Displaying publications 41 - 60 of 177 in total

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  1. IL-23/IL-17 axis in the pathogenesis and treatment of systemic lupus erythematosus and rheumatoid arthritis
    Farah Izati A, Wong KK, Che Maraina CH
    Malays J Pathol, 2020 Dec;42(3):333-347.
    PMID: 33361714
    Interleukin-23 (IL-23) and IL-17 are the gatekeepers of CD4+ T helper 17 (Th17) cells where IL-23 is required for the development and expansion of Th17 cells that subsequently produce IL-17 to promote inflammation. Owing to such pro-inflammatory properties, the IL-23/IL-17 axis has emerged as an important mechanism in the pathogenesis of autoimmune diseases including systemic lupus erythematosus (SLE) and rheumatoid arthritis (RA). In recent years, therapeutic antibodies targeting IL-23 (e.g. ustekinumab, tildrakizumab, guselkumab) or IL-17 (e.g. brodalumab, secukinumab, ixekizumab) have been approved for the treatment of various autoimmune diseases. In this review, we describe the pathogenic mechanisms of IL-23/IL-17 axis in SLE and RA, as well as summarising the findings from phase II and III clinical trials of anti-IL-23/IL-17 therapeutic antibodies in SLE and RA patients. In particular, phase II study has demonstrated that the anti-IL-23 antibody (ustekinumab) confers enhanced treatment outcomes in SLE patients, while anti-IL-17 antibodies (secukinumab and ixekizumab) have shown improved clinical benefits for RA patients in phase II/III studies. Our review highlights the emerging importance of targeting the IL-23/IL-17 axis in SLE and RA patients.
    Matched MeSH terms: Arthritis, Rheumatoid/drug therapy; Arthritis, Rheumatoid/immunology*
  2. Fulltext Detection of anti-cell membrane DNA antibodies by indirect immunoflouresencence technique in systemic lupus erythematosus
    Faten Nurul Amira Awing Kechik, Maha Abdullah, Masriana Hassan, Masita Arip, Hasni Mahayidin
    Malaysian Journal of Medicine and Health Sciences, 2019;15(108):28-28.
    MyJurnal
    Introduction: Systemic lupus erythematosus (SLE) has a broad spectrum of clinical presentations. The diagnosis of SLE remains a challenge and largely depends on the presence of several serum autoantibodies including anti-nuclear antibody (ANA), anti-double-stranded DNA antibody (anti-dsDNA) and anti-Smith antibody (anti-Sm). ANA, a highly sensitive but not specific marker is used for SLE screening Anti-dsDNA and anti-Sm are SLE-specific biomarkers but has lower sensitivity of 80% and 30% for SLE, respectively. However, it is noted that there are SLE patients who are persistently negative for SLE-specific autoantibodies. Anti-dsDNA and anti-Sm were reported to be negative in up to 51.2% and 62.4% of SLE, respectively. This limitation can lead to misdiagnosis and halter proper treatment to SLE patients. Previous studies have suggested that cell membrane DNA (cmDNA) can act as a specific target for the autoantibodies in SLE patients. Autoantibodies towards cmDNA (anti-cmDNA) were reported to have promis-ing value as a reliable biomarker for SLE. In this study, we would like to determine the usefulness of anti-cmDNA in diagnosing SLE as compared to the standard SLE-specific autoantibodies. Methods: Serum samples from 83 SLE patients, 86 other connective tissue diseases and 61 healthy subjects were included in this study. The other connec-tive tissue diseases include samples from 10 Sjogren’s syndrome, 56 rheumatoid arthritis, 12 scleroderma and eight mixed connected tissues disease (MCTD) patients. All samples were analysed by indirect immunofluorescence (IIF) technique using Raji cells as substrate to detect the presence of anti-cmDNA. Anti-cmDNA was reported as positive if there was presence of a fluorescent ring, either continuous or punctate. Sera from SLE patients were also tested for anti-dsDNA and anti-Sm antibodies by using enzyme-immunoassays. Results: Anti-cmDNA positivity