Spondyloarthritis (SpA) constitute a group of chronic inflammatory immune-mediated rheumatic diseases characterized by genetic, clinical, and radiological features. Recent efforts have concentrated on identifying biomarkers linked to axial SpA associated with inflammatory bowel disease (IBD), offering predictive insights into disease onset, activity, and progression. Genetically, the significance of the HLA-B27 antigen is notably diminished in ankylosing spondylitis (AS) associated with IBD, but is heightened in concurrent sacroiliitis. Similarly, certain polymorphisms of endoplasmic reticulum aminopeptidase (ERAP-1) appear to be involved. Carriage of variant NOD2/CARD15 polymorphisms has been demonstrated to correlate with the risk of subclinical intestinal inflammation in AS. Biomarkers indicative of pro-inflammatory activity, including C-reactive protein (CRP) along with erythrocyte sedimentation rate (ESR), are among the consistent predictive biomarkers of disease progression. Nevertheless, these markers are not without limitations and exhibit relatively low sensitivity. Other promising markers encompass IL-6, serum calprotectin (s-CLP), serum amyloid (SAA), as well as biomarkers regulating bone formation such as metalloproteinase-3 (MMP-3) and Dickkopf-related protein 1 (DKK-1). Additional candidate indicators of structural changes in SpA patients include matrix metalloproteinase-3 (MMP-3), vascular endothelial growth factor (VEGF), tenascin C (TNC), and CD74 IgG. Fecal caprotein (f-CLP) levels over long-term follow-up of AS patients have demonstrated predictive value in anticipating the development of IBD. Serologic antibodies characteristic of IBD (ASCA, ANCA) have also been compared; however, results exhibit variability. In this review, we will focus on biomarkers associated with both axial SpA and idiopathic intestinal inflammation, notably enteropathic spondyloarthritis.
- MeSH
- ankylózující spondylitida krev diagnóza imunologie MeSH
- axiální spondyloartritida krev diagnóza MeSH
- biologické markery * krev MeSH
- C-reaktivní protein analýza metabolismus MeSH
- HLA-B27 antigen genetika imunologie MeSH
- idiopatické střevní záněty * krev imunologie diagnóza komplikace MeSH
- leukocytární L1-antigenní komplex krev MeSH
- lidé MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- přehledy MeSH
Synovial fluid (SF)-derived monocyte-macrophage (MON-Mφ)-lineage cells in knee osteoarthritis (KOA) remain poorly understood. We analyzed SF samples from 420 patients with KOA with effusion. The MON-Mφ cells accounted for 47.4% (median; range 7.1%-94.4%) of CD45+ cells and consisted of four subpopulations that correlated with the distribution and activation of other immune cells. The most abundant subpopulation was that of inactive CD11b+CD14-CD16- myeloid dendritic cells (mDCs; cDC2), which exhibited low cytokine production, low T lymphocyte stimulation, and high migratory ability. Other major subpopulations included CD11b+CD14+CD16- monocyte-like cells and CD11b+CD14+CD16+ macrophages, which share a similar transcriptomic profile. A subpopulation of CD11b-CD14-CD16- mDCs (cDC1) was less common. A higher proportion of CD11b+CD14-CD16- mDCs was linked to early-stage KOA and mild joint pain. Dendritic cells were rarely present in KOA synovium. This study revealed the considerable complexity of SF-derived MON-Mφ subpopulations and highlighted the role of inactive mDCs in KOA.
