26 results on '"Keith MP"'
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2. Lay it again, Sam
- Author
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Hampson, Keith, MP
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- 1978
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3. It's time the talking had to stop
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Hampson, Keith, MP
- Published
- 1979
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- View/download PDF
4. Europe a` la carte for UK is a fantasy
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Vaz, Keith Mp
- Subjects
Banking, finance and accounting industries ,Business ,Business, international ,European Union - Abstract
From Keith Vaz MP. Sir, John Maples' article 'Flexibility should be the rule in Europe' (November 8) is a surprisingly temperate statement on Europe by the standards of the Opposition [...]
- Published
- 1999
5. A 31-year-old Army specialist presenting with acute oligoarthritis.
- Author
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Keith MP, Roebuck JD, Keith, Michael P, and Roebuck, Jonathan D
- Abstract
A 31-year-old Army specialist was evaluated at Walter Reed Army Medical Center for an acute attack of arthritis in the left hand. After an initial evaluation, the patient was referred to the rheumatology service, and gout was diagnosed on the basis of synovial fluid analysis. This case demonstrates an uncommon presentation of a common disorder in an active duty soldier. The discussions presented following the clinical data are meant to expand diagnostic considerations for patients with similar symptoms, to address risk factors for gout relevant to the military, and to clarify the management of gout. [ABSTRACT FROM AUTHOR]
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- 2008
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6. Refractory polyarticular gouty arthritis as a manifestation of immune reconstitution inflammatory syndrome.
- Author
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Sebeny PJ, Keith MP, Love KM, Dwyer TX, and Ganesan A
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- 2010
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7. Polymyalgia rheumatica and breast cancer.
- Author
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Keith MP and Gilliland WR
- Published
- 2006
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8. Why Is My Foot Swollen?
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Stitt RS and Keith MP
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- Aged, 80 and over, Agnosia diagnosis, Agnosia etiology, Diagnosis, Differential, Humans, Lumbar Vertebrae pathology, Male, Arthropathy, Neurogenic diagnosis, Arthropathy, Neurogenic etiology, Arthropathy, Neurogenic physiopathology, Edema diagnosis, Edema etiology, Foot Diseases diagnosis, Foot Diseases etiology, Foot Diseases physiopathology, Radiography methods, Spinal Stenosis diagnosis, Spinal Stenosis etiology, Spinal Stenosis physiopathology, Spondylosis complications
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- 2019
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9. Dysregulation of innate and adaptive serum mediators precedes systemic lupus erythematosus classification and improves prognostic accuracy of autoantibodies.
- Author
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Lu R, Munroe ME, Guthridge JM, Bean KM, Fife DA, Chen H, Slight-Webb SR, Keith MP, Harley JB, and James JA
- Subjects
- Biomarkers, Case-Control Studies, Disease Progression, Humans, Lupus Erythematosus, Systemic diagnosis, Prognosis, Signal Transduction, Time Factors, Tumor Necrosis Factors blood, Adaptive Immunity, Autoantibodies blood, Autoantibodies immunology, Cytokines blood, Immunity, Innate, Lupus Erythematosus, Systemic blood, Lupus Erythematosus, Systemic immunology
- Abstract
Systemic lupus erythematosus (SLE) is a complex autoimmune disease with a poorly understood preclinical stage of immune dysregulation and symptom accrual. Accumulation of antinuclear autoantibody (ANA) specificities is a hallmark of impending clinical disease. Yet, many ANA-positive individuals remain healthy, suggesting that additional immune dysregulation underlies SLE pathogenesis. Indeed, we have recently demonstrated that interferon (IFN) pathways are dysregulated in preclinical SLE. To determine if other forms of immune dysregulation contribute to preclinical SLE pathogenesis, we measured SLE-associated autoantibodies and soluble mediators in samples from 84 individuals