June 3, 2009, 5:11 AM CT

Surgery in patients with RA

A newly released study published by the American Society of Plastic Surgeons reveals that one of the most common conditions caused by Rheumatoid Arthritis (RA) is best treated surgically, sooner rather than later. Patients with RA frequently experience a debilitating condition known as metacarpophalangeal joint disease, which is commonly treated by replacing the knuckle joints with solid silicone joints. However, this therapy (and others like it) has spurred great disagreement between hand surgeons and rheumatologists regarding the indications, timing and perceived outcomes of the procedure; rheumatologists tend to refer late-stage patients for surgery whereas hand surgeons think that earlier intervention can yield more positive outcomes.

In the largest cohort study of its kind, scientists from Michigan, Maryland, and the United Kingdom reviewed the surgical outcomes of 70 RA patients who suffered from varying degrees of hand deformities. Following reconstruction, patients were separated into two groups based on the degree of deformity, and the outcomes of the reconstruction were assessed at 6 months and at years 1, 2 and 3. After reconstruction, both groups had positive self-reported hand outcomes and showed statistically significant improvement from baseline. However, scientists observed that the more severe group still had significant deformities - showing that the more serious the malformation, the more difficult it is to correct......... Posted by: Mark      Read more         Source

June 1, 2009, 7:07 PM CT

Genes, smoking and rheumatoid arthritis

Recent genetic studies have revealed several new sites of genes that are risk factors for developing rheumatoid arthritis (RA). The strongest association with anti-citrullinated protein antibody (ACPA)-positive RA (ACPAs are autoantibodies detected in RA that are used as a major diagnostic tool) has been found for the HLA-DRB1 gene, and this site seems to play a central role in susceptibility to the disease in Caucasian populations. Prior studies have shown a high increase in the risk of ACPA-positive RA linked to smoking in those who have certain variations of the HLA-DRB1 gene. There are several types of such alleles correlation to a particular amino acid sequence known as shared epitope (SE). ACPAs occur in about 60 percent of RA patients and are closely associated with the presence of SE alleles. In fact, SE alleles are the strongest genetic risk factor for ACPA-positive RA.

Of several environmental factors that predispose people toward developing RA, smoking has been found to be the main risk factor and a strong gene-environment interaction between smoking and SE alleles for ACPA-positive patients has been shown in prior studies in Europe. Results in North America have not been as conclusive, however. A new large population-based study examined the gene-environment interaction between smoking and SE alleles in RA and observed that all SE alleles strongly interact with smoking in conferring an increased risk of ACPA-positive RA. The study was reported in the recent issue of Arthritis & Rheumatism (http://www3.interscience.wiley.com/journal/76509746/home)......... Posted by: Mark      Read more         Source

June 1, 2009, 7:00 PM CT

Tai chi helps to improves arthritis pain

The results of a new analysis have provided strong evidence to suggest that Tai Chi is beneficial for arthritis. Specifically, it was shown to decrease pain with trends towards improving overall physical health, level of tension and satisfaction with health status.

Musculoskeletal pain, such as that experienced by people with arthritis, places a severe burden on the patient and community and is recognized as an international health priority. Exercise treatment including such as strengthening, stretching and aerobic programs, have been shown to be effective for arthritic pain. Tai Chi, is a form of exercise that is regularly practiced in China to improve overall health and well-being. It is commonly preformed in a group but is also practiced individually at one's leisure, which differs from traditional exercise treatment approaches used in the clinic.

Recently, a newly released study examined the effectiveness of Tai Chi in decreasing pain and disability and improving physical function and quality of life in people with chronic musculoskeletal pain. The study is reported in the recent issue of Arthritis Care & Research (http://www3.interscience.wiley.com/journal/77005015/home). Led by Amanda Hall of The George Institute in Sydney, Australia, scientists conducted a systematic review and meta-analysis. They analyzed seven eligible randomized controlled trials that used Tai Chi as the main intervention for patients with musculoskeletal pain. The results demonstrate that Tai Chi improves pain and disability in patients suffering arthritis......... Posted by: Mark      Read more         Source

April 21, 2009, 5:12 AM CT

Looking to prevent kidney damage in lupus

Kidney damage linked to the autoimmune disease lupus is associated with a malfunction of immune cells that causes them to congregate in and attack the organs, scientists at UT Southwestern Medical Center have discovered in a mouse study.

