• IMMUNE NETWORK
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• v.24 no.1
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• pp.10.1-10.17
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• 2024

In this review, we will explore the intricate roles of cytokines and vascular endothelial growth factors in autoimmune diseases (ADs), with a particular focus on rheumatoid arthritis (RA) and multiple sclerosis (MS). AD is characterized by self-destructive immune responses due to auto-reactive T lymphocytes and Abs. Among various types of ADs, RA and MS possess inflammation as a central role but in different sites of the patients. Other common aspects among these two ADs are their chronicity and relapsing-remitting symptoms requiring continuous management. First factor inducing these ADs are cytokines, such as IL-6, TNF-α, and IL-17, which play significant roles in the pathogenesis by contributing to inflammation, immune cell activation, and tissue damage. Secondly, vascular endothelial growth factors, including VEGF and angiopoietins, are crucial in promoting angiogenesis and inflammation in these two ADs. Finally, placental growth factor (PlGF), an emerging factor with bi-directional roles in angiogenesis and T cell differentiation, as we introduce as an "angio-lymphokine" is another key factor in ADs. Thus, while angiogenesis recruits more inflammatory cells into the peripheral sites, cytokines secreted by effector cells play critical roles in the pathogenesis of ADs. Various therapeutic interventions targeting these soluble molecules have shown promise in managing autoimmune pathogenic conditions. However, delicate interplay between cytokines, angiogenic factors, and PlGF has more to be studied when considering their complementary role in actual pathogenic conditions. Understanding the complex interactions among these factors provides valuable insights for the development of innovative therapies for RA and MS, offering hope for improved patient outcomes.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.10
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• pp.4588-4597
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• 2012

This study aimed to investigate pain, perceived exercise barriers, and related factors in arthritis patients. The study was conducted on 140 arthritis patients (89 rheumatoid arthritis patients and 51 osteoarthritis patients) who visited C University Hospital in Daejeon due to arthritis and agreed to participate in a survey. The self-administered survey was conducted from February 2011 to September 2011. The results are as follow. The perceived exercise barriers increased in both groups as the education level and monthly household income decreased. In the rheumatoid arthritis group, the pain became more intense as the self-rated health status became poorer while the perceived exercise barriers became more significant as the self-rated health status became poorer and the patients had other diseases besides arthritis. In the osteoarthritis group, the pain was greater as the duration of arthritis was longer and the self-rated health status became poorer. In both groups, the perceived exercise barriers became more significant as the exercise stage approached the pre-planning stage. The results of the multiple linear regression analysis showed that the most influential factor on pain in both groups was the 'very bad' self-rated health status. In the rheumatoid arthritis group, influential factors on the perceived exercise barriers were the exercise stage and the education level while for the osteoarthritis group, they were the exercise stage and the monthly household income. In conclusion, the results of this study showed that the pain and perceived exercise barriers of arthritis patients were associated with various factors such as the education level, monthly household income, self-rated health status, and exercise stage, which suggests that these factors should be considered in the planning of exercise programs.

• Journal of Korean Academy of Nursing
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• v.27 no.3
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• pp.614-626
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• 1997

