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1.
Sci Rep ; 14(1): 23708, 2024 10 10.
Artigo em Inglês | MEDLINE | ID: mdl-39390074

RESUMO

The phosphorites of the Quercy from SouthWest France are well known for fossils preserved in 3D with phosphatized soft-tissues. Given that phosphatization is known to favor fine cellular preservation, the present study delves into the histological analysis of white and brown bones of Cainotheriidae (Artiodactyla) recently excavated from the DAM1 site near Caylus. Microscopy revealed that the white bones were completely filled with bacterial erosions, while the brown bones showed a pristine histology and intralacunar content resembling fossilized osteocytes in some areas. After decalcification, a brown bone revealed an abundance of blood vessel-like structures, innumerable osteocyte-like structures with canaliculi and a few chondrocyte-like structures, while a white bone revealed only blood vessel-like structures that looked eaten away. All the data combined suggest the brown bones were shielded from bacterial attacks and were filled with fossilized organic matter and original biological structures. The data taken all together do not support that these structures are casts, but indeed original and endogenous cells. This study encourages further histochemical and mineralogical analyses on Quercy fossils and the unique taphonomy of DAM1 to better understand fossilization processes and their impact on the color of bones, the chemistry of skeletal tissues, soft tissues, and cells.


Assuntos
Osso e Ossos , Fósseis , Animais , França , Osteócitos/citologia
2.
Eur J Radiol ; 181: 111743, 2024 Sep 23.
Artigo em Inglês | MEDLINE | ID: mdl-39341167

RESUMO

PURPOSE: To demonstrate the clinical applicability of zero echo time magnetic resonance imaging (ZTE MRI) in bone assessment of the sacroiliac joint in ankylosing spondylitis. METHOD: Between January 2021 and November 2021, twenty-one ankylosing spondylitis patients underwent clinically indicated MRI including ZTE sequence, in addition, all patients underwent a CT scan covering the sacroiliac joints within 6 months of the MRI examination. The sensitivity, specificity, and accuracy of ZTE MRI were calculated using CT as the reference standard. Cohen's κappa tests were applied to assess the agreement of positive imaging findings (including erosions, osteosclerosis, bony cystic changes, and joint space changes) between MRI and CT as well as the inter-reader agreement for the grading of sacroiliitis in AS patients. RESULTS: There was no statistical significance between ZTE MRI and CT in detecting of ankylosing spondylitis(p>0.05). The consistency of the diagnosis of positive imaging findings between ZTE MRI and CT was moderate to excellent (ranging from 0.611 to 0.889), and the consistency of the scores of positive imaging was good to excellent (ranging from 0.857 to 0.979). CONCLUSIONS: ZTE MRI provides "CT-like" contrast for bony changes of the sacroiliac joint in ankylosing spondylitis and could simplify and reduce costs for some AS patients when both MRI and CT are typically required.

4.
Clin Rheumatol ; 43(10): 3239-3248, 2024 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-39172292

RESUMO

INTRODUCTION/OBJECTIVES: Among people with or without hand osteoarthritis, we aimed to identify characteristics of people (e.g., age and gender) with marginal erosions (MEs). We also examined changes in MEs during 48 months. We described radiographic severity and progression among joints with MEs, changes in MEs, or central erosions (CEs). DESIGN: We studied participants from the Osteoarthritis Initiative with baseline and 48-month hand radiographs. A radiologist and rheumatologist evaluated the radiographs for disease severity (Kellgren-Lawrence grades) and erosions (central or marginal), respectively. We used descriptive statistics to characterize participants and calculated frequencies at the joint level. RESULTS: Of the 3558 participants, 89 had a ME at baseline. People with MEs were more often male, older, and ever (former and current) smokers than those without a ME. There was no difference in inflammatory biomarkers or the presence of hand pain between individuals with and without a baseline ME. Almost all hands had only one ME (80%), whereas only 50% of individuals with CEs had only one CE at baseline. Compared to CEs, MEs appeared more frequently in joints without osteoarthritis (54% vs. < 1%). Approximately 18% of joints with an ME progressed in Kellgren-Lawrence grade versus 4% without ME. Among the joints with an ME at baseline, 10% resolved by 48 months. Less than 0.1% of joints developed a new ME. CONCLUSION: MEs appear to be distinct from CEs. MEs are predominantly present in males, isolated to one specific joint without osteoarthritis within a hand, and possibly predictive of radiographic progression. Key Points • Marginal erosions appear to be distinct from central erosions. • Most marginal erosions occur in joints without radiographic osteoarthritis. • Radiographic progression but not hand pain is more common in joints with a marginal erosion than without one.


