Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UNIPROT:P01889 (ankylosing spondylitis)
 5,717 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The cases of seventeen children whose ages ranged from two to eighteen years and who were treated for a disorder of a sacro-iliac joint between 1975 and 1983 were reviewed retrospectively. Thirteen children were acutely ill, with a temperature of more than 38 degrees Celsius, and four had chronic symptoms that had persisted for three weeks to one year. Pain in the hip, thigh, and buttock was the most common symptom. Of the thirteen acutely ill patients, eleven had septic arthritis of a sacro-iliac joint, while one who had ankylosing spondylitis and one who had juvenile rheumatoid arthritis had acutely painful arthritis of a sacro-iliac joint. Of the four patients who had chronic symptoms, two had septic arthritis of a sacro-iliac joint; one, ankylosing spondylitis with sacro-iliac involvement; and one, eosinophilic granuloma of the ilium. Thus, thirteen patients had septic arthritis of a sacro-iliac joint and four had some other disorder. For the seventeen children who had acute or chronic symptoms, at admission the white blood-cell count ranged from 3,500 to 26,200 per cubic millimeter (average, 11,100 per cubic millimeter) and the sedimentation rate, as determined by the Westergren technique, ranged from twenty-two to sixty-five millimeters per hour (average, fifty millimeters per hour). Twelve of the plain radiographs of the seventeen patients were negative. The initial bone scans of all seventeen patients were positive in eleven and negative in six. Of these six, five had septic arthritis and one, juvenile rheumatoid arthritis. A computed tomographic scan was performed in four patients and was positive in all of them: three had septic arthritis and one had ankylosing spondylitis. Organisms were cultured successfully from blood, from material aspirated from the sacro-iliac joint, or from stool of all thirteen patients who had sepsis. The thirteen infections responded well to appropriate antibiotics, which were administered intravenously to seven patients and first intravenously and then orally to six.
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PMID:Disorders of the sacro-iliac joint in children. 333 71

One hundred porous surface replacements (PSR) were performed in 92 patients (63 men and 29 women) with a mean age of 53 (range 17-76). Follow-up times range from 1 to 4 years, with 48 patients having a follow-up of at least 2 years. Preoperative diagnoses were osteoarthritis (OA) 63, osteonecrosis (ON) 13, dysplasia 9, rheumatoid-ankylosing spondylitis 6, and other 9. Seventeen hips had metal-backed acrylic-fixed THARIES acetabular sockets, nine hips had a porous cobalt chrome hemispheric beaded acetabular component with adjuvant fixation screws and externally protruding screw hubs, and 74 hips had a porous chamfered cylinder-design acetabulum. Pain relief had been immediate and more complete than with acrylic-fixed or biologic-ingrowth stem-type replacement with comparable walking and function improvements. There have been no major systemic complications, sepsis, or loosening. There have been two transient peroneal nerve palsies and three trochanteric fibrous unions. There have been three reoperations, one for subluxation, one for "metalosis" due to mesh pad loosening, and one femoral neck fracture. Examination of one removed femoral surface component which has been histologically sectioned revealed excellent (90%) bone in-growth. Circumferential progressive radiolucencies developed at the bone-cement interface by 1 year in all of the 17 acrylic-fixed acetabular components. Reaming or seating defects were noted in 25% of the ingrowth components on postoperative radiographs. Radiographic analysis of immediate postoperative films of the chamfered cylinder design acetabular components frequently demonstrated bone-component interface radiolucencies which represented component seating defects. These initial interface radiolucencies became progressively more narrow over the first six months postoperatively suggesting "healing" of the reamed bone-component interface with trabecular bone around the chamfered cylinder acetabular components. Partial healing of initial interface voids with residual narrow radiolucencies were typical of the nine hemispheric-design acetabula with adjuvant screws and screw hubs. This new porous surface replacement (PSR) of the hip using porous ingrowth fixation avoids the major disadvantages of acrylic-fixed SR: excessive acetabular reaming and difficulty with acetabular revision. (When conversion to stem-type replacement is necessary the modular polyethylene socket liner can be exchanged.) The PSR has the prospect of enhanced fixation and improved longterm durability.
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PMID:Porous surface replacement of the hip with chamfered-cylinder component. 335 70

