• Journal of Acupuncture Research
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• v.39 no.1
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• pp.64-69
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• 2022

The risk of stress fractures is associated with rheumatoid arthritis (RA), which can aggravate bone loss. We report the case of a patient who was on long-term medication for RA presenting with lower extremity pain on the left and swelling without trauma. Magnetic resonance imaging and plain radiographs at the previous hospital showed no signs of fracture, but radiographs performed later, revealed a stress fracture of the left distal tibia. The stress fracture may have occurred due to multiple reasons such as long-term use of methotrexate and glucocorticoids, active RA, postmenopausal state, and immobility. Suspicion of a stress fracture should not be ruled out especially in RA patients with persistent pain, even if the radiographical findings are normal. Additional imaging and follow-ups are essential. The patient's pain was relieved with Korean medicine treatments, which suggests their potential application for stress fractures in RA patients.

• Clinics in Shoulder and Elbow
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• v.19 no.3
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• pp.179-185
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• 2016

Rheumatoid arthritis (RA) is a systemic disease with medication as the treatment of choice. However, surgical treatment is recommended when no improvement is noted despite aggressive conservative treatment. Synovectomy provides desirable outcomes for RA patients in the early stage with a glenohumeral joint of Larsen grade II or less; conversely, arthroplasty is recommended for patients with a glenohumeral joint of grade III or higher. RA patients often have attenuation and dysfunction of the rotator cuff, and reverse shoulder arthroplasty has been proven to provide favorable outcomes in some patients. RA is often complicated with osteoporosis and bony deformity; therefore, close attention is necessary to prevent fractures during shoulder arthroplasty.

• Korean Journal of Clinical Pharmacy
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• v.8 no.1
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• pp.1-12
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• 1998

Rheumatoid arthritis (RA) is a common systemic inflammatory disease which DMARDS have been widely used as a treatment modality both as monotherapy and combination therapy Bucillamine, one of newer DMARDS, has recently proven its efficacy as monotherapy in the treatment of RA. The objective of this study was to compare the efficacy and the safety of bucillamine monotherapy and bucillamine plus methotrexate combination therapy in the treatment of rheumatoid arthritis. Forty-nine mild RA patients were enrolled in this prospective, open-trial and were assigned to receive bucillamine 200 mg/day (n=18) or bucillamine 200 mg/day and methotrexate 7.5-15 mg/week (n=31) orally for 16 weeks. Concomitant use of NSAID and prednisolone <5 mg/day or equivalent dose of steroid were allowed. Both monotherapy group and combination therapy group have shown significant improvement in disease activities (Ritchie index, painful joints, swollen joints, morning stiffness, grip strength, ESR, RF, CRP, patient's self assessment of pain, physician's global assessment of disease activity) from the baseline. However, there was no statistically significant difference between two groups. The adverse effects were more frequently shown in combination therapy group than monotherapy group. In conclusion, in patients with mild RA monotherapy has shown to be equally efficacious as combination therapy with less side effects.

• Reproductive and Developmental Biology
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• v.35 no.2
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• pp.143-149
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• 2011

Arthritis is a common disease in aged people, and is clinically divided into rheumatoid arthritis (RA) and osteoarthritis (OA). Although common symptoms such as pain are present, the underlying pathological mechanisms are slightly different. Therefore, the objectives of the present study were to compare joint damage induced by RA and OA by analyzing the major morphological and molecular differences, and to propose a suitable therapeutic intervention based on the pathophysiological conditions of bones and joints. For the RA animal model, 8-week-old DBA1/J mice were immunized with bovine type II collagen emulsified in complete Freund's adjuvant (CFA). Normal C57BL/6 mice (over 2 years of age) were used for OA. The clinical arthritis score was calculated using a subjective scoring system, and paw thicknesses were measured using calipers. The serum TNF ${\alpha}$ level was analyzed using an ELISA kit. Micro-CT was used to identify pathological characteristics and morphological changes. In collagen-induced RA mice, there were increased ankle joint volumes and clinical scores (p<0.01). The concentration of TNF ${\alpha}$ was significantly increased from 3 to 7 weeks after immunization. Micro-CT images showed trabecular bone destruction, pannus formation, and subchondral region destruction in RA mice. OA among aged mice showed narrowed joint spaces and breakdown of articular cartilage. This study suggests that a careful therapeutic intervention between RA and OA is required, and it should be based on morphological alteration of bone and joint.

