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.
Hyemin Kim;Soyoung Lee;Ji-Won Kim;Ju-Yang Jung;Chang-Hee Suh;Hyoun-Ah Kim
The Korean journal of internal medicine
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v.39
no.1
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pp.172-183
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2024
Background/Aims: This study aimed to identify the clinical characteristics of patients with concurrent rheumatoid arthritis (RA) and suspected non-tuberculous mycobacterial (NTM) infections as well as determine their prognostic factors. Methods: We retrospectively reviewed the medical records of 91 patients with RA whose computed tomography (CT) findings suggested NTM infection. Subsequently, we compared the clinical characteristics between patients with and without clinical or radiological exacerbation of NTM-pulmonary disease (PD) and investigated the risk factors for the exacerbation and associated mortality. Results: The mean age of patients with RA and suspected NTM-PD was 65.0 ± 10.2 years. The nodular/bronchiectatic (NB) form of NTM-PD was the predominant radiographic feature (78.0%). During follow-up, 36 patients (41.9%) experienced a radiological or clinical exacerbation of NTM-PD, whereas 12 patients (13.2%) died. Combined interstitial lung disease (ILD), microbiologically confirmed NTM-PD, and NB with the fibrocavitary (FC) form on chest CT were identified as risk factors for the clinical or radiological exacerbation of NTM-PD. Hydroxychloroquine use was identified as a good prognostic factor. Conversely, history of tuberculosis, ILD, smoking, microbiologically confirmed NTM-PD, and NB with the FC form on chest CT were identified as poor prognostic factors for mortality in suspected NTM-PD. Conclusions: ILD and NB with the FC form on chest CT were associated with NTM-PD exacerbation and mortality. Hydroxychloroquine use may lower the risk of NTM-PD exacerbation. Therefore, radiographic features and presence of ILD should be considered when predicting the prognosis of patients with RA and suspected NTM-PD.
Kesharwani, Disha;Paliwal, Rishi;Satapathy, Trilochan;Paul, Swarnali Das
Journal of Pharmacopuncture
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v.22
no.4
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pp.210-224
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2019
Rheumatoid arthritis is a severe autoimmune disorder, related to joints. It is associated with serious cartilage destruction. This causes disability and reduces the excellence of life. Numerous treatments are existed to combat this disease, however, they are not very efficient and possess severe side effects, higher doses, and frequent administration. Therefore, newer therapies are developed to overcome all these limitations. These include different monoclonal antibodies, immunoglobulins, small molecules used for immunotherapy and transgenes for gene therapy. One of the main goals of these new generation therapeutics is to address the underlying distressing biological processes by specifically targeting the causative agents with fewer systemic side effects and greater patient console. It is very fortuitous that loads of progressive investigations are going on in this field and many of them have entered into the successful clinical trial. But till date, a limited molecule has got FDA clearance and entered the market for treating this devastating disease. This review highlights the overview of conventional therapy and advancements in newer therapeutics including immunotherapy and gene therapy for rheumatoid arthritis. Further, different novel techniques for the delivery of these therapeutics of active and passive targeting are also described.
Objective : The aim is to examine the effect of Soyeum Pharmacopuncture (SPP) on collagen-induced arthritis (CIA) in DBA/1OlaHsd mice. Methods : To determine the effect of SPP on chronic IFNlammatory joint disease, we induced CIA in DBA/1OlaHsd mice by immunization with bovine type II collagen. Animals were treated with intraperitoneal injection doses of 2 mg/kg of SPP, beginning 3 days before the expected onset of disease symptoms. Inhibitory Effects of SPP were observed by serum levels of TNF-${\alpha}$, and IFN-${\gamma}$,,, or cell proliferation in the spleen cell culture and histological examination of knee joint. Results : In the CIA Mice, serum levels of TNF-${\alpha}$, and IFN-${\gamma}$,, production in the spleen cell culture were reduced. At the histopathological examination of knee joint, chondropathy of cartilage in the synovial joint in the SP group was repaired while compared with control group. Conclusion : These results suggest that the SPP may be effective for the prevention and treatment of rheumatoid arthritis disease.