In a separate study with an international team, the scientists also observed that a certain set of genes appears to protect the kidneys from a different sort of immune attack in both mice and humans.

"These studies, taken together, uncover two important molecules that underlie the pathology of lupus, especially kidney disease," said Dr. Edward Wakeland, chairman of immunology at UT Southwestern and co-senior author of the studies.

"In addition, they highlight a certain molecule as a potential target for treating this disease," he said.

In the first study, which appears in the recent issue of The Journal of Immunology, the scientists examined several strains of mice that mimic human lupus. They observed that immune cells in those mice overproduced a particular molecule called CXCR4. In fact, the mice had up to twice as much CXCR4 as their normal counterparts in several types of immune cells. The lupus-prone mice also had more immune-system cells in their kidneys, indicating that the inflammatory action of the immune cells might be causing the kidney damage......... Posted by: Mark      Read more         Source

April 17, 2009, 5:12 AM CT

New drug for fibromyalgia

For Tara Campbell, the onset of her fibromyalgia began slowly with repeated sore throats, fevers and fatigue. By the time she was diagnosed, a year later, she had become so debilitated by flulike symptoms and exhaustion that she often couldn't get off the couch all day.

"Fall, a year ago, I hit my very, very worst," said Campbell, 39, of Walnut Creek, Calif. "I felt overall pain to the point that even when my children or husband just touched me it hurt".

Campbell's symptoms still linger, but since taking part in a Stanford University School of Medicine clinical trial in the spring of 2008, she's improved enough that she's gone back to working again as an interior decorator and even headed up the fundraising auction at her daughters' school.

"I am really, really good," Campbell said. "Having said that, I'm not yet 100 percent. I'm not yet that person I was before".

Campbell was one of 10 women with fibromyalgia to take part in a small pilot study at Stanford over a 14-week period to test the new use of a low dose of a drug called naltrexone for the therapy of chronic pain. The drug, which has been used clinically for more than 30 years to treat opioid addiction, was found to reduce symptoms of pain and fatigue an average of 30 percent over placebo, as per the results of the study to be published April 17 online in the journal Pain Medicine........ Posted by: Mark      Read more         Source

April 9, 2009, 4:45 AM CT

Vitamin D may make autoimmune disease worse

Deficiency in vitamin D has been widely regarded as contributing to autoimmune disease, but a review appearing in Autoimmunity Reviews explains that low levels of vitamin D in patients with autoimmune disease appears to be a result rather than a cause of disease and that supplementing with vitamin D may actually exacerbate autoimmune disease.

Authored by a team of scientists at the California-based non-profit Autoimmunity Research Foundation, the paper goes on to point out that molecular biologists have long known that the form of vitamin D derived from food and supplements, 25-hydroxyvitamin D (25-D), is a secosteroid rather than a vitamin. Like corticosteroid medications, vitamin D may provide short-term relief by lowering inflammation but may exacerbate disease symptoms over the long-term.

The insights are based on molecular research showing that 25-D inactivates rather than activates its native receptor - the Vitamin D nuclear receptor or VDR. Once associated solely with calcium metabolism, the VDR is now known to transcribe at least 913 genes and largely control the innate immune response by expressing the bulk of the body's antimicrobial peptides, natural antimicrobials that target bacteria.

Written under the guidance of professor Trevor Marshall of Murdoch University, Western Australia, the paper contends that 25-D's actions must be considered in light of recent research on the Human Microbiome. Such research shows that bacteria are far more pervasive than previously thought 90% of cells in the body are estimated to be non-human increasing the likelihood that autoimmune diseases are caused by persistent pathogens, a number of of which have yet to be named or have their DNA characterized......... Posted by: Mark      Read more         Source

March 30, 2009, 5:02 AM CT

Why mostly women get lupus?