- MeSH
- artróza kolenních kloubů * patologie metabolismus imunologie MeSH
- buněčný rodokmen MeSH
- dendritické buňky * metabolismus imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- makrofágy * metabolismus imunologie MeSH
- monocyty * metabolismus imunologie MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- synoviální tekutina * metabolismus imunologie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři nad 80 let MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
PURPOSE OF THE STUDY: Osteoarthritis (OA) of the joints of the hand is one of the most common musculoskeletal disorders in the elderly population. It is a complex, degenerative disease affecting all components of the joint. Surgical treatment is indicated when conservative therapy fails. The ultimate solution is arthrodesis of the distal interphalangeal (DIP) joint. Various methods of arthrodesis have been described, ranging from the use of K-wires or compression screw to different types of intra-articular (intramedullary) implants. The aim of this study is to evaluate the surgical outcomes of arthrodesis of the distal interphalangeal (DIP) joint of the fingers using intramedullary implants. MATERIAL AND METHODS: Since 2011, arthrodesis of the distal interphalangeal joint using an intramedullary implant has been performed at our department 97 times in total, in 59 patients. 9 patients (15 cases of arthrodesis) were excluded from the study group due to their failure to complete the questionnaire, 1 female patient died. In the final group, 82 cases of arthrodesis in 49 patients (47 women, 2 men) were evaluated. In 72% of cases, the surgery was performed on the dominant hand. The mean age at the time of surgery was 58 years (median 59 years). The patients were indicated for surgery after the failure of all conservative treatment options. In addition to radiographs, also the hand function and pain were assessed based on the preand postoperative DASH score questionnaires. RESULTS: The surgical outcomes for all implants are satisfactory. In all 82 patients, the surgical wounds healed per primam. In one case, implant extraction was performed due to infection. Another complication was an unhealed fusion and formation of a non-union with minimum pathological mobility (the patient is satisfied with the outcome). In three patients, a fracture at the base of the distal phalanx was observed on postoperative radiographs, which fully healed within 3 months after surgery. The mean DASH score decreased from 41.95 preoperatively to 14.93 postoperatively. The mean time to healing of the arthrodesis observed on radiographs was 9.1 weeks. DISCUSSION: Currently, there are many different types of arthrodesis of the distal interphalangeal joint of the hand. Each method has its pros and cons. Arthrodesis using an intramedullary implant has the advantages of the older methods while minimizing postoperative complications. Our results are comparable to those reported in the foreign literature. CONCLUSIONS: Based on the evaluated outcomes, arthrodesis of the distal interphalangeal joint using an intramedullary implant can be considered valid. It definitely deserves to be included in the portfolio of surgical treatment of osteoarthritis of the DIP joints of the hand. According to our observation, the differences between various types of implants are minimal and their outcomes are comparable to those reported in foreign publications. The pain relief, restored finger function and fusion rate are comparable to, if not better than, those achieved by the older surgical methods. The advantage of this method is mainly easier implantation, fewer complications, and the possibility of implantation without the use of an X-ray image intensifier, which ultimately reduces the cost of surgery. The main disadvantage is the higher purchase price of the implant. KEY WORDS: osteoarthritis, distal interphalangeal joint, arthrodesis.
- MeSH
- artrodéza * metody přístrojové vybavení MeSH
- kloub prstu ruky * chirurgie MeSH
- lidé středního věku MeSH
- lidé MeSH
- osteoartróza * chirurgie MeSH
- rentgendiagnostika MeSH
- senioři MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
Background: Femoroacetabular impingement syndrome (FAI) is a complex, often post-traumatically developing impairment of the hip joint. It is characterized by ambiguous symptomatology, which makes early diagnosis difficult. Aim: The study was conducted to evaluate the applicability of a triaxial gyroscopic sensor in routine practice as an additional indication criterion for operative versus conservative treatment procedures. Methods: Ninety-two patients were included in the experimental retrospective study and 62 completed the examination. All patients signed informed consent. A gyroscopic sensor was placed on the right side of the pelvis above the hip joint and patients walked approximately 15 steps. Data were also evaluated while the patients climbed stairs. A complete clinical examination of the dynamics and physiological movements in the joint was performed. The data measured by the gyroscopic sensor were processed using differential geometry methods and subsequently evaluated using spectral analysis and neural networks. Results: FAI diagnosis using gyroscopic measurement is fast and easy to implement. Our approach to processing the gyroscopic signals used to detect the stage of osteoarthritis and post-traumatic FAI could lead to more accurate detection and capture early in FAI development. Conclusions: The obtained data are easily evaluated, interpretable, and beneficial in the diagnosis of the early stages of FAI. The results of the study show that this approach can lead to more accurate and early detection of osteoarthritis and post-traumatic FAI.
- MeSH
- analýza chůze metody MeSH
- biomechanika * MeSH
- femoroacetabulární impingement * chirurgie diagnóza patofyziologie MeSH
- kyčelní kloub patofyziologie MeSH
- lidé MeSH
- nositelná elektronika * MeSH
- osteoartróza diagnóza patofyziologie MeSH
- retrospektivní studie MeSH
- telemedicína metody MeSH
- umělá inteligence MeSH
- Check Tag
- lidé MeSH
Background: Lipocalin-2 (LCN2) is a protein that has been associated with skeletal muscle regeneration, but details regarding its role in Arthritis remain unclear. The aim of the current study was to investigate LCN2 levels of Arthritis patients and its relationship with oxidative and antioxidative factors.Methods: The study includes (125) blood samples of persons aged 20-65 years were divided into a control group (apparently healthy) consisting of 55 samples [31female, 24 males] and a Patient group consisting of 70 samples [37female, 33 males] who were attending the bone diseases consultation unit at the Ibn Sina Teaching Hospital in Mosul, Iraq. Venous blood samples (10 ml) were collected after overnight fasting. To conduct Clinical analyses: Serum LCN2 level was determined by ELISA, also Malonaldehyde, glutathione, vitamin E, vitamin C, peroxy nitrite, peroxidase, and aryl esterase were estimated.Results: The findings revealed a significant increase in the levels of LCN2 in Arthritis compared to the control group and there was a significant decrease in the concentration of vitamin C, glutathione, vitamin E and the activity of the arylesterase in serum of patients with arthritis compared with the control group. Also, a significant increase in the activity of peroxidase, concentration of peroxynitrite and malondialdehyde for patients than a control group.Conclusion: These findings imply that LCN2 may play a substantial role in iron-related oxidative stress damage in arthritis. Thus a therapeutic candidate target for treatment.
