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1.  How much sleep apnea is too much? 
doi:10.1186/ar2690
PMCID: PMC2745770  PMID: 19664182
4.  Measuring metacarpal cortical bone by digital x-ray radiogrammetry: a step forward? 
Changes in metacarpal cortical bone mineral density (BMD) using digital x-ray radiogrammetry were studied in patients with early rheumatoid arthritis. After 1, 2, and 5 years, large BMD losses were found: -1.7%, -2.8%, and -5.6%, respectively. Elevated erythrocyte sedimentation rate and anti-cyclic citrullinated peptide levels were independent predictors of bone loss, indicating that the largest amount of bone loss was found in patients with severe inflammation and high production of auto-antibodies, who are known to be at the highest risk of developing radiological bone damage. Studies are needed about the spatial and time relationship between erosions and juxta-articular and metacarpal bone loss.
doi:10.1186/ar2788
PMCID: PMC2787260  PMID: 19833006
5.  Androgens in rheumatoid arthritis: when are they effectors? 
Neither hormone receptor genes nor plasma androgens seem significantly altered in female subjects before they became affected by rheumatoid arthritis (RA) and, therefore, do not seem to play a role as risk factors for its development. However, serum testosterone levels are inversely correlated with RA activity and dehydro-epiandrosterone sulfate (DHEAS) plasma levels are inversely correlated with both disease duration and clinical severity in patients already affected by active RA. In particular, gonadal and adrenal androgens (that is, testosterone and DHEAS) are significantly decreased in inflamed synovial tissue/fluids during active disease as a consequence of the inflammatory reaction, which supports a pro-inflammatory milieu in RA joints. Recently, male gender has been found to be a major predictor of remission in early RA.
doi:10.1186/ar2804
PMCID: PMC2787302  PMID: 19804618
7.  Anticitrullinated protein/peptide antibodies and rheumatoid factors: two distinct autoantibody systems 
In a previous issue of Arthritis Research and Therapy, Ursum and colleagues report the relative stabilities of anticitrullinated protein/peptide antibodies (ACPAs) and IgM rheumatoid factors during the course of rheumatoid arthritis and their differential correlation with markers of the acute-phase response. These findings add to a growing body of evidence highlighting the distinct nature of these two autoantibody systems and the role of ACPAs as a disease-specific marker of rheumatoid arthritis.
doi:10.1186/ar2786
PMCID: PMC2787266  PMID: 19796372
10.  Colony variability under the spotlight in animal models of arthritis 
A recent article by Farkas and colleagues, published in Arthritis Research & Therapy, is from the laboratory of Dr Tibor Glant and his research team in Chicago, who have investigated in considerable depth the immunopathology of experimental arthritis induced by the major cartilage component proteoglycan aggrecan in an animal model that mimics many features of human rheumatoid arthritis and ankylosing spondylitis. This present report takes our understanding a significant step forward by questioning whether genetic drift in distinct colonies of the same inbred strains of mice has an impact on the parity between data published by different laboratories.
doi:10.1186/ar2653
PMCID: PMC2688192  PMID: 19439055
12.  Effective rheumatoid arthritis treatment requires comprehensive management strategies 
Work by Lee and colleagues has shown that decreased sleep quality and increased psychiatric distress increase pain sensitivity at both articular and nonarticular sites in rheumatoid arthritis (RA) patients. This work is consistent with prior studies showing that factors independent of RA disease activity can influence RA outcome measures. Owing to increasing pressure on rheumatologists to use outcome measures to inform treatment decisions, the work by Lee and colleagues highlights the need for comprehensive RA management strategies to understand and address the human factors that influence outcomes measures. Such strategies will ensure appropriate use of increasingly expensive therapies while maximizing patient satisfaction and reimbursement.