was highest in SLE (55.4%) than in other connective tissue diseases (9.3%) and healthy subjects (0%). Anti-cmDNA was 100% spe-cific at differentiating SLE from healthy subjects and 90.7% specific at differentiating SLE from other connective tissue diseases. There was no difference in the sensitivity (55.4%) of anti-cmDNA at differentiating SLE from both groups. Anti-cmDNA were present in 46 SLE samples negative for standard SLE-specific autoantibodies. It was detected in 11 (42.3%) of anti-dsDNA, 23 (63.9%) of anti-Sm and 8 (12.9%) of both anti-Sm and anti-dsDNA negative samples. Conclusion: The high specificity of anti-cmDNA detection using IIF method makes it an excellent diagnostic tool for SLE. Anti-cmDNA is potentially a very useful biomarker for SLE with negative anti-dsDNA or/and anti-Sm antibodies.
    Matched MeSH terms: Arthritis, Rheumatoid
  3. Fulltext Health benefits and potential risk of tropical herbs from the leguminosae family: a review
    Fatin Afifah Rosli, Mohd Rahman Omar, Abdul Aziz Marwan, Ummu Aiman Faisal, Hana Maizuliana Solehan, Ummi Affah Mahamad, et al.
    Malaysian Journal of Medicine and Health Sciences, 2019;15(106):59-59.
    MyJurnal
    Introduction:Tropical herbs are used as a medicine long before the introduction of modern medicine, especially by traditional healers. However, its’ scientific benefits are not widely investigated. There is a belief that the use of tradi-tional herbs potentially causing health deterioration due to its unknown mechanism of actions and interactions, and the nature of its unregulated processing as a health supplement. Parkia speciosa (local: petai) and Pithecellobium jir-inga (local: jering) are two tropical herbs from the Leguminosae family that are widely used raw as salads with many perceived health benefits and harms. We reviewed both species, looking into scientific pieces of evidence supporting the belief. Methods: The databases of MEDLINE, PubMed, EBSCOhost, and Google Scholars were systematically searched for both in vitro and in vivo effects of both species with no language restriction. Data were extracted using standardised fashioned. Results:P speciosa has pharmacological properties including antioxidant and anti-inflam-mation. It has shown to have antibacterial properties and glucose-lowering activity. P jiringa contains known an-tioxidant metabolites such as flavonoids, phenolics and terpenoids. It also contains antiangiogenic properties with potential use in retinopathy, cancer, and Rheumatoid arthritis. However, both herbs have potentially harmful effects which include liver injuries. Large consumption of P jiringa leads to acute kidney injury. Conclusion: Consumption of both P speciosa and P jiringa has medicinal properties as well as health harm. If taken as a supplement, rigorous clinical trials are needed to delineate benefit vs harm effect of both herbs.
    Matched MeSH terms: Arthritis, Rheumatoid
  4. A clinical update and global economic burden of rheumatoid arthritis
    Fazal SA, Khan M, Nishi SE, Alam F, Zarin N, Bari MT, et al.
    Endocr Metab Immune Disord Drug Targets, 2018 Feb 13;18(2):98-109.
    PMID: 29141572 DOI: 10.2174/1871530317666171114122417
    BACKGROUND AND OBJECTIVE: Rheumatoid arthritis (RA) is a predominant inflammatory autoimmune disorder. The incidence and prevalence of RA is increasing with considerable morbidity and mortality worldwide. The pathophysiology of RA has become clearer due to many significant research outputs during the last two decades. Many inflammatory cytokines involved in RA pathophysiology and the presence of autoantibodies are being used as potential biomarkers via the use of effective diagnostic techniques for the early diagnosis of RA. Currently, several disease-modifying anti-rheumatic drugs are being prescribed targeting RA pathophysiology, which have shown significant contributions in improving the disease outcomes.

