Search

El virus de chikunguña (CHIKV) es un Alfavirus perteneciente al grupo denominado del Viejo Mundo; estos son virus artritogénicos que causan una enfermedad febril caracterizada por artralgias y mialgias. Aunque la muerte por CHIKV es poco frecuente, la enfermedad puede llegar a ser incapacitante y generar un amplio espectro de manifestaciones atípicas, como complicaciones cardiovasculares, respiratorias, oculares, renales y dérmicas, entre otras. Cuando el dolor articular persiste por tres o más meses, da lugar a la forma crónica de la enfermedad denominada reumatismo inflamatorio crónico poschikunguña, el cual es la principal secuela de la enfermedad. Se considera que este virus no es neurotrópico, sin embargo, puede afectar el sistema nervioso central y generar secuelas graves y permanentes, principalmente, en niños y ancianos.En África, Asia y Europa se habían reportado anteriormente brotes epidémicos por CHIKV, pero solo hasta finales del 2013 se documentó la introducción del virus a las Américas; desde entonces, el virus se ha propagado a 45 países o territorios del continente y el número de casos acumulados ascendió a cerca de dos millones en dos años.Esta revisión describe de manera general la biología molecular del virus, sus manifestaciones clínicas, su patogénesis y las principales complicaciones posteriores a la infección. Además, reúne la información de la epidemia en Colombia y el continente americano publicada entre el 2014 y el 2020.

Bovine respiratory disease (BRD) is one of the most frequent clinical concerns in weaned calves after their arrival at the feedlot. This work reports the first local isolation of Mycoplasma bovis from feedlot calves with pneumonia and polyarthritis in Argentina. Twenty four out of 545 calves showed progressive, subacute to chronic respiratory distress, coughing, and fever. Thirty percent of the affected calves also showed lameness and swelling of elbow or carpal, and knee or tarsal joints. Five necropsies were performed and severe multifocal to coalescent pulmonary nodules, containing white-yellowish caseous exudate encircled by fibrous tissue, and fibrinonecrotic arthritis and tenosynovitis were detected. Mycoplasma was isolated from lung and joint samples. The 16S-23S rRNA ITS consensus sequence obtained from these isolates showed 100% similarity with the same region of M. bovis strains. Since there are no commercially available vaccines in the region for the prevention and control of M. bovis pneumonia and arthritis, surveillance is a priority to reduce the source of disease to naïve animals. La enfermedad respiratoria bovina es uno de los problemas sanitarios más frecuentes en terneros recién destetados luego de su arribo a los corrales de encierre (feedlots). Este trabajo describe el primer aislamiento local de Mycoplasma bovis de terneros de feedlot con neumonía y poliartritis en Argentina. Se vieron afectados 24 de 545 terneros; mostraron enfermedad respiratoria progresiva, subaguda a crónica, tos y fiebre. De los terneros afectados, el 30% presentó, además, problemas en articulaciones carpales o tarsales. Se realizaron 5 necropsias de terneros afectados y se observaron nódulos pulmonares multifocales a coalescentes, que contenían un exudado caseoso blanco-amarillento, rodeados de tejido fibroso, artritis y tenosinovitis fibrinonecrótica. Se aisló Mycoplasma de muestras de pulmón y articulación. La secuencia consenso del gen codificante del ARNr 16S-23S rRNA obtenido de estos aislamientos mostró un 100% de similitud con la misma región de cepas de M. bovis. Teniendo en cuenta que no hay vacunas disponibles comercialmente en la región para la prevención y el control de neumonías y poliartritis por M. bovis, es importante realizar una vigilancia epidemiológica a fin de reducir las fuentes de infección para animales susceptibles. EEA Balcarce Fil: Cantón, Germán José. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Llada, Ignacio. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Margineda, Carlos Augusto. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Marcos Juárez; Argentina. Fil: Urtizbiría, Facundo Nahuel. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Fanti, Sofía. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Scioli, María Valeria. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Fiorentino, María Andrea. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Louge Uriarte, Enrique Leopoldo. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Morrell, Eleonora Lidia. Instituto Nacional de Tecnología Agropecuaria (INTA). Estación Experimental Agropecuaria Balcarce; Argentina. Fil: Sticotti, Erika. Universidad Nacional de Río Cuarto. Facultad de Agronomía y Veterinaria; Argentina. Fil: Tamiozzo, Pablo. Universidad Nacional de Río Cuarto. Facultad de Agronomía y Veterinaria; Argentina.

Objectives: Our study was planned to investigate the effect of Clinical Pilates exercises in children and adolescents with Juvenile Idiopathic Arthritis (JIA). Methods: Fifteen participants diagnosed with JIA (mean age = 12.00 ±3.40 years) were included. The participants were randomly divided into two groups as Clinical Pilates exercise group (n = 6), and home exercise group (n = 9). Clinical Juvenile Arthritis Disease Activity Score (cJADAS), Wong Baker Face Scale, Brunininks-Oseretsky Test of Motor Proficiency Second Edition Short Form (BOT-2 SF), Juvenile Arthritis Biopsychosocial Scale (JAB-Q scale), and Pediatric Quality of Life Inventory (PedsQL) 3.0 Arthritis Module was used for evaluation before and after treatment. Exercises were performed by both groups 3 times a week for 6 weeks. Results: In the analysis of the before and after treatment results, a significant difference was observed in cJADAS (p = .027), manual dexterity (p = .020), running speed and agility (p = .027) subtests of BOT-2 SF, total score of BOT-2 SF (p = .042) and daily activity (p = .043) subtests of PedsQL child form in the Clinical Pilates exercise group. While there was statistically significant differences in manual dexterity (p = .024), running speed and agility (p = .041) and upper limb coordination (p = .034) subtests of BOT-2, and parent form of JAB-Q (p = .041) in home exercise group. When the delta values were compared, the difference was significant in the upper limb coordination subtest of BOT-2 SF (p = .008), and daily activities subtest of PedsQL child form (p = .003) in favour of the Clinical Pilates exercise group. Conclusions: Clinical Pilates exercises are a safe and useful method for children/adolescent with JIA. RESUMEN Objetivos: Nuestro estudio fue planeado para investigar el efecto de los ejercicios de pilates clínico en niños y adolescentes con artritis idiopática juvenil (AIJ). Métodos: Se incluyeron 15 participantes diagnosticados con AIJ (edad media = 12,00 ±3,40 años). Los participantes fueron divididos al azar en 2 grupos como grupo de ejercicio de pilates clínico (n = 6) y grupo de ejercicio en el hogar (n = 9). Para la evaluación antes y después del tratamiento se utilizó la puntuación de actividad de la artritis juvenil clínica (cJADAS), la escala Wong-Baker FACES®, la prueba Brunininks-Oseretsky de proficiencia motora en su segunda edición (BOT-2 SF), la escala biopsicosocial de artritis juvenil (escala JAB-Q) y el inventario de calidad de vida pediátrica (módulo PedsQL® 3.0) de artritis. Se realizaron ejercicios a ambos grupos, 3 veces por semana, durante 6 semanas. Resultados: Cuando se analizaron los resultados, antes y después del tratamiento, se observó una diferencia significativa en las subpruebas de cJADAS (p = 0,027), destreza manual (p = 0,020), velocidad y agilidad en la carrera (p = 0,027) de BOT-2 SF, puntuación total de BOT-2 SF (p = 0,042) y actividad diaria (p = 0, 043) subpruebas de PedsQL® forma infantil en el grupo de ejercicio de pilates clínico, mientras que hubo una diferencia estadísticamente significativa en la destreza manual (p = 0,024), la velocidad y la agilidad en la carrera (p = 0,041) y la coordinación de las extremidades superiores (p = 0,034) subpruebas de BOT-2 SF y forma parental de JAB-Q (p = 0,041) en el grupo de ejercicio en casa. Cuando se compararon los valores delta, la diferencia fue significativa en la subprueba de coordinación de los miembros superiores de BOT-2 SF (p = 0,008) y en la subprueba de actividades diarias de la forma infantil de PedsQL® (p = 0,003) a favor del grupo de ejercicio de pilates clínico. Conclusiones: Los ejercicios de pilates clínico son un método seguro y útil para niños/adolescentes con AIJ.

Psoriasis and PsA have predominantly shared genetic background and overlapping immunologic signature, confirming their denomination as falling within a spectrum of one single disease. Local tissue factors induce a primary inflammatory response, followed by a persistent inflammatory environment that hosts innate and adaptive immune cells with overlapping functional effects. The local inflammatory process of the tissue is capable of determining the phenotype: where psoriasis and/or arthritis can occur in an independent fashion both from clinical and pathophysiological point of view. In the circulating compartment we detected only subtle changes between patients with psoriasis compared to PsA, indicating that if cross-tissue contamination occurs, this is a chronic and subtle process not readily detectible by cross-sectional screening. The result from the clinical work presented in this thesis indicate that screening questionnaires for PsA should be implemented in care for psoriasis patients attending dermatology clinics. Our results indicate major phenotypic manifestation should drive the choice of therapy, with methotrexate as preferred option over sulfasalazine for treating arthritis. Main phenotypic manifestations should drive study participant selection for both clinical and basic research questions, without the need to dichotomize PsA versus psoriasis. Future work should examine if the inflammatory response at the primary tissue site is capable of priming distant tissue sites for a secondary inflammatory response, in order to better understand and better treat PsA.

