and 0.58 respectively, p < 0.05). Conclusions Rheumatoid arthritis patients have significantly elevated plasma and synovial levels of sPD-1 that remarkably correlated with the DAS28 suggesting that it could be a useful marker to reflect RA disease activity. The considerable association of sPD-1 with autoantibodies production implies a possible role in the pathogenesis of RA. [ABSTRACT FROM AUTHOR]

Alternative tumor necrosis factor-α (TNF-α) inhibitors and non-TNF biologics are available as treatment options for rheumatoid arthritis patients who exhibit inadequate response to TNF-α inhibitor (TNF-IR patients). These agents have considerable efficacy compared with placebo, but head-to-head comparisons among these agents have not been performed. The objective of this study was to use Bayesian approach to compare the effectiveness of cycling TNF-α inhibitors versus switching to non-TNF biologics in TNF-IR patients. A systematic review was conducted using MEDLINE and Cochrane library. Key endpoints were the American College of Rheumatology (ACR) responses of 20/50/70 and the health assessment questionnaire (HAQ) score change at six months. Bayesian outcomes were calculated as the probability that OR is greater than one and HAQ score change difference is less than zero. Compared with TNF-α inhibitors, non-TNF biologics were associated with higher ACR response rates; in ACR20, the OR was 1.639 for abatacept [P(OR > 1) = 90.7 %], 1.871 for rituximab [P(OR > 1) = 96.2 %] and 3.52 for tocilizumab [P(OR > 1) = 99.9 %]. Similar trends were shown in the HAQ change comparison; the median differences (MD) were −0.259 for abatacept [P(MD < 0) = 100 %], −0.160 for rituximab [P(MD < 0) = 98.2 %], and −0.200 for tocilizumab [P(MD < 0) = 99.3 %]. In conclusion, switching to non-TNF biologics was more effective than cycling TNF-α inhibitor in TNF-IR patients. [ABSTRACT FROM AUTHOR]

Abstract: Objectives: Rheumatoid arthritis (RA) is a chronic inflammatory disease. Transforming growth factor-β1 (TGF-β1) may be a promising candidate gene for susceptibility and severity in RA. We aimed to determine whether TGF-β1 polymorphism is associated with susceptibility to RA and progression of joint destruction, as well as to identify the interaction between TGF-β1 polymorphism and biochemical risk factor. Methods: A total of 160 RA patients and 168 healthy unrelated controls were tested for the TGF-β1 (869C/T) polymorphism using polymerase chain reaction. Results: The TGF-β1 T allele was associated with susceptibility to RA. Within the RA group, TGF-β1 T allele carriers had a significant increased risk to develop osteoporosis (OR=4.4, 95% CI=-2. 4–8.1, P<0.001), as well as more likely to develop bone erosion (OR=1.7, 95% CI=0. 99–2.7, P=0. 034). Better prediction was achieved when the TGF-β1 TT genotype was used in combination with either elevated, rheumatoid factor (RF) or C-reactive protein (CRP) (OR=6.8, 3.7 respectively). Also, they increased the risk to develop bone erosion in patients with rheumatoid arthritis (OR=3.3, 9.8, P=0.017, 0.001 respectively). Conclusion: Our results suggest that TGF-β1 TT genotype may determine the development of osteoporosis and bone erosion in RA. Also, our results points to a synergism between TGF-β1 TT genotype and elevated serum RF or elevated CRP that lead to the development of osteoporosis and bone erosion in patients with rheumatoid arthritis. [Copyright &y& Elsevier]

It is well accepted that patients with antibodies against cyclic citrullinated peptides (anti-CCP) and rheumatoid arthritis (RA) suffer from more severe forms of RA in terms of clinical presentation and radiographic destruction at long term compared to anti-CCP-negative patients. The purpose of this cross-sectional study was to investigate whether the measures of self-reported health among patients with RA of <5 years of duration are influenced by anti-CCP status. Additionally, we aimed to determine whether the measures of self-reported health among the two patient groups differ from those of a control group. Telephone interviews were conducted with 464 patients with RA and 637 population controls, who reported educational level, income, smoking habits and lifestyle 10 years before the interview and completed the Health Assessment Questionnaire and the Short-Form Health Survey Questionnaire, version 2 (SF-36v2); 424 (91 %) patients submitted a blood sample for analysis. Patients with anti-CCP-positive and anti-CCP-negative RA showed no significant differences in self-reported disability and physical health after adjustment for age, gender, socioeconomic factors, lifestyle and disease-related variables ( p > 0.05). Both groups of RA patients reported significantly more physical disabilities in everyday life and significantly poorer physical health than the controls (both p < 0.001). A similar pattern was seen for self-reported mental health (both p < 0.05). Patients with RA of <5 years of duration report significantly more disability and poorer physical health than the general population of Denmark, but these reports were independent of anti-CCP status. [ABSTRACT FROM AUTHOR]