    DISCUSSION: Even though innovations in treatment strategies and monitoring are helping the patients to achieve early and sustained clinical and radiographic remission, the high cost of drugs and limited health care budgets are restricting the easy access of RA treatment. Both direct and indirect high cost of treatment are creating economic burden for the patients and affecting their quality of life.

    CONCLUSION: The aim of this review is to describe the updated concept of RA pathophysiology and highlight current diagnostic tools used for the early detection as well as prognosis - targeting several biomarkers of RA. Additionally, we explored the updated treatment options with side effects besides discussing the global economic burden.
    Matched MeSH terms: Arthritis, Rheumatoid/diagnosis; Arthritis, Rheumatoid/economics; Arthritis, Rheumatoid/physiopathology; Arthritis, Rheumatoid/therapy*
  5. Fulltext Association of Immunoglobulin G abnormalities in diseases: a mini review
    Foong, Audrey Kow Siew, Nuha Fahimah Binti Wan Zahidi, Chau, Ling Tham
    Life Sciences, Medicine and Biomedicine, 2018;2(1):24-39.
    MyJurnal
    Immunoglobulins are antibodies that play important roles in preserving our immune system. They have the ability to initiate humoral responses and remove antigen from the body. Out of the five major isotypes of immunoglobulins, IgG are most abundantly found in human serum. Abnormalities – deficiency or elevation in the level of IgG are found to be associated to the occurrence of several autoimmune diseases. These may include rheumatoid arthritis, Crohn’s disease, Mikulicz’s disease, Kuttner’s tumour and Hashimoto’s thyroiditis. Apart from autoimmune diseases, IgG has been found to play a role in initiating anaphylaxis, a severe and life threatening form of allergy and lately it has been discovered in cases of dengue virus infection too. It is important to acknowledge the roles of IgG on diseases especially subclass IgG4 which the elevation has been tied to numerous diseases such as Kuttner’s tumour and Hashimoto’s thyroiditis hence termed IgG4-related diseases. In addition, the roles of IgG in anaphylaxis are of importance, too, as IgG has been used in allergy immunotherapy. Hence, this review is a mini compilation of effects of IgG abnormalities based on their subclasses. Hopefully it will provide insightful understanding on the development of diagnostic and therapeutic courses for the aforementioned IgG abnormalities in the future.
    Matched MeSH terms: Arthritis, Rheumatoid
  6. Rheumatoid arthritis
    Giritharan R
    Family Practitioner, 1984;7(1):25-28.
    Matched MeSH terms: Arthritis, Rheumatoid
  7. Fulltext Ethnic differences in the prognostic utility of rheumatoid factor isotypes and anticyclic citrullinated peptides in rheumatoid arthritis patients: a cross-sectional study
    Gomez EL, Gun SC, Somanath SD, Chinna K, Radhakrishnan AK
    Mod Rheumatol, 2013 Jul;23(4):716-21.
    PMID: 22854883 DOI: 10.1007/s10165-012-0718-6
    OBJECTIVES: The prognostic significance of rheumatoid factor (RF) and anticyclic citrullinated peptide antibody (anti-CCP) in rheumatoid arthritis (RA) remains contentious due to the conflicting lines of evidence. This study aims to determine the association between RF isotypes and anti-CCP with disease severity in RA patients from three ethnic groups.
    METHODS: A total of 147 RA patients from three different ethnic groups (Malays, Chinese, and Indians) who fulfilled the 1987 American College of Rheumatology (ACR) revised criteria for RA were recruited into this study. The seroprevalence of RF isotypes immunoglobulin (Ig)A, IgG, and IgM, as well as anti-CCP was determined using commercial enzyme-linked immunosorbent assay (ELISA) kits. Multinomial regression analysis was performed to assess the independent effects of autoantibody status on the development of deforming and erosive RA and the presence of extra-articular manifestations (EAM).
    RESULTS: In Chinese patients, we found a significant association (p < 0.05) between IgG RF and anti-CCP and the presence of erosive disease, as well as IgM RF and IgG RF with the presence of joint deformities. In Indian patients, IgM RF was associated with deforming disease, whereas none of the antibodies were associated with disease severity in Malay patients. Multinomial regression analysis revealed that IgG RF was the most important predictor variable for erosive disease in Chinese patients, and IgM RF the only predictor variable associated with deforming disease in both Chinese and Indian RA patients.
    CONCLUSIONS: There is variability in the phenotypic association of RF isotypes and anti-CCP in relation to disease severity of RA in the three ethnic groups. RF, in particular, IgG and IgM, may be better prognosticators of severe disease in Chinese and Indian patients.
    Matched MeSH terms: Arthritis, Rheumatoid/ethnology; Arthritis, Rheumatoid/immunology*
  8. Fulltext The prevalence of rheumatoid factor isotypes and anti-cyclic citrullinated peptides in Malaysian rheumatoid arthritis patients
    Gomez EL, Gun SC, Somnath SD, D'Souza B, Lim AL, Chinna K, et al.
    Int J Rheum Dis, 2011 Feb;14(1):12-7.
    PMID: 21303477 DOI: 10.1111/j.1756-185X.2010.01573.x
    AIM: The purpose of this study is to compare the prevalence of rheumatoid factor (RF) isotypes and second generation anti-cyclic citrullinated peptides (anti-CCP) in Malaysian rheumatoid arthritis (RA) patients.
    METHODS: In this cross-sectional study, 147 established RA patients from three ethnic groups were recruited from a major rheumatology clinic in Malaysia. Enzyme-linked immunosorbent assays (ELISA) for serum RF isotypes IgA, IgG and IgM as well as second-generation anti-CCP were performed and the prevalence of each auto-antibody was compared in the three ethnic groups.
    RESULTS: The anti-CCP was the most prevalent auto-antibody in each of the ethnic groups, followed closely by RF IgM and RF IgG. Rheumatoid factor IgA was the least prevalent across all three ethnic groups. The anti-CCP-RF IgM combination provided the best test sensitivity. Seroprevalence of anti-CCP was strongly associated with the presence of each of the RF isotypes. The seroprevalence of RF and anti-CCP did not increase or decrease with advancing age, age at onset and disease duration.
    CONCLUSION: When used alone, anti-CCP provides a diagnostic advantage over RF IgM on the basis of test sensitivity. Considering the high cost of the anti-CCP assay, step-wise serum testing with IgM RF followed by anti-CCP may provide a more economically sensible option to optimize test sensitivity for RA.
    Study site: Rheumatology clinic, Hospital Tuanku Jaafar, Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Arthritis, Rheumatoid/ethnology; Arthritis, Rheumatoid/immunology*
  9. Effects of vitamin D on disease activity and serum interleukin-6 in rheumatoid arthritis
    Gopal K, Thevarajah M, Ng CM, Raja J
    Int J Rheum Dis, 2019 May;22(5):834-841.
    PMID: 30729713 DOI: 10.1111/1756-185X.13484
    AIM: Vitamin D3 or 25(OH)D3 may have a potential role in rheumatoid arthritis (RA) pathogenesis by inhibiting the expression of pro-inflammatory cytokines including interleukin-6 (IL-6). The aim of this study is to determine the clinical factors of vitamin D deficiency in multi-ethnic Malaysian RA patients and its association with disease activity, functional disability and serum IL-6 levels.