doi:10.1186/ar2872
PMCID: PMC3003495  PMID: 20067592
13.  The 'RASor's' edge: Ras proteins and matrix destruction in arthritis 
The shared characteristics of rheumatoid arthritis (RA) and cancer, particularly their unchecked growth and invasive behaviors, have been apparent for some time. However, the molecular mechanisms underlying these similarities are not clear. In a recent issue of Arthritis Research & Therapy, Abreu and colleagues link a well-studied oncogene, Ras, with expression of matrix metalloproteinase-3 (MMP-3) in RA. Their study correlates expression of the Ras guanine nucleotide exchange factor RasGRF1 with MMP-3 expression in RA synovium. They elucidate a potential mechanism of regulation of MMP-3 expression in RA, suggesting a potential target for RA treatment.
doi:10.1186/ar2840
PMCID: PMC3003537  PMID: 20067598
14.  Microparticles as biomarkers in autoimmunity: from dust bin to center stage 
Microparticles are small membrane-bound vesicles released from activated and dying cells. As shown in a study of primary Sjogren's syndrome, systemic lupus erythematosus and rheumatoid arthritis, levels of microparticles in the blood, as measured by a solid-phase prothrombinase assay or flow cytometry, are increased with autoimmunity. Among patients with these conditions, however, particle numbers were inversely related to disease activity and levels of the enzyme secretory phospholipase A2 that can digest membrane lipids and perhaps cause particle loss. These findings suggest microparticles as novel biomarkers for autoimmunity, with levels reflecting events leading to their loss as well as production.
doi:10.1186/ar2856
PMCID: PMC3003533  PMID: 19954508
15.  Rituximab treatment in rheumatoid arthritis: how does it work? 
Treatment with the chimerical monoclonal antibody rituximab results in CD20-directed B cell depletion. Although this depletion is almost complete in the peripheral blood of nearly all patients with rheumatoid arthritis, a proportion of patients does not exhibit a clinical response. The paper by Nakou and colleagues suggests that a decrease in CD19+CD27+ memory B cells in both peripheral blood and bone marrow precedes the clinical response to rituximab. This finding adds to the emerging evidence that lack of response to rituximab is associated with persistence of B lineage cells in specific body compartments.
doi:10.1186/ar2852
PMCID: PMC3003538  PMID: 20017888
16.  Immunocytokines: the long awaited therapeutic magic bullet in rheumatoid arthritis? 
Modulatory cytokines such as IL-4 and IL-10 looked promising biologicals, but suffered from poor exposure at the inflamed joints when administered via the patient-friendly subcutaneous route. Immunocytokines have now been engineered with tissue targeting potential and are a possible solution to this problem, although challenges still exist. Local inflammatory processes cause destruction of extracellular matrix (ECM) components, leading to neo-eptitopes, and/or elicit the synthesis of new ECM components. This makes ECM elements interesting targets for antibody-mediated recognition and retention, to achieve higher levels of immunocytokines at the site of therapeutic interference. The study presented by Schwager and colleagues shows that targeted delivery of IL-10 is more efficacious in experimental arthritis. Clinical studies are warranted to show whether this strategy works for all rheumatoid arthritis patients or is better for subgroups with a defined ECM phenotype. In principle, the scFv-targeting system is plastic enough to allow for personalized strategies.
doi:10.1186/ar2835
PMCID: PMC3003506  PMID: 19903325
17.  Biomarkers: in combination they may do better 
The field of biomarkers is a growing one, particularly in osteoarthritis (OA). OA is the most common disabling condition in older persons and a major cause of morbidity. While the debate continues about which of the involved tissues - cartilage, bone or synovium - is the most important in OA aetiology, there is no doubt that the three develop abnormalities in concert; perhaps a truly useful biomarker will reflect just that. While efforts continue to identify reliable biomarkers useful for characterising the status, prognosis and measurement of treatment response in OA, combining existing biomarkers to improve their accuracy looks promising.