In an international human genetic study, scientists at UT Southwestern Medical Center have identified a gene associated with the autoimmune disease lupus, and its location on the X chromosome might help explain why females are 10 times more susceptible to the disease than males.

Identifying this gene, IRAK1, as a disease gene may also have therapeutic implications, said Dr. Chandra Mohan, professor of internal medicine and senior author of the study. "Our work also shows that blocking IRAK1 action shuts down lupus in an animal model. Though a number of genes appears to be involved in lupus, we only have very limited information on them," he said.

The study appears online this week in the Proceedings of the National Academy of Sciences.

Locating IRAK1 on the X chromosome also represents a breakthrough in explaining why lupus seems to be sex-linked, Dr. Mohan said. For decades, scientists have focused on hormonal differences between males and females as a cause of the gender difference, he pointed out.

"This first demonstration of an X chromosome gene as a disease susceptibility factor in human lupus raises the possibility that the gender difference in rates may in part be attributed to sex chromosome genes," Dr. Mohan said.

Systemic lupus erythematosus, or lupus for short, causes a wide range of symptoms such as rashes, fever or fatigue that make it difficult to diagnose......... Posted by: Mark      Read more         Source

February 26, 2009, 6:20 AM CT

Physical therapy effective for low-back ache

A new review article reported in the Journal of the American Academy of Orthopaedic Surgeons should help convince a number of patients with low back pain to consider physical treatment as a first line of therapy for their condition, as per the American Physical Therapy Association (APTA). The review, published in February 2009, recommends that in most cases of symptomatic lumbar degenerative disc disease, a common cause of low back pain (LBP), the most effective therapy is physical treatment combined with anti-inflammatory medications. Approximately 75 to 85 percent of adults will be affected by low back pain during their lifetimes.1.

Symptomatic lumbar degenerative disc disease develops when a disc weakens (often due to repetitive strain), is injured, or deteriorates from aging. As a result, the disc is unable to hold the vertebrae as it should and the lack of stability can cause back pain.

The review details the different therapy methods for symptomatic lumbar degenerative disc disease, including physical treatment with the use of nonsteroidal anti-inflammatory drugs (NSAIDs), and concludes that, in most patients with low back pain, symptoms resolve without surgical intervention. The review also concludes that physical treatment and nonsteroidal anti-inflammatory drugs are the "cornerstones" of non-surgical therapy......... Posted by: Mark      Read more         Source

January 26, 2009, 11:32 PM CT

Gene therapy for rheumatoid arthritis

Scientists have reported the first clinical evidence that gene treatment reduces symptoms in patients with rheumatoid arthritis, an important milestone for this promising therapy which has endured a sometimes turbulent past. Described in the recent issue of the journal Human Gene Therapy the findings stem from a study of two patients with severe rheumatoid arthritis conducted in Gera number of and led by an investigator at Beth Israel Deaconess Medical Center (BIDMC).

Originally conceived as a means of treating genetic diseases, such as cystic fibrosis and hemophilia, gene treatment involves implanting a normal gene to compensate for a defective gene in the patient. The first clinical trial to test gene treatment was launched in 1990 for the therapy of a rare, genetic immunodeficiency disease.

"This study helps extend gene treatment research to nongenetic, nonlethal diseases," explains principal investigator Christopher Evans, PhD, Director of the Center for Advanced Orthopaedic Studies at BIDMC. "Rheumatoid arthritis [RA] is an extremely painful condition affecting multiple joints throughout the body. Arthritis is a good target for this therapy because the joint is a closed space into which we can inject genes," adds Evans, who is also the Maurice Muller Professor of Orthopaedic Surgery at Harvard Medical School......... Posted by: Mark      Read more         Source