Fifty-seven porous surface replacements (PSR) were performed in 53 patients (36 men and 17 women) with a mean age of 54 years (range, 19-75 years). Follow-up examination times ranged from one year to 2.5 years with 33 patients having follow-up periods of at least two years. Preoperative diagnoses were osteoarthritis (OA), 37; osteonecrosis (ON), six; dysplasia, nine; rheumatoid ankylosing spondylitis, three; and other, two. Sixteen hips had metal-backed acrylic-fixed THARIES (total hip articular replacement by internal eccentric shells) acetabular sockets, nine hips had a cobalt chrome hemispherical beaded acetabular component with adjuvant screws, and 32 hips had a chamfer-cylinder designed acetabulum. Pain relief has been immediate and more complete than with acrylic-fixed or biologic-in-growth stem-type replacements with comparable walking and function improvements. There have been no major systemic complications, sepsis, or loosening. There have been two transient peroneal nerve palsies and three trochanteric fibrous unions. There has been one subluxation requiring reoperation. Histologic sections of the removed femoral surface component showed excellent (90%) bone ingrowth. Circumferential progressive radiolucencies developed at the bone-cement interface by one year in all of the 16 acrylic-fixed acetabular components. Reaming or seating defects were noted in 25% of the patients on postoperative radiographs. Serial radiographic analyses demonstrate progressive narrowing of all of the chamfered cylinder design and less in hemispherical design with screw fixation. These observations are encouraging and suggest healing of the bone-component interface with bony trabeculae in the porous-coated acetabular design. This new surface replacement (SR) of the hip uses porous-ingrowth fixation to overcome the major disadvantages of acrylic-fixed SR which are as follows: (1) excessive acetabular reaming, (2) poor long-term fixation, and (3) difficulty with acetabular revision.
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PMID:Porous surface replacement of the hip with chamfer cylinder design. 362 14

Neurologic deterioration after cervical spinal cord injury (SCI) at a regional spinal cord center was examined. This study examined the incidence of neurologic deterioration as well as associated risk factors in our patient population. Up to 5.8% of cervical SCI patients have been noted to deteriorate neurologically after admission. Risk factors have been early surgery, halo application, traction, and Stryker frame rotation. All cervical SCI patients admitted between 1978 and 1993 who had neurologic deterioration were studied for characteristics of their event, operative status, risk factors, mortality, and neurologic return at 1 year postinjury. Patients were divided into minor and major groups based on the degree of neurologic loss. Nineteen of 1,031 patients were identified as neurologically deteriorated (1.84%). There were 8 major and 11 minor group patients. The average time from injury to deterioration was 3.95 days. Of 10 patients undergoing surgery at < or =5 days, 8 deteriorated postoperatively. Potential risk factors were ankylosing spondylitis (three patients), sepsis (four patients), and intubation (four patients). Neurologic recovery at 1 year showed that 11 of 12 patients were improved. Neurologic deterioration occurred in 1.84% of our patients. Deteriorations were associated with surgery at <5 days after injury, ankylosing spondylitis, sepsis, and intubation.
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PMID:Neurologic deterioration after cervical spinal cord injury. 965 41