Introduction: Registries are essential to keep track of inflammatory bowel disease (IBD) and related arthritis epidemiology, and to provide better care to patients. In Colombia, the health ministry has adopted a tool, SISPRO, to gather all information coming from the whole health system structure. Given that the information collected from SISPRO is available for anyone, it provides an opportunity to get an insight into health topics. Objectives: The data collected from SISPRO were used to analyse the prevalence and specific characteristics of patients with IBD and related arthritis registered between 2012 and 2016. Methods: This is a descriptive epidemiological study using the International Statistical Classification of Diseases and Related Health Problem as keywords related to IBD and related arthritis during the analysis of SISPRO data. Results: National records report 42,647 patients with a diagnosis of IBD for an estimated prevalence of 87/100,000 subjects, being more frequent in women. The prevalence of Crohn's disease was 17/100,000 subjects, and 113/100,000 subjects for ulcerative colitis. The prevalence of arthritis related to inflammatory bowel disease was 5/100,000 subjects. Conclusions: This is the first study that describes the demographic characteristics of IBD in Colombia. This study is in accordance with that previously described in the available literature, which supports the theory about increasing global prevalence of IBD. Also, there are some differences between Colombian regions, which could be related to environmental factors and ancestry, which deserve further study. RESUMEN Introducción: Los registros son esenciales para seguir la epidemiología de la enfermedad inflamatoria intestinal (EII) y el compromiso articular asociado y brindar mejor atención a los pacientes. En Colombia, el Ministerio de Salud y de la Protección Social utiliza la herramienta SISPRO para recolectar información del sistema de salud, la cual es de dominio público y amerita un análisis como el realizado en este trabajo. Objetivos: Utilizando los datos de SISPRO se realizó un análisis de la prevalencia y las características de los pacientes con EII y artritis relacionada, con los registros correspondientes a los arios 2012 a 2016. Métodos: Estudio descriptivo de corte transversal en el que se tomaron los datos de SISPRO, utilizando como palabras clave los diagnósticos del manual internacional de enfermedades relacionados con el diagnóstico de EII y la artritis asociada. Resultados: Se documentaron 42.647 individuos con diagnóstico de EII, con una pre-valencia estimada de 87 casos por 100.000 habitantes, más frecuente en mujeres. La prevalencia de la enfermedad de Crohn fue de 17 por 100.000 habitantes y la colitis ulcerativa de 113 por 100.000 habitantes. La prevalencia del compromiso articular asociado a EII fue de 5 por 100.000 habitantes. Conclusión: Este es el primer estudio que describe las características demográficas de la EII en Colombia. Los resultados son acordes con lo reportado en la literatura mundial y la teoría del aumento de la prevalencia de la EII. Así mismo, existen diferencias entre regiones que pueden estar relacionadas con ancestría y factores medioambientales que requieren estudios complementarios.

La gota es una enfermedad caracterizada por un aumento del ácido úrico, el cual es un producto de desecho del catabolismo de las purinas en humanos y es excretado por la orina. Clínicamente, se presenta como una monoartritis inflamatoria aguda y autolimitada que afecta las articulaciones de la extremidad inferior. En cuanto a su clasificación, se divide en gota primaria y secundaria. Para el diagnóstico, el papel del microbiólogo es fundamental, ya que es el que reporta los cristales de ácido úrico, los cuales, correlacionando la clínica y diversos exámenes, podría llevar a la conclusión de la enfermedad de la gota.

Background and objective: Ninety percent of patients with rheumatoid arthritis (RA) feel foot pain during the disease process. Pharmacological treatment of RA has a systematic effect on the body and includes: Nonsteroidal anti-inflammatory drugs, disease-modifying antirheumatic drugs (DMARDs) and biologics. The objective of our review was to examine the impact of biologics on patients with RA ‘foot. Methods and material: A systematic review of randomized control trials and observational studies that evaluated the efficacy of biologics against other pharmacological treatment, and included a foot outcome measure. The search covered MEDLINE Ovid, Pubmed, CINAHL, Cochrane Library, Evidence Search, and Web of Science. Risk of bias was evaluated using Cochrane guidance and the Newcastle Ottawa Scale adapted version. Results: A total of eight studies fully met the inclusion criteria: Three randomized control trials, and five observational studies were the basis of our review. A total sample of 1856 RA patients with RA treatment participated. The use of biologics was not associated as a risk factor for post-operative surgical site infection or delayed wound healing. The benefits of biologics, in terms of the disease evolution, were assessed using X-ray. Conclusion: Evidence suggests that the use of biologics is not a risk factor for post-operative surgical site infection or delayed wound healing. The use of biologics presents benefits in terms of the disease evolution assessed through X-ray.

Although several randomized clinical trials and observational studies have evaluated the effectiveness, safety and drug survival of etanercept (ETN) in the treatment of psoriatic arthritis (PsA), long-term data regarding these aspects are currently scarce. For this reason, we sought to investigate the long-term survival and safety of ETN in PsA patients in 4 tertiary care Spanish hospitals over a 13-year observation period (from 2004 to 2017). The records of 85 PsA patients were reviewed. ETN showed an excellent survival profile, with rates of treatment discontinuation at 1, 3, 5 and 10 years of 15, 37, 46 and 59%, respectively. In our cohort, a trend toward longer drug survival in patients with shorter disease duration and those who were treated with ETN as their first biologic agent was observed. On the other hand, combination therapy with conventional disease-modifying antirheumatic drugs did not provide greater improvement on the long-term drug survival. Only 12% of the patients reported adverse events (AEs) during therapy, being most of them of mild to moderate intensity, and in only 7% AEs led to drug discontinuation. To the best of our knowledge, the present study shows the largest follow-up period of ETN-treated population analyzed in a real-life setting, and these results demonstrate the positive safety profile and long-term effectiveness of this biologic agent in the management of PsA patients.

Evaluar la presencia de IgG contra C. trachomatis en mujeres entre 18 a 30 años con diagnóstico de artritis de la ciudad de Bogotá D.C. Métodos. Los grupos de estudio están compuestos por un grupo de casos AR (mujeres con diagnóstico de artritis reumatoide y reactiva) y un grupo control. Se obtuvieron muestras de suero y se realizó la determinación cuantitativa de IgG contra C. trachomatis, la determinación PCR (proteína C reactiva) y FR (factor reumatoide). Resultados. Las variables de talla y peso descritas en la población de estudio, muestran un comportamiento homogéneo, por lo cual no interfieren en los resultados obtenidos. Las medias se compararon por los test Mann Whitney y t test no pareado. El porcentaje de resultados positivos en la determinación cualitativa de PCR fueron de: 36,6% para el grupo de casos y 14,5% para el grupo control. En la determinación cualitativa de FR el porcentaje de resultados positivos fueron: 48,8% para el grupo de casos y 5,3% para el grupo control. Finalmente, el porcentaje de resultados positivos en la determinación de anticuerpos IgG específicos contra C trachomatis fue de 2,4% para el grupo de casos y 22,4% para el grupo de controles. Las variables de PCR y FR mostraron mayor frecuencia de resultados positivos en el grupo de casos, en comparación con el grupo control, lo cual se correlaciona con la existencia de procesos inflamatorios propios del desarrollo de artritis. Sin embargo el grupo control presentó mayor frecuencia de anticuerpos IgG específicos contra C. trachomatis en comparación con el grupo de casos. Estos resultados hacen necesario evaluar a futuro, el comportamiento de las pacientes del grupo control con resultados positivos de IgG contra C. trichomatis que permitirían observar una posible aparición de síntomas relacionados con artritis.

ResumenObjetivo: indagar acerca de la connotación de cuerpo que tienen las mujeres con artritis reumatoide y el vínculo con la sintomatología propia de la enfermedad.Metodología: cualitativa de tipo fenomenológico-hermenéutico, en el cual se aplicaron técnicas de entrevistas en profundidad con grabaciones y diarios de campo. El trabajo de campo se realizó entre el primer y segundo periodo de 2015 con 17 mujeres con un promedio de edad de 48,07 años±6,29 con artritis reumatoide, que asistieron a tres consultorios de fisioterapia de la ciudad de Popayán, Colombia.Resultados:se obtuvieron cinco categorías de análisis que consistieron en a) el dolor y la inflamación una limitación para las actividades diarias; b) la artritis reumatoide una compañía permanente; c) cambios obligados en mi estilo de vida por mi salud; d) acepto mi cuerpo como es y con lo que tiene; e) mis deformidades una limitación social.Conclusiones: se evidenció que la mujer con artritis reumatoide de la ciudad de Popayán, Colombia, acepta su condición patológica pese al dolor y la inflamación asociados, pero a la vez genera en ella una lucha para mantenerse dentro del rango normal para la realización de sus actividades cotidianas, propiciando cambios en su estilo y modo de vida para estabilizar su enfermedad y desarrollar adecuadamente sus actividades diarias tanto del hogar como laboralmente; a la vez, no manifiesta incomodidad por su cuerpo, el cual acepta, pero intuye situaciones discapacitantes, cuando se enfrenta a la sociedad, la que en ciertas circunstancias la subvalora y la juzga, con una mirada inquisidora. AbstractObjective.To inquire about the connotation of body that has women with rheumatoid arthritis and the link with the own symptomatology of the disease.Methodology. Qualitative of the phenomenological-hermeneutic type, in which techniques of in-depth interviews with field recordings and diaries were applied. Field work was performed between the first and second periods of 2015 with 17 women with a mean age of 48.07 years ± 6.29 years with Rheumatoid Arthritis, who attended three physical therapy clinics in the city of Popayán-Colombia.Results. Five categories of analysis were obtained that consisted of: a) Pain and inflammation a limitation for daily activities; B) Rheumatoid Arthritis a permanent company; C) forced changes in my lifestyle for my health; D) I accept my body as it is and with what it has; E) My deformities a social limitation.Conclusions.It was evidenced that the woman with rheumatoid arthritis of the City of Popayán-Colombia, accepts its pathological condition despite the pain and the associated inflammation, but at the same time it generates in her a struggle to stay within the normal range for the accomplishment of its daily activities , Promoting changes in their style and way of life to stabilize their illness and adequately develop their daily activities both home and work; At the same time, does not show discomfort for his body which he accepts, but he intuits disabling situations when he confronts society, which in certain circumstances undervalues and judges, with an inquisitive look.

