- Functionally distinct disease-associated fibroblast subsets in rheumatoid arthritis. [Journal Article]
- NCNat Commun 2018 Feb 23; 9(1):789
- Fibroblasts regulate tissue homeostasis, coordinate inflammatory responses, and mediate tissue damage. In rheumatoid arthritis (RA), synovial fibroblasts maintain chronic inflammation which leads to ...
Fibroblasts regulate tissue homeostasis, coordinate inflammatory responses, and mediate tissue damage. In rheumatoid arthritis (RA), synovial fibroblasts maintain chronic inflammation which leads to joint destruction. Little is known about fibroblast heterogeneity or if aberrations in fibroblast subsets relate to pathology. Here, we show functional and transcriptional differences between fibroblast subsets from human synovial tissues using bulk transcriptomics of targeted subpopulations and single-cell transcriptomics. We identify seven fibroblast subsets with distinct surface protein phenotypes, and collapse them into three subsets by integrating transcriptomic data. One fibroblast subset, characterized by the expression of proteins podoplanin, THY1 membrane glycoprotein and cadherin-11, but lacking CD34, is threefold expanded in patients with RA relative to patients with osteoarthritis. These fibroblasts localize to the perivascular zone in inflamed synovium, secrete proinflammatory cytokines, are proliferative, and have an in vitro phenotype characteristic of invasive cells. Our strategy may be used as a template to identify pathogenic stromal cellular subsets in other complex diseases.
- Have the 10-year outcomes of patients with early inflammatory arthritis improved in the new millennium compared with the decade before? Results from the Norfolk Arthritis Register. [Journal Article]
- ARAnn Rheum Dis 2018 Feb 23
- CONCLUSIONS: Disease activity significantly improved in the new millennium, whereas disability and mortality were unchanged.
- The Role of Statins in Disease Modification and Cardiovascular Risk in Rheumatoid Arthritis. [Review]
- FMFront Med (Lausanne) 2018; 5:24
- Rheumatoid arthritis (RA) is an autoimmune, inflammatory disorder associated with excess cardiovascular morbidity and mortality. A complex interplay between traditional risk factors (dyslipidemia, in...
Rheumatoid arthritis (RA) is an autoimmune, inflammatory disorder associated with excess cardiovascular morbidity and mortality. A complex interplay between traditional risk factors (dyslipidemia, insulin resistance, arterial hypertension, obesity, smoking) and chronic inflammation is implicated in the development of premature atherosclerosis and consequently in the higher incidence of cardiovascular events observed in RA patients. Despite the acknowledgment of elevated cardiovascular risk among RA individuals, its management remains suboptimal. While statin administration has a crucial role in primary and secondary cardiovascular disease prevention strategies as lipid modulating factors, there are limited data concerning the precise benefit of such therapy in patients with RA. Systemic inflammation and anti-inflammatory treatments influence lipid metabolism, leading to variable states of dyslipidemia in RA. Hence, the indications for statin therapy for cardiovascular prevention may differ between RA patients and the general population and the precise role of lipid lowering treatment in RA is yet to be established. Furthermore, some evidence supports a potential beneficial impact of statins on RA disease activity, attributable to their anti-inflammatory and immunomodulatory properties. This review discusses existing data on the efficacy of statins in reducing RA-related cardiovascular risk as well as their potential beneficial effects on disease activity.
- Attenuated effectiveness of tumor necrosis factor inhibitors for anti-human T-lymphotropic virus type 1 antibody-positive rheumatoid arthritis. [Journal Article]
- ARArthritis Rheumatol 2018 Feb 22
- CONCLUSIONS: The efficacy of TNF inhibitors may be attenuated in RA patients with positive anti-HTLV-I antibody. ATL and HAM did not develop when TNF inhibitors were used for 24 weeks, but the long-term risk is not known. This article is protected by copyright. All rights reserved.
- Farming characteristics and self-reported health outcomes of Irish farmers. [Journal Article]
- OMOccup Med (Lond) 2018 Feb 17
- CONCLUSIONS: This study identified self-reported patterns of risky lifestyle behaviours among particular subgroups of Irish farmers for whom targeted health interventions are warranted. Interventions are particularly important for younger farmers who may see themselves as invincible and impregnable to ill-health.
- Anti-interleukin 6 receptor tocilizumab in refractory uveitis associated with Behçet's disease: multicentre retrospective study. [Journal Article]
- RRheumatology (Oxford) 2018 Feb 19
- CONCLUSIONS: TCZ could be a therapeutic option in patients with BD and refractory uveitis.
- The Cost-Effectiveness of Screening in the Community to Reduce Osteoporotic Fractures in Older Women in the UK: Economic Evaluation of the SCOOP Study. [Journal Article]
- JBJ Bone Miner Res 2018 Feb 22
- The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in add...
