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Content available remote The role of Th17 lymphocytes in pathogenesis of autoimmune arthritides
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EN
Th17 cells are newly described population of lymphoctyes, that recruits neutrophils to the site of inflammation and activate inflammatory phenotype of various tissues. They also play a pivotal role in autoimmune diseases and cancers. These cells secrete mainly different isoforms of IL-17, but also IL-21 and IL-22. Rheumatoid arthritis and juvenile idiopathic arthritis are the most common autoimmune joints’ inflammatory disease, affecting respectively adults and children. For a long time the immunopathogenesis of autoimmune diseases has been associated with Th1 lymphocytes. This hypothesis has changed after the discovery of Th17 cells, which are thought to be key mediators of autoimmune arthritides
PL
Reumatoidalne Zapalenie Stawów (RZS) jest przewlekłą, zapalną chorobą układową tkanki łącznej. Celem niniejszej pracy była ocena wpływu czasu trwania choroby, od momentu postawienia diagnozy RZS, na temperaturę stawów objętych procesem zapalnym. Za pomocą kamery termowizyjnej przebadano następujące stawy: stawy nadgarstka, stawy śródręczno-paliczkowe, stawy międzypaliczkowe bliższe, stawy międzypaliczkowe dalsze dłoni prawej i lewej oraz stawy: skokowo goleniowy i śródstopno-paliczkowy stopy prawej i lewej. Zaobserwowano istotnie niższą temperaturę stawu skokowo-goleniowego stopy prawej u pacjentów chorujących dłużej niż 10 lat w porównaniu z osobami zdrowymi.
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Rheumatoid Arthritis (RA) is a chronic inflammatory disease of human connective tissue. The aim of the study was to assess the impact of RA duration on the temperature of inflamed joints. Temperatures of the following joints were measured: wrist joints, metacarophalangeal joints, proximal interphalangeal joints, distal interphalangeal joints of left and right hand as well as ankle joints and metatarsophalangeal joints of right and left foot. Significantly lower right ankle joint temperature was observed for patients of more than 10 years’ disease duration compared to healthy subjects
EN
Introduction and aim. With increasing ultrasound US assessment opportunities for tight rheumatoid arthritis (RA) management, more simplified accurate US-assessment is desired in clinical practice. Aim of the work is assessing modified vs simplified ultrasound 6-joint scores relevance in assessing rheumatoid arthritis disease activity. Material and methods. Fifty-five RA patients were subjected to detailed history, clinical, and musculoskeletal examination with disease activity assessment by clinical disease activity index, simple disease activity index and disease activity score in 28 joints. Complete blood count, erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti-cyclic citrullinated peptide antibodies were done. Patients underwent US examination (gray-scale and power Doppler) for wrist, 2nd and 3rd metacarpophalangeal and knee joints bilaterally. Synovitis composite score was added. Two US indices were constructed: simplified S6 and modified M6 joint scores. Results. Statistical significant positive correlations were high between S6/M6 score parameters (total, grey-scale (GS), power doppler (PD), Composite) and disease activity markers. Both M6 and S6 scores differentiated mild-moderate and moderate-severe disease activity patients. However, only S6 score differentiated remission from mild disease activity patients. Conclusion. Ultrasound 6-joint scores (especially simplified S6) were rapid, easy and sensitive ultrasound tools assessing rheumatoid arthritis disease activity in clinical practice.
EN
Purpose: The aim of the study is comparative analyze the Health Related Quality of Life (HRQOL); effect of social-demographic factors on quality of life also taking into account four domains and effect of the duration of disease on quality of life. Material and Methods: The evaluation of the quality of life in patients with rheumatoid arthritis (RA)(n=64), ankylosing spondylitis (AS) (n=60) and systemic sclerosis (SSc) (n=63) was conducted with the use of a standardized research tool - WHOQOL Bref. Results: The conducted general analysis of particular life quality domains showed that for RA patients the weakest domain was the one related the environment (11.3) and physical health (11.6), with the strongest social domain (14.7). The respondents with AS had the lowest score for physical health (12.2), also with the strongest social domain (14.2). The results obtained from SSc patients are slightly better than for RA and AS patients as regards physical health (12.6) and the environment (13.9). Conclusions: It seems that, taking into account the patient’s own opinion about the treatment and its consequences by means of QOL evaluation, makes the patient a partner in the process of treatment and nursing, which leads to a greater humanization of medicine.