Background JIA-associated uveitis (JIAU) is a serious, sight-threatening disease with significant long-term complications and risk of blindness, even with improved contemporary treatments. The MIWGUC was set up in order to propose specific JIAU activity and response items and to validate their applicability for clinical outcome studies. Methods The group consists of 8 paediatric rheumatologists and 7 ophthalmologists. A consensus meeting took place on November 2015 in Barcelona (Spain) with the objective of validating the previously proposed measures. The validation process was based on the results of a prospective open, international, multi-centre, cohort study designed to validate the outcome measures proposed by the initial MIWGUC group meeting in 2012. The meeting used the same Delphi and nominal group technique as previously described in the first paper from the MIWGUC group (Arthritis Care Res 64:1365–72, 2012). Patients were included with a diagnosis of JIA, aged less than 18 years, and with active uveitis or an uveitis flare which required treatment with a disease-modifying anti-rheumatic drug. The proposed outcome measures for uveitis were collected by an ophthalmologist and for arthritis by a paediatric rheumatologist. Patient reported outcome measures were also measured. Results A total of 82 patients were enrolled into the validation cohort. Fifty four percent (n = 44) had persistent oligoarthritis followed by rheumatoid factor negative polyarthritis (n = 15, 18%). The mean uveitis disease duration was 3.3 years (SD 3.0). Bilateral eye involvement was reported in 65 (79.3%) patients. The main findings are that the most significant changes, from baseline to 6 months, are found in the AC activity measures of cells and flare. These measures correlate with the presence of pre-existing structural complications and this has implications for the reporting of trials using a single measure as a primary outcome. We also found that visual analogue scales of disease activity showed significant change when reported by the ophthalmologist, rheumatologist and families. The measures formed three relatively distinct groups. The first group of measures comprised uveitis activity, ocular damage and the ophthalmologists’ VAS. The second comprised patient reported outcomes including disruption to school attendance. The third group consisted of the rheumatologists’ VAS and the joint score. Conclusions We propose distinctive and clinically significant measures of disease activity, severity and damage for JIAU. This effort is the initial step for developing a comprehensive outcome measures for JIAU, which incorporates the perspectives of rheumatologists, ophthalmologists, patients and families.

Objective: The aim of this study was to evaluate the effects of a manual therapy using fascial therapy on joint bleeding, joint pain and joint function in patients with hemophilic ankle arthropathy. Setting: Hemophilia patient associations. Design: Randomized, controlled trial, multicenter and intention-to-treat analysis. Participants: A total of 65 patients with hemophilic ankle arthropathy. Intervention: The experimental group ( n = 33) received one fascial therapy session per week for three weeks. The control group ( n = 32) received no treatment. Outcome measure: The primary outcome was frequency of joint bleeding measured using self-reporting. Secondary outcomes were joint pain (under load-bearing and non-load-bearing conditions) measured using the visual analog scale; joint condition was measured using the Hemophilia Joint Health Score. Outcomes were measured at baseline, posttreatment and after five months of follow-up. Results: Improvements in the frequency joint bleeding at T0, T1 and T2 were significantly higher in the experimental group (T0: mean (SD) = 1.56 (1.30); T1: mean (SD) = 0.00 (0.00); T2: mean (SD) = 0.27 (0.57)) compared to the control group (T0: mean (SD) = 1.70 (1.78); T1: mean (SD) = 0.05 (0.21); T2: mean (SD) = 0.58 (0.85)). Mean improvement of joint state after the study period was 1.74 points (±1.66) for patients in the experimental group, while the control group exhibited a joint deterioration with 0.43 points (±0.85). Ankle joint pain under load-bearing and non-load-bearing conditions improved in the experimental group with −1.72 (±1.86) and −0.50 (±1.39) points, respectively. Conclusion: The study showed that fascial therapy is favorable for patients with hemophilic ankle arthropathy.

Objective To evaluate the responsiveness in terms of correlation of the Hospital Universitario La Princesa Index (HUPI) comparatively to the traditional composite indices used to assess disease activity in rheumatoid arthritis (RA), and to compare the performance of HUPI-based response criteria with that of the EULAR response criteria. Methods Secondary data analysis from the following studies: ACT-RAY (clinical trial), PROAR (early RA cohort) and EMECAR (pre-biologic era long term RA cohort). Responsiveness was evaluated by: 1) comparing change from baseline (Delta) of HUPI with Delta in other scores by calculating correlation coefficients; 2) calculating standardised effect sizes. The accuracy of response by HUPI and by EULAR criteria was analyzed using linear regressions in which the dependent variable was change in global assessment by physician (Delta GDA-Phy). Results Delta HUPI correlation with change in all other indices ranged from 0.387 to 0.791); HUPI's standardized effect size was larger than those from the other indices in each database used. In ACT-RAY, depending on visit, between 65 and 80% of patients were equally classified by HUPI and EULAR response criteria. However, HUPI criteria were slightly more stringent, with higher percentage of patients classified as non-responder, especially at early visits. HUPI response criteria showed a slightly higher accuracy than EULAR response criteria when using Delta GDA-Phy as gold standard. Conclusion HUPI shows good responsiveness in terms of correlation in each studied scenario (clinical trial, early RA cohort, and established RA cohort). Response criteria by HUPI seem more stringent than EULAR's., Our study was supported by grants RD16/0012/0011 and PI14/00442 from the Ministerio de Economia y Competitividad (Instituto de Salud Carlos III; Spain) and cofunded by the Fondo Europeo de Desarrollo Regional (FEDER). Data from ACT-RAY clinical trial were kindly provided by Hoffmann-La Roche Ltd. No financial support was received from Hoffmann-La Roche Ltd Data from EMECAR and PROAR cohorts were provided by the Spanish Society of Rheumatology. No financial support was received from the Spanish Society of Rheumatology. None of these institutions played any role in the analysis or interpretation of data, nor were they involved in the writing of the manuscript. Roche and Sociedad Espanola de Reumatologia were involved in the collection of data from ACT-RAY, and EMECAR and PROAR, respectively. However, these funders had no role in study design, analysis, decision to publish, or preparation of the manuscript.

ObjectivePsoriatic arthritis (PsA) is a chronic inflammatory arthritis affecting up to 30% of patients with psoriasis (Ps). To date, most of the known risk loci for PsA are shared with Ps, and identifying disease-specific variation has proven very challenging. The objective of the present study was to identify genetic variation specific for PsA.MethodsWe performed a genome-wide association study in a cohort of 835 patients with PsA and 1558 controls from Spain. Genetic association was tested at the single marker level and at the pathway level. Meta-analysis was performed with a case–control cohort of 2847 individuals from North America. To confirm the specificity of the genetic associations with PsA, we tested the associated variation using a purely cutaneous psoriasis cohort (PsC, n=614) and a rheumatoid arthritis cohort (RA, n=1191). Using network and drug-repurposing analyses, we further investigated the potential of the PsA-specific associations to guide the development of new drugs in PsA.ResultsWe identified a new PsA risk single-nucleotide polymorphism at B3GNT2 locus (p=1.10e-08). At the pathway level, we found 14 genetic pathways significantly associated with PsA (pFDRConclusionThese findings provide insights into the biological mechanisms that are specific for PsA and could contribute to develop more effective therapies.

This study aimed to investigate the cross-sectional association between arthritis and migraine in a large representative sample of the US adult population. The study used data from adults who participated in the RAND American Life Panel (ALP). Arthritis (excluding rheumatoid arthritis) and migraine were self-reported. Control variables included sex, age, ethnicity, marital status, education, employment, annual family income, stroke, epilepsy, coronary artery disease, asthma, depression, anxiety, bipolar disorder, and alcohol dependence. The association between arthritis and migraine was investigated using multivariable logistic regression models, while sex and age interaction analyses were also conducted. This study included 2649 adults (51.7% women, mean (SD) age 50.6 (15.9 years). The prevalence of migraine was 10.7% in the sample. After adjusting for several potential confounders, there was a significant association between arthritis and migraine (OR = 1.83, 95% CI = 1.20&ndash, 2.81). Further sensitivity analyses revealed that the association was significant in women, adults aged &le, 45 years, and those aged &gt, 65 years. The mere fact that arthritis and migraine may coexist is problematic, as this could lead to an important medical and economic burden. Therefore, strategies should be implemented to reduce the cooccurrence of these two chronic conditions.

Annals of the rheumatic diseases 76(5), 906-913 (2017). doi:10.1136/annrheumdis-2016-210324, Published by BMJ Publ. Group, London

OBJECTIVE: A study is made of the main oral manifestations of patients with rheumatoid arthritis (RA), particularly salivary flow, and of its possible association to periodontal disease. MATERIAL AND METHODS: A prospective comparative study was made of 146 patients (73 with RA and 73 controls), recording pocket depth, clinical attachment loss, bleeding index, plaque index, and the DMFT index to assess periodontal and dental alterations. Sialometric measurements were also made to determine resting, stimulated, and parotid salivary flow. RESULTS: The patients with RA had greater periodontal pocket depths (with moderate depths in most cases), as well as greater attachment loss and more bacterial plaque. The resting whole saliva and stimulated parotid saliva rates were also clearly decreased in the RA group compared with the controls. CONCLUSIONS: Patients with RA are more likely to present periodontal disease, poorer oral hygiene manifesting as an increased accumulation of bacterial plaque, and decreased salivary flow rates. CLINICAL RELEVANCE: Vulnerability to periodontitis is confirmed in one of the largest samples ever studied of patients with rheumatoid arthritis (RA). Also, there is evidence of hyposialia (decrease in salivary rate) in RA patients without Sjögren's syndrome. Sin financiación 2.308 JCR (2016) Q1, 20/90 Destistry, Oral Surgery & Medicine UEV

En este artículo se reporta un caso clínico de una yegua criolla de 4 años, que llega a consulta por cojera y aumento de tamaño de la articulación del tarso en el miembro posterior derecho producto de un traumatismo. Se realiza examen clínico de la paciente en el cual se evidencia una claudicación de apoyo 5/5 con notables movimientos compensatorios; a la palpación refiere dolor y se evidencia tumefacción, aumento de temperatura y del tamaño. Se realizó hemograma, química sanguínea, evaluación del líquido articular por medio de citología y cultivo; a su vez, se realiza diagnóstico imagenológico mediante radiografía convencional y ecografía articular, el mismo se hace durante varios períodos de la evolución del caso, se realiza radiografía convencional en la cual se encuentran hallazgos como reacción proliferativa, presencia de osteofitos, anquilosis, entre otros; la evaluación ecográfica presentó hallazgos como disminución del líquido sinovial, aumento de tamaño y de ecogenicidad de la membrana sinovial y presencia de bandas de fibrina presentes en el líquido articular. El abordaje terapéutico se realiza mediante fármacos analgésico, lavado articular e infiltración con corticoides, e infusión intraarticular con DMSO al 10%. El presente caso describe el seguimiento imagenológico mediante ecografía y radiografía, hecho en un paciente equino con enfermedad articular degenerativa del tarso, lo cual entrega herramientas útiles a la comunidad veterinaria en el conocimiento y la interpretación de los cambios radiográficos y ultrasonográficos en un equino con enfermedad articular degenerativa durante el tiempo de evolución patológica.