The impressive anti-inflammatory effects of the tumor necrosis factor (TNF)alpha blockers etanercept and infliximab have led to their use in multiple inflammatory diseases besides their original indication, rheumatoid arthritis (RA). The well-studied clinical effects of both agents in RA are the reduction of signs and symptoms of joint inflammation as well as the arrest of bone destruction. Infliximab has also been Food and Drug Administration-approved in the treatment of Crohn disease; etanercept is now FDA-approved for juvenile chronic arthritis and psoriatic arthritis. Favorable initial clinical trials have been reported in other rheumatic diseases, including ankylosing spondylitis and adult Still disease. In addition, TNF alpha blockade is being studied in the treatment of uveitis, myelodysplastic syndromes, and graft-versus-host disease. Studies in sepsis and septic shock have identified small subsets of patients that may benefit from TNF alpha blockade, but broader use in septic patients has not improved survival. The TNF alpha blockers have had relatively infrequent serious side effects, especially compared with the immunosuppressive and cytotoxic agents otherwise employed to treat these diseases. Further studies of optimal dosing, combination with other therapies, and long-term benefits and side effects will emerge from future trials.
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PMID:New indications for treatment of chronic inflammation by TNF-alpha blockade. 1258 32

The in vitro study of TNF promoter polymorphism (SNP) function was stimulated by the numerous case-control (association) studies of the polymorphisms in relation to human disease and the appearance of several studies claiming to show a functional role for these SNPs provided a further impetus to researchers interested in the role of TNF in their disease of interest. In this review we consider case-control studies, concentrating on the autoimmune and inflammatory diseases rheumatoid arthritis, multiple sclerosis, ankylosing spondylitis, and asthma, and on infectious diseases including malaria, hepatitis B and C infection, leprosy and sepsis/septic shock. We also review the available evidence on the functional role of the various TNF promoter polymorphisms. In general, case-control studies have produced mixed results, with little consensus in most cases on whether any TNF polymorphisms are actually associated with disease, although results have been more consistent in the case of infectious diseases, particularly malaria. Functional studies have also produced mixed results but recent work suggests that the much studied -308G/A polymorphism is not functional, while the function of other TNF polymorphisms remains controversial. Studies of the TNF region are increasingly using extended haplotypes that can better capture the variation of the MHC region.
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PMID:Is there a future for TNF promoter polymorphisms? 1497 48

Tumour necrosis factor (TNF) ligand members and their associated TNF receptor (TNFR) superfamilies have many diverse physiological roles. TNF is thought to play a critical role in the pathophysiology of a range of diseases including refractory asthma, sepsis, ankylosing spondylitis, lupus, type II diabetes, multiple sclerosis and psoriasis. The recent continued expansion of the novel anti-TNF therapeutic agents (etanercept and infliximab) has seen major improvements in the treatment of some inflammatory-based human diseases including notably rheumatoid arthritis and Crohn's disease, with other conditions currently being trialled using anti-TNF agents. The cellular signalling machinery used by TNFRs to achieve their many cellular responses are discussed, as is the gonadotrophin-releasing hormone (GnRH) receptor signalling mechanisms. TNF is known to have many actions throughout the body including effects on the hypothalamic-pituitary-adrenal/gonadal axes, with many anti-gonadotrophic effects including a role in the development of endometriosis. These interactions between TNF, GnRH and gonadotrophs are discussed.
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PMID:Interactions between TNF and GnRH. 1798 35

The role of microbial triggers in the pathogenesis of the ankylosing spondylitis (AS) has remained an active area of clinical and basic research but remains unresolved. We have recently found evidence of an important role for TLR4 in experimental reactive arthritis, raising the question to be addressed whether genetic polymorphisms in TLR4 affects susceptibility to AS. Innate immune responses to Gram-negative bacteria involve in a central role the binding of lipopolysaccharide to TLR4. Two commonly occurring SNPs in the human TLR4 gene (Asp299Gly and Thr399Ile) have been shown to be associated with increased risk of Gram-negative bacteremia in sepsis patients and with susceptibility to inflammatory bowel disease. It remains unresolved whether these SNPs are associated with AS and we have addressed this in a relatively genetically homogeneous population in Korea. A cohort of 200 Korean AS patients and 197 ethnically matched controls were studied. All patients were native Koreans with AS satisfying the modified New York criteria. Korean controls were examined and confirmed to be unaffected by AS. All subjects were genotyped for two functional SNPs in the TLR4 gene: Asp299Gly (A/G polymorphism) and TLR-4 (Thr399Ile) (C/T polymorphism) The Sequenom MassARRAY system was used for genotyping (Sequenom Inc., San Diego, CA, USA). All cases and controls were homozygous for the (A) allele for 299 variant and similarly for the 399 variant all cases and controls were homozygous for the (C) allele. Genetic-environmental interactions figure prominently in current concepts of the pathogenesis of AS. Our findings indicate that the polymorphisms in the TLR4 gene cannot be regarded as major contributors to AS susceptibility in the Korean population.
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PMID:Analysis of single nucleotide polymorphisms in Toll-like receptor 4 shows no association with ankylosing spondylitis in a Korean population. 1803 44