The treatment of rheumatoid arthritis (RA) has improved dramatically with the advent of the latest generation of disease-modifying antirheumatic drugs. Despite these advances, in some patients inflammation is not diminished sufficiently to prevent irreversible musculoskeletal damage, thereby necessitating surgical intervention to reduce pain and improve function. For RA treatment, Japanese orthopedic surgeons also prescribe medication. In this study, we examined whether this Japanese system is effective for RA treatment. We analyzed the clinical condition of RA patients treated by rheumatologists and those treated by orthopedists in a linked registry study using information from a large observational cohort of RA patients followed every half year from 2000 to 2010 (the IORRA cohort). Two groups of patients were compared: patients treated by rheumatologists (rheumatologic group) and patients treated by orthopedists (orthopedic group). The results revealed that patients in the orthopedic group were older, more likely to be female, and had a longer disease duration than patients in the rheumatologic group. The proportion of patients with a history of joint surgery was also much higher in the orthopedic group than in the rheumatologic group. The average scores on the Japanese version of the Health Assessment Questionnaire, and the remission ratio determined using a Boolean-based definition gradually increased from 2000 until 2010, and these findings were consistently better in the rheumatologic group than in the orthopedic group. These data suggest that patients treated primarily by orthopedists are more likely to have long-standing RA compared to patients treated by rheumatologists. Therefore, it is critical for rheumatologists and orthopedists to complement each other medically in the treatment of RA patients. [ABSTRACT FROM AUTHOR]

Though excellent clinical results have been reported for total joint arthroplasty (TJA) in rheumatoid arthritis (RA) patients, the longitudinal effects of TJA on pain, physical function, and health-related quality of life in RA patients remain unknown. This study aimed to assess changes in disease activity and health-related quality of life after TJA in patients with established RA. We analyzed the effect of total knee arthroplasty (TKA) and total hip arthroplasty (THA) on RA disease activity in an observational cohort of RA patients. Of the registered RA patients, 333 TKA and 77 THA patients were followed for 5 years after surgery. RA disease activity and health-related quality of life were measured using the Disease Activity Score 28 (DAS28) and a Japanese version of the Stanford health assessment questionnaire (J-HAQ). The mean DAS28 in TKA patients decreased from 4.66 (preoperatively) to 4.02 (3 years postoperatively) and to 3.94 (5 years postoperatively); the mean DAS28 in THA patients decreased from 4.41 (preoperatively) to 3.99 (3 years postoperatively) and to 3.92 (5 years postoperatively). The mean J-HAQ for TKA remained essentially unchanged, ranging from 1.48 (preoperatively) to 1.45 (3 years postoperatively) and to 1.47 (5 years postoperatively); the mean J-HAQ for THA also remained unchanged, ranging from 1.74 (preoperatively) to 1.74 (3 years postoperatively) and to 1.73 (5 years postoperatively). Of the total J-HAQ score, the lower limb score improved while the upper limb score worsened. Although TKA and THA improve clinical outcomes in damaged knees and hips and have a positive secondary systemic effect on RA disease activity, they have not had a continuously good effect on the measures of health-related quality of life. We conclude that tight control of RA disease activity is indicated for those patients with TKA and/or THA. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Explore the potential use of a cytokine panel as biochemical markers of disease activity in rheumatoid arthritis (RA) patients. Design and methods: 57 adult RA patients were assessed using five validated clinical disease activity tools: Health Assessment Questionnaire (HAQ), standard 28-joint Disease Activity Score (DAS28), DAS28 using C-reactive protein (DAS28-CRP), Clinical Disease Activity Index (CDAI), and Simple Disease Activity Index (SDAI). Plasma cytokine levels (IL-2, IL-4, IL-6, IL-8, IL-10, VEGF, IFN-γ, TNF-α, IL1α, IL1β, MCP1, and EGF) were measured in 47 of the 57 patients and correlated with clinical indicators. Results: We found significant correlations between plasma levels of IL-6 and all clinical measures of disease activity; Spearman coefficients (p values) were: HAQ: 0.347(0.017); DAS28: 0.409(0.005); DAS-CRP: 0.378(0.011); CDAI: 0.312(0.033); SDAI: 0.310(0.039); ESR: 0.448(0.002); and CRP: 0.513(0.001). IFN-γ also correlated with DAS-CRP: 0.309(0.039) and SDAI: 0.301(0.044). Furthermore, the levels of IL-6 and IFN-γ increased significantly with worsening disease, as defined by the European League Against Rheumatism (EULAR) classification of disease activity. Conclusion: A significant correlation between plasma levels of IL-6 and clinical disease activity in patients with RA suggests a future role of IL6 as a disease activity marker. [ABSTRACT FROM AUTHOR]