N. Meningitidis serogroup (A, B, C), are main causers of disease. Serogroup W-135 incidence is lower nowadays and, although it is increasing, is such an uncommon infection in adults. We report a case of a monoarthritis knee due to Neisseria meningitidis ( W- 135 ) in an inmunocompetent 50 year- old male.

ObjectiveTo examine the association between chronic immune-mediated diseases (rheumatoid arthritis, systemic lupus erythematosus or the following chronic immune-mediated inflammatory diagnoses groups: inflammatory bowel diseases, inflammatory polyarthropathies, systemic connective tissue disorders and spondylopathies) and the 6-year coronary artery disease, stroke, cardiovascular disease incidence and overall mortality; and to estimate the population attributable fractions for all four end-points for each chronic immune-mediated inflammatory disease.MethodsCohort study of individuals aged 35–85 years, with no history of cardiovascular disease from Catalonia (Spain). The coded diagnoses of chronic immune-mediated diseases and cardiovascular diseases were ascertained and registered using validated codes, and date of death was obtained from administrative data. Cox regression models for each outcome according to exposure were fitted to estimate HRs in two models 1 : after adjustment for sex, age, cardiovascular risk factors and 2 further adjusted for drug use. Population attributable fractions were estimated for each exposure.ResultsData were collected from 991 546 participants. The risk of cardiovascular disease was increased in systemic connective tissue disorders (model 1: HR=1.38 (95% CI 1.21 to 1.57) and model 2: HR=1.31 (95% CI 1.15 to 1.49)), rheumatoid arthritis (HR=1.43 (95% CI 1.26 to 1.62) and HR=1.31 (95% CI 1.15 to 1.49)) and inflammatory bowel diseases (HR=1.18 (95% CI 1.06 to 1.32) and HR=1.12 (95% CI 1.01 to 1.25)). The effect of anti-inflammatory treatment was significant in all instances (HR=1.50 (95% CI 1.24 to 1.81); HR=1.47 (95% CI 1.23 to 1.75); HR=1.43 (95% CI 1.19 to 1.73), respectively). The population attributable fractions for all three disorders were 13.4%, 15.7% and 10.7%, respectively.ConclusionSystemic connective tissue disorders and rheumatoid arthritis conferred the highest cardiovascular risk and population impact, followed by inflammatory bowel diseases.

Objetivo: Describir la evolución clínica de pacientes con artritis reumatoide con actividad alta y moderada tratados con bDMARDS, medida con DAS28. Fundación Investigación Médica del Atlántico, periodo enero-mayo de 2015.Materiales y Métodos: Estudio descriptivo observacional serie de casos, ambispectivo, en 39 pacientes con diag-nóstico de artritis reumatoide que recibieron previamente metotrexate (MTX) que se les inició bDMARDS con actividad alta y moderada según el DAS28 y les realizaron controles establecidos (3, 6, 9 y 12 meses).Resultados: La distribución del género mostró mayor frecuencia en el género femenino con el 84,6 %; la edad media fue de 51,4 ± 16,0 años; el tiempo medio de diagnóstico 7,1 ± 5,2 años; el 100 % de los pacientes ingresa-ron con actividad moderada y alta (DAS28), a los 12 meses de tratamiento se observó baja actividad en el 33,3 %, actividad moderada en el 56,4 % y alta actividad en el 10,3 %.Conclusiones: Los pacientes que reciben tratamiento con bDMARDS presentan una evolución clínica satisfactoria, mejorando significativamente su capacidad funcional, el daño estructural y la calidad de vida

Carlos M González,1 Loreto Carmona,2 Javier de Toro,3 Enrique Batlle-Gualda,4 Antonio I Torralba,5 María J Arteaga,6 Luis Cea-Calvo6 1Department of Rheumatology, Gregorio Marañón Hospital, 2Instituto de Salud Musculoesquelética, Madrid, 3Department of Rheumatology, Hospital Universitario A Coruña, A Coruña, 4Department of Rheumatology, Hospital Universitario de Sant Joan d’Alacant, Alicante, 5Coordinadora Nacional de Artritis, 6Medical Affairs Department, Merck Sharp & Dohme, Madrid, Spain Objective: The aim of this study was to explore perceptions of patients with rheumatic diseases treated with subcutaneous (SC) biological drugs on the impact on daily life and satisfaction with current therapy, including preferred attributes. Methods: A survey was developed ad hoc by four rheumatologists and three patients, including Likert questions on the impact of disease and treatment on daily life and preferred attributes of treatment. Rheumatologists from 50 participating centers were instructed to handout the survey to 20 consecutive patients with rheumatoid arthritis (RA), axial spondyloarthritis (ax-SpA), or psoriatic arthritis (PsA) receiving SC biological drugs. Patients responded to the survey at home and sent it to a central facility by prepaid mail. Results: A total of 592 patients returned the survey (response rate: 59.2%), 51.4% of whom had RA, 23.8% had ax-SpA, and 19.6% had PsA. Patients reported moderate-to-severe impact of their disease on their quality of life (QoL) (51.9%), work/daily activities (49.2%), emotional well-being (41.0%), personal relationships (26.0%), and close relatives’ life (32.3%); 30%–50% patients reported seldom/never being inquired about these aspects by their rheumatologists. Treatment attributes ranked as most important were the normalization of QoL (43.6%) and the relief from symptoms (35.2%). The satisfaction with their current antirheumatic therapy was high (>80% were “satisfied” or “very satisfied”), despite moderate/severe impact of disease. Conclusion: Patients with rheumatic diseases on SC biological therapy perceive a high disease impact on different aspects of daily life, despite being highly satisfied with their treatment; the perception is that physicians do not frequently address personal problems. Normalization of QoL is the most important attribute of therapies to patients. Keywords: rheumatic diseases, quality of life, emotional well-being, biological drugs, patient’s satisfaction

La sarcoidosis es una enfermedad granulomatosa crónica de origen no infeccioso que puede comprometer diversos órganos. Su prevalencia es baja, y en Colombia se han reportado casos de manera aislada. Su etiología y fisiopatología aún no se conocen completamente. La presentación clínica y las diferentes manifestaciones de la enfermedad son variables. Cuando su debut se presenta en niños menores de 5 años se denomina sarcoidosis de inicio temprano, mientras que cuando lo hace en niños mayores de 5 años recibe el nombre de sarcoidosis de inicio tardío. En este reporte de caso se presentan 7 pacientes pediátricos, de los cuales 5 correspondieron a sarcoidosis de inicio temprano y 2 a sarcoidosis de inicio tardío. Todos los pacientes tuvieron un diagnóstico tardío de la enfermedad, manifestaciones de varios órganos y sistemas, y recibieron tratamiento inmunosupresor. Cuatro tuvieron curso crónico, 2 remisiones de la enfermedad y 1 recaídas frecuentes. Fue llamativa una asociación poco usual de 2 pacientes con sarcoidosis de inicio temprano quienes adicionalmente presentaron la enfermedad de Ollier. Sarcoidosis is a chronic granulomatous disease of non-infectious origin which can involve various target organs. Its prevalence is low and there have been only isolated cases reported in Colombia. Its etiology and pathophysiology are not well known. The clinical presentation and signs of the disease vary. When its onset is before five years of age it is recognized as early onset sarcoidosis, while if its onset is after five years of age it is called late onset sarcoidosis. In this case report all patients had a delayed diagnosis and they presented with a multiple organ involvement which required an immunosuppressive treatment. Of the 7 patients, 4 had a chronic course, 2 had remission, and 1 with frequent relapses of the disease. There was an unusual relationship of two patients with early onset disease who additionally presented with Ollier's disease.

The IL-23/IL-17 pathway is implicated in autoimmune diseases, particularly psoriasis, where biologics targeting IL-23 and IL-17 have shown significant clinical efficacy. Retinoid-related orphan nuclear receptor gamma t (RORγt) is required for Th17 differentiation and IL-17 production in adaptive and innate immune cells. We identified JNJ-54271074, a potent and highly-selective RORγt inverse agonist, which dose-dependently inhibited RORγt-driven transcription, decreased co-activator binding and promoted interaction with co-repressor protein. This compound selectively blocked Th17 differentiation, significantly reduced IL-17A production from memory T cells, and decreased IL-17A- and IL-22-producing human and murine γδ and NKT cells. In a murine collagen-induced arthritis model, JNJ-54271074 dose-dependently suppressed joint inflammation. Furthermore, JNJ-54271074 suppressed IL-17A production in human PBMC from rheumatoid arthritis patients. RORγt-deficient mice showed decreased IL-23-induced psoriasis-like skin inflammation and cytokine gene expression, consistent with dose-dependent inhibition in wild-type mice through oral dosing of JNJ-54271074. In a translational model of human psoriatic epidermal cells and skin-homing T cells, JNJ-54271074 selectively inhibited streptococcus extract-induced IL-17A and IL-17F. JNJ-54271074 is thus a potent, selective RORγt modulator with therapeutic potential in IL-23/IL-17 mediated autoimmune diseases.