The main purposes of the study were to develop and test a model which explains the dynamic relationship among factors reported as affecting to the quality of life of individuals with rheumatoid arthritis and to examine the relationship between self-help response and quaility of life. Data for the study were collected from March 1996 to December 1996 from 153 female patients who regularly visited a clinic for people with rheumatism. The patients were introduced to the investigators by nurses who worked at that clinic, and then the investigator interviewed the patients for 30 to 40 minutes to collect the data. Instruments used in the study were modified self-report questionaires from the ones which were already developed in previous studies or from related literature. Data analysis were performed using LISREL(Lineal Structural Relations) 8 program to test whether the proposed hypothesized model fit the collected data. To test the fitablity of the hypothesized model both a general fit measure and a detailed fit measure were used. Based on the test results from the various fit measures, the hypothesized model was found to be well suited to the real data. As characteristics related to illness becomes severe, the feasibility for these characteristics leading to the perception of uncertainty about the illness tend to increase, but, the direct effects from the illness characteristics(such as level of physical symptoms, sense of social-psychologic change, limitations of action) as they are related to the other intrinsic variables (self-efficacy or self-help behavior and quality of life), were found to be not significant. It was found that uncertainty had a direct effect on self-efficacy but did not have a direct effect on self-help behavior or quality of life. Also, it is noted that self-efficacy had a positive effect on self-help behavior and quality of life and there was a bilateral relationship between self-efficacy and self-help behavior. Lastly, the hypothesis proposed from the theoretical model in this study was supported basis of the results that self-help behavior provides both direct and positive effects to quality of life. Particularity, since a bilateral relationship was also found between self-help behavior and quality of life in the modified model, as self-help behavior increased, so did quality of life. And, reversely, as quality of life increased, so did self-help behavior. In conclusion, the results of this study suggest that focusing on both acquirement and reinforcement of adjustment factors or self-help behavior is more efficient than focusing on the characteristics of illness in establishing the stategies for improving quality of life of individuals with rheumatoid arthritis.

• Korean Journal of Acupuncture
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• v.26 no.2
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• pp.27-38
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• 2009

Objectives: Rheumatoid arthritis (RA) is a chronic autoimmune disease, principally characterized by synovial inflammation of the joints. We previously reported the effect of acupuncture for RA, but the mechanism is still unclear. Various factors such as oxidative stress and angiogenesis were involved in the pathogenesis of RA, and recently, it has also been reported that cytokines also play a major role in RA. Thus, we investigated whether acupuncture could induce any changes in the levels of cytokines including vascular endothelial growth factor (VEGF), angiogenin and epidermal growth factor (EGF) as well as erythrocyte sedimentation rate (ESR), c-reactive protein (CRP), and rheumatoid factor (RF) in the sera of RA patients. Methods: The forty three patients who met the American College of Rheumatology (ACR) criteria for RA recruited. The acupuncture group (n=21) underwent 14 sessions of partially individualized acupuncture treatment for 6 weeks, and the control group had no treatment (n=13) over the same periods. We evaluated ESR, CRP and RF. In addition, to find out the mechanism of acupuncture, we assessed the changes of the cytokine activities using protein cytokine array in the sera of the patients. Results: Acupuncture significantly decreased the levels of ESR and CRP, but RF were not changed after 6-week acupuncture treatments. Moreover, acupuncture reduced the levels of VEGF, angiogenin and EGF in the sera of the patients. Interestingly, they were related with angiogenesis, which is an important process in the pathogenesis of RA. The levels of oncostatin, interleukin(IL)-$1{\alpha}$, IL-8, leptin, monocyte chemotactic protein-1, macrophage-derived chemokine, macrophage inflammatory proteins-1, platelet-derived growth factor BB and RANTES were not changed significantly. Conclusions: The effect of acupuncture for reliving RA symptoms can be partially explained by inhibition of angiogenesis factors in the sera of the RA patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.21 no.12
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• pp.331-338
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• 2020

This study examined factors affecting the stages of exercise behavior among patients with rheumatoid arthritis. The analysis was based on data collected from 238 patients who enrolled at the medical center of D university. The participants showed 5 stages of exercise behavior: pre-contemplation 23.9%, contemplation 23.0%, preparation 33.2%, action 5.0%, and maintenance 29.0%. There were statistically significant differences in perceived barriers of exercise, exercise self-efficacy, and perceived health status according to the stage of exercise behavior of the subjects. It was found that among the barriers to exercise, physical and cognitive psychological factors significantly influenced the stages of exercise behavior. Also, exercise self-efficacy significantly affected the stages of exercise behavior. Thus, for rheumatoid arthritis patients to practice and maintain proper exercise behavior, the nursing staff should continue to assess and reduce the barriers to exercise. Exercise programs should enhance self-efficacy to achieve long-term exercise behavior.