The SCOOP study was a two-arm randomized controlled trial conducted in the UK in 12,483 eligible women aged 70 to 85 years. It compared a screening program using the FRAX® risk assessment tool in addition to bone mineral density (BMD) measures versus usual management. The SCOOP study found a reduction in the incidence of hip fractures in the screening arm, but there was no evidence of a reduction in the incidence of all osteoporosis-related fractures. To make decisions about whether to implement any screening program, we should also consider whether the program is likely to be a good use of health care resources, ie, is it cost-effective? The cost per gained quality adjusted life year of screening for fracture risk has not previously been demonstrated in an economic evaluation alongside a clinical trial. We conducted a "within trial" economic analysis alongside the SCOOP study from the perspective of a national health payer, the UK National Health Service (NHS). The main outcome measure in the economic analysis was the cost per quality adjusted life year (QALY) gained over a 5-year time period. We also estimated cost per osteoporosis-related fracture prevented and the cost per hip fracture prevented. The screening arm had an average incremental QALY gain of 0.0237 (95% confidence interval -0.0034 to 0.0508) for the 5-year follow-up. The incremental cost per QALY gained was £2772 compared with the control arm. Cost-effectiveness acceptability curves indicated a 93% probability of the intervention being cost-effective at values of a QALY greater than £20,000. The intervention arm prevented fractures at a cost of £4478 and £7694 per fracture for osteoporosis-related and hip fractures, respectively. The current study demonstrates that a systematic, community-based screening program of fracture risk in older women in the UK represents a highly cost-effective intervention. © 2018 The Authors. Journal of Bone and Mineral Research Published by Wiley Periodicals, Inc.
- Are older adults with symptomatic knee osteoarthritis less active than the general population?: Analysis from the Osteoarthritis Initiative and NHANES. [Journal Article]
- ACArthritis Care Res (Hoboken) 2018 Feb 22
- CONCLUSIONS: Time spent in MVPA was similarly low in those with SxOA as in older adults without knee pain or OA. This article is protected by copyright. All rights reserved.
- Residual disease activity in rheumatoid arthritis patients treated with subcutaneous biologic drugs that achieved remission or low disease activity: a longitudinal observational study. [Journal Article]
- CRClin Rheumatol 2018 Feb 21
- The aim of this study was to evaluate the residual disease activity (RDA) and function in rheumatoid arthritis (RA) patients treated with subcutaneous biologic drugs that achieved a status of remissi...
The aim of this study was to evaluate the residual disease activity (RDA) and function in rheumatoid arthritis (RA) patients treated with subcutaneous biologic drugs that achieved a status of remission and low disease activity (LDA) according to the various indices validated for RA and to explore the factors associated with RDA. We consecutively enrolled RA patients that started a new subcutaneous biologic treatment. At baseline and after 3 and 6 months of treatment, we assessed the rate of patients that achieved remission or LDA using the Disease Activity Score on 28 joints, Clinical Disease Activity Index, Simplified Disease Activity Index, and American College of Rheumatology/European League Against Rheumatism remission criteria. The presence of RDA was evaluated as the rate of patients with at least tender joint count > 1, swollen joint count > 1, pain on VAS > 10 mm, general health (VAS) > 10, patient's disease activity (VAS) > 10, physician disease activity (VAS) > 10, and C reactive protein > 1 mg/dl. We also evaluated the impaired function defined as HAQ score > 0.5. Factors associated to RDA were also investigated. Ninety-three adult patients with RA were enrolled. At 6 months, RDA occurred mostly at the level of Patient's reported outcome items and less frequently in tender and swollen joints and acute-phase reactants. Interestingly, about one fourth of patients in LDA and up to one fifth of patients in remission had residual functional impairment with an HAQ score greater than 0.5. RDA in RA was present even in patients with remission or LDA, especially for the patient's reported outcome. Impaired function was also present in a significantly rate of patients.
New Search Next
- Smoking and female sex as key risk factors associated with severe arthralgia in acute and chronic phases of Chikungunya virus infection. [Journal Article]
- ETExp Ther Med 2018; 15(3):2634-2642
- Arthralgia is a potentially incapacitating condition and a persistent symptom in chronic or acute episodes of Chikungunya fever caused by infection with the Chikungunya virus (CHIKV). To the best of ...
Arthralgia is a potentially incapacitating condition and a persistent symptom in chronic or acute episodes of Chikungunya fever caused by infection with the Chikungunya virus (CHIKV). To the best of our knowledge, there are no reports on risk factors associated with the intensity of arthralgias in typical acute episodes of the disease. Although a number of studies have reported on risk factors associated with the development of the chronic stage of the disease, smoking habits have not been analyzed. Smoking is an interesting factor to consider since it is the main environmental risk factor for the development of rheumatoid arthritis (RA), a similar disease to CHIKV in many aspects. In the present study, 140 patients infected with CHIKV were assessed for risk factors associated with severe arthralgia intensity in the acute phase (pain of 9/10 on the visual analog scale of 0-10) and moderate to severe intensity (according to the Routine Assessment of Patient Index Data 3) 3.5 months after infection in patients that experienced the chronic phase of the disease. Women and smokers were 2- to 3-times more likely to experience severe pain in the acute and chronic stages. Likewise, the presence of severe arthralgia during the acute disease phase resulted in a 4-fold increased risk for entering the chronic phase. Smoking was a more important risk factor in males compared with females. Smoking resulted in a 20-fold increased risk for severe arthralgia during the acute phase in men, as well as a 10-fold increased risk for developing chronic disease with moderate-to-severe pain 3.5 months after the acute stage. The presence of rash, headache, muscular weakness or conjunctivitis in the acute phase, the presence of diabetes and age >40 years were considered significant risk factors due to their influence on illness progression. In conclusion, smoking and female sex were the main risk factors associated with development of severe joint pain in the acute and chronic phases of Chikungunya fever. These risk factors are similar to those associated with the development and severity of RA, possibly because the two diseases share pathophysiological mechanisms, including elevated interleukin-6 levels.