January 8, 2009, 9:06 PM CT

For fats, longer may not be better

Scientists have uncovered why some dietary fats, specifically long-chain fats, such as oleic acid (found in olive oil), are more prone to induce inflammation. Long-chain fats, it turns out, promote increased intestinal absorption of pro-inflammatory bacterial molecules called lipopolysaccharides (LPS). This study appears in the recent issue of JLR

While dietary fats that have short chains (such as those found in milk and cheese products) can be absorbed directly into the bloodstream from the intestines, long-chain fats need to be first packaged by the intestinal cells into particles known as chylomicrons (large complexes similar to HDL and LDL particles). Erik Eckhardt and his colleagues at the University of Kentucky wondered whether some unwanted LPS particles, routinely shed by the bacteria that inhabit the human gut, might also be sneaking in the chylomicrons.

Their hypothesis turned out to be correct; when they treated cultured human intestinal cells with oleic acid they observed significant secretion of LPS together with the chylomicron particles, a phenomenon that was not observed when the cells were treated with short-chain butyric acid. Similar findings were found in mouse studies; high amounts of dietary oleic acid, but not butyric acid, promoted significant absorption of LPS into the blood and lymph nodes and subsequent expression of inflammatory genes......... Posted by: Mark      Read more         Source

January 7, 2009, 11:22 PM CT

How skeletal muscle stabilizes the spine?

The novel design of a deep muscle along the spinal column called the multifidus muscle may in fact be key to spinal support and a healthy back, as per scientists at the University of California, San Diego School of Medicine. Their findings about the potentially important "scaffolding" role of this poorly understood muscle has been published on line in advance of the recent issue of the Journal of Bone and Joint Surgery

"The multifidus muscle was formerly believed to be relatively unimportant based on its fairly small size," said Richard L. Lieber, Ph.D., Professor and Vice Chair of UC San Diego's Department of Orthopedic Surgery and Director of the National Center for Skeletal Muscle Rehabilitation Research, based at UC San Diego. Lieber is also Senior Research Career Scientist at the Veterans Affairs San Diego Health System. "Our research shows that it's actually the strongest muscle in the back because of its unique design. It's like a long, skinny pencil packed with millions of tiny fibers".

The scientists discovered that the multifidus has a unique packing design consisting of short fibers arranged within rods, and that these fibers are stiffer than any other in the body. Using laser diffraction methods that they developed to measure muscle internal properties during back surgery, they demonstrated that the multifidus' unique design serves a critical function as a stabilizer of the lumbar spine. These findings could have implications for surgery, as per Steven R. Garfin, M.D., Professor and Chair of UCSD's Department of Orthopaedic Surgery......... Posted by: Mark      Read more         Source

December 1, 2008, 5:47 PM CT

New treatment eliminates heel pain

Combining an ultrasound-guided technique with steroid injection is 95 percent effective at relieving the common and painful foot problem called plantar fasciitis, as per a research studypresented today at the annual meeting of the Radiological Society of North America (RSNA).

"There is no widely accepted treatment or standard of care for patients when first-line therapys fail to relieve the pain of plantar fasciitis," said the study's lead author, Luca M. Sconfienza, M.D., from Italy's University of Genoa. "Our new technique is an effective, one-time outpatient procedure".

Plantar fasciitis, the most common cause of heel pain, is an inflammation of the connective tissue called the plantar fascia that runs along the bottom of the foot, from the heel to the ball of the foot. The condition accounts for 11 percent to 15 percent of all foot symptoms requiring professional care and affects one million people annually in the U.S.

Conservative therapys, which may take up to a year to be effective, include rest, exercises to stretch the fascia, night splints and arch supports.