doi:10.1186/ar2839
PMCID: PMC2787279  PMID: 19886980
18.  How can we reduce the risk of serious infection for patients with systemic lupus erythematosus? 
Infection is responsible for approximately 25% of all deaths in patients with systemic lupus erythematosus (SLE), making it a leading cause of mortality among patients. Ruiz-Irastorza and colleagues, in a recent issue of Arthritis Research & Therapy, report the clinical predictors of major infections found in a prospective study of patients with SLE. Similar patterns of infection and pathogens as reported in previous studies were seen; what is striking, however, was the protective effect seen with anti-malarial use. Many infections in patients with SLE could be prevented with timely vaccinations, reducing exposure to contagious contacts, screening for latent infections, minimizing exposure to corticosteroids, targeted prophylaxis for high risk patients, and, unless contraindicated, anti-malarial therapy as standard of care.
doi:10.1186/ar2818
PMCID: PMC2787187  PMID: 19960581
20.  Anti-tumour necrosis factor therapy and B cells in rheumatoid arthritis 
The efficacy of B-cell depletion therapy in rheumatoid arthritis (RA) has led to a renewed interest in B cells and their products and the role they play in the pathogenesis of the disease. Agents blocking tumour necrosis factor (TNF) are also very effective in the treatment of RA. It has long been known that the use of anti-TNF therapy can be associated with development of anti-nuclear and anti-double-stranded DNA antibodies and, more rarely, a lupus-like syndrome. Recently, studies have been published investigating further possible effects of anti-TNF agents on B cells and whether these could contribute to their effectiveness in RA.
doi:10.1186/ar2809
PMCID: PMC2787257  PMID: 19818166
21.  Predicting joint damage in rheumatoid arthritis using MRI scanning 
Predicting prognosis in the patient with newly diagnosed rheumatoid arthritis is of key importance so that high-cost therapies can be tailored to the needs of the individual. In a recent issue of Arthritis Research and Therapy, the prognostic significance of MRI changes at the forefoot has been studied. While progression to radiographic erosion occurred rarely in this group of patients exposed to potent disease-suppressing therapies, including TNF inhibitors, MRI bone edema, representing osteitis, has been further implicated as a forerunner to bone erosion. Early MRI scans of the forefoot were helpful in defining those with the potential to progress as well as those in a good prognosis category.
doi:10.1186/ar2778
PMCID: PMC2787290  PMID: 19796371
23.  Novel genetic analysis in Behçet's disease 
Behçet's disease (BD) is characterized by oral and genital ulceration and is complicated by eye, skin, joint and central nervous system lesions. It has long been understood that BD has a strong genetic component, but to date the identified genes account for only around 30% of the risk for developing the disease, and the work has mostly been based on candidate gene analysis. In a recent report, Fei and coworkers presented the results of the first genome-wide analysis of patients with BD. These findings suggest new pathways for investigation in this complex disease.
doi:10.1186/ar2757
PMCID: PMC2745786  PMID: 19678913
24.  New data favouring that neurotrophins are of importance in arthritis 
Neurotrophins are important in inflammation. In an article in Arthritis Research & Therapy, Barthel and collaborators give new information on the existence of neurotrophin production in the synovial tissue of arthritic joints. These findings, together with other recent findings, stress that neurotrophins should be considered important factors in arthritis. This is reinforced by the facts that they are also produced by articular chondrocytes and that receptors for these are present in the synovial tissue and on chondrocytes. The importance of neurotrophins in joints should be further studied, including examinations on the efficacy of interfering with their effects in arthritis.
doi:10.1186/ar2754
PMCID: PMC2745783  PMID: 19678907
25.  Articular cartilage stem cell signalling 
The view of articular cartilage as a non-regeneration organ has been challenged in recent years. The articular cartilage consists of distinct zones with different cellular and molecular phenotypes, and the superficial zone has been hypothesized to harbour stem cells. Furthermore, the articular cartilage demonstrates a distinct pattern regarding stem cell markers (that is, Notch-1, Stro-1, and vascular cell adhesion molecule-1). These results, in combination with the positive identification of side population cells in articular cartilage, give additional support for the hypothesis that articular cartilage has residing stem cells with a potential regenerative capacity where the controlling mechanism could be future biomarkers or drug targets or both.
doi:10.1186/ar2753
PMCID: PMC2745782  PMID: 19664192

Results 1-25 (310)