• Clinical and Experimental Pediatrics
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• 제54권7호
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• pp.313-315
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• 2011

Reactive arthritis comprises a subgroup within infection-associated arthritides in genetically susceptible hosts. Researchers and clinicians recognize two clinical forms of reactive arthritis which occurs after genitourinary tract infection and after gastrointestinal tract infection. Chlamydia infection has been implicated as the most common agent associated with post-venereal reactive arthritis. Studies have proposed Shigella infection, Salmonella infection, or Yersinia infection as the microorganisms responsible for the post-dysenteric form. The human leukocyte antigen (HLA)-B27 antigen is the best-known predisposing factor. We report a case of HLA-B27-associated reactive arthritis after Salmonella enteritis at Pusan National University hospital.

• Pediatric Infection and Vaccine
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• 제11권2호
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• pp.208-211
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• 2004

임상적으로 급성 류마티스 열을 진단할 때 Jones 진단기준에 맞지 않는 경우, 특히 관절염이 있고, 이하학적 검사상 A군 베타 용혈성 연구균감염과 관련이 있을 때, 급성 류마티스 열과 연구균 감염성 반응성 관절염의 구분은 치료나 예후를 결정하는데 중요하다. 지금까지의 문헌을 참고한 결과, 연구균 감염성 반응성 관절염으로 진단된 환아 중 소수에서도 심염이 발생했음을 알 수 있고, 따라서 예방적 항생제 요법을 시행함에 있어 1년간 매달 페니실린 예방요법을 시행하고 심염이 발생한 경우에는 급성 류마티스 열로 재분류 후 이에 준해 치료하여야 하겠다. 저자들의 증례는 고열과 왼쪽 무릎 관절통을 주소로 내원한 연구균 감염성 반응성 관절염 환아 1례를 경험하였기에 보고하는 바이다.

• 대한의생명과학회지
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• 제27권4호
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• pp.298-309
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• 2021

Rheumatoid arthritis refers to acute and chronic arthritis due to unexplained autoantibody attack. Rheumatoid arthritis should be accompanied by difficulty in mobility and severe distress due to the progression of systemic arthritis. Therefore, this study early diagnoses the effects of Rheumatoid factor (RF), C-reactive protein (CRP), and Anti-cyclic citrullinated peptide (Anti-CCP), which are typical serum markers for rheumatoid arthritis by meta-analysis. Pubmed and EMBASE, were used as PICO criteria, and two independent researchers selected papers according to the criteria set in this study. The selection criteria was a study of patients with rheumatoid arthritis who developed early onset, and the paper was evaluated using the NCS. Forest plot and Funnel plot graphs for each serum marker were calculated using Revman 5.4. After finding 193 papers on Pubmed and 184 papers on EMBASE and selecting according to the criteria, a total of 41 papers were used for the analysis. The magnitude of the effect that appears in the Forest plot of RF with the Mean differnce value is 134.34, CRP is 21.42 and Anti-CCP is 270.41. The magnitude of the effect of Anti-CCP in meta-analysis was analyzed to be larger than that of RF and CRP, and it is considered that the development of early-diagnosis serum markers using Anti-CCP and additional retrospective studies are highly effective. The combination of RF, CRP, and Anti-CCP as a panel marker is expected to be very efficient.

• Biomolecules & Therapeutics
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• 제28권5호
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• pp.414-422
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• 2020

Fangchinoline (FAN) is a bisbenzylisoquinoline alkaloid that is widely known for its anti-tumor properties. The goal of this study is to examine the effects of FAN on arthritis and the possible pathways it acts on. Human fibroblast-like synovial cells (FLS), carrageenan/kaolin arthritis rat model (C/K), and collagen-induced arthritis (CIA) mice model were used to establish the efficiency of FAN in arthritis. Human FLS cells were treated with FAN (1, 2.5, 5, 10 µM) 1 h before IL-1β (10 ng/mL) stimulation. Cell viability, reactive oxygen species measurement, and western blot analysis of inflammatory mediators and the MAPK and NF-κB pathways were performed. In the animal models, after induction of arthritis, the rodents were given 10 and 30 mg/kg of FAN orally 1 h before conducting behavioral experiments such as weight distribution ratio, knee thickness measurement, squeaking score, body weight measurement, paw volume measurement, and arthritis index measurement. Rodent knee joints were also analyzed histologically through H&E staining and safranin staining. FAN decreased the production of inflammatory cytokines and ROS in human FLS cells as well as the phosphorylation of the MAPK pathway and NF-κB pathway in human FLS cells. The behavioral parameters in the C/K rat model and CIA mouse model and inflammatory signs in the histological analysis were found to be ameliorated in FAN-treated groups. Cartilage degradation in CIA mice knee joints were shown to have been suppressed by FAN. These findings suggest that fangchinoline has the potential to be a therapeutic source for the treatment of rheumatoid arthritis.