    METHOD: One hundred RA patients and 50 healthy controls, sex- and age-matched, were recruited. Disease Activity Score of 28 joints and Health Assessment Questionnaire scores were assessed. Baseline serum 25(OH)D3 and IL-6 were measured in all subjects. RA patients who were vitamin D deficient were given loading doses of vitamin D3 and repeated assessments were done.

    RESULTS: Vitamin D deficiency (<50 nmol/L) was found in 63% of RA patients and 76% of healthy controls. Chinese RA patients and healthy controls had significantly more sufficient 25(OH)D3 levels compared to Malays and Indians (P 

    Matched MeSH terms: Arthritis, Rheumatoid/blood*; Arthritis, Rheumatoid/diagnosis; Arthritis, Rheumatoid/ethnology
  10. To compare ESR and CRP as predictors of disease activity in rheumatoid arthritis patients in Hospital Seremban. [Abstract]
    Gun SC, Loh YL, Das Gupta E
    APLAR Journal of Rheumatology, 2006;9 Suppl 1:A185.
    Background: Rheumatoid arthritis (RA) is an inflammatory disease. Predictors of disease activity include presence of joint inflammation, blood investigations such as erythrocyte sedimentation rate (ESR) and c-reactive protein (CRP). ESR is said to be imprecise as it is affected by aging, female sex, obesity, pregnancy, anaemia and polycythaemia. But it is inexpensive and easy to perform. CRP is produced as an acute phase reactant by the liver in response to interleukin 6 and other cytokines. CRP is more specific but costs more than ESR. Both tests are done in the rheumatology clinic of Hospital Seremban. Objective: To compare the usefulness of ESR and CRP as a predictor of disease activity in rheumatoid arthritis (RA) patients. Method: This was a retrospective study. The medical records of 248 RA patients who attended the rheumatology clinic, Hospital Seremban between 1 January 2004 and 31 Dec 2004 were reviewed. The following data were obtained: joint swelling and tenderness, other clinical features which indicate inflammation secondary to infection or trauma and inflammation of soft tissue, ESR, CRP, FBC and UFEME. Results: Data was analysed and the results showed that a total number of 248 patients were seen. There were 13 defaulters. Of the 248 patients there were 929 patients' visits. Of the total number of patients' visits where patients clinically had active disease, 80.2% had raised ESR while 88.8% had raised CRP. As for visits where patients had quiescent disease clinically, 57.3% had normal ESR and 36.5% had normal CRP. Conclusion: CRP is more sensitive but less specific than ESR. This suggests that we still should use both tests as they complement each other. ESR can serve as a countercheck for CRP and vice versa.
    Matched MeSH terms: Arthritis, Rheumatoid
  11. Fulltext A replication study confirms the association of dendritic cell immunoreceptor (DCIR) polymorphisms with ACPA - negative RA in a large Asian cohort
    Guo J, Wu X, Too CL, Yin F, Lu X, He J, et al.
    PLoS One, 2012;7(7):e41228.
    PMID: 22829930 DOI: 10.1371/journal.pone.0041228
    OBJECTIVES: Dendritic cell immunoreceptor (DCIR) has been implicated in development of autoimmune disorders in rodent and DCIR polymorphisms were associated with anti-citrullinated proteins antibodies (ACPA)-negative rheumatoid arthritis (RA) in Swedish Caucasians. This study was undertaken to further investigate whether DCIR polymorphisms are also risk factors for the development of RA in four Asian populations originated from China and Malaysia.