Abstract: Background: This study compared Raloxifen (Evista) with placebo in treatment of fibromyalgia. Methods: One hundred menopausal women with fibromyalgia enrolled in a double-blind randomized study from Feb 2005 until Oct 2006. We compared efficacy of Raloxifen, and placebo over 16 weeks of treatment. Fifty patients received Raloxifen 49 of which (98%) completed the study and 47 (94%) of 50 patients who received placebo completed the study. Raloxifen in 60 mg or identical placebo dose was given every other day over 16 weeks and patients were followed up. Improved recovery for a treatment group was assessed by a significantly higher mean score from baseline to the end of the treatment trial, compared with patients treated with placebo, on measures of Stanford Health Assessment Questionnaire (HAQ); Iranian version of Hospital Anxiety and Depression questionnaire (IHAD); sleep disturbance; number of tender points; reduction of pain and fatigue based on Visual Analogue Score (VAS). Results: Raloxifen produced a significantly higher response rate than placebo in treating fibromyalgia by improving pain and fatigue, reducing of the tender point count, sleep disturbance and recovery of usual activities as measured by the Stanford Health Assessment Questionnaire (HAQ). The significant effect of Raloxifen on HAD score among patients with fibromyalgia was not seen. Conclusion: Raloxifen was superior to placebo in the treatment of menopausal patients with fibromyalgia. [Copyright &y& Elsevier]

Abstract: It has been recently hypothesized that both TNFalpha and anti TNFalpha treatment have a stimulating effect on nitric oxide synthesis and release. Moreover, an in vitro experiment has demonstrated that HDL-cholesterol binds TNFalpha. Aims of our study were to investigate wall shear stress of peripheral arteries and endothelial function of brachial artery in subjects with Rheumatoid Arthritis (RA) at baseline and after infliximab. Moreover, we evaluated the effect of anti TNFalpha therapy on lipid profile. Ten patients with RA received infliximab therapy at weeks 0, 2 and 6. Lipids and vascular parameters were measured before and the day after each infusion. After the first treatment, FMD increased (3.7 ± 1.9% versus 17.5 ± 2.9%, P < 0.01) and common carotid and brachial artery diameters decreased (5.9 ± 0.2mm versus 5.5 ± 0.2mm; 3.5 ± 0.4mm versus 3.1 ± 0.4mm, respectively, P < 0.005). Common carotid and brachial artery wall shear stress increased (21.1 ± 1.1dynes/cm2 versus 23.9 ± 1.4dynes/cm2; 42.0 ± 4.7dynes/cm2 versus 51.6 ± 5.7dynes/cm2, P < 0.01). Similar results were observed after the second and third infusion. All these parameters returned to pre-treatment level at the following infusion. HDL-cholesterol and apolipoprotein AI significantly decreased after each treatment (1st treatment: 1.4 ± 0.05mmol/L versus 1.2 ± 0.06mmol/L, P < 0.01; 1.73 ± 0.05g/L versus 1.57 ± 0.02g/L, P < 0.03). The present data show vasoconstriction and an increase of wall shear stress in studied arteries after infliximab. HDL cholesterol is reduced by treatment and does not seem to influence FMD. [Copyright &y& Elsevier]

To study the pathogenic importance of the rheumatoid factor (RF) in rheumatoid arthritis (RA) and to identify genes differentially expressed in patients and healthy individuals, total RNA was isolated from peripheral blood mononuclear cells (PBMC) from eight RF-positive and six RF-negative RA patients, and seven healthy controls. Gene expression of about 10,000 genes were examined using oligonucleotide-based DNA chip microarrays.The analyses showed no significant differences in PBMC expression patterns from RF-positive and RF-negative patients. However, comparisons of gene expression patterns from all fourteen RA patients and healthy controls identified a subset of discriminative genes. These results were validated by real time reverse transcription polymerase chain reaction (RT-PCR) on another group of RA patients and healthy controls. This confirmed that the following genes had a significantly higher expression in RA patients than in healthy controls: CD14 antigen, defensin α-1 and α-3 (DEFA), fatty-acid-Coenzyme A ligase, long-chain 2 (FACL), ribonuclease 2 (RNASE2), S100 calcium-binding protein A8 and A12 (S100A8 and S100A12). In contrast, the expression of MHC class II, DQ β1 (HLA-DQB1) was significantly reduced in RA patients compared to healthy controls. Conclusions: With the analytical procedure employed, we did not find any indication that RF-positive and RF-negative RA are two fundamentally different diseases. Most of the genes discriminative between RA patients and healthy individuals are known to be involved in immunoinflammatory responses, especially those related to altered phagocytic functions. [Copyright &y& Elsevier]