• Journal of Life Science
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• v.23 no.7
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• pp.919-925
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• 2013

Human thymic stromal lymphopoietin receptor (TSLPR) might play an important role in the development of inflammatory and allergic responses. We previously identified eleven single nucleotide polymorphisms (SNPs) and two variation sites in the TSLPR gene and showed that all the SNPs of the TSLPR gene are associated with susceptibility to atopic asthma. The present study aimed to investigate whether the TSLPR gene SNPs are associated with susceptibility to rheumatoid arthritis (RA). We compared the genotype and the allele frequencies of the TSLPR SNPs in 457 RA patients and 570 healthy controls. The genotype and the allele frequencies of the TSLPR gene SNPs in the RA patients were not significantly different from the respective frequencies of the healthy controls. Additional analysis showed that the genotype and the allele frequencies of the TSLPR gene SNPs did not appear to be associated with RA in female RA patients. The TSLPR gene SNPs in the RA patients did not affect the production of rheumatoid factor (RF) and antisynthetic cyclic citrullinated peptide (CCP). Our results suggest that the TSLPR gene SNPs are not associated with susceptibility to RA in the Korean population.

• Food Science and Biotechnology
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• v.16 no.1
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• pp.43-48
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• 2007

Collagen-induced arthritis (CIA) is a model for some types of human autoimmune rheumatoid arthritis (RA). In this study, we examined whether ethanol extract of potato (Solanum tuberosum) is efficacious against CIA in mice. Potato extracts (100 and 200 mg/kg) were orally administered to DBA/1J mice once daily for 49 day after initial immunization with type II collagen. Clinical assessment of disease and measurement of paw edema were conducted throughout the study. The production of CIA-related rheumatoid factor, anti-type II collagen antibody, and cytokines were examined in DBA/1J mice. Serum levels of AST, ALT, creatinine, and lipids were measured, and antioxidant enzyme activity in the spleen was also determined. The arthritis score and paw edema were markedly suppressed in the groups treated with potato extract. Levels of rheumatoid factor, anti-type II collagen antibody, interleukin (IL)-1, IL-6, LDL-cholesterol, and malondialdehyde in sera were also reduced by potato extract treatment. The activities of glutathione peroxidase and glutathione reductase were increased in the spleens of CIA mice treated with potato extract. These findings suggest that potato extract has suppressive effects on type II collagen-induced arthritis, an animal model for human RA.

• Journal of Oral Medicine and Pain
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• v.48 no.1
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• pp.31-36
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• 2023

This report presents the case of a 14-year-old male with rheumatoid arthritis (RA) in both temporomandibular joints (TMJs), in whom a bone scan and laboratory tests were used to confirm the diagnosis. The patient visited the Department of Orofacial Pain and Oral Medicine at the affiliation hospital with a complaint of a 1-year history of bilateral TMJ pain and sound. Clinical examination revealed bilateral TMJ and masseter muscle pain during mouth opening and palpation. Radiological examination revealed no significant morphological changes in either TMJ. The patient was prescribed medications at the first visit to address the pain, inflammation, and stiffness. A bone scan and laboratory tests were planned/scheduled for differential diagnosis between simple arthralgia and osteoarthritis. The bone scan revealed increased radiotracer uptake in both TMJs. The laboratory tests revealed a RA factor of 82.4 IU/mL, which is more than four times the normal range. The final diagnoses were bilateral TMJ early rheumatoid arthritis (ERA) and juvenile idiopathic arthritis. We created a stabilization splint and referred the patient to the Department of Rheumatology for further evaluation of the ERA. After fitting of the stabilization splint and giving instructions regarding its use, the patient has been receiving monthly follow-up checks for symptoms and undergoes follow-up blood tests every 3 months. About 14 months after the initial visit, the pain had significantly decreased from a Visual Analog Scale score of 5 to 1, and the RA factor decreased to 66.6 IU/mL. A regular follow-up check will continue until the end of growth.