collected prior to SLE classification (average timespan = 5.98 years), compared to unaffected, healthy control samples matched by race, gender, age (±5 years), and time of sample procurement. We found that multiple soluble mediators, including interleukin (IL)-5, IL-6, and IFN-γ, were significantly elevated in cases compared to controls more than 3.5 years pre-classification, prior to or concurrent with autoantibody positivity. Additional mediators, including innate cytokines, IFN-associated chemokines, and soluble tumor necrosis factor (TNF) superfamily mediators increased longitudinally in cases approaching SLE classification, but not in controls. In particular, levels of B lymphocyte stimulator (BLyS) and a proliferation-inducing ligand (APRIL) were comparable in cases and controls until less than 10 months pre-classification. Over the entire pre-classification period, random forest models incorporating ANA and anti-Ro/SSA positivity with levels of IL-5, IL-6, and the IFN-γ-induced chemokine, MIG, distinguished future SLE patients with 92% (±1.8%) accuracy, compared to 78% accuracy utilizing ANA positivity alone. These data suggest that immune dysregulation involving multiple pathways contributes to SLE pathogenesis. Importantly, distinct immunological profiles are predictive for individuals who will develop clinical SLE and may be useful for delineating early pathogenesis, discovering therapeutic targets, and designing prevention trials., (Copyright © 2016 Elsevier Ltd. All rights reserved.)
- Published
- 2016
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10. Altered type II interferon precedes autoantibody accrual and elevated type I interferon activity prior to systemic lupus erythematosus classification.
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Munroe ME, Lu R, Zhao YD, Fife DA, Robertson JM, Guthridge JM, Niewold TB, Tsokos GC, Keith MP, Harley JB, and James JA
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- Adult, B-Cell Activating Factor blood, Case-Control Studies, Female, Humans, Interferon-alpha blood, Lupus Erythematosus, Systemic diagnosis, Lupus Erythematosus, Systemic immunology, Male, Multivariate Analysis, Time Factors, Autoantibodies blood, Interferon Type I blood, Interferon-gamma blood, Lupus Erythematosus, Systemic blood
- Abstract
Objectives: The relationship of immune dysregulation and autoantibody production that may contribute to systemic lupus erythematosus (SLE) pathogenesis is unknown. This study evaluates the individual and combined contributions of autoantibodies, type I interferon (IFN-α) activity, and IFN-associated soluble mediators to disease development leading to SLE., Methods: Serial serum specimens from 55 individuals collected prior to SLE classification (average timespan=4.3 years) and unaffected healthy controls matched by age (±5 years), gender, race and time of sample procurement were obtained from the Department of Defense Serum Repository. Levels of serum IFN-α activity, IFN-associated mediators and autoantibodies were evaluated and temporal relationships assessed by growth curve modelling, path analysis, analysis of covariance and random forest models., Results: In cases, but not matched controls, autoantibody specificities and IFN-associated mediators accumulated over a period of years, plateauing near the time of disease classification (p<0.001). Autoantibody positivity coincided with or followed type II IFN dysregulation, preceding IFN-α activity in growth curve models, with elevated IFN-α activity and B-lymphocyte stimulator levels occurring shortly before SLE classification (p≤0.005). Cases were distinguished by multivariate random forest models incorporating IFN-γ, macrophage chemoattractant protein (MCP)-3, anti-chromatin and anti-spliceosome antibodies (accuracy 93% >4 years pre-classification; 97% within 2 years of SLE classification)., Conclusions: Years before SLE classification, enhancement of the type II IFN pathway allows for accumulation of autoantibodies and subsequent elevations in IFN-α activity immediately preceding SLE classification. Perturbations in select immunological processes may help identify at-risk individuals for further clinical evaluation or participation in prospective intervention trials., (Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.)
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- 2016
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11. Anthrax Vaccine and the Risk of Rheumatoid Arthritis and Systemic Lupus Erythematosus in the U.S. Military: A Case-Control Study.