EN
Rheumatoid arthritis (RA) is a chronic, systemic inflammatory disease which affects approximately 1% of the population worldwide. Recent research on the role of heat shock proteins (Hsps) in RA development indicates that they may have pro- or anti-inflammatory effect, most probably via modulating cytokine secretion. We investigated type Th1 (INFγ, TNFα, IL-2) and type Th2 (IL-10, IL-6, IL-4) cytokine levels in sera of RA patients and healthy controls, using flow cytometric bead array assay, and searched for correlations between the cytokine levels and serum antibodies against bacterial (DnaJ) and human (Hdj1, Hdj2 and Hdj3) Hsp40 proteins, as well as clinical and laboratory parameters. The levels of all cytokines studied were significantly increased in RA patients; the highest increase relative to healthy controls (7-fold) was observed for IL-6 and its levels correlated positively with the antibodies directed to DnaJ and to the C-terminal domain of Hdj2, and with diagnostic parameters (DAS 28, Steinbrocker RTG criteria, ARA/7, ESR, TEN, SW and GH). INFγ levels correlated negatively with DAS 28, ESR, TEN and SW. No correlations were found for TNFα, IL-2 or IL-4. Our results support the hypothesis of Hsp40 involvement in RA as well as indicate that IL-6 serum level is a good marker of the RA activity.
EN
Introduction. Rheumatoid arthritis (RA) is a progressive joint condition that leads to joints destruction and complications in the internal organs and significantly affects the a patient’s functional, physical, psychological and social condition. Over the last few years, research into the quality of life (QoL) in people with chronic disease has been conducted to assess the results of treatment. Aim. The aim of the study was to assess QoL in various areas of life in regards to physical and mental functioning, social relations, and environmental influences in people with RA. Material and methods. The study group (subjects with RA) and the control group (subjects without RA) consisted of 48 people each. Subject age ranged from 19 to 68. In order to assess QoL, the WHOQOL-BREF questionnaire was used, while socio-demographic data were assessed with a questionnaire developed by the authors. Results. QoL in people with RA was lower than that of healthy individuals. The worst QoL was observed in the physical domain. No statistically significant association was found between BMI and QoL. It was found, however, that subjects with RA and a higher level of physical activity had a better QoL than those with a lower level of physical activity. Conclusion. There was no association between the body mass of RA patients and QoL assessment. However, an association was found between the level of physical activity in people with RA and QoL in the physical and environmental domain.
EN
Objectives. Recent epidemiological studies suggested an association between a poor vitamin D [25(OH)D] status, inflammatory mediators, and rheumatoid arthritis (RA). We have recently proposed that pro-inflammatory interleukin 6 (IL-6) may represent a good marker for disease activity of RA. The aim of this study was to investigate the relationship between serum 25(OH)D levels and disease activity, joint damage, as well as serum IL-6 levels in a Polish RA population. Materials and Methods. Serum 25(OH)D levels were measured in 35 female RA patients and 38 age- and gender-matched healthy controls. Statistical correlations between 25(OH)D levels and the disease activity score 28 (DAS 28), joint damage based on the Steinbrocker criteria, as well as serum IL-6 levels were performed. Results. There was no statistically significant difference between levels of 25(OH)D in RA (16.89±8.57 ng/ml) and healthy controls (14.12±7.51 ng/ml), and the vitamin D deficiency (<20 ng/ml) was found in 71.43% of RA patients and 73.68 % of healthy controls. While vitamin D status did not correlate with DAS 28 (r=0.265, p=0.149) and joint damage based on the Steinbrocker criteria (r=0.367, p=0.065), a positive correlation between 25(OH)D and IL-6 (r=0.537, p=0.002) was observed in RA. Conclusion. Although further studies on a larger group of patients will be needed to confirm the data presented here, it seems that hypovitaminosis D is common in the RA patients and middle-aged non-RA healthy women in the Polish population. 25(OH)D levels were similar in the RA patients and age- and gender-matched healthy controls, and were not associated with joint damage and disease activity in patients.