• Journal of Physiology & Pathology in Korean Medicine
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• v.21 no.1
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• pp.39-49
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• 2007

Rheumatoid arthritis is an autoimmune disease involving multiple joint. In order to access the suppressive effects of JTT on rheumatoid arthritis and it's effects on immune system we investigated whether JTT could suppress the disease progression of collagen-induced arthritis. DBA/1 mice were immunized with bovine type II collagen. After a second collagen immunization, mice were treated with DW, JTT (200 or 400 mg/kg) or methotrexate (MTX, 30 mg/kg) as a positive control. Oral administration of JTT significantly suppressed the progression of CIA, which extend is comparable to that of MTX. Histological examination reveled that JTT inhibited infiltration of inflammatory cells into affected paw joint and bone erosion and cartilage destruction were greatly reduced compared with control. Total cell number of spleen, lymph node and peripheral blood were significantly reduced. The absolute number of CD19$^+$, CD3$^+$/CD69$^+$, CD4$^+$/CD25$^+$ cell in spleen from JTT treated mice were significantly decreased. The absolute number of CD19$^+$, CD3$^+$, CD3$^+$/CD69$^+$, CD4$^+$, CD4$^+$/CD25$^+$ CD8$^+$, CD49b, CD3/CD49b cells in draining lymph node were significantly increased compared with control. In peripheral blood mononuclear cells of JTT treated mice, the absolute number of CD4$^+$, CD4$^+$/CD25$^+$, CD3$^+$/CD69$^+$ cells were significantly decreased compared with control, while that of CD49b$^+$ was slightly increased. Infiltration of CD3$^+$ cells and CD11b$^+$/Gr-1$^+$ cells into paw joint was significantly reduced in JTT treated mice. The levels of pathologic cytokines including TNF-a and IL-6 in serum were significantly decreased by oral treatment with JTT The levels of IFN-g in the culture supernatant of splenocyte stimulated with CD3$^+$/CD28$^+$ or collagen were dramatically decreased, while the levels of IL-4 was increased under CD3$^+$/CD28$^+$ or collagen stimulation. Rheumatoid factors including IgG, IgM and collagen specific antibody were present much lower in the serum of JTT treated mice than control. Taken together, JTT has suppressive effects on rheumatoid arthritis by modulating immune system, and has potential to use anti-rheumatic arthritic agent in human.

• Journal of muscle and joint health
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• v.7 no.1
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• pp.131-147
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• 2000

Almost all patients with rheumatic disease experience fatigue. The fatigue affects the patient's life extensively at home and at work, therefore it is necessary to investigate the nature of the fatigue which the patients perceive. The purpose of this study is to explore the nature and pattern of fatigue of the patients with rheumatic diseases. Rheumatoid arthritis is typical disease for its joint involvement which leads to deformity. Whereas lupus is a characteristic systemic autoimmune disease and the fibromyalgia is characterized by the general bodyache and multiple local tenderness. The prevalence of these diseases and the fatigue was known to be higher in women than men. Therefore the subjects were woman patient diagnosed as rheumatoid arthritis, lupus or fibromyalgia, and they were recruited from the H-Rheumatic Disease Hospital. The two instruments, the Multidimensional Assessment of Fatigue by Belza(1995) and the Piper Fatigue Scale by Piper, et al(1995) were used to explore the nature and pattern of self-reported fatigue. In total, the data from 157 patients were analysed by the SPSS-PC program for statistical analysis. The results were as follows: 1. Most patients with rheumatic disease experienced fatigue and the degree of fatigue was at the middle range by the scores of the two instruments. 2. The degree of fatigue of the patients with fibromyalgia was the highest and the next was that of the patients with lupus and the fatigue of the patients with rheumatoid arthritis. But there were no statistically significant differences among the patients with three rheumatic diseases, except the subcategory, the meaning of fatigue of the Piper Fatigue Scale. 3. Even when the period of the symptom and pain were covariated, there were no statistically significant differences among patients with three rheumatic diseases. The fatigue of the patients with lupus and fibromyalgia is rarely investigated in Korea and this study can be the base for the further understanding of the patients with rheumatic diseases. Therefore repeated studies are required to identify the factors to affect the fatigue and to understanding the nature of the diseases and to develop the nursing interventions to alleviate the fatigue.

