Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0003864 (arthritis)
 69,039 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The association between three major spondyloarthritic diseases, ankylosing spondylitis, Reiter's syndrome, and reactive arthritis, and the major histocompatibility complex (MHC) class 1 antigen HLA-B27 is well documented. The hypothesis of cross-reactivity between HLA-B27 and the antecedent infection-causing Gram-negative pathogens such as Salmonella, Shigella and Yersinia has been suggested by in vitro studies employing monoclonal antibodies. We have examined the possibility of such cross-reactivity in vivo using various rabbit immune sera and patient sera as the source of cross-reacting antibody. Mouse L cells were transfected with HLA-A3 or HLA-B27 and used as a source of antigen. Western blot analysis employing denatured antigen, FACS analysis employing native antigen and immunoprecipitation studies were undertaken to detect cross-reacting antibodies generated in vivo to HLA-B27 antigen. Antibodies generated in vivo by infection in patients or immunization in animals against arthritogenic bacteria did not demonstrate any cross-reactivity with HLA-B27 by any of the methods used. As defined by the humoral immune response, molecular mimicry appears unlikely to explain the role of B27 in the pathogenesis of reactive arthritis.
 ...
PMID:HLA-B27/microbial mimicry: an in vivo analysis. 147 90

Eighty-one patients with systemic onset juvenile chronic arthritis (JCA) have been tested for HLA-A, -B, -C, and -DR antigens. This study confirms previous reports of an increased incidence of DR4 in these patients. Subdivision of the patients according to their disease course over ten years showed different HLA associations with different disease courses. The frequency of DR4 tended to be greater in patients with less severe disease. There was also an increased incidence of HLA B27 in patients in whom relapses of disease were associated with intercurrent infections.
 ...
PMID:Increased frequency of DR4 in systemic onset juvenile chronic arthritis. 150 14

Psoriatic spondyloarthropathy as defined by the presence of inflammatory back pain and stiffness, sacroiliitis on physical examination, radiographic evidence of grade greater than or equal to 2 sacroiliitis, and classical or paramarginal syndesmophytes on spinal radiographs was identified in 82 women and 112 men followed at the Psoriatic Arthritis Clinic according to a standard protocol. A logistic regression analysis was performed to look for variables which discriminate between men and women with this condition. No differences in type of peripheral arthritis, degree of damage, or medication were noted between the two groups. However, there was some evidence for more advanced spondyloarthropathy in men. There were no differences in the frequency of HLA B27 or any of the psoriatic arthritis-related HLA antigens. Thus, there may be gender-related differences in the expression of psoriatic spondyloarthropathy, which are unrelated to HLA antigens.
 ...
PMID:Psoriatic spondyloarthropathy in men and women: a clinical, radiographic, and HLA study. 151 94

For more than 100 years it has been suspected that bacteria or products derived from them are deposited in joints and cause arthritis without suppuration. Over this time a vast amount of evidence, much of which is still unchallenged, has accumulated to demonstrate that whole bacteria and subcellular bacterial elements do pass, under certain circumstances, from sites of mucosal colonization or infection into the circulation and thence into joints. Similarly, experimental studies have demonstrated that the deposition of both inert material and bacterial components within synovium is sometimes, but not always, associated with the development and persistence of synovitis. In human reactive arthritis aseptic synovitis follows localized bacterial infection in the gut or genitourinary tract. A genetic predisposition, associated with the HLA B27 antigen, is recognized, and interaction between class I HLA determinants and bacteria-derived antigens may underlie the development of arthritis. Although much remains to be learned about the dissemination of antigens from the primary site of infection in reactive arthritis, strong evidence implicates the deposition of antigenic elements of Chlamydia, Yersinia, Salmonella and perhaps other micro-organisms within the synovium. Immunological findings support the notion that such antigens are being presented within the joint and participating in the induction and/or maintenance of synovitis. It is not yet clear whether such bacteria are complete or viable or whether persistence at an extra-articular site is important to the persistence of arthritis. The possibility that reactive arthritis, and perhaps other forms of seronegative arthritis also, is caused and perpetuated by bacterial antigens within the joint poses new questions about the role of HLA B27 in pathogenesis. It also raises important and exciting issues regarding treatment. Already, studies of antimicrobial therapy have yielded encouraging initial findings, and it is now possible to design and evaluate therapies aimed at blocking specific antigen recognition within the joint.
 ...
PMID:Reactive arthritis: the role of bacterial antigens in inflammatory arthritis. 152 41

Erythrocyte C3b receptor (CR1) activity was measured in 27 patients with yersinia triggered reactive arthritis and in 151 control subjects, including 36 patients with uncomplicated yersiniosis and 115 healthy subjects. CR1 was measured by the immune adherence haemagglutination method. Patients with yersinia triggered reactive arthritis had reduced levels of CR1 compared with the controls. This difference was mainly due to the finding that five out of six HLA B27 negative patients with arthritis had decreased CR1 activity. Such a quantitative difference may contribute to the pathogenesis of reactive arthritis by affecting the clearance of immune complexes.
 ...
PMID:Does reduced erythrocyte C3b receptor (CR1) activity contribute to the pathogenesis of yersinia triggered reactive arthritis? 153 47

Ankylosing spondylitis and related spondyloarthropathies form a family of rheumatic diseases that are characterized by inflammatory peripheral and axial arthritis, with predilection for sacroiliitis, and a remarkably strong association with a genetic marker, HLA-B27. The association with B27 has provided a great impetus to the epidemiologic studies of spondyloarthropathies and also helped broaden the clinical spectrum of these diseases. There are at least six subtypes of B27, and the x-ray crystallographic structure of the common B27 subtype (B*2705) is now known. Endogenous peptides bound in the B27 antigen-binding cleft have been isolated and all seem to be nonamers (i.e., nine amino acids long).
 ...
PMID:An overview of clinical spectrum and heterogeneity of spondyloarthropathies. 156 95