When the condition does not respond to conservative therapys, patients may opt for shockwave treatment, in which sound waves are directed at the area of heel pain to stimulate healing. Shockwave treatment is painful, requires multiple therapys and is not always effective. Complications may include bruising, swelling, pain, numbness or tingling and rupture of the plantar fascia. In the most severe cases of plantar fasciitis, patients may undergo invasive surgery to detach the fascia from the heel bone......... Posted by: Mark      Read more         Source

September 29, 2008, 10:35 PM CT

Pain is not a symptom of arthritis, pain causes arthritis

Pain is more than a symptom of osteoarthritis, it is an inherent and damaging part of the disease itself, as per a research studypublished recently in journal Arthritis and Rheumatism More specifically, the study revealed that pain signals originating in arthritic joints, and the biochemical processing of those signals as they reach the spinal cord, worsen and expand arthritis. In addition, scientists observed that nerve pathways carrying pain signals transfer inflammation from arthritic joints to the spine and back again, causing disease at both ends.

Technically, pain is a patient's conscious realization of discomfort. Before that can happen, however, information must be carried along nerve cell pathways from say an injured knee to the pain processing centers in dorsal horns of the spinal cord, a process called nociception. The current study provides good evidence that two-way, nociceptive "crosstalk" may first enable joint arthritis to transmit inflammation into the spinal cord and brain, and then to spread through the central nervous system (CNS) from one joint to another.

Furthermore, if joint arthritis can cause neuro-inflammation, it could have a role in conditions like Alzheimer's disease, dementia and multiple sclerosis. Armed with the results, scientists have identified likely drug targets that could interfere with key inflammatory receptors on sensory nerve cells as a new way to treat osteoarthritis (OA), which destroys joint cartilage in 21 million Americans. The most common form of arthritis, OA eventually brings deformity and severe pain as patients loose the protective cushion between bones in weight-bearing joints like knees and hips......... Posted by: Mark      Read more         Source

September 29, 2008, 9:28 PM CT

Supplements no better than placebo in slowing cartilage loss

In a two-year multicenter study led by University of Utah doctors, the dietary supplements glucosamine and chondroitin sulfate performed no better than placebo in slowing the rate of cartilage loss in the knees of osteoarthritis patients.

This was an ancillary study concurrently conducted on a subset of the patients who were enrolled in the prospective, randomized GAIT (Glucosamine/chondroitin Arthritis Intervention Trial). The primary objective of this ancillary study was to investigate whether these dietary supplements could diminish the structural damage of osteoarthritis. The results, reported in the recent issue of Arthritis & Rheumatism, show none of the agents had a clinically significant effect on slowing the rate of joint space width loss the distance between the ends of joint bones as shown by X-ray.

However, in line with other recent studies, the scientists found that all the study's participants had a slower rate of joint space width loss than expected, making it more difficult to detect the effects of the dietary supplements and other agents used in the study.

Rheumatologist Allen D. Sawitzke, M.D., associate professor of internal medicine at the University of Utah School of Medicine, was lead investigator. "At two years, no therapy achieved what was predefined to be a clinically important reduction in joint space width loss," Sawitzke said. "While we found a trend toward improvement among those with moderate osteoarthritis of the knee in those taking glucosamine, we were not able to draw any definitive conclusions"......... Posted by: Mark      Read more         Source

August 20, 2008, 8:16 PM CT

New test to diagnose osteoarthritis early

A newly developed medical imaging technology may provide doctors with a long-awaited test for early diagnosis of osteoarthritis (OA), researchers from New York reported today at the 236th National Meeting of the American Chemical Society. By far the most common form of arthritis, OA is a bane of the Baby Boom generation, causing joint pain and disability for more than half of those over 65 nearly 21 million people in the United States.

Current diagnostic methods commonly do not catch the disease until OA is in advanced stages when joint damage may already have occurred. A method for early diagnosis could open a window of opportunity for preventing or reducing permanent damage particularly with evidence that dietary supplements like glucosamine and chondroitin can halt further joint degeneration, says Alexej Jerschow, Ph.D., who reported on the research jointly with Ravinder R. Regatte, Ph.D.

"Our methods have the potential of providing early warning signs for cartilage disorders like osteoarthritis, thus potentially avoiding surgery and physical treatment later on," states Jerschow. "Also, the effectiveness of early preventative drug therapies can be better assessed with these methods".