INTRODUCTION: Knee osteoarthritis is causing pain and functional disability. One of the inherent problems with efficacy assessment of pain medication was the lack of objective pain measurements, but functional magnetic resonance imaging (fMRI) has emerged as a useful means to objectify brain response to painful stimulation. We have investigated the effect of chondroitin sulfate (CS) on brain response to knee painful stimulation in patients with knee osteoarthritis using fMRI. METHODS: Twenty-two patients received CS (800mg/day) and 27 patients placebo, and were assessed at baseline and after 4 months of treatment. Two fMRI tests were conducted in each session by applying painful pressure on the knee interline and on the patella surface. The outcome measurement was attenuation of the response evoked by knee painful stimulation in the brain. RESULTS: fMRI of patella pain showed significantly greater activation reduction under CS compared with placebo in the region of the mesencephalic periaquecductal gray. The CS group, additionally showed pre/post-treatment activation reduction in the cortical representation of the leg. No effects of CS were detected using the interline pressure test. CONCLUSIONS: fMRI was sensitive to objectify CS effects on brain response to painful pressure on patellofemoral cartilage, which is consistent with the known CS action on chondrocyte regeneration. The current work yields further support to the utility of fMRI to objectify treatment effects on osteoarthritis pain. This work was supported in part by the Ministry of Science and Innovation of Spain (Grant SAF2010-19434) and by Bioiberica, SA, Barcelona. M. López-Solà and J. Deus are part of the Research Group SGR 1450 from the Agency of University and Research Funding Management of the Catalan Government and M. López-Solà is supported by the post-doctoral fellowship Beatriu de Pinós awarded by the Agency for the Management of University and Research funding (Agència de Gestió d’Ajuts Universitaris i de Recerca; AGAUR), from the Catalan Government (2010 BP_A 00136).

Altres ajuts: This study was partially funded by the 2013 and 2014 Osteoarthritis Grant of the Catalan Rheumatology Society and by the Bioiberica collaboration. Adipokines are related to knee osteoarthritis, but their exact role is not well known. The aim of this study was to evaluate the association between adipokines in synovial fluid and clinical severity in patients with knee osteoarthritis with joint effusion. Cross-sectional study with systematic inclusion of female patients with symptomatic primary knee osteoarthritis with ultrasound-confirmed joint effusion. Age, physical exercise, knee osteoarthritis symptoms duration, classical cardiovascular risk factors and different anthropometric measurements were collected. Metabolic syndrome was defined in accordance to National Cholesterol Education Program-Adult Treatment Panel III. Radiographic severity was evaluated according to Kellgren-Lawrence scale and Lequesne index was used to assess clinical severity. Seven adipokines (leptin, adiponectin, resistin, visfatin, osteopontin, omentin and chemerin) and three inflammatory markers (tumor necrosis factor α, interleukin 6 and high sensitivity C-reactive protein) were measured by enzyme-linked immunosorbent assay in synovial fluid. Kellgren-Lawrence grade, physical exercise, all anthropometric measurements (especially waist circumference), tumor necrosis factor α, and high levels of leptin, resistin, and ostepontin were related to knee osteoarthritis severity. After adjustment for clinical confounders (age, symptom duration, and radiology), anthropometric measurements, inflammatory markers, and all evaluated adipokines, there were independent associations with clinical severity for resistin (directly associated) and visfatin (inversely associated). No other adipokines or inflammatory markers were independently associated with Lequesne index. The association of radiological parameters, physical exercise, and waist circumference with Lequesne index remained after adjustment. Resistin was directly associated, and visfatin was inversely associated, with clinical severity in female patients with knee osteoarthritis with joint effusion. These associations were more important after adjustment for confounders, especially when all adipokines were evaluated. The online version of this article (doi:10.1186/s13075-016-1103-1) contains supplementary material, which is available to authorized users.

Cocoa and its flavonoids have potential anti-inflammatory properties in vitro and in acute inflammation models in vivo. The aim of the present study was to ascertain the effects of two cocoa-enriched diets on adjuvant arthritis (AA) in rats, considering not only clinical and biochemical inflammatory indices, but also antibody response and lymphocyte composition. Female Wistar rats were fed with a 5 or 10 % cocoa-enriched diet beginning 2 weeks before arthritis induction and until the end of the study. AA was induced by an intradermal injection of heat-killed Mycobacterium butyricum suspension. The hind-paw swelling (plethysmometry), serum anti-mycobacterial antibody concentration (ELISA), blood and inguinal lymph node lymphocyte subset percentage (flow cytometry), and IL-2, interferon γ and PGE2 released from splenocytes (ELISA) were assessed. Although the cocoa diets had no significant effect on hind-paw swelling, a tendency to reduce it was observed at the end of the study. Cocoa-enriched diets were able to decrease the serum anti-mycobacterial antibody concentration and the splenocyte PGE2 production, as well as the proportion of T-helper (Th) lymphocytes in blood and regional lymph nodes, which probably includes cells responsible for the arthritic process. The cocoa diets prevented a decrease in the proportion of regulatory T-cells in blood and a disequilibrium between inguinal lymph node natural killer (NK) CD8+ and NK CD8− subsets. In conclusion, the cocoa-enriched diets during AA were not able to significantly decrease joint inflammation but modified Th-cell proportions and prevented specific antibody synthesis.

Oxaprozin (3-(4,5-diphenyloxazol-2-yl)propanoic acid) is a nonsteroidal anti-inflammatory drug (NSAID) used in the treatment of numerous inflammatory musculoskeletal diseases, including rheumatoid arthritis, osteoarthritis, tendonitis, ankylosing spondylitis and bursitis. It is the first representative member of the diaryl- substituted heterocyclic compounds, which have found clinical use as selective cyclooxygenase-2 (COX-2) inhibitors. The U.S. Food and Drug Administration (FDA) approved its official use in 1992. Both the anti-inflammatory and analgesic properties of oxaprozin are mainly due to the potent inhibition of COX. However, oxaprozin-induced benefits might be also regulated by other COX-independent pathways. It has been shown that oxaprozin induced direct proapoptotic effects in CD40L-treated human monocytes independently of COX inhibition. It also has several advantages in the treatment of inflammatory diseases in comparison to other NSAIDs such as aspirin, naproxen, indomethacin and phenylbutazone, which enabled oxaprozin to become one of the most used NSAIDs in America. Oxaprozin, as other members of the group of NSAIDs, can cause gastrointestinal complications, but significantly lower due to relatively high pKa value. In this paper, the importance of oxaprozin in the treatment of arthritis and its pharmacokinetic properties were described, therewith its activity and side effects were compared with other commercially available anti-inflammatory drugs. Oksaprozin (3-(4,5-difeniloksazol-2-il)propanska kiselina) jeste nesteroidni anti-inflamatorni agens koji se koristi za simptomatsko lečenje inflamacije, bola i reumatoidnih oboljenja. U ovom radu prikazani su različiti postupci dobijanja oksaprozina, njegovih derivata i detaljan opis mehanizma reakcija sinteze, kao i njegova fizička i hemijska svojstva. Pored osnovnih molekulskih osobina koje su značajne za aktivnost oksaprozina kao nesteroidnog anti-inflamatornog leka, navedeni su najznačajniji podaci SAR (eng. Structure-Activity Relationship) studije sintetisanih njegovih analoga. Istaknut je značaj oksaprozina u lečenju artritisa, njegova farmakokinetička svojstva i poređena je njegava aktivnost i sporedni efekti sa ostalim komercijalno dostupnim anti-inflamatornim lekovima.

Background: Macrophage activation syndrome (MAS) is a severe and potentially lethal complication of several inflammatory diseases but seems particularly linked to systemic juvenile idiopathic arthritis (sJIA). Standardized diagnostic and treatment guidelines for MAS in sJIA are currently lacking. The aim of this systematic literature review was to evaluate currently available literature on diagnostic criteria for MAS in sJIA and provide an overview of possible biomarkers for diagnosis, disease activity and treatment response and recent advances in treatment. Methods: A systematic literature search was performed in MEDLINE, EMBASE and Cochrane. 495 papers were identified. Potentially relevant papers were selected by 3 authors after which full text screening was performed. All selected papers were evaluated by at least two independent experts for validity and level of evidence according to EULAR guidelines. Results: 27 papers were included: 7 on diagnosis, 9 on biomarkers and 11 on treatment. Systematic review of the literature confirmed that there are no validated diagnostic criteria for MAS in sJIA. The preliminary Ravelli criteria, with the addition of ferritin, performed well in a large retrospective case-control study. Recently, an international consortium lead by PRINTO proposed a new set of diagnostic criteria able to distinguish MAS from active sJIA and/or infection with superior performance. Other promising diagnostic biomarkers potentially distinguish MAS complicating sJIA from primary and virusassociated hemophagocytic lymphohistiocytosis. The highest level of evidence for treatment comes from case-series. High dose corticosteroids with or without cyclosporine A were frequently reported as first-line therapy. From the newer treatment modalities, promising responses have been reported with anakinra. Conclusion: MAS in sJIA seems to be diagnosed best by the recently proposed PRINTO criteria, although prospective validation is needed. Novel promising biomarkers for sJIA related MAS are in need of prospective validation as well, and are not widely available yet. Currently, treatment of MAS in sJIA relies more on experience than evidence based medicine. Taking into account the severity of MAS and the scarcity of evidence, early expert consultation is recommended as soon as MAS is suspected.