Seventy-nine consecutive patients with active ulcerative colitis were studied to establish the prevalence and clinical features of articular involvement. HLA typing for A and B loci was performed. Forty-nine patients showed an articular involvement (62%). Three different clinical patterns were identified: ankylosing spondylitis occurring in 20 subjects; peripheral arthritis in 15; unclassifiable spondylitis in 14. When compared to the general population in our area, patients with colitis showed a significantly higher prevalence of the HLA-A1 (p less than 0.005), B21 (p less than 0.001) and B27 (p less than 0.05); among patients with colitis, those with arthritis revealed higher frequency of HLA-B27 (p less than 0.05). Our study reveals a high prevalence of unclassifiable spondylitis during ulcerative colitis, and suggests a new approach to the classification of seronegative spondarthritis.
 ...
PMID:The arthritis of ulcerative colitis: clinical and genetic aspects. 157 50

In order to establish how many children with seronegative spondyloarthropathy (SpA) starting with peripheral arthritis and/or enthesitis will develop ankylosing spondylitis (AS), 13 consecutive Caucasian pediatric patients, (11 with the seronegative enthesopathy and arthropathy (SEA) syndrome and 2 with isolated B27 associated peripheral arthritis or enthesitis at entry), were followed prospectively with no loss for more than 5 years. Sacroiliac joint plain films obtained at the last visit were mixed with those of 14 control subjects and read blindly. The course of SpA was self-limiting in 6 patients and recurrent in the other 7. Six patients had episodes of inflammatory cervical and/or lumbar pain during followup. However, none showed any limitation of spinal movement in the asymptomatic periods. Only one patient (9.1%) of 11 with the SEA syndrome showed bilateral sacroiliitis and met New York criteria for AS after 5 years of disease. Our results suggest that the proportion of Caucasian children with the SEA syndrome developing AS is much lower than the 75% found in a similar study on Mexican children. Lack of evaluation of all patients after 5 years, the reading of pelvic plain films without reducing observer error, and the male predominance in the Mexican study, probably in addition to ethnic or environmental factors, may account for differences.
 ...
PMID:Low frequency of axial involvement in Caucasian pediatric patients with seronegative enthesopathy and arthropathy syndrome after 5 years of disease. 157 64

Clinical, laboratory and radiological findings were evaluated in 26 children with Reiter's syndrome, all of whom met the 1982 diagnostic criteria of A. Calin. Twenty-two of the patients (85%) were male and 4 were female (15%); the mean age at onset was 10.5 years (range 4-15.5 yrs). Mean follow-up time was 28.6 months. Diarrhea prior to onset was observed in 18 cases (69%), but there was no report of venereal disease. The full classic triad was initially observed in only 9 patients (35%), urethritis alone in 6 (23%) and conjunctivitis alone in 4 (15%). Arthritis was present in all patients, with the lower limb joints involved in 25 cases (96%); the pattern was pauciarticular in 18 (69%), polyarticular in 7 (27%) and monoarticular in one (4%). There was complete remission in 15 out of the 26 patients (58%), while a sustained and fluctuating course was seen in 7 (27%) and 3 (11.5%) patients, respectively; a single patient showed a remitting course. Balanitis was present in 11 out of the 22 male (50%) cases. Twelve out of 18 patients tested (67%) proved to be HLA B27 positive and there was radiological evidence of sacroiliitis in 5 out of 24 patients (21%). Reiter's syndrome should be included in the differential diagnosis of the arthritic child. As a rule, the course of joint involvement is remittent and sequelae affecting functional capacity are indeed exceptional.
 ...
PMID:Juvenile onset Reiter's syndrome. A retrospective study of 26 patients. 158 74

The mechanism by which HLA-B27 confers genetic susceptibility to the seronegative spondyloarthropathies ankylosing spondylitis, Reiter's syndrome, and reactive arthritis, is not well understood. The current concept of an extraarticular bacterial infection functioning as the triggering event in a genetically susceptible host suggests the possibility of direct microbial-MHC interaction. We have addressed the role of HLA-B27 in microbial-host cell interaction by examining invasion by putatively arthritogenic gram-negative bacteria. Target cells used were murine L cells transfected with HLA-B27, HLA-A3, HLA-A2, HLA B44, HLA B18, or pSV2neo vector alone. Relative to the pSV2neo control and the HLA-A3 transfectant, HLA-B27-transfected cells demonstrated a consistent decrease in invasion for each of the following pathogens: Salmonella typhimurium (45 +/- 2% decrease), Shigella sonnei (53 +/- 13% decrease), Shigella flexneri (45 +/- 5% decrease), and enteroinvasive Escherichia coli (57 +/- 8% decrease). This decrease was specific for the HLA B27-transfected L cells and was not observed in the other B allele transfectants. The decreased invasion in the HLA-B27 transfectants is not the result of either altered endogenous mouse class I expression as a result of human class I transfection or increased intracellular bacterial killing within the B27 transfectants. There was an inverse relationship between the amount of surface expression of HLA-B27, as measured by FACS, and the degree of invasion. Blocking of surface B27 Ag with anti-B27 mAb augmented bacterial invasion in the B27 transfectants. These studies demonstrate a novel bacterial-B27 interaction that may have relevance to the pathogenesis of B27-related arthritis.
 ...
PMID:HLA-B27 expression modulates gram-negative bacterial invasion into transfected L cells. 158 45


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>