Showing papers in "Arthritis & Rheumatism in 1973"

Patterns of finger capillary abnormalities in connective tissue disease by "wide-field" microscopy.

Abstract: The fingers of 75 patients with connective tissue disorders were examined by “wide-field” capillary microscopy Four diagnostic groups were included in this study: rheumatoid arthritis—28, scleroderma—22, dermatomyositis—8, and systemic lupus erythematosus—17On the basis of different patterns of elementary microvascular abnormalities and their distribution, 3 distinct groups were recognized among these patients: 1) increased visibility of nailfold subpapillary plexus in rheumatoid arthritis, 2) massive capillary dilatation in scleroderma-dermatomyositis, and 3) focal loss of capillaries and prominence of subpapillary vessels with “punched-out” lesions in systemic lupus erythematosus

Experimentally induced degenerative joint lesions following partial meniscectomy in the rabbit.

Abstract: Degenerative lesions characterized by osteochondrophyte spur formation and cartilage degeneration were induced by partial meniscectomy in the rabbit knee. Cartilage degenerative lesions included ulceration, fissure and cyst formation, and diminished concentration of matrix proteinpolysaccharide. Proliferation of chondrocytes represented efforts at repair. Osteophytes increased in size with time. Changes resembled certain components of degenerative joint disease. The partial meniscectorny animal may be useful in studies of osteoarthritis pathogenesis, pathology and treatment.

A Controlled Trial of Gold Salt Therapy in Rheumatoid Arthritis

Abstract: Sixty-eight patients with definite or classic rheumatoid arthritis were enrolled in a double-blind, controlled study of gold salt therapy. The initial phase compared weekly injections of gold thiomalate to placebo. One-third of the gold group were withdrawn from the trial because of toxicity and one-fourth of the controls because of no benefit. The gold-treated patients showed slight, but definite, improvement in all parameters measured, although only the change in sedimentation rate was statistically significant. In Phase 2, designed to ascertain the effects of maintenance therapy, the gold group showed no increase in the number of involved joints, improved their grip strength and had a fall in erythrocyte sedimentation rate. Over the same period the placebo group deteriorated in all these parameters. The number of patients treated, however, was too small to allow definite conclusions.

A Millipore filter assay for antibodies to native DNA in sera of patients with systemic lupus erythematosus.

Abstract: Serum levels of antibody to native DNA (nDNA) in patients with systemic lupus erythematosus (SLE) correlate with disease activity. We describe a sensitive, simple and rapid assay for these antibodies based on the observation that 3H-labeled nDNA passes through Millipore filters while 3H-nDNA complexed with specific antibody is retained. The simplicity and rapidity of this assay should allow general utilization of serum anti-nDNA antibody determinations for monitoring disease activity in patients with SLE.

Relative T-cell specificity of lymphocytotoxins from patients with systemic lupus erythematosus.

Abstract: Lymphocytotoxic antibody activity of dera from 23 patients with systemiclupus erythematosus (SLE) was compared using three different sets of lymphocytes-peripheral blood lymphocytes from 20 normal controls, perpheral blood lymphocytes from 10 patients with chronic lymphocytic leudemia (CLL) and thymic [thymus-derived (T)] cells of 5 human fetuses. A marked decreased reactivity of the SLE sera with CLL lymphocytes and marked increased reactivity with fetal thymic cells as compared to controls was found. These data suggest T-cell specificity of lymphoctotoxic antibodies in SLE.

The past four decades of progress in the knowledge of gout, with an assessment of the present status.

Abstract: Advances in management of acute gouty arthritis, tophaceous gout and uric acid nephrolithiasis are briefly reviewed. With respect to pathogenesis, specific enzyme abnormalities have been demonstrated in rare monogenic cases but the presumptive polygenic and multifactorial pathogenesis in most cases of primary gout remains uncertain. The hypothesis favored here is that, possibly secondary to altered glutamate catabolism, glutamine apparently is overutilized for urate overproduction by the liver, underutilized for reduced renal ammonia formation. The kidneys, modulating urinary uric acid excretion, sustain the hyperuricemia.

Detection of circulating dna by counterimmunoelectrophoresis (cie)

Abstract: Using counterimmunoelectrophoresis, DNA may be detected at concentrations as low as 1.5 μ/ml in plasma and 0.2 μg/ml in serum. Serum, however, was not suitable for this study because DNA was sporadically released into serum during the clotting process. Counterimmunoelectrophoresis is at least ten times more sensitive than simple immunodiffusion in the detection of DNA. DNA was found in plasma in a variety of illnesses which are delineated in this study.