Background: Antibodies to citrullinated proteins (ACPA) occur years before RA diagnosis. Porphyromonas gingivalis expresses its own peptidylarginine deiminase (PPAD), and is a proposed aetiological factor for the ACPA response. Smoking is a risk factor for both ACPA-positive RA and periodontitis. We aimed to study the relation of these factors to the risk of RA in a prospective cohort. Methods: We performed a nested case-control study by identifying pre-RA cases in four populations from the European Prospective Investigation into Cancer and nutrition, matched with three controls. Data on smoking and other covariates were obtained from baseline questionnaires. Antibodies to CCP2 and citrullinated peptides from a-enolase, fibrinogen, vimentin and PPAD were measured. Antibodies to arginine gingipain (RgpB) were used as a marker for P. gingivalis infection and validated in a separate cohort of healthy controls and subjects with periodontitis. Results: We studied 103 pre-RA cases. RA development was associated with several ACPA specificities, but not with antibodies to citrullinated PPAD peptides. Antibody levels to RgpB and PPAD peptides were higher in smokers but were not associated with risk of RA or with pre-RA autoimmunity. Former but not current smoking was associated with antibodies to a-enolase (OR 4.06; 95 % CI 1.02, 16.2 versus 0.54; 0.09-3.73) and fibrinogen peptides (OR 4.24; 95 % CI 1.2-14.96 versus 0.58; 0.13-2.70), and later development of RA (OR 2.48; 95 % CI 1.27-4.84 versus 1.57; 0.85-2.93), independent of smoking intensity. Conclusions: Smoking remains a risk factor for RA well before the clinical onset of disease. In this cohort, P. gingivalis is not associated with pre-RA autoimmunity or risk of RA in an early phase before disease-onset. Antibodies to PPAD peptides are not an early feature of ACPA ontogeny., Funding was received from the Imperial College London National Institute of Health Research (NIHR) Biomedical Research Centre, and from the European Union funded IMI project 'BeTheCure' (contract number 115142-2) and FP7 grant 'Gums & Joints' (HEALTH-F2-2010-261460). JP acknowledges support by grant DE 022597 from NIH/NIDCR.

Introduction: The aim was to study the association between 25-hydroxyvitamin D (25(OH) D) levels and the clinical characteristics of patients with chronic inflammatory rheumatic diseases (CIRD). Methods: We studied a cross-section from the baseline visit of the CARMA project (CARdiovascular in rheuMAtology), a 10-year prospective study evaluating the risk of cardiovascular events in rheumatoid arthritis (RA), ankylosing spondylitis (AS) and psoriatic arthritis (PsA) patients, and non-CIRD patients who attended rheumatology outpatient clinics from 67 hospitals in Spain. Non-CIRD group was frequency matched by age with the joint distribution of the three CIRD groups included in the study. 25(OH) D deficiency was defined if 25(OH) D vitamin levels were < 20 ng/ml. Results: 2.234 patients (775 RA, 738 AS and 721 PsA) and 677 non-CIRD subjects were assessed. The median (p25-p75) 25(OH) D levels were: 20.4 (14.4-29.2) ng/ml in RA, 20.9 (13.1-29.0) in AS, 20.0 (14.0-28.8) in PsA, and 24.8 (18.4-32.6) ng/ml in non-CIRD patients. We detected 25(OH) D deficiency in 40.5 % RA, 39.7 % AS, 40.9 % PsA and 26.7 % non-CIRD controls (p < 0.001). A statistically significant positive association between RA and 25(OH) D deficiency was found (adjusted (adj.) OR = 1.46; 95 % CI = 1.09-1.96); p = 0.012. This positive association did not reach statistical significance for AS (adj. OR 1.23; 95 % CI = 0.85-1.80) and PsA (adj. OR 1.32; 95 % CI = 0.94-1.84). When the parameters of disease activity, severity or functional impairment were assessed, a marginally significant association between 25(OH) D deficiency and ACPA positivity in RA patients (adj. OR = 1.45; 95 % CI = 0.99-2.12; p = 0.056), and between 25(OH) D deficiency and BASFI in AS patients (adj. OR = 1.08; 95 % CI = 0.99-1.17); p = 0.07) was also found. Conclusions: Patients with RA show an increased risk of having 25(OH) D deficiency compared to non-CIRD controls., This publication was aided by members of the Research Unit of the SER. Dedicated to Dr Jose L Fernandez Sueiro who took part in the initial design of this project and passed away in 2012. The authors thank all of the health professionals and patients who generously participated in this study. Furthermore, the authors thank the approval of the study from all participating centers: Complejo Hospitalario A Coruna, A Coruna; Instituto Dexeus, Barcelona; Hospital Universitari Vall d'Hebron, Barcelona; Hospital Infanta Sofia, Madrid; Hospital S. Pedro de Alcantara, Caceres; Hospital Son Llatzer, Palma de Mallorca; Hospital Univ. de Guadalajara; Hospital Clinic i Provincial, Barcelona; Hospital Clinico Univ. San Carlos, Madrid; Hospital de Barbastro, Huesca; Hospital Univ. de Bellvitge, Barcelona; Hospital Univ. de La Princesa, Madrid; Hospital de Merida, Badajoz; Hospital General Carlos Haya, Malaga; Hospital General Virgen de la Concha, Zamora; Hospital Virgen de la Salud, Toledo; Hospital del Sureste, Madrid; Hospital Ramon y Cajal, Madrid; Hospital Univ. Miguel Servet, Zaragoza; Hospital Dr. Negrin, Las Palmas de Gran Canaria; Hospital de Cabuenes, Gijon; Hospital Gregorio Maranon, Madrid; Hospital Univ. de Salamanca; Hospital Univ. Marques de Valdecilla, Santander; Hospital de la Marina Baixa, Alicante; Hospital de San Rafael, Barcelona; Hospital General. Universitario, Valencia; Instituto Poal, Barcelona; Hospital Universitario Puerta de Hierro, Madrid; Hospital Clinico Univ. San Cecilio, Granada; Hospital Santiago Apostol, Vitoria-Gasteiz; Consorci Sanitari de Terrassa, Terrassa; Hospital de Viladecans, Barcelona; Hospital General de Albacete; Hospital Mutua Terrassa, Terrassa; Hospital Ntra. Sra. de Candelaria, Santa Cruz de Tenerife; Hospital Univ. de Canarias, La Laguna, Tenerife; Hospital Univ. de Valme, Sevilla; Instituto Provincial de Rehabilitacion, Madrid; Hospital de Cantoblanco, Madrid; Hospital de Jerez de la Frontera, Cadiz; Hospital Obispo Polanco, Teruel; Hospital Infanta Leonor, Madrid; Hospital General de Elda, Alicante; Hospital Los Arcos, Murcia; Hospital Severo Ochoa, Madrid; Hospital Principe de Asturias, Madrid; Hospital Univ. 12 de Octubre, Madrid; Hospital Univ. Reina Sofia, Cordoba; Hospital Univ. La Paz, Madrid; Hospital Gutierrez Ortega, Valdepenas, Ciudad Real; Hospital Virgen de la Arrixaca, Murcia; Hospital de El Escorial, Madrid; Hospital de Basurto, Bilbao; Hospital Dos de Maig, Barcelona; Hospital del Mar, Barcelona; Hospital Universitario Son Espases, Palma de Mallorca; Hospital de Donostia, Donostia; Hospital de la Santa Creu i Sant Pau, Barcelona; Hospital de Palamos, Gerona; Hospital Comarcal de L'Alt Penedes, Vilafranca del Penedes, Barcelona; Hospital Sierrallana, Torrelavega; Complejo Asistencial de Leon; Hospital General de Ciudad Real; Hospital General de Mostoles, Madrid; Hospital General Universitario de Elche, Alicante; Hospital Xeral Calde, Lugo. This project has been supported by an unrestricted grant from Abbvie, Spain. The design, analysis, interpretation of results and preparation of the manuscript has been done independently of Abbvie. Dr Gonzalez-Gay's studies have been supported by grants from Fondo de Investigaciones Sanitarias, PI06/0024, PS09/00748 and PI12/00060, and RD12/0009/0013 (RIER) from Instituto de Salud Carlos III (ISCIII) (Spain).