    METHODS: We genotyped two DCIR SNPs rs2377422 and rs10840759 in Han Chinese population (1,193 cases, 1,278 controls), to assess their association with RA. Subsequently, rs2377422 was further genotyped in three independent cohorts of Malaysian-Chinese subjects (MY_Chinese, 254 cases, 206 controls), Malay subjects (MY_ Malay, 515 cases, 986 controls), and Malaysian-Indian subjects (MY_Indian, 378 cases, 285 controls), to seek confirmation of association in various ethnic groups. Meta-analysis was preformed to evaluate the contribution of rs2377422 polymorphisms to the development of ACPA-negative RA in distinct ethnic groups. Finally, we carried out association analysis of rs2377422 polymorphisms with DCIR mRNA expression levels.

    RESULTS: DCIR rs2377422 was found to be significantly associated with ACPA -negative RA in Han Chinese (OR 1.92, 95% CI 1.27-2.90, P=0.0020). Meta-analysis confirms DCIR rs2377422 as a risk factor for ACPA-negative RA across distinct ethnic groups (OR(overall) =1.17, 95% CI 1.06-1.30, P=0.003). The SNP rs2377422 polymorphism showed significant association with DCIR mRNA expression level, i.e. RA-risk CC genotype exhibit a significant increase in the expression of DCIR (P=0.0023, Kruskal-Wallis).

    CONCLUSIONS: Our data provide evidence for association between DCIR rs2377422 and RA in non-Caucasian populations and confirm the influence of DCIR polymorphisms on RA susceptibility, especially on ACPA-negative RA.
    Matched MeSH terms: Arthritis, Rheumatoid/genetics*
  12. Fulltext Medical conditions associated with tooth loss among Saudi adults
    Hamasha, Abed Al-Hadi, Almogbel, Lolowh, Alshehri, Abeer, Alssafia, Fatimah, Alghamdi, Hanan, Alajmia, Alanoud, et al.
    Archives of Orofacial Sciences, 2018;13(1):16-21.
    MyJurnal
    Upon reviewing the literature, the prevalence of many systemic conditions such as diabetes,
    hypertension, asthma and rheumatoid arthritis were reported to be high in Saudi Arabia. The relationship of these
    conditions with tooth loss among Saudi population was not investigated. Therefore, the aim of the present study
    is to explore the relationship between tooth loss and most common medical conditions among Saudi dental
    patient. The study participants were 250 patients who were randomly selected from the College of Dentistry
    database of King Saud bin Abdulaziz University for Health Sciences (KSAU-HS) in Riyadh, Saudi Arabia.
    Participants were requested to answer self-administered questionnaires related to their demographic as well as
    general health questions concerned to the presence of systemic medical conditions. Missing teeth were
    determined after examining the orthopantogram radiographs and reviewing the Romexis and SALUD databases.
    Descriptive statistics, independent t-test and linear multiple regression model were performed using SPSS
    software. The mean number of missing teeth among the study population was 5.8 teeth per person. The mean
    number of missing teeth was higher among subjects with diabetes, hypertension, rheumatoid arthritis,
    cardiovascular diseases, or osteoporosis compared to healthy individuals. A multiple linear regression analysis
    model revealed that diabetes, hypertension and rheumatoid were significant predictors of missing teeth among
    Saudi population. These results highlight the importance of the effect of medical conditions on oral health.
    Matched MeSH terms: Arthritis, Rheumatoid
  13. Fulltext Impact of periodontitis on quality of life among subjects with rheumatoid arthritis: a cross sectional study
    Han PSH, Saub R, Baharuddin NA, Sockalingam S, Bartold PM, Vaithilingam RD
    BMC Oral Health, 2020 11 23;20(1):332.
    PMID: 33225923 DOI: 10.1186/s12903-020-01275-4
    BACKGROUND: This study aimed to assess the impact of periodontitis (PD) on the health related quality of life (HRQoL) and oral health related QoL (OHRQoL) of subjects with rheumatoid arthritis (RA) and PD.