• IMMUNE NETWORK
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• 제3권1호
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• pp.1-7
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• 2003

Type II collagen (CII), major component of hyaline cartilage, has been considered as an auto-antigen in rheumatoid arthritis (RA). However, the clinical and biological significances with regard to the CII autoimmunity need to be clarified in human RA. The presence of antibodies to CII has been identified in sera, synovial fluid, and cartilage of patients with RA. In our study, the increased titer of IgG anti-CII in sera was well correlated with C-reactive protein, suggesting that this antibody may reflect the inflammatory status of RA. The titer of anti-CII antibodies (anti-CII Abs) tended to be higher in early stages of diseases. In our extending study, among 997 patients with RA, 269 (27.0%) were positive for circulatory IgG antibody to CII, those levels were fluctuated over time. It is hard to assess the significant amount of T cell responses to CII and CII (255~274) in RA. By using a sensitive method of antigen specific mixed lymphocyte culture, we can detect the presence of CII-reactive T cells in peripheral blood mononuclear cells of RA patients. Sixty seven (46.9%) of 143 patients showed positive CII reactive T cell responses to CII or CII (255~274). The frequencies of CII reactive T cells were more prominent in inflamed synovial fluid (SF) than in peripheral blood. These T cells could be clonally expanded after consecutive stimulation of CII with feeding of autologous irradiated antigen presenting cells (APC). Moreover, the production of Th1-related cytokine, such as IFN-${\gamma}$, was strongly up-regulated by CII reactive T cells. These data suggest that T cells responding to CII, which are probably presenting the IFN-${\gamma}$ producing cells, may play an important role in the perpetuation of inflammatory process in RA. To evaluate the effector function of CII reactive T cells, we investigated the effect of CII reactive T cells and fibroblasts-like synoviocytes (FLS) interaction on the production of pro-inflammatory cytokines. When the CII reactive T cells were co-cultured with FLS, the production of IL-15 and TNF-${\alpha}$ from FLS were significantly increased (2 to 3 fold increase) and this increase was clearly presented in accord to the expansion of CII reactive T cells. In addition, the production of IFN-${\gamma}$ and IL-17, T cell derived cytokines, were also increased by the co-incubation of CII reactive T cells with FLS. We also examined the impact of CII reactive T cells on chemokines production. When FLS were co-cultured with CII stimulated T cells, the production of IL-8, MCP-1, and MIP-1${\alpha}$ were significantly enhanced. The increased production of these chemokines was strongly correlated with increase the frequency of CII reactive T cells. Conclusively, immune response to CII was frequently found in RA. Activated T cells in response to CII contributed to increase the production of proinflammatory cytokines and chemokines, which were critical for inflammatory responses in RA. The interaction of CII-reactive T cells with FLS further augmented this phenomenon. Taken together, our recent studies have suggested that autoimmunity to CII could play a crucial role not only in the initiation but amplification/perpetuation of inflammatory process in human RA.

• IMMUNE NETWORK
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• 제14권1호
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• pp.7-13
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• 2014

Molecular mimicry is an attractive mechanism for triggering autoimmunity. In this review, we explore the potential role of evolutionary conserved bacterial proteins in the production of autoantibodies with focus on granulomatosis with polyangiitis (GPA) and rheumatoid arthritis (RA). Seven autoantigens characterized in GPA and RA were BLASTed against a bacterial protein database. Of the seven autoantigens, proteinase 3, type II collagen, binding immunoglobulin protein, glucose-6-phosphate isomerase, ${\alpha}$-enolase, and heterogeneous nuclear ribonuclear protein have well-conserved bacterial orthologs. Importantly, those bacterial orthologs are also found in human-associated bacteria. The wide distribution of the highly conserved stress proteins or enzymes among the members of the normal flora and common infectious microorganisms raises a new question on how cross-reactive autoantibodies are not produced during the immune response to these bacteria in most healthy people. Understanding the mechanisms that deselect auto-reactive B cell clones during the germinal center reaction to homologous foreign antigens may provide a novel strategy to treat autoimmune diseases.

• 대한물리의학회지
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• 제6권1호
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• pp.39-49
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• 2011

Purpose : The purpose of this study was to investigate the effectiveness of pain release through the four weeks aquatic exercise among the female subjects aged above 50 and who suffered from arthritis. Methods : The assessment was validated by blood analysis which measured the fluctuations of Erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and Rheumatoid factor(RF). Among the 50 subjects of this experiment, the control group has only taken a regular treatment from the clinic and the other experimental group has done aquatic exercise. The experimental group has practiced the aquatic exercise 50 minutes a day for one month excluding the weekends. Results : Blood analysis revealed that ESR was decreased in both the control group and the experimental group and the major effect of CRP was diminished only in the experimental group. No significance of RF was found in both the control group and the experimental group. Conclusion : These results indicate that the aquatic exercise is an effective treatment for arthritis that is compatible with the similar results from the previous studies. In line with this, the aquatic exercise program can provide an effective treatment and control of the disease with the arthritis patient. Accordingly, the regular basis aquatic exercise proved to be quite satisfactory treatment in this regard and we contend that it is vital for the arthritis patients.