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2024
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tom Vol. 42, No. 2
21--44
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Rheumatoid arthritis is a chronic autoimmune-disease-causing inflammation, joint pain, and joint destruction, severely affecting the quality of life of millions worldwide. In the current research, a nanocarrier system was developed for the delivery of resveratrol and prednisolone to treat rheumatoid arthritis. The drug delivery system was characterized in vitro using scanning electron microscopy and various cell culture studies. Finally, the alleviative symptoms of the developed treatment strategy were investigated in a rat model of rheumatoid arthritis. In vitro studies showed that the carrier system released the drugs in a sustained manner and possessed strong immunomodulatory functions. Nanocarriers loaded with prednisolone, resveratrol, and drug-free carriers had 396.88 ± 76.41 nm, 392.49 ± 97.31 nm, and 338.02 ± 77.75 nm of mean particle size, respectively. In vivo studies revealed that local injection of the carrier system could alleviate the degenerative effects of rheumatoid arthritis. ELISA assays showed that the co-injection of resveratrol and prednisolone-loaded albumin nanoparticles could significantly modulate inflammatory responses. The developed treatment modality may potentially be used to treat rheumatoid arthritis.
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EN
Rheumatoid arthritis is the most common inflammatory arthritis, affecting approximately 1% of the world’s population. Its pathogenesis has not been completely understood. However, there is evidence that the disease may involve synovial joints, subchondral bone marrow as well as intra- and extraarticular fat tissue, and may lead to progressive joint destruction and disability. Over the last two decades, significant improvement in its prognosis has been achieved owing to new strategies for disease management, the emergence of new biologic therapies and better utilization of conventional disease-modifying antirheumatic drugs. Prompt diagnosis and appropriate therapy have been recognized as essential for improving clinical outcomes in patients with early rheumatoid arthritis. Despite the potential of ultrasonography and magnetic resonance imaging to visualize all tissues typically involved in the pathogenesis of rheumatoid arthritis, the diagnosis of early disease remains difficult due to limited specificity of findings. This paper summarizes the pathogenesis phenomena of rheumatoid arthritis and describes rheumatoid arthritis-related features of the disease within the synovium, subchondral bone marrow and articular fat tissue on MRI and ultrasound. Moreover, the paper aims to illustrate the significance of MRI and ultrasound findings in rheumatoid arthritis in the diagnosis of subclinical and early inflammation, and the importance of MRI and US in the follow-up and establishing remission. Finally, we also discuss MRI of the spine in rheumatoid arthritis, which may help assess the presence of active inflammation and complications.
PL
Reumatoidalne zapalenie stawów (RZS) jest najczęstszą chorobą zapalną stawów, występującą u ok. 1% populacji światowej(1). Charakteryzuje się zapaleniem błony maziowej oraz zapaleniem kości, które prowadzą do powstania nadżerek kostnych, niszczenia chrząstki stawowej, destrukcji stawu, a co za tym idzie – trwałej niepełnosprawności(2). W ciągu ostatnich 20 lat znacznie poprawiło się rokowanie u chorych na reumatoidalne zapalenie stawów dzięki wprowadzeniu nowych strategii leczenia, zastosowaniu terapii biologicznej i lepszemu wykorzystaniu konwencjonalnych leków modyfikujących przebieg choroby(1). Szybka diagnoza i wdrożenie odpowiedniego leczenia stały się kluczowe dla uzyskania dobrego wyniku leczenia u chorych z wczesnym RZS(1). Artykuł w wersji polskojęzycznej jest dostępny na stronie http://jultrason.pl/wydawnictwa/volume-17-no-68
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Content available remote Collagen type II modification by hypochlorite.