    METHODS: Subjects from dental and RA clinics were screened. Complete periodontal examinations were performed. Subjects were divided into 4 groups: RA-PD, RA, PD and healthy controls (HC). Questionnaires on characteristics and Malaysian versions of Oral Health Impact Profile (OHIP-14(M)) and Health Assessment Questionnaire (HAQ-DI)) were answered.

    RESULTS: A total of 187 subjects were included (29 RA-PD, 58 RA, 43 PD and 57 HC). OHIP-14(M) severity score was highest in the PD group (17.23 ± 10.36) but only significantly higher than the HC group (p 

    Matched MeSH terms: Arthritis, Rheumatoid
  14. Comparison of single nucleotide polymorphisms in the human interleukin-10 gene promoter between rheumatoid arthritis patients and normal subjects in Malaysia
    Hee CS, Gun SC, Naidu R, Das Gupta E, Somnath SD, Radhakrishnan AK
    Mod Rheumatol, 2007;17(5):429-35.
    PMID: 17929139 DOI: 10.1007/s10165-007-0612-9
    In this study, three single nucleotide polymorphisms (SNPs) located within the promoter of the human interleukin (IL)-10 gene [rs1800896 (position: -1087G>A), rs1800871 (position: -824C>T) and rs1800872 (position: -597C>A)] were investigated in 84 rheumatoid arthritis (RA) patients and 95 age- and sex-matched healthy subjects using polymerase chain reaction-restriction fragment length polymorphism method. Production of IL-10 by peripheral blood lymphocytes from the RA patients and healthy subjects cultured in the presence of Concanavalin A (Con A) was determined by using enzyme-linked immunosorbent assay. The results show that the distribution of the IL-10 genotypes did not differ significantly between RA patients and healthy subjects (P>0.05). However, a significant difference was observed in allele frequencies of -824CT, -824TT, -597CA, and -597AA between the RA patients and healthy volunteers (P=0.04). The -1087A/-824T/-597A (ATA) haplotype, which comprises all mutant alleles, was associated with lower IL-10 production when compared with the other haplotypes. In contrast, the RA patients who did not display the ATA haplotype produced significantly higher levels of IL-10 when compared with those carrying either one (P=0.012) or two (P=0.005) ATA haplotypes. Our findings suggest that there is an association between SNPs in the promoter of the human IL-10 gene and susceptibility to RA.
    Study site: Hospital Tuanku Ja’afar, (Hospital Seremban), Seremban, Negeri Sembilan, Malaysia
    Matched MeSH terms: Arthritis, Rheumatoid/diagnosis*; Arthritis, Rheumatoid/genetics*
  15. The relationship between soluble CD30 (sCD30) and rheumatoid arthritis (RA) patients. [Abstract]
    Hee CS, Gun SC, Naidu R, Das Gupta E, Somnath SD, Radhakrishnan A
    APLAR Journal of Rheumatology, 2006;9.
    Matched MeSH terms: Arthritis, Rheumatoid
  16. Fulltext Ultrasound assessment of synovial thickness of some of the metacarpophalangeal joints of hand in rheumatoid arthritis patients and the normal population
    Hussain Manik Z, George J, Sockalingam S
    Scientifica (Cairo), 2016;2016:5609132.
    PMID: 27190682 DOI: 10.1155/2016/5609132
    Objective. To compare ultrasound synovial thickness of the 2nd, 3rd and 4th metacarpophalangeal joints (MCPJ) in a group of patients with proven rheumatoid arthritis (RA) and a control group of normal individuals. Materials and Methods. This is a cross-sectional study comprising 30 rheumatoid arthritis patients and 30 healthy individuals. Ultrasound scans were performed at the dorsal side of 2nd, 3rd, and 4th MCPJ of both hands in RA patients and the healthy individuals. Synovial thickness was measured according to quantitative method. The synovial thickness of RA patients and healthy individuals was compared and statistical cut-off was identified. Results. Maximum synovial thickness was most often detected at the radial side of the 2nd MCPJ and 3rd MCPJ and ulnar side of the 4th MCPJ of both hands which is significantly higher (p < 0.05) in RA patients compared to healthy individuals. With high specificity (96%) and sensitivity (90%) the optimum cut-off value to distinguish RA patients and healthy individuals' synovial thickness differs for the radial side of the 2nd and 3rd MCPJ and ulnar side of the 4th MCPJ. Conclusion. Patients with early RA appear to exhibit a characteristic pattern of synovitis which shows radial side predominance in the 2nd and 3rd MCPJ and ulnar side in the 4th MCPJ.
    Study site: University Malaya Medical Centre (UMMC), Kuala Lumpur, Malaysia
    Matched MeSH terms: Arthritis, Rheumatoid
  17. Cross-cultural adaptation and validation of the Malay health assessment questionnaire for use in rheumatoid arthritis
    Hussein H, Mustafa R, Quek KF, Hassanudin NS, Shahid S
    Int J Rheum Dis, 2008;11(3):237-240.
    DOI: 10.1111/j.1756-185X.2008.00384.x