Salicylate hepatotoxicity in patients with juvenile rheumatoid arthritis

Abstract: Salicylates were administered to 6 patients with juvenile rheumatoid arthritis in doses sufficient to produce a serum salicylate level in excess of 25 mg/100 ml All 6 patients developed elevations of serum glutamic oxaloacetic transaminase and serum glutamic pyruvic transaminase In addition, 4 patients had other evidence of hepatic dysfunction Abnormalities were dose-related and were reversible upon lowering the salicylate dose Liver biopsies performed in 2 patients revealed a mononuclear cell infiltrate of portal triads in both and scattered single cell necrosis in the parenchyma in 1 case

Articular chondrocalcinosis. Microanalysis of pyrophosphate (PPi) in synovial fluid and plasma.

Abstract: A new microassay method with precision of ±5% was developed to quantitate pyrophosphate in synovial fluid and plasma with starting volumes of 0.5 ml. A highly significant elevation of synovial fluid pyrophosphate concentration was found in some patients with osteoarthritis and gouty arthritis in addition to the well-established elevation in synovial fluid of subjects with pseudogout. No gradient of pyrophosphate between plasma and synovial fluid of patients with rheumatoid arthritis or in normal subjects was detectable. Studies of various parameters reflecting inflammation failed to show a correlation with the concentration of pyrophosphate in patients with pseudogout.

Inhibition of mixed leukocyte culture responses by serum and γ-globulin fractions from certain patients with connective tissue disorders

Abstract: Sera and IgG fractions from normal subjects as well as patients with rheumatoid arthritis and systemic lupus erythematosus were added to mixed leukocyte reactions (MLC) in an attempt to study the effects on cell-to-cell interactions in such systems. Seven and seven-tenths percent of 52 RA sera and 26% of 27 SLE sera showed suppression of MLC reactivity. MLC suppression appeared to be localized to IgG serum fractions separated by DEAE chromatography. This suppressive effect showed a strong correlation with presence of lymphocytotoxic antibody in individual sera.

Experimental skin lesions in mice resembling systemic lupus erythematosus.

Abstract: An experimental model in mice was investigated to test the hypothesis that the immunohistochemical findings in skin lesions of human systemic lupus erythematosus (SLE) might be due to circulating antibody reacting with nuclear antigens. Mice were immunized with ultraviolet (UV)-irradiated DNA to produce high titers of circulating antibody to a DNA photoproduct, thymine dimer. These immunized mice were then whole-body irradiated with UV, a procedure which caused thymine dimer formation in DNA of skin cells and subsequent release of thymine dimers extracellularly during spontaneous repair of the photochemically damaged DNA. In immunized irradiated mice, immunofluorescent studies showed fixation of mouse Ig and complement in the form of finely stippled and large lumpy deposits in the dermal—epidermal areas and in nuclei of epidermal cells. These findings were morphologically quite similar to those seen in human SLE skin lesions. These immunohistochemical lesions in mice were not observed in mice receiving only immunization or only irradiation. These and other data lend support to the immune complex theory of pathogenesis of SLE skin lesions.

Suppression of acute and chronic inflammation in adrenalectomized rats by pharmacologic amounts of prostaglandins.

Abstract: Prostaglandin E1 (PGE1) suppressed acute carrageenan-induced inflammation and chronic joint inflammation characteristic of adjuvant disease in the rat. Placement of PGE1 into subcutaneous air blebs at the time of carrageenan injection retarded movement of polymorphonuclear leukocytes into the focus of inflammation and produced a concentration-dependent reduction in exudate β-glucuronidase and lactate dehydrogenase activities, an effect also observed in adrenalectomized rats. PGE2 also significantly reduced enzyme activities released into inflammatory exudates. Ultrastructural studies indicated that carrageenan was ingested by invading polymorphs and enclosed within phagocytic vacuoles, the membranes of which subsequently ruptured. More lysosomes remained intact after carrageenan uptake in bleb leukocytes from PGE1-treated than from control rats and there was no loss of phagosomal membrane integrity in cells from treated rats. Treatment of adrenalectomized rats with PGE1 (300 μg twice daily) prevented adjuvant-induced systemic arthritis, reduced the acute inflammatory reaction at the site of adjuvant injection, and reduced the number of circulating small lymphocytes. Together, these two sets of experiments suggest that pharmacologic doses of prostaglandins are anti-inflammatory in acute and chronic models, and that the effect is not mediated entirely by stimulation of the pituitary and/or adrenal glands.