- Author
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Bardenheier BH, Duffy J, Duderstadt SK, Higgs JB, Keith MP, Papadopoulos PJ, Gilliland WR, and McNeil MM
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- Adolescent, Adult, Anthrax prevention & control, Anthrax Vaccines therapeutic use, Case-Control Studies, Female, Humans, Logistic Models, Male, Middle Aged, Anthrax Vaccines adverse effects, Arthritis, Rheumatoid etiology, Lupus Erythematosus, Systemic etiology, Military Personnel statistics & numerical data
- Abstract
U.S. military personnel assigned to areas deemed to be at high risk for anthrax attack receive Anthrax Vaccine Adsorbed (AVA). Few cases of rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) have been reported in persons who received AVA. Using a matched case-control study design, we assessed the relationship of RA and SLE with AVA vaccination using the Defense Medical Surveillance System. We identified potential cases using International Classification of Diseases, 9th Revision, Clinical Modification codes and confirmed cases with medical record review and rheumatologist adjudication. Using conditional logistic regression, we estimated odds ratios (OR) for AVA exposure during time intervals ranging from 90 to 1,095 days before disease onset. Among 77 RA cases, 13 (17%) had ever received AVA. RA cases were no more likely than controls to have received AVA when looking back 1,095 days (OR: 1.03; 95% confidence interval [CI]: 0.48-2.19) but had greater odds of exposure in the prior 90 days (OR: 3.93; 95% CI: 1.08-14.27). Among the 39 SLE cases, 5 (13%) had ever received AVA; no significant difference in receipt of AVA was found when compared with controls (OR: 0.91; 95% CI: 0.26-3.25). AVA was associated with recent onset RA, but did not increase the risk of developing RA in the long term., (Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.)
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- 2016
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12. Inflammatory back pain and the diagnosis of axial spondyloarthritis.
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Keith MP
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- Adult, Back Pain etiology, Chronic Disease, Female, Humans, Inflammation, Male, Spondylarthritis classification, Spondylarthritis diagnosis
- Published
- 2012
13. Progress toward personalized treatment of rheumatoid arthritis.
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Keith MP, Edison JD, and Gilliland WR
- Subjects
- Humans, Methotrexate therapeutic use, Precision Medicine methods, Treatment Outcome, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid drug therapy, Arthritis, Rheumatoid etiology, Precision Medicine trends
- Abstract
Treatment of rheumatoid arthritis (RA) has advanced significantly over the past decade, in part because of the identification of key elements in the immunopathogenesis of the disease, leading to the development of targeted immune-based therapies. Despite the availability of many highly specific therapies, the process of selecting a treatment regimen for an individual patient remains empirical. Personalized treatment, focused on predicting efficacy, non-response, and toxicity to better guide medication selection, moves closer to realization as genomic methods continue to be extended and refined.
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- 2012
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14. Updates on intra-articular hyaluronic Acid therapy for knee osteoarthritis.
- Author
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Keith MP
- Subjects
- Adjuvants, Immunologic administration & dosage, Drug Therapy, Combination, Glucocorticoids therapeutic use, Humans, Hyaluronic Acid administration & dosage, Injections, Intra-Articular, Meta-Analysis as Topic, Randomized Controlled Trials as Topic, Adjuvants, Immunologic therapeutic use, Hyaluronic Acid therapeutic use, Osteoarthritis, Knee drug therapy