Assuntos
Progressão da Doença , Articulação da Mão , Osteoartrite , Radiografia , Índice de Gravidade de Doença , Humanos , Masculino , Feminino , Osteoartrite/diagnóstico por imagem , Pessoa de Meia-Idade , Idoso , Articulação da Mão/diagnóstico por imagem , Mãos/diagnóstico por imagem
5.
Radiol Clin North Am ; 62(5): 799-807, 2024 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-39059972

RESUMO

The correct interpretation of the most common radiological findings in rheumatological diseases can be pivotal for an accurate diagnosis. X rays offer immediacy, worldwide availability, affordability, and the ability to detect subtle bone changes. Numerous scoring systems that have been developed to support clinical practice are based on joint damage that can be observed on X rays. Metabolic, degenerative, infective, and inflammatory processes manifest as distinct alterations in joints and their identification can be challenging. In this review, the authors will discuss the most common radiological findings in hands, hips, and the spine that can serve as valuable diagnostic tools.


Assuntos
Doenças Reumáticas , Humanos , Doenças Reumáticas/diagnóstico por imagem , Reumatologia/métodos , Radiografia/métodos
7.
Artigo em Inglês | MEDLINE | ID: mdl-38631455

RESUMO

BACKGROUND: Glenoid bone loss in shoulder arthroplasty is a difficult problem that is prone to complications because of challenges with achieving glenoid component fixation and stability. The purpose of this study was to evaluate the outcomes of primary shoulder hemiarthroplasty for patients with severe glenoid medialization precluding placement of a glenoid component. METHODS: This was a retrospective case series evaluating patients who underwent shoulder hemiarthroplasty for severe glenoid erosion and medialization between 2010 and 2020. Patients were evaluated via chart review and phone survey to determine if there were any reoperations at final follow-up and to obtain Single Assessment Numeric Evaluation (SANE), American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), and Simple Shoulder Test (SST) scores. Preoperative and postoperative radiographs were evaluated and compared to determine glenoid morphology, version, medialization, acromiohumeral distance, and humeral offset. Final postoperative films were also evaluated for anterosuperior migration and signs of mechanical failure, including loosening or periprosthetic fracture. RESULTS: Overall, there were 28 patients during this period who underwent shoulder hemiarthroplasty for severe glenoid medialization. Eight patients were deceased at the time of the study, 2 were unable to complete surveys because of dementia, and 7 were lost to follow-up. The final cohort included 11 shoulders and 11 patients with a mean age of 71 ± 7.1 years and mean follow-up of 6.7 years (range 1.6-13.0 years). Mean postoperative SANE, ASES, and SST scores were 80.6 ± 17.6, 71.5 ± 29.3, and 7.6 ± 2.0, respectively. There were no reoperations or revision surgeries at final follow-up. Radiographic evaluation demonstrated severe glenoid medialization and decreased lateral humeral offset, which was unchanged postoperatively. There were 2 patients with signs of anterosuperior migration at final radiographic follow-up but no signs of implant failure. CONCLUSION: Shoulder hemiarthroplasty for severe medial glenoid bone loss provides modest clinical outcomes and low rates of reoperation at mid- to long-term follow-up and is an option worth considering in cases where placement of a glenoid component is challenging because of deficient bone stock and high risk for complications.