The effect of low oxygen concentration on growth, glycolysis, and sulfate incorporation by articular chondrocytes in monolayer culture.

Abstract: Radiosulfate incorporation, DNA synthesis, and glycoiysis by rabbit articular chondrocytes and skin fibrocytes in monolayer culture were compared under different concentrations of oxygen (19, 6.8, 1.3, and 0.6%). Cell for cell, chondrocytes under each condition had higher levels of radiosulfate incorporation and glycolysis than did fibrocytes. Growth of the fibrocytes was reduced approximately 20% when the oxygen concentration was reduced to 6.8%, but that of chondrocytes was unaffected. A progressive Pasteur effect was observed with both cell types. Radiosulfate incorporation was reduced at low oxygen concentrations. The findings in this cell culture system are thus at variance with other published evidence that hypoxia is a major histogenetic force favoring chondrogenic expression.

The Fourth Component of Complement in the Cerebrospinal Fluid in Systemic Lupus Erythematosus

Abstract: Of 35 patients with systemic lupus erythematosus (SLE) studied for up to 18 months, 6 had acute neurologic disease and 3 had acute psychiatric syndromes attributed to SLE during which the mean hemolytic titer of the fourth component of complement in the cerebrospinal fluid (CSF C4) did not differ significantly from the mean of 50 titers in control SLE patients. However, in 4 patients serial determinations disclosed a depression of titer at the time of acute central nervous system involvement (P < 0.01). Hemolytic C4 was unstable in CSF stored at -45°C. Two decay patterns were noted in SLE patients; titers fell more rapidly in patients with more active lupus (P < 0.001). The findings support the postulate that immune injury underlies the neurologic manifestations of SLE.

Mobilization and extracellular release of granular enzymes from human leukocytes during phagocytosis: inhibition by colchicine and cortisol but not by salicylate

Abstract: Granular (lysosomal) enzymes are released from phagocytizing human leukocytes and are believed to be important in the tissue damage of acute inflammation Antiinflammatory drugs such as colchicine, cortisol, and salicylate have been reported to “stabilize” isolated lysosomes or to inhibit degranulation within cells These drugs, by altering mobilization of granular enzymes within cells, might be expected to affect the release of these enzymes outside of cells Human blood leukocytes, isolated by dextran sedimentation, were incubated in autologous serum-buffer media, with or without colchicine (25 × 10−5M), cortisol (5 × 10−4M), Na salicylate (22 × 10−3M), or acetylsalicylic acid (10−3M), for 30 minutes, 375° C, and then with or without heat-killed staphylococci Both cellular and extracellular activities of granular enzymes (lysozyme, acid phosphatase, cathepsin) were measured Both intracellular mobilization and extracellular release of granular enzymes by phagocytizing leukocytes are inhibited by colchicine and cortisol Salicylate, contrary to suggestions based on studies with isolated lysosomes from liver, did not show these effects These results may account in part for antiinflammatory effects of colchicine and cortisol, but not of salicylate

Interactions of aspirin with nonsteroidal antiinflammatory drugs in man.

Abstract: Healthy volunteers ingested fenoprofen and indomethacin, each alone or combined with aspirin. Concentrations in plasma of both fenoprofen and indomethacin were reduced significantly when administered with aspirin. Reduction of fenoprofen concentrations depended on the aspirin dosage and occurred whether fenoprofen was administered orally or intravenously. Fenoprofen did not affect plasma concentrations of salicylates. These results emphasize the need to assess carefully the effects of salicylates in comparative clinical trials of nonsteroidal antiinflammatory agents.

Polyarthritis and subcutaneous nodules associated with carcinoma of the pancreas.

Abstract: A 52-year-old male developed subcutaneous nodules and polyarthritis in association with an acinar cell carcinoma of the pancreas. The arthritis did not respond to aspirin, phenylbutazone, indomethacin or corticosteroid therapy. Typical changes of pancreatic enzyme-induced injuries in the subcutaneous nodules and around the joints were found at autopsy.

Cellular immunity in rheumatic diseases. I. Rheumatoid arthritis.