    Objective: To validate the Malay version of the Health Assessment Questionnaire (Malay-HAQ) for use in Malay-speaking rheumatoid arthritis (RA) patients in the Malaysian setting. The HAQ - Disability Index has been validated in several languages, but not in Malay.Methods: The original HAQ was modified and translated into Malay by two translators, one of whom was aware of the objectives of the Questionnaire and the other as a lay translator. Two sets of Malay-HAQ were distributed to RA patients during their routine follow-up visits; one set to be completed immediately and another set to be completed 2 weeks later. A total of 61 patients completed the two sets of Malay-HAQ. The data collected was analysed using SPSS V. 11.0. Reliability of the data was evaluated using the test-retest method and internal consistency was assessed by Cronbach's alpha.Results: The study showed that the Malay-HAQ is feasible and reliable. The Spearman's correlation coefficient ranged from 0.65 to 0.82, while the internal consistency was 0.88-0.92.Conclusion: The Malay-HAQ is a sensitive, reliable and valid instrument for the measurement of functional status in RA patients in a Malay setting. © 2008 Asia Pacific League of Associations for Rheumatology.
    Matched MeSH terms: Arthritis, Rheumatoid
  18. Dietary Phytochemicals: Natural Swords Combating Inflammation and Oxidation-Mediated Degenerative Diseases
    Islam MA, Alam F, Solayman M, Khalil MI, Kamal MA, Gan SH
    Oxid Med Cell Longev, 2016;2016:5137431.
    PMID: 27721914
    Cumulatively, degenerative disease is one of the most fatal groups of diseases, and it contributes to the mortality and poor quality of life in the world while increasing the economic burden of the sufferers. Oxidative stress and inflammation are the major pathogenic causes of degenerative diseases such as rheumatoid arthritis (RA), diabetes mellitus (DM), and cardiovascular disease (CVD). Although a number of synthetic medications are used to treat these diseases, none of the current regimens are completely safe. Phytochemicals (polyphenols, carotenoids, anthocyanins, alkaloids, glycosides, saponins, and terpenes) from natural products such as dietary fruits, vegetables, and spices are potential sources of alternative medications to attenuate the oxidative stress and inflammation associated with degenerative diseases. Based on in vitro, in vivo, and clinical trials, some of these active compounds have shown good promise for development into novel agents for treating RA, DM, and CVD by targeting oxidative stress and inflammation. In this review, phytochemicals from natural products with the potential of ameliorating degenerative disease involving the bone, metabolism, and the heart are described.
    Matched MeSH terms: Arthritis, Rheumatoid/metabolism; Arthritis, Rheumatoid/therapy*
  19. Fulltext The clinical significance of interleukin-1 receptor antagonist +2018 polymorphism in rheumatoid arthritis
    Ismail E, Nofal OK, Sakthiswary R, Shaharir SS, Sridharan R
    PLoS One, 2016;11(4):e0153752.
    PMID: 27105431 DOI: 10.1371/journal.pone.0153752
    OBJECTIVE: Interleukin-1 receptor antagonist (IL-1Ra) acts as an inhibitor of IL-1; which is one of the culprit cytokines in rheumatoid arthritis (RA). Although +2018 polymorphism of IL-1Ra has been implicated in the pathogenesis of RA, its importance remains poorly understood. Hence, the purpose of this study was to determine the clinical significance of interleukin-1 receptor antagonist (IL-1Ra) +2018 polymorphism in RA.
    METHODS: Polymerase chain reaction (PCR) and sequencing were used to determine the genotypes of the IL-1Ra +2018 for 77 RA patients and 18 healthy controls. All RA patients were assessed for the disease activity score that includes 28 joints (DAS28) and radiographic disease damage based on Modified Sharp Score (MSS).
    RESULTS: The frequency of the T/T and C/T genotypes did not differ significantly (p = 0.893) between the RA patients and the controls. The C/T genotype had significantly higher mean disease activity (DAS 28) and disease damage (MSS) scores with p values of 0.017 and 0.004, respectively. Additionally, the ESR (erythrocyte sedimentation rate), CRP (C-reactive protein), the number of swollen and tender joints were higher for the C/T individuals. On multivariate analysis the CRP, swollen joint count and MSS remained significant with the following p values i.e. 0.045, 0.046 and less than 0.05.
    CONCLUSIONS: C/T genotype of IL-1Ra +2018 prognosticates more aggressive disease in RA.
    Study site: Outpatient clinic, Pusat Perubatan Universiti Kebangsaan Malaysia (PPUKM), Kuala Lumpur, Malaysia
    Matched MeSH terms: Arthritis, Rheumatoid/genetics*
  20. Serum prohepcidin concentrations in rheumatoid arthritis
    Jayaranee S, Sthaneshwar P, Sokkalingam S
    Pathology, 2009 Feb;41(2):178-82.
    PMID: 18972320 DOI: 10.1080/00313020802436840
    AIM: Hepcidin, a recently identified peptide, acts as a central regulator of iron metabolism. It is regarded as a factor regulating the uptake of dietary iron and its mobilisation from macrophages and hepatic stores. It is considered as a mediator of anaemia of inflammation. The aim of this study was to assess whether serum prohepcidin concentration is able to distinguish iron deficiency from anaemia of inflammation in patients with rheumatoid arthritis (RA).