- Published
- 2012
15. Treatment of hemophagocytic lymphohistiocytosis with alemtuzumab in systemic lupus erythematosus.
- Author
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Keith MP, Pitchford C, and Bernstein WB
- Subjects
- Alemtuzumab, Anti-Infective Agents administration & dosage, Antirheumatic Agents administration & dosage, Drug Therapy, Combination, Female, Glucocorticoids administration & dosage, Humans, Hydroxychloroquine administration & dosage, Lymphohistiocytosis, Hemophagocytic diagnosis, Lymphohistiocytosis, Hemophagocytic etiology, Middle Aged, Prednisone administration & dosage, Antibodies, Monoclonal, Humanized administration & dosage, Lupus Erythematosus, Systemic complications, Lymphohistiocytosis, Hemophagocytic drug therapy
- Abstract
Hemophagocytic lymphohistiocytosis (HLH) is an immune disorder characterized by cytokine dysregulation and uncontrolled activation of T lymphocytes and macrophages. It is categorized as primary when associated with specific genetic mutations or secondary when associated with infections, malignancies, or autoimmune disorders. Clinical features of HLH include unexplained fever, hepatosplenomegaly, pancytopenia, and severe hyperferritinemia. Treatment of primary HLH has become standardized based on the HLH-2004 protocol using cyclosporine, etoposide, and dexamethasone with or without intrathecal methotrexate followed by hematopoietic stem cell transplantation. Treatment of secondary HLH is directed at control of the underlying condition. If unsuccessful, cytotoxic agents such as those in HLH-2004, steroids, intravenous γ-globulin, or targeted immune therapy have been used. Immunotherapy targeting CD52 expressed on immune effector cells of HLH is a rational therapeutic approach in patients too ill for traditional cytotoxic chemotherapy. We describe the successful use of alemtuzumab to treat HLH due to systemic lupus erythematosus.
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- 2012
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16. Perspectives on rheumatoid arthritis for the orthopedic surgeon: overview of non-tumor necrosis factor biologic drugs and perioperative management.
- Author
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Keith MP
- Subjects
- Abatacept, Antibodies, Monoclonal, Humanized therapeutic use, Drug Therapy, Combination, Humans, Immunoconjugates therapeutic use, Orthopedics, Practice Guidelines as Topic, Rituximab, Standard of Care, Antibodies, Monoclonal, Murine-Derived therapeutic use, Antirheumatic Agents therapeutic use, Arthritis, Rheumatoid therapy, Methotrexate therapeutic use, Perioperative Care
- Abstract
Early use of disease modifying antirheumatic drug (DMARD) therapy has become the standard of care in the treatment of rheumatoid arthritis (RA). Methotrexate remains the DMARD of choice in patients without contraindications for its use. The addition of a tumor necrosis factor-α antagonist to methotrexate makes clinical remission more likely. Despite the effectiveness of this approach, some patients continue to have active disease. In these patients, the use of rituximab, abatacept, or tocilizumab provides additional options when first-line therapies inadequately control RA. For orthopedic surgeons and rheumatologists, additional therapeutic options increase the complexity of perioperative medical management. No consensus has been reached by rheumatology societies as to the optimal approach for the use of biologic and traditional DMARDs around the time of surgery. Therefore, perioperative medication management should be individualized and based on a discussion of potential risks and benefits involving patients, surgeons, and rheumatologists.
- Published
- 2011
17. Raynaud phenomenon of the nipple: a rare finding in rheumatology clinic.
- Author
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O'Sullivan S and Keith MP
- Subjects
- Adult, Breast Diseases therapy, Breast Feeding, Cold Temperature, Color, Female, Humans, Mastodynia diagnosis, Mastodynia therapy, Nifedipine administration & dosage, Raynaud Disease therapy, Vasodilator Agents administration & dosage, Breast Diseases diagnosis, Nipples, Raynaud Disease diagnosis
- Abstract
Many clinicians are familiar with the common presentation of Raynaud phenomenon affecting the hands and feet. Patients with Raynaud phenomenon, even in the absence of systemic disease, are frequently treated by rheumatologists. Raynaud phenomenon of the nipple is an important entity to recognize as a cause of severe nipple pain with breast-feeding and is perhaps underrecognized by patients and physicians. We describe a patient with Raynaud phenomenon of the nipple to improve identification of this clinical entity so that appropriate treatment may be instituted, thus allowing mothers to continue nursing.
- Published
- 2011
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18. Chondrocalcinosis and hypomagnesemia in a 26-year-old woman.