Abstract: Cell-mediated immunity in rheumatoid arthritis (RA) was assessed by skin testing with 5 common antigens in 84 patients, dinitrochlorobenzene (DNCB) application in 13, and in Vitro phytohemagglutinin (PHA) stimulation of buffy coat cells in 39.Routine skin-test reactions were recorded as the largest diameter of induration present at 48 hours. Controls included normal subjects, family members of patients with rheumatic disorders, and patients with unrelated illnesses. Results revealed two populations of RA patients. Forty-two percent were completely anergic to the 5 antigens and 14% gave a history of herpes zoster. The remainder showed reactivity similar to that seen in patient controls. Most RA subjects demonstrated normal or only minimally diminished PHA responses. The RA patients had normal inflammatory responses to the initial DNCB application, but immune reactions to this agent paralleled skin-test reactivity to the other antigens. The anergic individuals could be separated from the reactive population primarily by the increased duration of disease activity but not by medication taken or the degree of disease activity when tested.

Hemodialysis and kidney transplantation for renal failure from scleroderma

Abstract: A merchant mariner had scleroderma with polyarthralgias and Raynaud's phenomenon for 15 years before the onset of rapidly progressive renal failure and severe hypertension. Intimal proliferation obliterated or greatly narrowed the lumina of renal arterioles. Initially, he tolerated periodic hemodialysis and efforts to reduce hypertension poorly but did better after bilateral nephrectomy. In the 18 months since successful kidney transplantation, arthralgias and Raynaud's phenomenon have disappeared and skin has become less tightly bound to underlying structures. Blood pressure remains normal. The grafted kidney shows no evidence of disease. For patients whose primary organ involvement by scleroderma is renal and whose other lesions are relatively stable, hemodialysis and kidney transplantation may provide additional years of reasonably comfortable life.

Prostaglandin e1 (pge1) suppression of adjuvant arthritis histopathology

Abstract: Histopathologic studies of tibiotarsal joints from rats with adjuvant disease show complete suppression of arthritis in animals treated with prostaglandin E1 (PGE1) from time of adjuvant injection. Established synovitis is improved by PGE1 treatment and progression of arthritis and cartilage destruction is halted.

Abnormal Structures in Circulating Lymphocytes from Patients with Systemic Lupus Erythematosus and Related Diseases

Abstract: A prospective electron microscopic study, incorporating blind controls, demonstrated tubuloreticular structures (TRS) in the buffy coat lymphocytes of 32 patients with connective tissue disease. From 1 to 8% of the lymphocyte sections were involved. The abnormal structures consisted of interwoven, electron-dense tubules (220 to 280 A diameter) which were located within the endoplasmic reticulum. Tubuloreticular structures were found in lymphocytes from 20 of 30 patients with systemic lupus erythematosus (SLE), 2 of 4 with discoid lupus erythematosus, 8 of 20 with other connective tissue disease and none of 22 control cases. Clinical evaluation of the patients with SLE disclosed no specific differences between those with TRS-positive or TRS-negative lymphocytes; there were some indications of greater disease activity in the TRS-positive group. The biologic nature of TRS is unknown, but they have been linked to virus infection under both clinical and experimental conditions.

Calcific periarthritis involving multiple sites in identical twins.

Abstract: Identical twins with calcific periarthritis demonstrable at multiple sites first developed painful episodes of inflammation at age 22.The occurrence of this disorder in twins has not been reported previously. This observation, particularly if supported by additional cases with familial involvement, supports the possibility that the disease might be due to genetic inheritance of a metabolic defect.

Filter radioimmunoassay for antibodies to reovirus RNA in systemic lupus erythematosus.

Abstract: Antibodies binding reovirus RNA (3H-reovirus RNA) were demonstrated in 35 of 50 sera (70%) from patients with systemic lupus erythematosus (SLE) and in 22 of 29 sera (76%) from New Zealand hybrid mice (NZB/NZW F1) using a cellulose ester filter radioimmunoassay. By contrast, they were present in only 19% of 69 patients with Sjogren's syndrome, 14% of 21 patients with rheumatoid arthritis and 4% of 88 normal adult controls. This assay method will also measure antibodies to DNA and synthetic RNA and depends on entrapment of radioactive nucleic acid immune complexes on the filter. Serial studies in three patients treated with a stable dose of corticosteroids demonstrated similar binding and specificity over several years of disease.