In a retrospective cohort of more than 4 million white and black male United States (US) veterans, we explored the role of specific prior autoimmune, infectious, inflammatory, and allergic disorders in the etiology of multiple myeloma (MM) and monoclonal gammopathy of undetermined significance (MGUS). Patients were selected from computerized inpatient discharge records at US Veterans Affairs hospitals. The analysis included 4641 patients (3040 white, 1601 black) and 2046 patients (1312 white; 734 black) with a discharge diagnosis of MM and MGUS, respectively. Using Poisson regression, we calculated age-adjusted relative risks (RRs) and 95% confidence intervals (CIs) for the relationship between MM, MGUS, and specific prior medical conditions. Significantly elevated risks of MM were associated with broad categories of autoimmune (RR, 1.15; 95% CI, 1.02-1.28), infectious (RR, 1.29; 95% CI, 1.20-1.38), and inflammatory disorders (RR, 1.18; 95% CI, 1.10-1.27) and specific prior autoimmune (polymyositis/dermatomyositis, systemic sclerosis, autoimmune hemolytic anemia, pernicious anemia, and ankylosing spondylitis), infectious (pneumonia, hepatitis, meningitis, septicemia, herpes zoster, and poliomyelitis), and inflammatory (glomerulonephritis, nephrotic syndrome, and osteoarthritis) disorders. Risks for MGUS were generally of similar magnitude. Our results indicate that various types of immune-mediated conditions might act as triggers for MM/MGUS development.
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PMID:Risk of multiple myeloma and monoclonal gammopathy of undetermined significance among white and black male United States veterans with prior autoimmune, infectious, inflammatory, and allergic disorders. 1823 85

Septic arthritis (SA) is a clinical emergency with considerable morbidity and mortality that can lead to rapid joint destruction and irreversible loss of function. The reported incidence varies from 2-5 cases per 100.000 individuals per year in the general populations to 70 cases per 100.000 individuals annually among patients with rheumatoid arthritis (RA). Predisposing factors are immunosuppressive and corticosteroids therapy and RA "itself". The expected decrease in incidence of SA was not seen over the last 20 years period but we can, on the contrary, expect an increase in the frequency of its appearance because of the population ageing, the increasingly prosthetic joint replacement, the ability of the bacteria to evade clearance by the host immune response and the rapidly growing number of patients with RA, ankylosing spondylitis and psoriatic arthritis treated with tumour necrosis factor alpha (TNF alpha) antagonists. Up to now there have been conflicting reports regarding joint infections in patients under anti-TNF therapy but according to data from Deutsch as well as the British register there might be an increase in the incidence of joint infections in anti-TNF treated patients. Microscopic analysis and culture of synovial fluid are fundamental diagnostic tools in the evaluation of possible joint sepsis. Sonographic guidance of arthrocentesis led to successful aspiration of difficult-to-access joints as shoulder and hip. There is controversy over which mode of drainage of septic synovial fluid should be employed but needle aspiration appear to be preferable to surgical treatment as an initial mode of treatment of SA. Rheumatologists should have a central role in the diagnosis and management of SA.
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PMID:[Septic arthritis: what is the role for the rheumatologist?]. 1843 19


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