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Rim PC and Keith MP
- Subjects
- Adult, Female, Gitelman Syndrome complications, Gitelman Syndrome genetics, Humans, Hypercalciuria drug therapy, Knee Joint diagnostic imaging, Magnesium therapeutic use, Nephrocalcinosis drug therapy, Potassium therapeutic use, Radiography, Receptors, Drug genetics, Renal Tubular Transport, Inborn Errors drug therapy, Solute Carrier Family 12, Member 3, Symporters genetics, Treatment Outcome, Chondrocalcinosis diagnosis, Chondrocalcinosis etiology, Hypercalciuria complications, Hypercalciuria diagnosis, Nephrocalcinosis complications, Nephrocalcinosis diagnosis, Renal Tubular Transport, Inborn Errors complications, Renal Tubular Transport, Inborn Errors diagnosis
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- 2011
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19. Improving the use of allopurinol in chronic gout: monitoring oxypurinol levels to guide therapy.
- Author
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Keith MP and Gilliland WR
- Subjects
- Female, Humans, Male, Allopurinol therapeutic use, Arthritis, Gouty drug therapy, Enzyme Inhibitors blood, Gout drug therapy, Gout Suppressants therapeutic use, Oxypurinol blood, Uric Acid blood
- Abstract
Urate-lowering therapy (ULT), adjusted to achieve and maintain a serum uric acid (SUA) of <6 mg/dl, remains the standard of care for the chronic management of gout. New urate-lowering medications are important options; however, these agents should be reserved for patients who do not tolerate or cannot achieve SUA <6 mg/dl on allopurinol. The result of oxypurinol monitoring to guide allopurinol therapy suggests that allopurinol should still be considered first-line ULT for gout.
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- 2011
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20. Perspectives on rheumatoid arthritis for the orthopedic surgeon: overview of early diagnosis and the tumor necrosis factor antagonists.
- Author
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Keith MP
- Subjects
- Arthritis, Rheumatoid diagnosis, Arthritis, Rheumatoid epidemiology, Arthritis, Rheumatoid therapy, Disease Progression, Humans, Incidence, United States epidemiology, Antirheumatic Agents therapeutic use, Early Diagnosis, Orthopedic Procedures methods, Tumor Necrosis Factor-alpha antagonists & inhibitors
- Abstract
Rheumatoid arthritis (RA) is the most common inflammatory arthritis in the United States. As part of ongoing efforts to halt joint damage, preserve function, and reduce associated mortality, the current emphasis in RA management is on prompt diagnosis and the early use of disease modifying antirheumatic drug (DMARD) therapy. Improved serologic tests and updated classification criteria are now available to assist in making an earlier diagnosis of RA. As a therapeutic class, tumor necrosis factor antagonists are widely used by rheumatologists and provide significant benefits to patients who have an incomplete response to methotrexate or other DMARDs. With the reported low concordance between orthopedic surgeons and rheumatologists regarding the potential benefits of surgery to treat RA, there is an opportunity for improved collaboration between these specialties in the care of RA patients. Updates on diagnosis and medical therapy of RA may help orthopedic surgeons appreciate the rheumatologist's approach to this disease.