Purpose: Rheumatoid arthritis (RA) is a chronic multi-systemic disease that causes damage to the bone and connective tissues. This study was conducted in order to accurately measure the correlation between RA and periodontitis, and to obtain an unbiased estimate of the effect of RA on periodontal indices. Methods: In this historical cohort study, which was conducted from February to May 2011 in Hamadan city, Iran, 53 exposed people (with RA) were compared with 53 unexposed people (without RA) in terms of clinical periodontal indices (the outcomes of interest) including 1) plaque index (PI), 2) bleeding on probing (BOP), and 3) clinical attachment loss (CAL). Results: A sample of 106 volunteers were evaluated, 53 rheumatoid versus 53 non-rheumatoid subjects. There was a statistically significant correlation between RA and BOP (P<0.001) and between RA and CAL (P<0.001). However, there was no statistically significant correlation between RA and any of the periodontal indices. No correlation was seen between gender and any of the indices either. There was a strong positive correlation between age and all three periodontal indices (P<0.001). Conclusions: The present study indicated a potential effect of RA on periodontal indices. However, much more evidence based on a prospective cohort study is needed to support the cause and effect relationship between RA and periodontal indices.
Objectives : The aim of this study was to know the immunity reponse of Esubwhaltong-tang(hereafter referred to ESWTT) to rheumatoid arthrits in CIA(collagen induced arthritis) mice. Methods : For this purpose, ESWTT was orally administerd to mice with arthritis induced by collagen II and then value of immunocyte in paw joint, cytokine(IL-6, $TNF-{\alpha}$), rheumatoid factor(IgG and IgM) and collagen II specific antibody in the serum were measured. Results : 1. The cytotoxicity was not shown on hFLSs and liver. 2. Marginal erosion, necrotic chodrocytes, cartilage and bone degradation were improved in histological section of paw joints from CIA mice(ESWTT extract administration group). 3. Total cell number of paw joint in CIA mice(ESWTT extract administration group) was decreased significantly. 4. The absolute number of CD3+, CD3+/CD69+, CD4+, CD4+/CD25+, CD49b+, CD3+/CD49b+ cells in CIA mice(ESWTT extract administration group) were decreased significantly. 5. The levels of IL-6 and $TNF-{\alpha}$ in the serum of CIA mice(ESWTT extract administration group) were decreased significantly. 6. The levels of total IgG and IgM in the serum of CIA mice(ESWTT extract administration group) were decreased significantly. 7. The level of collagen II specific antibody in the serum of CIA mice(ESWTT extract administration group) was decreased significantly. Conclusions : Comparison of the results for this study showed that ESWTT had immunomodulatory effects of suppressing. So we expect that ESWTT could be used as an effective drugs for not only rheumatoid arthritis but also auto-immune disease.
Background: Intraarticular local anesthetic injection has been therapeutically applied for pain control in various arthritis patients. However, little physiologic effects of local anesthetics on their tissue were known. This study was conducted to determine its effects on the cell proliferation and matrix metalloproteinases (MMP) production of cultured fibroblast like synoviocytes (FLS) derived from synovial tissues of rheumatoid arthritis patients. Methods: Bupivacaine with varying concentrations 0 (control), 0.1, 0.25, 0.5% was applied to experimental cell groups growing as monolayers in culture plates for varying durations 0 (control), 30, 90, 180 seconds in the presence and absence of interleukin-$1\beta$. Results: No statistical significances were noted in thymidine incorporation between 0, 30, 90 and 180 seconds exposure groups with 0.5% bupivacaine after 1 day and 2 days. Thymidine incorporation between 0, 0.1, 0.25, 0.5% exposure groups 1 day and 2 days after 90 seconds exposure did not show any differences. After exposure to bupivacaine, there were statistically significant increases in MMP-1 (p=0.025) and MMP-3 productions (p=0.000) of FLS in the absence of IL-$1\beta$, but no differences among the groups in the presence of IL-$1\beta$. Conclusion: We concluded that in this short-term in vitro study, bupivacaine does not have injurious effect on cultured rheumatoid arthritic joint tissues. The long-term effect cannot be known from this investigation.