    METHOD: Blood samples were obtained from 20 healthy blood donors, 30 RA patients who presented with anaemia and 30 patients who had pure iron deficiency anaemia (IDA). The samples were analysed for full blood count, iron, ferritin, transferrin, soluble transferrin receptor and prohepcidin.

    RESULTS: The mean prohepcidin level in the control subjects was 256 microg/L. The prohepcidin level was significantly lower in IDA patients (100 microg/L; p < 0.0001) but not significantly different from that of control in RA patients (250 microg/L; p > 0.05). Higher serum soluble transferrin receptor (sTfR) levels were observed in IDA (p < 0.0001) but not in RA compared with that of control (p > 0.05). RA patients were divided into iron depleted and iron repleted subgroups based on the ferritin level. Prohepcidin in the iron depleted group was significantly lower than the iron repleted group and the control (p < 0.0001) and higher levels were observed in the iron repleted group (p < 0.01). sTfR levels in the iron depleted group were significantly higher than the control and the iron repleted patients (p < 0.001). In the iron repleted group, sTfR level was not statistically different from that of control (p > 0.05).

    CONCLUSION: Serum prohepcidin is clearly reduced in uncomplicated iron deficiency anaemia. The reduced prohepcidin levels in the iron depleted RA patients suggests that there may be conflicting signals regulating hepcidin production in RA patients. In RA patients who have reduced hepcidin in the iron depleted group (ferritin <60 microg/L) where sTfR levels are increased suggests that these patients are iron deficient. Further studies with a larger cohort of patients are required to substantiate this point.

    Matched MeSH terms: Arthritis, Rheumatoid/blood*; Arthritis, Rheumatoid/complications; Arthritis, Rheumatoid/diagnosis
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