- Published
- 2011
21. Ribosomal P autoantibodies are present before SLE onset and are directed against non-C-terminal peptides.
- Author
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Heinlen LD, Ritterhouse LL, McClain MT, Keith MP, Neas BR, Harley JB, and James JA
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- Adolescent, Adult, Black or African American, Autoantigens blood, Female, Humans, Lupus Erythematosus, Systemic blood, Lupus Erythematosus, Systemic diagnosis, Male, Middle Aged, Young Adult, Autoantibodies blood, Autoantibodies immunology, Autoantigens immunology, Epitopes immunology, Lupus Erythematosus, Systemic immunology, Peptide Fragments immunology, Ribosomal Proteins immunology
- Abstract
Autoantibodies to ribosomal P (ribo P) are found in 15-30% of systemic lupus erythematosus (SLE) patients and are highly specific for SLE. The goal of this study is to assess the temporal association of anti-ribosomal P (anti-P) responses with SLE disease onset, as well as to characterize select humoral ribo P epitopes targeted in early, pre-diagnostic SLE samples. Patients with stored serial serum samples available prior to SLE diagnosis were identified from a military cohort. Each sample was tested for antibodies against ribo P utilizing standard C terminus ribo P enzyme-linked immunosorbent assays (ELISA) and a solid phase, bead-based assay with affinity-purified ribo P proteins. In this study, antibodies to ribo P were more common in African American SLE patients (p = 0.026), and anti-P-positive patients comprised a group with more measured autoantibody specificities than did other SLE patients (3.5 vs 2.2, p < 0.05). Antibodies against ribo P were present on average 1.7 years before SLE diagnosis and were detected an average of 1.08 years earlier in pre-diagnostic SLE samples using affinity-purified whole protein rather than C-terminal peptide alone (p = 0.0019). Furthermore, 61% of anti-P-positive patients initially had antibodies to aa 99-113, a known ribosomal P0 antigenic target, at a time point when no antibodies to the clinically used C terminus were detected. Our findings provide evidence that antibodies against ribosomal P frequently develop before clinical SLE diagnosis and are more broadly reactive than previously thought by targeting regions outside of the C terminus.
- Published
- 2010
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22. 60 kD Ro and nRNP A frequently initiate human lupus autoimmunity.
- Author
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Heinlen LD, McClain MT, Ritterhouse LL, Bruner BF, Edgerton CC, Keith MP, James JA, and Harley JB
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- Autoantigens blood, Case-Control Studies, Epitopes chemistry, Female, HeLa Cells, Humans, Lupus Erythematosus, Systemic blood, Male, Ribonucleoproteins blood, Autoantigens chemistry, Autoimmunity, Lupus Erythematosus, Systemic immunology, Ribonucleoproteins chemistry
- Abstract
Systemic lupus erythematosus (SLE) is a clinically heterogeneous, humoral autoimmune disorder. The unifying feature among SLE patients is the production of large quantities of autoantibodies. Serum samples from 129 patients collected before the onset of SLE and while in the United States military were evaluated for early pre-clinical serologic events. The first available positive serum sample frequently already contained multiple autoantibody specificities (65%). However, in 34 SLE patients the earliest pre-clinical serum sample positive for any detectable common autoantibody bound only a single autoantigen, most commonly 60 kD Ro (29%), nRNP A (24%), anti-phospholipids (18%) or rheumatoid factor (15%). We identified several recurrent patterns of autoantibody onset using these pre-diagnostic samples. In the serum samples available, anti-nRNP A appeared before or simultaneously with anti-nRNP 70 K in 96% of the patients who had both autoantibodies at diagnosis. Anti-60 kD Ro antibodies appeared before or simultaneously with anti-La (98%) or anti-52 kD Ro (95%). The autoantibody response in SLE patients begins simply, often binding a single specific autoantigen years before disease onset, followed by epitope spreading to additional autoantigenic specificities that are accrued in recurring patterns.
- Published
- 2010
- Full Text
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23. Anti-ribonucleoprotein antibodies mediate enhanced lung injury following mesenteric ischemia/reperfusion in Rag-1(-/-) mice.