Park, Ki-Bum;Baek, Seung-Tae;Lee, Seung-Deok;Kim, Kyung-Ho;Kim, Kap-Sung
Journal of Acupuncture Research
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v.23
no.6
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pp.103-115
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2006
Objectives : Rheumatoid arthritis(RA) is a systemic & a chronic inflammatory autoimmune disease . A chronic , locally destructive inflammmatory reaction in human is examplified by the synovitis present in some connective tissue disorder. The presence of a number of cytokines, $TNF-{\alpha}$, iNOS & expression of nitric oxide, NF-kB p65 activation implies an important role of cellular immune response in RA inflammatory reaction. This study was designed to evaluate on the effects of the Homnis Placenta herbal acupuncture on EX-LE201 & ST 35 reducing expression of LPS-induced arthritis model in mice. Materials and Methods : Homnis Placenta herbal acupuncture was inserted into 10 rats induced rheumatoid arthritis. The acupunctures were injected into the EX-LE201 and ST35 points. Such indexes were measured the inhibition of inducible nitric oxide synthase(iNOS) expression, nitric oxide(NO) production in vitro experiment and Tumor Necrosis $Factor-{\alpha}(TNF-{\alpha})$ & Nuclear Factor kappa $B(NF-{\kappa}B)$ p65 activation, synovial hyperplasia, angiogenesis and fibrosis in synovial membrane of knee joint of mice in vivo experiment. Results : 1.Homnis Placenta Herbal acupuncture inhibited iNOS mRNA and NO in RAW 264.7 cell of LPS-induced rheumatoid arthritis in a dose dependent manner. 2.Homnis Placenta Herbal acupuncture also showed significant inhibition of $TNF-{\alpha}$ & $NF-{\kappa}B$ p65, activation, synovial hyperplasia, angiogenesis and fibrosis in synovial membrane of knee joint of mice. Conclusion : These results suggest that Homnis Placenta Herbal acupuncture has an therapeutic effects on LPS induced-rheumatoid arthritis by inhibiting $TNF-{\alpha}$ activation.
Journal of the Korean Applied Science and Technology
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v.39
no.1
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pp.18-26
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2022
The present study aimed to evaluate the effect of Eucommia ulmoides extracts on rheumatoid arthritis biomarker in a CIA-induced DBA/1 mice. For evaluation, Eucommia ulmoides extracts was administered orally at dose of 100 mg/kg/day for 4 weeks after production of an animal model of rheumatoid arthritis and we confirmed the treatments' effects based on serum biomarker, radiological, structural parameter analysis. Compared to the negative control group, the Eucommia ulmoides extracts treatments significantly reduced the serum level of inflammation and immunoglobulin markers (i.e., TNF-α, IgG, and hs-CRP), and significantly decreased the monocyte count of white blood cells. Furthermore, the Eucommia ulmoides extracts treatments effectively preserved the joint destruction, and little the joint deformation. Moreover, compared to the negative control group, the Eucommia ulmoides extracts treatments increased the bone volume, and significantly decreased bone inflammation. The results indicate that the Eucommia ulmoides extracts improved rhrumatoid arthritis symptoms. Thus, the Eucommia ulmoides extracts may be a novel therapeutic option for the management of rheumatoid arthritis.
The purposes of this research are to examine the effects of muscle relaxation to the rheumatoid arthritis patients' physiological, psychological, and social adaptation, and to verify that the technique Is an effective tool for improving the patients' adaptation. This research utilized a qusi-experimental design that compares the pre-experiment measures and the post-experiment measures. The subjects of this study were 37 out-patients who were diagnosed for rheumatoid arthritis in P university hospital and K clinic between September 12, 1993 and November 30, 1993. The experimental group consisted of patients treated on Monday, Wednesday and Friday. The control group consisted of patients treated on Tuesday, Thursday and Saturday The pre-experimental survey utilized the following tools. The physiological adaptation was measured by a graphic rating scale for pain and activity of daily living. The psychological adaptation was measured by Zung's depression scale and Rosenberg's self-esteem scale : and the social adaptation was measured by Derogatis' psychosocial adjustment scale. The experimental group received muscle relaxation treatment for 15 minutes per day for the period of 2 weeks, the control group received no treatment and had quiet time. The post-experiment measurement was carried out similar to the pre-experiment survey, SPSS $PC^+$ is used to analyze the collected data. The reliabilities of the measurement tools were examined by Cronbach's ${\alpha}$ coefficients. The homogeneities between the experimental and control groups were tested by t-test and chi-square test, hypotheses were tested by t-test. This research found that the general characteristics between the groups were statistically homogenious. The physiological, psychological, and social adaptation between the groups in the pre-experimental survey were also statistically homogenious. The results of this research can be summarized as follows : 1. Concerning the Physiological adaptation, the experimental group showed a statistically lower pain score than the control group. Thus, muscle relaxation was effective to relieve the pain of rheumatoid arthritis patients (t=-2.95, p=.006). 2. Concerning the psychological adaptation, the experimental group showed a statistically lower depression score than the control group. Thus, muscle relaxation was effective to reduce the patient's depression(t=-4.00, p=.001). 3. Concerning social adaptation, the experimental group showed a statistically higher score for the health maintenance and disease control than the control groups. Thus, muscle relaxation was effective for the health maintenance and disease control (t=2.09, p=.004). This research showed that the muscle relaxation is a nursing intervention that can promote the physiological, psychological and social adaptation of the rheumatoid arthritis patients in terms of short-term and cognitive changes. However, more fundomental changes in behavior and long-term physiology could not be found through such a short-term relaxation treatment.
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