Anti Jo-1 antibodies are the main markers of the antisynthetase syndrome (ASSD), an autoimmune disease clinically characterized by the occurrence of arthritis, myositis, and interstitial lung disease (ILD). These manifestations usually co-occur (for practical purpose complete forms) in the same patient, but cases with only 1 or 2 of these findings (for practical purpose incomplete forms) have been described. In incomplete forms, the ex novo occurrence of further manifestations is possible, although with frequencies and timing not still defined. The aim of this international, multicenter, retrospective study was to characterize the clinical time course of anti Jo-1 positive ASSD in a large cohort of patients. Included patients should be anti Jo-1 positive and with at least 1 feature between arthritis, myositis, and ILD. We evaluated the differences between complete and incomplete forms, timing of clinical picture appearance and analyzed factors predicting the appearance of further manifestations in incomplete ASSD. Finally, we collected 225 patients (58 males and 167 females) with a median follow-up of 80 months. At the onset, complete ASSD were 44 and incomplete 181. Patients with incomplete ASSD had frequently only 1 of the classic triad findings (110 cases), in particular, isolated arthritis in 54 cases, isolated myositis in 28 cases, and isolated ILD in 28 cases. At the end of follow-up, complete ASSD were 113, incomplete 112. Only 5 patients had an isolated arthritis, only 5 an isolated myositis, and 15 an isolated ILD. During the follow-up, 108 patients with incomplete forms developed further manifestations. Single main feature onset was the main risk factor for the ex novo appearance of further manifestation. ILD was the prevalent ex novo manifestation (74 cases). In conclusion, ASSD is a condition that should be carefully considered in all patients presenting with arthritis, myositis, and ILD, even when isolated. The ex novo appearance of further manifestations in patients with incomplete forms is common, thus indicating the need for an adequate clinical and instrumental follow-up. Furthermore, the study clearly suggested that in ASSD multidisciplinary approach involving Rheumatology, Neurology, Pneumology, and Internal Medicine specialists is mandatory. CA extern

La demanda funcional de la Articulación Temporomandibular requiere de una adecuada respuesta biológica de los tejidos que recubren las superficies articulares y el disco, los cuales son interdependientes en lo funcional y estructural juntamente con el líquido sinovial Los fibrocartílagos tienen gran capacidad de respuesta celular frente a los requerimientos funcionales, en condiciones de carga normal es capaz de soportar y disipar las fuerzas, sin embargo, en eventuales cargas que superan la tolerancia tisular se romperá el equilibrio homeostático y se iniciará la enfermedad. Las deficiencias nutricionales es el factor vinculante con los trastornos articulares por deficiencia o ausencia del líquido sinovial, alterando el proceso de lubricación.La injuria mecánica, además que puede limitar las funciones celulares y alterar el paso de los nutrientes por vía del fluido sinovial, produce liberación de radicales libres que pueden estar implicados en la degradación del Acido Hialurónico y la producción de Prostaglandinas. La liberación de calepsinas B y D por ruptura de condrocitos superficiales, injuriaran al cartílago generando reacciones inflamatorias persistentes. Otras enzimas que participan en la degradación de matriz extracelular de cartílagos, huesos, ligamentos y tendones, son las metaloproteinasas, elaboradas por condrocitos por inducción de la Interleucina-1, sintetizada por macrófagos duranle la inflamación. El Factor de Necrosis Tumoral Alfa (FNT ), secretado por monocitos y macrófagos, no solo actúa como mediador de la inflamación, estimulando a células sinoviales a la producción de Prostaglandina, sino también induce a fibroblastos a sintetizar Colagenaza, que actúa como mediador de la resorción ósea.

Remitting seronegative symmetrical synovitis with pitting oedema (RS3PE) syndrome mainly affects elderly men and responds well to steroids. Since this syndrome can resemble other diseases, its diagnosis is a significant challenge. Through the following paper, we hope to improve the diagnosis of RS3PE by presenting a table comparing RS3PE to two other common polyarthritic conditions affecting the elderly.

Producción Científica, Between May 1999 and April 2002 a total of 69 consecutive thumb carpometacarpal joint arthoplasties were performed in a total of 64 patients for carpometacarpal joint osteoarthritis using the cementless hydroxyapatite (HA)-coated unconstrained ARPE implant. Clinical, functional and radiological results at 10-year follow-up are presented. Survival analysis was performed using the Kaplan–Meier method. Of the 64 patients, fourwere lost to follow-up, 60 implants (92.3%) were functional and five (7.7%) were not (two dislocated, two were removed and one with aseptic loosening). Survival estimate for functional implants over 10 years was 93.9%(95% confidence interval 82.3–97.9). The radiographs were satisfactory in 82.4%. There was subsidence of thecup in 15.8%. Thumb carpometacarpal joint arthroplasty with the ARPE implant offers a reliable treatmentalternative in patients with Eaton grade III or IV thumb carpometacarpal joint arthritis in the presence of good bone stock.

The human PFKFB3 is composed of 19 exons spanning genomic region about 90,6 Kb (GenBank). Alternative splicing variants have been reported. The main variants corresponding to mRNAs of 4453 bp and 4224 bp for the variant 1 u-PFK2 (NM_004566.3) and variant 2 i-PFK2 (NM_001145443.1), respectively...

Cocoa contains flavonoids with antioxidant properties. The aim of this study was to ascertain the effect of cocoa intake on oxidative stress associated with a model of chronic inflammation such as adjuvant arthritis. Female Wistar rats were fed with a 5% or 10% cocoa-enriched diet or were given p.o. a quercetin suspension every other day for 10 days. Arthritis was induced by a heat-killed Mycobacterium butyricum suspension. Reactive oxygen species (ROS) produced by macrophages, and splenic superoxide dismutase (total, cytoplasmic and mitochondrial) and catalase activities were determined. Clinically, joint swelling in arthritic rats was not reduced by antioxidants; however, the 5% cocoa diet and quercetin administration reduced ROS production. Moreover, the 5% cocoa diet normalized the activities of superoxide dismutase and catalase. In conclusion, a cocoa diet reduces the oxidative stress associated with a chronic inflammatory pathology, although it was not enough to attenuate joint swelling.

Background: The number of copies of the HLA-DRB1 shared epitope, and the minor alleles of the STAT4 rs7574865 and the PTPN22 rs2476601 polymorphisms have all been linked with an increased risk of developing rheumatoid arthritis. In the present study, we investigated the effects of these genetic variants on disease activity and disability in patients with early arthritis. Methodology and Results: We studied 640 patients with early arthritis (76% women; median age, 52 years), recording disease-related variables every 6 months during a 2-year follow-up. HLA-DRB1 alleles were determined by PCR-SSO, while rs7574865 and rs2476601 were genotyped with the Taqman 5′ allelic discrimination assay. Multivariate analysis was performed using generalized estimating equations for repeated measures. After adjusting for confounding variables such as gender, age and ACPA, the TT genotype of rs7574865 in STAT4 was associated with increased disease activity (DAS28) as compared with the GG genotype (β coefficient [95% confidence interval] = 0.42 [0.01-0.83], p = 0.044). Conversely, the presence of the T allele of rs2476601 in PTPN22 was associated with diminished disease activity during follow-up in a dose-dependent manner (CT genotype = -0.27 [-0.56- -0.01], p = 0.042; TT genotype = -0.68 [-1.64- -0.27], p = 0.162). After adjustment for gender, age and disease activity, homozygosity for the T allele of rs7574865 in STAT4 was associated with greater disability as compared with the GG genotype. Conclusions: Our data suggest that patients with early arthritis who are homozygous for the T allele of rs7574865 in STAT4 may develop a more severe form of the disease with increased disease activity and disability. © 2012 Lamana et al.

Background The presence of enthesitis (insertional inflammation) in patients with juvenile idiopathic arthritis (JIA) is difficult to establish clinically and may influence classification and treatment of the disease. We used ultrasonography (US) and color Doppler (CD) imaging to detect enthesitis at the small and deep-seated proximal insertion of the gluteus medius fascia on the posterior iliac crest where clinical diagnosis is difficult. The findings in JIA patients were compared with those obtained in healthy controls and with the patients' MRI results. Methods Seventy-six proximal gluteus medius insertions were studied clinically (tenderness to palpation of the posterior iliac crest) and by US and CD (echogenicity, thickness, hyperemia) in 38 patients with JIA and in 38 healthy controls, respectively (median age 13 years, range 7-18 years). In addition, an additional MRI examination of the sacroiliac joints and iliac crests was performed in all patients. Results In patients with focal, palpable tenderness, US detected decreased echogenicity of the entheses in 53% of the iliac crests (bilateral in 37% and unilateral in 32%). US also revealed significantly thicker entheses in JIA patients compared to healthy controls (p < 0.003 left side, p < 0.001 right side). There was no significant difference in thickness between the left and right sides in individual subjects. Hyperemia was detected by CD in 37% (28/76) of the iliac crests and by contrast-enhanced MRI in 12% (6/50). Conclusions According to US, the gluteus medius insertion was thicker in JIA patients than in controls, and it was hypoechoic (enthesitis) in about half of the patients. These findings may represent chronic, inactive disease in some of the patients, because there was only limited Doppler flow and MRI contrast enhancement. The present study indicates that US can be useful as an adjunct to clinical examination for improved assessment of enthesitis in JIA. This may influence disease classification, ambition to treat, and choice of treatment regimen.

Previously we established that a cocoa-enriched diet in young rats reduces specific antibody production and the T helper (Th) lymphocyte proportion in lymphoid tissues. The aim of the present study was to ascertain the modulatory ability of a cocoa flavonoid-enriched diet on collagen-induced arthritis (CIA), which is mediated by anti-collagen autoantibody response and Th lymphocyte activation. Female Louvain (LOU) rats were fed with a cocoa-enriched diet, beginning 2 weeks before CIA induction. Hind-paw swelling and serum cytokine and anti-collagen antibody concentrations were determined. Anti-collagen antibody-secreting cell counts and lymphocyte subset proportions were established in inguinal lymph nodes (ILN). Reactive oxygen species (ROS), nitric oxide (NO) and TNFα produced by peritoneal macrophages were determined. Although arthritic cocoa-fed rats showed a similar hind-paw swelling time course as the arthritic animals fed a standard diet, the cocoa intake was able to decrease specific IgG2a, IgG2b and IgG2c titres. Moreover, cocoa intake in CIA rats reduced ROS production, TNFα and NO release from peritoneal macrophages, and decreased the Th:cytotoxic T cell ratio in ILN. In conclusion, a cocoa flavonoid-enriched diet in LOU rats with CIA produced no effect on hind-paw swelling but was able to modulate the specific antibody response and also the Th lymphocyte proportion, as well as the synthesis of pro-inflammatory mediators from peritoneal macrophages. Therefore, a cocoa-enriched diet could be a good adjuvant therapy in disorders with oxidative stress or autoimmune pathogenesis.