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EN
Oxidation of proteins is a common phenomenon in the inflammatory process mediated by highly reactive agents such as hypochlorite (HOCl/OCl-) produced by activated neutrophils. For instance, in rheumatoid arthritis hypochlorite plays an important role in joint destruction. One of the major targets for HOCl/OCl- is collagen type II (CII) - the primary cartilage protein. In our study, HOCl/OCl- mediated collagen II modifications were tested using various methods: circular dichroism (CD), HPLC, ELISA, dynamic light scattering (DLS), fluorimetry and spectrophotometry. It was shown that hypochlorite action causes deamination with consecutive carbonyl group formation and transformation of tyrosine residues to dichlorotyrosine. Moreover, it was shown that ammonium chloramine (NH2Cl) formed in the reaction mixture reacts with CII. However, in this case the yield of carbonyl groups and dichlorotyrosine is lower than that observed for HOCl/OCl- by 50%. CD data revealed that collagen II exists as a random coil in the samples and that chlorination is followed by CII fragmentation. In the range of low HOCl/OCl- concentrations (up to 1 mM) 10-90 kDa peptides are predominant whereas massive production of shorter peptides was observed for high (5 mM) hypochlorite concentration. DLS measurements showed that chlorination with HOCl/OCl- decreases the radius of collagen II aggregates from 30 to 6.8 nm. Taking into account the fact that chlorinated collagen is partially degraded, the DLS results suggest that smaller micelles are formed of the 10-90 kDa peptide fraction. Moreover, collagen chlorination results in epitope modification which affects CII recognition by anti-CII antibodies. Finally, since in the synovial fluid the plausible hypochlorite concentration is smaller than that used in the model the change of size of molecular aggregates seems to be the best marker of hypochlorite-mediated collagen oxidation.
EN
Rheumatoid arthritis (RA) is a chronic autoimmune disease of unknown etiopathogenesis, characterised by persistent joint pain, stiffness and swelling due to inflammation and erosion of the synovial joints. Uncontrolled active RA leads to decreased quality of life, disability, and comorbidity. Despite surgical and pharmacological interventions, many patients with RA continue to experience symptoms such as pain, fatigue and psychological distress such as anxiety and depression. Research shows that these psychological factors in turn, lead to adverse physiological outcomes and negatively affect treatment compliance. In addition, some RA medications have psychological side-effects especially when taken over long periods making psychotherapeutic interventions an important but often overlooked adjuvant treatment option. The focus of psychological treatments in RA is to attain better quality of life including, inter alia, increased self-efficacy, management of psychological distress, enhancing the patient’s emotional and cognitive state, and exploring adaptive coping styles. Research demonstrates that Cognitive Behaviour Therapy (CBT) is an effective intervention in ameliorating psychological distress in patients with RA. Ethical and effective adjuvant psychotherapy is an important component in the management of RA patients.
EN
Introduction and aim. Rheumatoid arthritis is a chronic progressive systemic disease of the connective tissue affecting the joints, mainly small, of the erosive-destructive polyarthritis type, and frequent systemic inflammatory damage to internal organs. The purpose of the research is to evaluate the effectiveness of physical therapy on the muscles of upper limbs in patients with rheumatoid arthritis by the dynamics of muscle strength and strength index. Material and methods. To determine the strength of the muscles of the affected upper limbs were used dynamometry, calculated strength index as a percentage to assess the functional ability of the affected limb. All patients were divided into control (n=92) and main (n=96) groups, taking into account the functional insufficiency of the joints. Results. After 6 months of physical therapy, muscle strength indicators in the main group of patients with 1st degree of functional joints insufficiency (FJI) in the affected right limb increased by 3.1 kg, in the left by 3 kg; with 2nd degree FJI – in the right limb by 4.2 kg, in the left – by 3.7 kg, significantly exceeded the same indicators in patients of the control group (р<0.05). Similarly, there was an increase in the strength index in the patients of the main group. Conclusion. Physical therapy technology has been developed and implemented effectively influenced the increase in muscle strength and strength index of affected upper limbs of the main group of patients with rheumatoid arthritis.
PL
Celem niniejszej pracy było zastosowanie wybranych technik obróbki obrazów i ocena ich wpływu na analizę zdjęć rentgenowskich. Przedmiotem analizy były stawy między-paliczkowe bliższe palców II, III, IV obu rąk osób zdrowych i chorujących na reumatoidalne zapalenie stawów. Porównywano wyniki pomiarów szpar stawowych uzyskane przed i po filtracji komputerowej. Do obróbki wybrano trzy filtry oferowane przez program Optimas: Horizontal, Mediana i Sharpen Hi. Zwrócono uwagę, że na dokładność pomiaru szerokości szpary stawowej wpływa sposób obróbki obrazu. Udowodniono również, że u osób chorych szpary stawowe są węższe niż u osób zdrowych.