• IMMUNE NETWORK
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• v.2 no.4
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• pp.208-216
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• 2002

Background: Reactive oxygen and nitrogen are produced by rheumatoid arthritis (RA) synovial tissue and can induce mutations in key genes. Normally, this process is prevented by a DNA mismatch repair (MMR) system that maintains sequence fidelity. Key members of the MMR system include MutS${\alpha}$ (comprised of hMSH2 and hMSH6), which can sense and repair single base mismatches and 8-oxoguanine, and MutS${\beta}$ (comprised of hMSH2 and hMSH3), which repairs longer insertion/deletion loops. Methods: To provide further evidence of DNA damage, we analyzed synovial tissues for microsatellite instability (MSI). MSI was examined by PCR on genomic DNA of paired synovial tissue and peripheral blood cells (PBC) of RA patients using specific primer sequences for 5 key microsatellites. Results: Surprisingly, abundant MSI was observed in RA synovium compared with osteoarthritis (OA) tissue. Western blot analysis of the same tissues for the expression of MMR proteins demonstrated decreased hMSH6 and increased hMSH3 in RA synovium. To evaluate potential mechanisms of MMR regulation in arthritis, fibroblast-like synoviocytes (FLS) were isolated from synovial tissues and incubated with the nitric oxide donor S-nitroso-N-acetylpenicillamine (SNAP). Western blot analysis demonstrated constitutive expression of hMSH2, 3 and 6 in RA and OA FLS. When FLS were cultured with SNAP, the RA synovial pattern of MMR expression was reproduced (high hMSH3, low hMSH6). Conclusion: Therefore, oxidative stress can relax the DNA MMR system in RA by suppressing hMSH6. Decreased hMSH6 can subsequently interfere with repair of single base mutations, which is the type observed in RA. We propose that oxidative stress not only creates DNA adducts that are potentially mutagenic, but also suppresses the mechanisms that limit the DNA damage.

• Journal of muscle and joint health
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• v.18 no.2
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• pp.137-146
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• 2011

Purpose: The purpose of the study was to compare the effects of Tai Chi exercise program on arthritic pain, difficulties in performing activities of daily living, and fear of falling in women with osteoarthritis (OA) and rheumatoid arthritis (RA). Method: A quasi-experimental design with two intervention groups was used. According to the inclusion criteria, 35 women with OA and 22 with RA were recruited and participated in the Tai Chi for arthritis program for 12 weeks. In 12 weeks, 21 in the OA group and 15 in the RA group completed both pretest and posttest measures. Outcome variables consisted of pain, difficulties in performing activities of daily living, and fear of falling for both groups. Results: The women with OA (64 years) were significantly older and perceived better health than those with RA (49 years) with more than 6 years of diagnosis. The pain scores and the performance of activities of daily living were significantly improved in the OA group at the completion of 12 week Tai Chi exercise, but RA group decreased pain only. The improvements in pain and activities of daily living were significantly more in women with OA than those with RA. No significant changes were found in fear of falling for both groups. Conclusion: The 12 week Tai Chi exercise was more effective on pain and activities of daily living for women with OA than those with RA. Considering that the women with RA perceived more pain and had limited activities of daily living, Tai Chi exercise should be applied slowly and gradually for longer period of time than those with OA.

• Molecules and Cells
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• v.46 no.4
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• pp.231-244
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• 2023

Leucine-rich repeat containing 15 (LRRC15) has been identified as a contributing factor for cartilage damage in osteoarthritis; however, its involvement in rheumatoid arthritis (RA) and the underlying mechanisms have not been well characterized. The purpose of this study was to explore the function of LRRC15 in RA-associated fibroblast-like synoviocytes (RA-FLS) and in mice with collagen-induced arthritis (CIA) and to dissect the epigenetic mechanisms involved. LRRC15 was overexpressed in the synovial tissues of patients with RA, and LRRC15 overexpression was associated with increased proliferative, migratory, invasive, and angiogenic capacities of RA-FLS and accelerated release of pro-inflammatory cytokines. LRRC15 knockdown significantly inhibited synovial proliferation and reduced bone invasion and destruction in CIA mice. Runt-related transcription factor 1 (RUNX1) transcriptionally represses LRRC15 by binding to core-binding factor subunit beta (CBF-β). Overexpression of RUNX1 significantly inhibited the invasive phenotype of RA-FLS and suppressed the expression of proinflammatory cytokines. Conversely, the effects of RUNX1 were significantly reversed after overexpression of LRRC15 or inhibition of RUNX1-CBF-β interactions. Therefore, we demonstrated that RUNX1-mediated transcriptional repression of LRRC15 inhibited the development of RA, which may have therapeutic effects for RA patients.