• Clinics in Shoulder and Elbow
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• 제8권2호
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• pp.110-116
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• 2005

Purpose: Urgent diagnosis and treatment of the septic arthritis is required. The purpose of this study is to review to correlate preoperative MRI findings with arthroscopic findings in septic arthritis of the glenohumeral joint. Materials and Methods: Eleven patients with acute septic arthritis of the glenohumeral joint were treated with combination of arthroscopic lavage, debridement, and systemic antibiotics. The arthroscopic staging of infection was made based on the modified criteria of $G\"{a}chter$ and five major findings of MRI were marked in each stage of septic shoulder. Results: Bone and cartilage erosion was the end stage finding and two patients with all five positive findings had failed with arthroscopic treatment. Reactive bone marrow edema was evident in the greater tuberosity. Joint effusion, synovial thickening and soft tissue edema were rather non-specific finding and presented in all stages of septic shoulder. Conclusion: Diffuse marrow edema with metaphyseal cyst formation in the preoperative MRI implied advanced stage of septic arthritis, which may fail with arthroscopic debridement.

• 대한정형외과학회지
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• 제54권1호
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• pp.30-36
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• 2019

목적: 관절경적 수술을 시행받은 감염성 슬관절염 환자들에서 성별, 나이, 기저질환, 증상 발생 후 수술까지 걸린 기간, 발병 전 침습적 시술의 시행 여부, 관절 천자액의 세균 배양, Gachter 분류를 통한 세균 감염의 정도가 치료 예후에 미치는 영향에 대해 알아보고자 한다. 대상 및 방법: 2014년 6월부터 2016년 12월까지 감염성 슬관절염으로 관절경적 수술을 시행받은 51명의 환자를 대상으로 하였으며, 평균 추시 기간은 14.2±2.1개월(12-20개월)이었다. 남자가 27명(52.9%), 여자가 24명(47.1%)이며, 평균 나이는 55.1±17.6세(13-84세)였다. 수술 전 시행한 관절 천자검사상 백혈구 수가 50,000개 이상, 다형핵 백혈구 수의 비율이 95% 이상인 환자를 감염성 슬관절염으로 진단하고 수술을 시행하였다. 모든 환자에서 관절경적 수술과 수술 후 지속적인 관절 세척을 시행하였다. 결과: C-반응 단백의 초기 평균 수치는 9.55±6.76 mg/dl (1.51-31.06 mg/dl)에서 최종 평균 수치는 0.74±1.26 mg/dl (0.08-6.77 mg/dl)로 감소하였으며, 평균 C-반응 단백의 정상화 기간은 27.6±18.9일(8-93일)이었다. 관절경적 수술과 항생제 사용 후 발열, 동통, 부종 등의 임상증상이 호전되고 C-반응 단백의 수치가 0.5 mg/dl 이하로 감소하여 감염성 슬관절염의 완치 판정을 받은 환자는 51예 중 44예(86.3%)이며, 최종적으로 두 번 이상의 관절경적 수술을 시행한 환자가 5예, prosthesis of antibiotic-loaded acrylic cement 후 인공관절 치환술로 전환한 환자가 2예이다. 결론: 지금까지 문헌들에서 알려진 것처럼 증상 발생 후 수술까지 걸린 기간과 Gächter 분류에 따른 병기는 감염성 슬관절염의 치료 성공 여부에 유의하게 영향을 주었다. 하지만 이외의 인자들은 통계적으로 유의한 상관관계가 없었다. 단 관절 천자액에서 세균이 배양된 환자군은 대조군보다 유의하게 C-반응 단백의 정상화 기간이 짧아 치료 기간을 반영하는 것으로 보인다.

• BMB Reports
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• 제49권6호
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• pp.331-336
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• 2016

In murine collagen-induced arthritis (CIA), self-reactive T cells can recognize peptide antigens derived from type-II collagen (CII). Activation of T cells is an important mediator of autoimmune diseases. Thus, T cells have become a focal point of study to treat autoimmune diseases. In this study, we evaluated the efficacy of recombinant MHC class II molecules in the regulation of antigen-specific T cells by using a self peptide derived from CII (CII260-274; IAGFKGEQGPKGEPG) linked to mouseI-A^q in a murine CIA model. We found that recombinant I-A^q/CII260-274 molecules could be recognized by CII-specific T cells and inhibit the same T cells in vitro. Furthermore, the development of CIA in mice was successfully prevented by in vivo injection of recombinant I-A^q/CII260-274 molecules. Thus, treatment with recombinant soluble MHC class II molecules in complex with an immunodominant self-peptide might offer a potential therapeutic for chronic inflammation in autoimmune disease such as rheumatoid arthritis.