OBJECTIVE: Radiographic assessment of sacroiliac joints (SIJs) according to the modified New York (mNY) criteria is key in the classification of axial spondyloarthritis but has moderate interreader agreement. We aimed to investigate the improvements of the reliability in scoring SIJ radiographs after applying an online real-time iterative calibration (RETIC) module, in addition to a slideshow and video alone. METHODS: Nineteen readers, randomized to 2 groups (A or B), completed 3 calibration steps: (1) review of manuscripts, (2) review of slideshow and video with group A completing RETIC, and (3) re-review of slideshow and video with group B completing RETIC. The RETIC module gave instant feedback on readers' gradings and continued until predefined reliability ([Formula: see text]) targets for mNY positivity/negativity were met. Each step was followed by scoring different batches of 25 radiographs (exercises I to III). Agreement ([Formula: see text]) with an expert radiologist was assessed for mNY positivity/negativity and individual lesions. Improvements by training strategies were tested by linear mixed models. RESULTS: In exercises I, II, and III, mNY [Formula: see text] were 0.61, 0.76, and 0.84, respectively, in group A; and 0.70, 0.68, and 0.86, respectively, in group B (ie, increasing, mainly after RETIC completion). Improvements were observed for grading both mNY positivity/negativity and individual pathologies, both in experienced and, particularly, inexperienced readers. Completion of the RETIC module in addition to the slideshow and video caused a significant [Formula: see text] increase of 0.17 (95% CI 0.07-0.27; P = 0.002) for mNY-positive and mNY-negative grading, whereas completion of the slideshow and video alone did not ([Formula: see text] = 0.00, 95% CI -0.10 to 0.10; P = 0.99). CONCLUSION: Agreement on scoring radiographs according to the mNY criteria significantly improved when adding an online RETIC module, but not by slideshow and video alone.
- MeSH
- axiální spondyloartritida * diagnostické zobrazování MeSH
- lidé MeSH
- odchylka pozorovatele * MeSH
- rentgendiagnostika * metody MeSH
- reprodukovatelnost výsledků MeSH
- sakroiliakální kloub * diagnostické zobrazování MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- randomizované kontrolované studie MeSH
Introduction: Rheumatoid arthritis (RA) is a chronic autoimmune disease with unknown cause. It mainly affects joints and, without proper treatment, negatively impacts their movement, causes painful deformities, and reduces the patients' quality of life. Current treatment options consist of various types of disease-modifying antirheumatic drugs (DMARDs), however 20-30% of patients are partially resistant to them. Therefore, development of new drugs is necessary. Possible option are compounds exhibiting their action via endocannabinoid system, which plays an important role in pain and inflammation modulation. One such compound - cannabidiol (CBD) has already been shown to attenuate synovitis in animal model of RA in in vivo studies. However, it has low bioavailability due to its low water solubility and lipophilicity. This issue can be addressed by preparation of a lipid containing formulation targeting lymphatic system, another route of absorption in the body. Materials and Methods: CBD-containing emulsion was prepared by high-shear homogenization and its droplet size distribution was analysed by optical microscopy. The relative oral bioavailability compared to oil solution as well as total availability of CBD were assessed in a cross-over study in rats and absorption of CBD via lymphatic system was observed. The effect of CBD on the animal model of RA was determined. Results: Compared to oil solution, the emulsion exhibited higher absolute oral bioavailability. Significant lymphatic transport of CBD was observed in all formulations and the concentrations in lymph were calculated. The therapeutic effect of CBD on RA was confirmed as an improvement in clinical symptoms as well as morphological signs of disease activity were observed during the study. Conclusion: In this work, we prepared a simple stable emulsion formulation, determined the pharmacokinetic parameters of CBD and calculated its absolute bioavailability in rats. Moreover, we successfully tested the pharmaceutical application of such a formulation and demonstrated the positive effect of CBD in an animal model of RA.