• The Korean Journal of Food And Nutrition
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• v.20 no.2
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• pp.173-178
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• 2007

In this study we manufactured mulberry fruit tea(MFT) to be used as an anti-inflammatory agent. Here, MFT was consumed by thirty middle-aged women with symptoms of rheumatoid arthritis for 4 weeks. The anthropometric measurements and serum inflammatory factors were measured before and after consumption of the MFT. For the anthropometric measurements, BMI and body fat decreased after 4 weeks of tea consumption although there were no significant differences. The serum inflammatory factors(uric acid and homocysteine) as well as serum amino transferase activity(aspartate trans-aminase and alanine transaminase) showed a decreasing trend. In addition, serum carbon reactive protein(CRP) decreased significantly decreased after MFT consumption 4 weeks. It's concluded that this MFT is helpful to for rheumatyroid arthritis patients in order to decrease serum inflammatory factors such as CRP.

• The Journal of Korean Academic Society of Nursing Education
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• v.9 no.2
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• pp.253-263
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• 2003

Rheumatoid arthritis patients not only suffer from the physical damage, but they are afflicted severely mental and psychologic after effects. Their depression and low self-esteem eventually yields serious mental damages, which makes difficult for them to recover. The states of mental health of arthritis patients are diversified depending on the characters and surrounding circumstances, although they may have suffered from the similar condition. Therefore this research was conbucted to the factors that can give positive influences to the patients. In recent time, social support for the arthritis patients has become an important factor that can positively influence their mental health. In other words, social support can act as an important environmental system for arthritis patients to recover their damaged mental health. In order to fulfill this purpose, 118 patients were examined to identify the relationship between the variables. The summary of the result obtained from the research is as follow: 1. The structural aspect of social support for arthritis patients showed the most of them had various social support network size and their highest support system were 'family', 'relative' and 'friends'. The functional aspect of social support for arthritis patients showed moderate degree and their highest sub component was 'approval'. 2. High correlation was found between duration of relationship, similarity, frequency of meeting and functional support. There was no relationship between depression, self-esteem and social support. 3. Therefore this research has suggested that nurses who care rheumatoid arthritis patient consider the above condition to develop self-help group.

• Food Science and Biotechnology
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• v.16 no.4
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• pp.594-599
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• 2007

In this study, we evaluated whether the oral administration of chondroitin from the cartilage of Raja kenojei is effective on the progression of rheumatoid arthritis (RA), using collagen-induced arthritic (CIA) mice. Arthritis development was delayed dose-dependently in the chondroitin-treated groups. The pre- and late-treated groups receiving 1,000 mg/kg of chondroitin had clinical scores that were reduced significantly by 56.9 (p<0.05) and 43.3% (p<0.05), respectively, compared to the vehicle-treated groups. Hematoxylin eosin staining and X-ray radiography showed that the chondroitins reduced the infiltration of inflammatory cells and prevented joint destruction of the knee and paw. Reverse transcription-polyerase chain reaction analysis revealed that chondroitin administration inhibited the expressions of tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), $interlukin-1{\beta}$ ($IL-1{\beta}$), and $interferon-{\gamma}$ ($IFN-{\gamma}$) in joints more than the administration of vehicle. Chondroitin treatment also decreased the production of rheumatoid factors (RF), IgG and IgM, in the serum of CIA mice. These results indicate that chrondroitin administration has a protective effect involving the inhibition of pro-inflammatory cytokine production in CIA mice.