Particularly common in the knee and hip, osteoarthritis damages cartilage, the tough, elastic material that cushions moving parts of joints. OA is the most common reason for total hip and total knee replacement surgery. "It has all these painful consequences and makes it difficult to move it results in a severe loss of quality of life for those who are affected by it," says Regatte......... Posted by: Mark      Read more         Source

August 20, 2008, 6:29 PM CT

How rheumatoid arthritis causes bone loss

Scientists have discovered key details of how rheumatoid arthritis (RA) destroys bone, as per a research studyreported in the Aug. 22 edition of the Journal of Biological Chemistry The findings are already guiding attempts to design new drugs to reverse RA-related bone loss and may also address more common forms of osteoporosis with a few adjustments.

Two million Americans suffer from rheumatoid arthritis (RA), which causes swelling, pain and deformity in joints and also lead to the thinning of bone. In autoimmune diseases like RA, the body's disease-fighting immune cells mistakenly identify parts of a person's body as foreign invaders, akin to bacteria, and produce chemicals to destroy them. Among the immune chemicals known to play a central in autoimmune disease is tumor necrosis factor alpha (TNF alpha), which ramps up the production of immune cells and chemicals as part of the body's response to disease. When overproduced in RA patients, TNF alpha signals for the destruction of cartilage and bone.

Beyond its control over immune cells, TNF alpha also influences bone mass. Human bone is continually regenerated to maintain strength. Under the control of signaling molecules which include TNF alpha, two cell types, balanced against each other, make bone recycling possible. Osteoclasts break down aging bone to make way for new bone, while osteoblasts build new bone at the sites where osteoclasts have removed it. Going into the study, the field understood that TNF alpha decreases the number of bone-building osteoblasts, but not how. The current study provides the first direct proof that the TNF alpha affects osteoblasts through an enzyme called Smad Ubiquitin Regulatory Factor 1 (Smurf1), which in turn shuts down two proteins that would otherwise drive bone-building......... Posted by: Mark      Read more         Source

June 4, 2008, 10:53 PM CT

Regular tipple may curb risk of rheumatoid arthritis

Alcohol cuts the risk of developing rheumatoid arthritis by up to 50%, reveals research published ahead of print in the Annals of the Rheumatic Diseases.

The Scandinavian scientists base their findings on more than 2750 people taking part in two separate studies, which assessed environmental and genetic risk factors for rheumatoid arthritis.

Over half the participants (1650) had the disease and had been matched for age, sex, and residential locality with randomly selected members of the general public.

All participants were quizzed about their lifestyle, including how much they smoked and drank. And blood samples were taken to check for genetic risk factors.

The results showed that drinking alcohol was linked to a significantly lower risk of developing rheumatoid arthritis. And the more alcohol was consumed, the lower the risk of rheumatoid arthritis.

Among those who drank regularly, the quarter with the highest consumption were up to 50% less likely to develop the disease compared with the half who drank the least.

The effect was the same for both men and women.

Among those with antibodies to a specific group of proteins involved in the development of the disease, alcohol cut the risk most in smokers with genetic risk factors for rheumatoid arthritis......... Posted by: Mark      Read more         Source

June 3, 2008, 10:31 PM CT

Toward Ending Cartilage Loss

Researchers have long wrestled with how to aid those who suffer cartilage damage and loss. One popular way is to inject an artificial gel that can imitate cartilage's natural ability to act as the body's shock absorber. But that solution is temporary, requiring follow-up injections.

Now Brown University nanotechnology specialist Thomas Webster has found a way to regenerate cartilage naturally by creating a synthetic surface that attracts cartilage-forming cells. These cells are then coaxed to multiply through electrical pulses. It's the first study that has shown enhanced cartilage regeneration using this method; it appears in the current issue of the Journal of Biomedical Materials Research, Part A.

"Cartilage regeneration is a big problem," said Webster, an associate professor in the Division of Engineering and the Department of Orthopaedics at Brown. "You don't feel pain until significant cartilage damage has occurred and it's bone rubbing on bone. That's why research into how to regenerate cartilage is so important".