Neural, endocrine, and immune stress mediators are hypothesized to increase risks of diverse chronic diseases, including arthritis. Retrospective data from the World Mental Health Surveys (N=18,309) were employed to assess whether adult onset of arthritis was associated with childhood adversities and early onset psychological disorder. Cox proportional hazard models assessed the association of number of childhood adversities and the presence of early onset psychological disorder with arthritis age of onset. Controlling for age, sex, and early onset mental disorder, relative to persons with no childhood adversities, persons with two adversities had an increased risk of adult onset arthritis (hazard ratio=1.27, 95% CI=1.08, 1.50), while persons with three or more adversities had a higher risk (HR=1.44, CI=1.24, 1.67). Early onset depressive and/or anxiety disorder was associated with an increased risk of adult onset arthritis after controlling for childhood adversities (HR=1.43, CI=1.28, 1.61). Since psychosocial stressors may be broad spectrum risk factors that increase risks of diverse chronic conditions in later life (e.g. arthritis, heart disease, diabetes, asthma, and chronic pain), prospective studies of childhood psychosocial stressors may be most productive if multiple disease outcomes are assessed in the same study. Results from this study provide methodological guidance for future prospective studies of the relationship between childhood psychosocial stressors and subsequent risk of adult onset arthritis. These activities were supported by the United States National Institute of Mental Health (R01MH070884), the John D. and Catherine T. MacArthur Foundation, the Pfizer Foundation, the US Public Health Service (R13- MH066849, R01-MH069864, and R01 DA016558), the Fogarty International Center (FIRCA R01-TW006481). The Mexican National Comorbidity Survey (MNCS) is supported by The National Institute of Psychiatry Ramon de la Fuente (INPRFMDIES 4280) and by the National Council on Science and Technology (CONACyT-G30544- H). The Lebanese survey is supported by the Lebanese Ministry of Public Health, the WHO (Lebanon) and unrestricted grants from Janssen Cilag, Eli Lilly, GlaxoSmithKline, Roche, Novartis, Fogerty (R03 TW0006481). The ESEMeD project was funded by the European Commission (Contracts QLG5-1999-01042; SANCO 2004123), the Piedmont Region (Italy), Fondo de Investigación Sanitaria, Instituto de Salud Carlos III, Spain (FIS 00/0028), Ministerio de Ciencia y Tecnología, Spain (SAF 2000-158-CE), Departament de Salut, Generalitat de Catalunya, Spain. The World Mental Health Japan (WMHJ) Survey is supported by the Grant for Research on Psychiatric and Neurological Diseases and Mental Health (H13-SHOGAI-023, H14-TOKUBETSU-026, H16-KOKORO-013) from the Japan Ministry of Health, Labour and Welfare. The South Africa Stress and Health Study (SASH) is supported by the US National Institute of Mental Health (R01-MH059575). The Ukraine Comorbid Mental Disorders during Periods of Social Disruption (CMDPSD) study is funded by the US National Institute of Mental Health (RO1-MH61905). The US National Comorbidity Survey Replication (NCS-R) is supported by the National Institute of Mental Health (NIMH; U01- MH60u0) with supplemental support from the Robert Wood Johnson Foundation (RWJF; Grant 044780)

Presentamos el caso de una paciente afecta de artritis juvenil en tratamiento con etanercept que tras quedar embarazada mantiene el tratamiento a dosis estándar con dicho fármaco 25 mg dos veces por semana, sin presentar actividad ni complicaciones y con embarazo normal a término.

POLYARTHRITIS SECONDARY TO INTRAVESICAL BCG INSTILLATION, A CASE REPORT Immunotherapy with intravesical instillation of Bacillus Calmette is the best complementary after TUR treatment against T1 grade 2- 3 and CIS bladder cancer. However, this therapy is associated with several side- effects, incluiding joint symptoms. In this article we describe a case of polyarthritis associated with intravesical instillation, a rare complication. We review the clinical features, the pathogenic mechanisms and treatments described previously in the medical literature. Finally, we expose our brief experience and our final result.

Cryptococcal infection is not frequent in immunocompetent patients. The most commonly involved sites are the lungs and the central nervous system. Cryptococcal osteomyelitis occurs in 5-10% of patients with disseminated cryptococcosis with few reports of cryptococcal arthritis in elderly adults. We describe the case of a 92-year-old woman with a Cryptococcus neoformans knee joint infection associated to osteomyelitis.

Adjuvant-induced arthritis is associated with body weight loss and decreased pituitary growth hormone (GH) and hepatic insulin-like growth factor-I (IGF-I) synthesis. Cytokines as tumor necrosis factor (TNF) mediate wasting associated with chronic inflammation. The aim of this study was to analyse whether the inhibition of TNF is able to revert the decrease in the body weight and the GH/IGF-I axis in arthritic rats. Male Wistar rats were injected with Freund's adjuvant, and 15 days later arthritic and control rats were daily injected with polyethylene glycol linked to soluble TNF receptor p55 (PEG-sTNFRI) (1 mg/kg, s.c.) or saline for 8 days. There was a significant decrease in pituitary GH mRNA (P < 0.05), hepatic IGF-I mRNA (P < 0.01) and serum concentrations of IGF-I (P < 0.01) in arthritic rats. The 8-day administration of PEG-sTNFRI resulted in an increase in food intake (P < 0.05) and body weight gain (P < 0.01) in arthritic but not in control rats. There was an increase in pituitary GH mRNA after PEG-sTNFRI treatment both in control and in arthritic rats. There was a significant increase in IGF-I serum concentrations (P < 0.05) and hepatic IGF-I mRNA expression (P < 0.05) in control rats treated with PEG-sTNFRI, whereas the effect of this anti-TNF agent in arthritic rats was only statistically significant in hepatic IGF-I mRNA expression (P < 0.05). These data suggest that TNF seems to be involved in the decrease in GH and IGF-I synthesis in arthritic rats. Sin financiación 2.522 JCR (2006) Q2, 72/199 Pharmacology & pharmacy UEM

Experimental arthritis induced by Freund-adjuvant administration is a model of chronic inflammation and rheumatoid arthritis associated with a decrease in pituitary growth hormone (GH) and hepatic insulin-like growth factor I (IGF-I) gene expression. Excessive nitric oxide (NO) synthesis by inducible NO synthase (iNOS) has been implicated in the pathogenesis of inflammatory illness. Moreover, NO participates in the regulation of GH secretion at both the hypothalamus and the pituitary. We have examined the role of iNOS activation in producing the changes in the GH-IGF-I axis in arthritic rats. Adult male Wistar rats received aminoguanidine or vehicle from day 20, after adjuvant or vehicle injection, until day 28. Two hours and 30 min after the last aminoguanidine injection, all rats were killed by decapitation. Arthritis increased hypothalamic expression of somatostatin mRNA while it decreased pituitary GH mRNA expression, and both effects were prevented by aminoguanidine administration. In arthritic rats, the parallel decrease in serum IGF-I, and in hepatic IGF-I content and mRNA expression, correlates with the decrease in circulating GH concentrations. Aminoguanidine administration to arthritic rats did not modify either serum GH or serum IGF-I concentrations, or hepatic IGF-I mRNA expression. However, aminoguanidine administration to control rats resulted in a decrease in serum GH concentrations and in a decrease in both hepatic IGF-I mRNA expression and serum IGF-I concentrations. These data suggest that NO mediates the arthritis-induced decrease in GH mRNA expression by acting at a hypothalamic level, but it is not involved in the decrease in hepatic IGF-I mRNA expression. Sin financiación 3.418 JCR (2003) Q2, 24/88 Endocrinology & metabolism, 50/198 Neurosciences UEM

This study was designed to investigate whether nitric oxide (NO) mediates changes in insulin-like growth factor binding protein-3 (IGFBP-3) levels in rats with adjuvant-induced arthritis. Male Wistar rats were injected with complete Freund's adjuvant, and 20 days afterwards arthritic and control rats were injected daily with an inhibitor of inducible NO synthase (iNOS), aminoguanidine, or vehicle for 8 days. The increase in serum levels of IGFBP-3 induced by arthritis was exacerbated by aminoguanidine treatment. Arthritis increased IGFBP-3 mRNA levels in the kidney but not in the liver. The inhibition of iNOS did not modify IGFBP-3 gene expression in the kidney or in the liver in arthritic rats. However, the inhibitory effect of arthritis on the proteolysis of IGFBP-3 in serum was potentiated by aminoguanidine administration. These results indicate that arthritis increases serum IGFBP-3 by increasing its synthesis in the kidney and decreasing its proteolysis in serum and that these effects are not mediated by NO. Sin financiación 2.352 JCR (2003) Q2, 56/185 Pharmacology & pharmacy UEM

Experimental arthritis in rats results in a growth failure and a decrease in circulating and hepatic concentrations of insulin-like growth factor I (IGF-I). Renal damage has also been reported in arthritic rats. The aim of this study was 1) to analyse if alterations in the IGF-I system in the kidney occurs in adjuvant-induced arthritis and 2) to analyse if recombinant human GH (rhGH) administration is able to reverse these effects. Male Wistar rats were injected with complete Freund's adjuvant or vehicle and 22 days later they were killed. Arthritis increased serum creatinine levels, relative kidney weight and IGF-I concentrations in this organ. In a second experiment, arthritic and control rats received rhGH (3 UI/Kg sc) or 250 μl saline from day 14, after adjuvant or vehicle injection, until day 22. IGF-I concentrations were higher in both the renal cortex and medulla of arthritic rats. In contrast, kidney IGF-I mRNA was lower in both areas of arthritic animals. GH treatment significantly decreased serum creatinine levels and IGF-I concentrations in the kidney cortex and medulla of arthritic rats. However, the administration of rhGH to arthritic animals significantly increased the IGF-I gene expression in both the renal cortex and medulla. Serum and kidney concentrations of IGF-I binding proteins (IGFBPs) were increased in arthritic animals and they were reduced by GH administration. Conclusion: These data suggest that experimental arthritis causes renal dysfunction and GH treatment can ameliorate this effect. Sin financiación 1.824 JCR (2002) Q2, 33/74 Medicine, research & experimental, 74/188 Pharmacology & pharmacy UEM