- Author
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Keith MP, Moratz C, Egan R, Zacharia A, Greidinger EL, Hoffman RW, and Tsokos GC
- Subjects
- Animals, Intestines immunology, Intestines pathology, Lung immunology, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Reperfusion Injury pathology, Reperfusion Injury physiopathology, Antibodies, Antinuclear physiology, Homeodomain Proteins genetics, Lung pathology, Reperfusion Injury immunology, Ribonucleoproteins immunology, Up-Regulation immunology
- Abstract
Natural Abs and autoantibodies bind antigens displayed by ischemia-conditioned tissues, followed by complement activation and enhanced tissue injury during reperfusion. Anti-ribonucleoprotein (RNP) Ab is associated with lung disease in patients with autoimmune disease but it is not known whether these abs contribute to lung injury. Mesenteric I/R in mice leads to local and remote lung injury. Accordingly, we used this model to investigate whether anti-RNP Abs would reconstitute I/R damage with prominent lung damage in injury-resistant Rag1(-/-) animals. Rag1(-/-) mice injected with anti-RNP Ab containing serum and subjected to mesenteric I/R suffered greater intestinal injury than control-treated and sham-operated animals. The magnitude of the reconstituted damage was anti-RNP Ab titer-dependent. Anti-RNP Ab-treated animals demonstrated a dose-dependent increase in lung histologic injury scores compared to control and sham animals. Anti-RNP mediated injury was shown to be complement dependent. These experiments reveal a novel mechanism whereby anti-RNP Abs contributes to the development of pulmonary pathology in patients with autoimmune diseases following exposure of remote organs to I/R injury.
- Published
- 2007
- Full Text
- View/download PDF
24. Updates in the management of gout.
- Author
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Keith MP and Gilliland WR
- Subjects
- Acute Disease, Adult, Aged, Allopurinol therapeutic use, Arthritis, Gouty diagnosis, Arthritis, Gouty drug therapy, Chronic Disease, Colchicine therapeutic use, Drug Therapy, Combination, Family Practice standards, Family Practice trends, Female, Gout diagnosis, Humans, Male, Middle Aged, Pain Measurement, Prognosis, Risk Assessment, Severity of Illness Index, Treatment Outcome, Uric Acid urine, Adrenal Cortex Hormones therapeutic use, Anti-Inflammatory Agents, Non-Steroidal therapeutic use, Gout drug therapy, Gout Suppressants therapeutic use
- Abstract
The majority of patients with gout are cared for by primary care physicians. Although both the physician and patient may easily recognize the acute arthritis of gout, errors in selecting the most appropriate medication and proper dose are common. The clinical stages of gout include asymptomatic hyperuricemia, intermittent gouty arthritis, and chronic tophaceous gout. Treatment of gout is usually considered after the first attack of arthritis, typically podagra. The aims of treatment are to alleviate the pain and inflammation associated with acute attacks, prevent future attacks, and decrease uric acid levels. Confusion frequently arises because certain medications such as colchicine may have dual purposes: to treat an acute attack and to suppress future attacks. The purpose of this management update is to provide practical advice about prescribing the proper medication considering both treatment goals and patient comorbidities.
- Published
- 2007
- Full Text
- View/download PDF
25. Anti-RNP immunity: implications for tissue injury and the pathogenesis of connective tissue disease.
- Author
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Keith MP, Moratz C, and Tsokos GC
- Subjects
- Animals, Humans, Toll-Like Receptors immunology, Antibodies, Antinuclear immunology, Connective Tissue Diseases immunology, Ribonucleoprotein, U1 Small Nuclear immunology
- Abstract
Certain autoantibodies are characteristic of autoimmune disease manifestations and contribute to organ pathology. The presence of high-titer antibodies to U1-RNP are associated with mixed connective tissue disease, although these antibodies may also be present in systemic lupus erythematosus and systemic sclerosis. However, the role of antibodies to U1-RNP in the pathogenesis of connective tissue disease remains unclear. Data from recent experimental studies promote the hypothesis that U1-RNP antibodies participate in both innate and adaptive immune responses, implicating them in the pathogenesis of connective tissue disease.
- Published
- 2007
- Full Text
- View/download PDF
26. Persistent localized rash after trauma. Infection or iatrogenic disease?
- Author
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Keith MP and Spooner K
- Subjects
- Administration, Topical, Adult, Anti-Inflammatory Agents administration & dosage, Clobetasol administration & dosage, Clobetasol analogs & derivatives, Diagnosis, Differential, Female, Glucocorticoids, Humans, Neomycin administration & dosage, Wounds and Injuries complications, Drug Eruptions diagnosis, Neomycin adverse effects, Skin injuries
- Published
- 2001
- Full Text
- View/download PDF
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