Webster's work involves carbon nanotubes, which are molecular-scale tubes of graphitic carbon that are among the stiffest and strongest fibers known and are great conductors of electrons. They are being studied intensively worldwide for a range of commercial, industrial and medical uses......... Posted by: Mark      Read more         Source

June 3, 2008, 10:23 PM CT

Recommendations for Rheumatoid Arthritis Therapy

To manage the painful and incapacitating symptoms of rheumatoid arthritis (RA), a chronic, inflammatory joint disease, the majority of patients rely on disease-modifying antirheumatic drugs (DMARDs). In addition to trusted nonbiologic DMARDs, many biologic agents now promise to improve therapy for RA. The American College of Rheumatology (ACR), respected worldwide for its devotion to fostering excellence in patient care, has not updated recommendations for non-biologic DMARDs since 2002 and has not previously developed recommendations for biologic agents. In view of that, ACR decided it was time for a major re-evaluation of the use of DMARD treatment in rheumatoid arthritis.

Under the guidance of a Core Expert Panel of clinicians and methodologists and based on a systematic review of the scientific evidence, a second group of internationally recognized clinicians, methodologists, and patient representatives with extensive expertise in the use of nonbiologic and biologic DMARDs developed these recommendations for the ACR and the results of their work will be presented in the June 2008 issue of Arthritis Care & Research (www.interscience.wiley.com/journal/arthritis). These recommendations on the use of non-biologic and biologic DMARDs in RA address 5 key areas pre-specified by the ACR: indications for use, monitoring for side-effects, assessing the clinical response, screening for tuberculosis (a risk factor linked to biologic DMARDs), and under certain circumstances (i.e. high disease activity) the roles of cost and patient preference in choosing biologic agents. When developing these recommendations, RA disease duration, disease severity, and prognostic features were also considered......... Posted by: Mark      Read more         Source

May 19, 2008, 6:41 PM CT

Cause of lupus

Scientists at Wake Forest University have uncovered evidence that the abnormal editing of gene messages in a type of white blood cell may be behind the development of lupus. Researchers hope the finding will lead to earlier diagnosis, a way to monitor patients response to treatment and possibly a new way to treat the disease.

The findings, reported online in the journal Immunology, involve an enzyme that edits and modifies the messages of genes before the protein-making process. It is protein molecules that carry out the instructions of our genes and determine how an organism looks, how well its body metabolizes food or fights infection, and even how it behaves.

Dama Laxminarayana, Ph.D., assistant professor of internal medicine and senior author, said that in systemic lupus erythematosus, the normal editing process goes awry, causing a shift in the balance of proteins that results in impaired functions in T cells, a type of white blood cell involved in the regulation of immune functions.

Impaired T cell function is a hallmark of lupus, a complex chronic autoimmune disorder that can range from a non-malignant skin disorder to severe, life-threatening multisystem disease. It primarily affects women in the child-bearing years and is more common in blacks......... Posted by: Mark      Read more         Source

May 12, 2008, 9:45 PM CT

Women who breastfeed for more than a year

Women who breast feed for longer have a smaller chance of getting rheumatoid arthritis, suggests a study published online ahead of print in the Annals of the Rheumatic Diseases.

The study also observed that taking oral contraceptives, which are suspected to protect against the disease because they contain hormones that are raised in pregnancy, did not have the same effect. Also, simply having children and not breast feeding also did not seem to be protective.

The scientists compared 136 women with rheumatoid arthritis with 544 women of a similar age without the disease. They observed that that those who had breast fed for longer were much less likely to get rheumatoid arthritis.

Women who had breastfed for 13 months or more were half as likely to get rheumatoid arthritis as those who had never breast fed. Those who had breast fed for one to 12 months were 25 per cent less likely to get the disease.