- MeSH
- aplikace orální MeSH
- bolest farmakoterapie MeSH
- emulze MeSH
- kanabidiol * farmakologie chemie MeSH
- klinické křížové studie MeSH
- krysa rodu rattus MeSH
- kvalita života MeSH
- revmatoidní artritida * farmakoterapie MeSH
- voda MeSH
- zvířata MeSH
- Check Tag
- krysa rodu rattus MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
OBJECTIVES: To re-evaluate cut-offs for disease activity states according to the Axial Spondyloarthritis Disease Activity Score (ASDAS), and study the impact of sex, age, calendar time, disease and symptom duration on ASDAS and ASDAS cut-offs in a large contemporary cohort. METHODS: Data from 2939 patients with axial spondyloarthritis (axSpA) starting their first tumour necrosis factor inhibitor in nine European registries were pooled and analysed. Receiver operating characteristic analyses were performed to identify cut-offs against external criteria. Six-month data including patient and physician global assessments, both ≤1 (0-10 integer scale), and Assessment of SpondyloArthritis International Society partial remission were used for separation of inactive disease (ID) from low disease activity (LDA), while patient and physician global ≤3 were applied as external criteria to separate LDA from high disease activity (HDA). Patient and physician global ≥6 were applied to separate HDA from very high disease activity in baseline data. RESULTS: The three ASDAS cut-offs identified to separate the four disease activity states in the overall patient population were <1.3, <2.0 and >3.5. Cut-offs for ID and LDA in women were higher (<1.5 and <2.0, respectively) than in men (<1.3 and <1.9), as were cut-offs in patients ≥45 years (<1.5 and <2.2) versus ≤34 years (<1.2 and <1.9) and 35-44 years (<1.3 and <1.8). Cut-offs were independent of calendar time and disease duration. CONCLUSIONS: Re-evaluation of ASDAS cut-offs for disease activity states in a large multi-national axSpA cohort resulted in cut-offs similar to those currently endorsed. Differences in cut-offs between sex and age groups for ID and LDA were observed, but the differences were minor.
- MeSH
- axiální spondyloartritida * diagnóza epidemiologie MeSH
- dospělí MeSH
- inhibitory TNF terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- registrace * MeSH
- revmatologie normy MeSH
- ROC křivka MeSH
- sexuální faktory MeSH
- stupeň závažnosti nemoci * MeSH
- věkové faktory MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Evropa MeSH
BACKGROUND: The presence of ACPA significantly increases the risk of developing RA. Dysregulation of lymphocyte subpopulations was previously described in RA. Our objective was to propose the predictive model for progression to clinical arthritis based on peripheral lymphocyte subsets and ACPA in individuals who are at risk of RA. METHODS: Our study included 207 at-risk individuals defined by the presence of arthralgias and either additional ACPA positivity or meeting the EULAR definition for clinically suspect arthralgia. For the construction of predictive models, 153 individuals with symptom duration ≥12 months who have not yet progressed to arthritis were included. The lymphocyte subsets were evaluated using flow cytometry and anti-CCP using ELISA. RESULTS: Out of all individuals with arthralgia, 41 progressed to arthritis. A logistic regression model with baseline peripheral blood lymphocyte subpopulations and ACPA as predictors was constructed. The resulting predictive model showed that high anti-CCP IgG, higher percentage of CD4+ T cells, and lower percentage of T and NK cells increased the probability of arthritis development. Moreover, the proposed classification decision tree showed that individuals having both high anti-CCP IgG and low NK cells have the highest risk of developing arthritis. CONCLUSIONS: We propose a predictive model based on baseline levels of lymphocyte subpopulations and ACPA to identify individuals with arthralgia with the highest risk of progression to clinical arthritis. The final model includes T cells and NK cells, which are involved in the pathogenesis of RA. This preliminary model requires further validation in larger at-risk cohorts.
- MeSH
- artralgie * imunologie MeSH
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- podskupiny lymfocytů * imunologie MeSH
- prediktivní hodnota testů MeSH
- progrese nemoci * MeSH
- protilátky proti citrulinovaným peptidům * krev imunologie MeSH
- revmatoidní artritida * imunologie krev MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- risankizumab, certolizumab,
- MeSH
- biologická terapie metody MeSH
- humanizované monoklonální protilátky * terapeutické užití MeSH
- interleukin-23 antagonisté a inhibitory MeSH
- interleukiny antagonisté a inhibitory MeSH
- kombinovaná farmakoterapie MeSH
- lidé středního věku MeSH
- lidé MeSH
- progrese nemoci MeSH
- psoriatická artritida farmakoterapie komplikace MeSH
- psoriáza * farmakoterapie komplikace MeSH
- terapie neúspěšná MeSH
- tumor nekrotizující faktory terapeutické užití MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