EN
The goal of the research was the evaluation of image processing methods applied for analysis of radiographic pictures. The proximal interphalangeal joints of II, III and IV finger of healthy subjects and patients suffering from rheumatoid arthritis were examined. The width of joint gap was measured. The image transforms offered by Optimas image processing program: Horizontal, Mediana i Sharpen Hi, were tested. The accuracy of the measurement is influenced by the applied image processing method. It was stated that healthy individuals have wider joint gaps than the ill persons.
PL
Cel badań: Celem pracy było zbadanie wpływu krioterapii ogólnoustrojowej na właściwości reologiczne krwi u kobiet z reumatoidalnym zapaleniem stawów. Materiał: Grupę badaną stanowiło 10 kobiet z reumatoidalnym zapaleniem stawów w wieku 57,2 ± 9,4 lat, które korzystały z zabiegów krioterapii ogólnoustrojowej (czas zabiegu 3 min, temperatura komory -120 °C, 10 zabiegów – 5 razy w tygodniu). Średnia wysokość ciała wynosiła 165,5 ± 4,6 cm, waga 68,5 ± 4,9 kg i BMI 24,8 ± 2,2 kg/m2. W celu analizy parametrów reologicznych krwi uczestniczącym w badaniu pobrano dwukrotnie krew żylną. Pierwsze badanie odbyło się w dniu rozpoczęcia zabiegów, a drugie po serii 10 zabiegów. Metodyka: Pomiary wykonano przy użyciu analizatora hematologicznego ABX MICROS 60 (USA). Do badania agregacji i odkształcalności erytrocytów wykorzystano analizator LORRCA (Laser-assisted Optical Rotational Cell Analyser RR Mechatronics, Holandia). Wyniki otrzymano jako indeks elongacji i agregacji, według metody Hardeman (2001). Wyniki: Analizując średnie wartości wskaźników morfologicznych i reologicznych krwi u kobiet z reumatoidalnym zapaleniem stawów w grupie badanej średnie wartości RBC i Hct i AI po serii 10 zabiegów były znacząco wyższe w porównaniu do pomiarów wykonanych przed zabiegami. Analizując średnie wartości T½ zaobserwowano statystycznie istotne zmniejszenie wartości po serii 10 zabiegów. Wnioski: Regularne korzystanie z zabiegów krioterapii ogólnoustrojowej może wpływać na wskaźniki morfologiczne i reologiczne krwi u kobiet z reumatoidalnym zapaleniem stawów – RBC, Hct i AI (zwiększenie) oraz T½ (zmniejszenie).
EN
Study aim: The aim of this study was to assess the effects of systemic cryotherapy on the rheological properties of the blood in women with rheumatoid arthritis. Study group: The study group consisted of 10 women with rheumatoid arthritis, aged 57.2 ± 9.4, who underwent systemic cryotherapy treatments (3 min treatment time, -120 °C chamber temperature, 10 treatment sessions - 5 times a week). Their average body height was 165.5 ± 4.6 cm, weight 68.5 ± 4.9 kg and BMI 24.8 ± 2.2 kg/m2. In order to analyze morphological and rheological parameters of the blood, venous blood samples were drawn from the participants of the study twice. The first study was held on the day of beginning treatments and the second test was conducted after a series of 10 treatments. Methodology: The morphological blood test - measurements were taken using the ABX MICROS 60 (USA) hematology analyser. Erythrocyte deformability and aggregation were tested using the LORCA analyser (Laser-assisted Optical Rotational Cell Analyser RR Mechatronics, The Netherlands). The results were obtained as the index of elongation and aggregation according to the Hardeman method (2001). Results: Analysing the average values of morphological and rheological parameters of the blood in women with rheumatoid arthritis in the study group, the mean values of RBC, Hct and AI following the series of 10 treatments were significantly higher after cryotherapy in comparison to the measurements taken before treatments. Analysing the mean concentrations of T½, there was statistically significant reduction after the series of 10 treatments. Conclusions: Regular usage of cryotherapy treatments may affect the levels of morphological and rheological parameters of the blood in women with rheumatoid arthritis - RBC, Hct and AI (increase) and T½ (reduction) in the blood. null
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