The proportion of women breast feeding for more than six months has increased dramatically over the past 30 years. The authors concluded that it was difficult to say whether there was a correlation between higher rates of breast feeding and a corresponding fall in the number of women affected by rheumatoid arthritis, but that the results of the study provided yet another reason why women should continue breast feeding......... Posted by: Janet      Read more         Source

April 8, 2008, 10:01 PM CT

Back pain may be in your genes

What do you learn by looking at the spines of hundreds of Finnish twins? If you are the international team of scientists behind the Twin Spine Study, you find compelling proof that back pain problems may be more a matter of genetics than physical strain.

The findings of the Twin Spine Study, an ongoing research program started in 1991, have led to a dramatic paradigm shift in the way disc degeneration is understood. Last month a paper presenting an overview of the Twin Spine Studys multidisciplinary investigation into the root causes of disc degeneration received a Kappa Delta Award from the American Academy of Orthopaedic Surgeons, arguably the most prestigious annual award in musculoskeletal research.

In the past, the factors most usually suspected of accelerating degenerative changes in the discs were various occupational physical loading conditions, such as handling of heavy materials, postural loading and vehicular vibration, said lead researcher Michele Crites-Batti of the University of Albertas Faculty of Rehabilitation Medicine.

Drawing on information from 600 participants in the population-based Finnish Twin Cohort147 pairs of identical and 153 pairs of fraternal male twinsthe Twin Spine Study has turned the dominant injury model approach to disc degeneration on its head. Scientists from Canada, Finland, the United States and the United Kingdom compared identical twin siblings who differed greatly in their exposure to a suspected risk factor for back problems; for example, one of the twins had a sedentary job while the other had heavy occupational physical demands, or one routinely engaged in occupational driving while the other did not. The studies yielded startling results, suggesting that genetics play a much larger role in disc degeneration than previously thought......... Posted by: Mark      Read more         Source

March 18, 2008, 8:57 PM CT

Vegan Diet Promotes Atheroprotective Antibodies

A gluten-free vegan diet may improve the health of patients with rheumatoid arthritis, as per new research from Karolinska Institutet. The diet has a beneficial effect on several risk factors for cardiovascular disease.

Rheumatoid arthritis is linked to an increased risk of atherosclerosis (hardening of the arteries) and cardiovascular diseases. The underlying causes are unknown, but scientists suspect that the disturbed balance of blood fats seen in patients with rheumatoid arthritis may be part of the explanation.

A research team at Karolinska Institutet has shown in a new study that a gluten-free vegan diet has a beneficial effect on cardiovascular risk factors in people with rheumatoid arthritis. The effect was seen when a group of patients who kept to a gluten-free vegan diet for a year were compared with a control group which had followed ordinary dietary advice.

Vegan food had a positive effect on symptoms of the disease, which were more pronounced in the control group. Blood levels of oxidised LDL-cholesterol, a risk factor for atherosclerosis, were also lower in the group which kept to the vegan diet. The vegan group also had higher levels of anti-PC, a type of antibody that the scientists believe has a protective effect against atherosclerosis......... Posted by: Mark      Read more         Source

March 16, 2008, 9:20 PM CT

new light on inflammatory diseases

Investigators at Hospital for Special Surgery have identified a new mechanism involved in the pathogenesis of inflammatory diseases such as rheumatoid arthritis. The mechanism may also shed some light on why gene treatment experiments that use adenoviruses to deliver genes to humans have run into problems. The study will appear online on March 16 in the journal Nature Immunology.

Tumor necrosis factor (TNF) is known to play a role in several important inflammatory diseases including rheumatoid arthritis. While much is known about early signaling pathways activated by TNF, little is known about delayed and chronic TNF responses. In addition, cells called macrophages produce TNF, but little is known about the effects of TNF on the macrophages themselves.

In studies using human blood cells and mice, researchers examined the responses of macrophages during a two-day period after being stimulated with TNF. They observed that macrophages secreted TNF and that then the TNF activated surface receptors on the macrophages themselves, spurring the cells into a low and sustained production of a protein called interferon-beta. This protein acted synergistically with TNF signals to induce 1) sustained expression of genes encoding inflammatory molecules and 2) delayed expression of genes encoding interferon-response molecules......... Posted by: Mark      Read more         Source