8.
J Rheumatol ; 51(5): 462-471, 2024 May 01.
Artigo em Inglês | MEDLINE | ID: mdl-38359938

RESUMO

OBJECTIVE: (1) To compare the capacity to detect sacroiliac joint (SIJ) erosions and baseline-to-week 104 change in erosions between magnetic resonance imaging (MRI) and radiographs in recent-onset axial spondyloarthritis (axSpA); and (2) to compare treatment-discriminatory capacities of MRI and radiographic scores for erosion detection in patients receiving etanercept in the Effect of Etanercept on Symptoms and Objective Inflammation in Nonradiographic axSpA (EMBARK) trial vs controls in the DESIR (Devenir des Spondylarthropathies Indifférenciées Récentes) cohort. METHODS: Anonymized SIJ MRI and radiographs were assessed at patient and joint surface levels. Three readers evaluated MRI; 3 different readers evaluated radiographs. Final scores for comparison of radiographs and MRI for detection of erosions were assigned based on agreement of ≥ 2 of 3 readers' assessments. RESULTS: At baseline, discordance in erosion detection between imaging methods was more frequent for MRI erosions in the absence of radiographic erosions (48/224 [21.4%] patients) than for radiographic erosions in the absence of MRI erosions (14/224 [6.3%] patients; P < 0.001). After 104 weeks, a decrease in erosions was observed on MRI but not radiographs in 49/221 (22.2%) patients, and on radiographs but not MRI in 6/221 (2.7%) patients (P < 0.001). In the treatment-discriminant capacity analysis, the largest standardized differences between etanercept and control cohorts at week 104 were changes in Spondyloarthritis Research Consortium of Canada MRI erosion discrete score, changes in erosion average score, and meeting the modified New York criteria on radiographs, with unadjusted/adjusted Hedges G effect sizes of 0.40/0.50, 0.40/0.56, and 0.40/0.43, respectively. CONCLUSION: In recent-onset axSpA, SIJ erosions and erosion change were observed more frequently on MRI than radiography. The significance of interval improvement of MRI erosions warrants further research. [ClinicalTrials.gov: NCT01258738, NCT01648907].


Assuntos
Espondiloartrite Axial , Etanercepte , Imageamento por Ressonância Magnética , Radiografia , Articulação Sacroilíaca , Humanos , Articulação Sacroilíaca/diagnóstico por imagem , Articulação Sacroilíaca/patologia , Imageamento por Ressonância Magnética/métodos , Adulto , Feminino , Masculino , Espondiloartrite Axial/diagnóstico por imagem , Espondiloartrite Axial/tratamento farmacológico , Etanercepte/uso terapêutico , Antirreumáticos/uso terapêutico , Resultado do Tratamento , Índice de Gravidade de Doença , Pessoa de Meia-Idade
9.
Avian Dis ; 67(4): 310-316, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38300652

RESUMO

A retrospective analysis encompassing 18 yr (1999-2016) of broiler chicken health surveys from broiler production complexes throughout the United States was conducted to identify trends and areas of opportunity. The analysis used necropsy data from 19,577 broiler chickens considered to be "healthy" or "clinically normal" by visual assessment. The very low incidence of dehydrated (0.01%) or undersized (0.02%) broilers is evidence that the objective of examining "healthy" birds was achieved. The results of the correlation analysis were what was expected for "healthy" broilers, with these birds having positive correlations with skin color and size of the bursa of Fabricius. The average age of broilers included in this analysis ranged from 26.2 days in 2008 to 33.7 days in 2013. The percentage of "normal" broilers (those without visible lesions or abnormalities) varied from 5.63% in 2012 to 28.33% in 1999. The results of this study identified four areas of opportunity for improving poultry health: 1) coccidiosis, 2) oral lesions and gizzard erosions, 3) retained yolks, and 4) pododermatitis.


Encuesta retrospectiva sobre la salud de los pollos de engorde: alcance, parámetros y tendencias generales. Se realizó un análisis retrospectivo que abarcó 18 años (1999-2016) de encuestas de salud de pollo de engorde de complejos de producción en los Estados Unidos para identificar tendencias y áreas de oportunidad. El análisis utilizó datos de necropsia de 19,577 pollos de engorde considerados "saludables" o "clínicamente normales" mediante evaluación visual. La incidencia muy baja de pollos de engorde deshidratados (0.01%) o de tamaño pequeño (0.02%) es evidencia de que se logró el objetivo de examinar aves "sanas". Los resultados del análisis de correlación fueron los esperados para pollos de engorde "sanos", ya que estas aves tuvieron correlaciones positivas con el color de la piel y el tamaño de la bolsa de Fabricio. La edad promedio de los pollos de engorde incluidos en este análisis osciló entre 26.2 días en 2008 y 33.7 días en 2013. El porcentaje de pollos de engorde "normales" (aquellos sin lesiones o anomalías visibles) varió del 5.63% en 2012 al 28.33% en 1999. Los resultados de este estudio identificaron cuatro áreas de oportunidad para mejorar la salud de las aves: 1) coccidiosis, 2) lesiones orales y erosiones de la molleja, 3) retención de saco vitelino y 4) pododermatitis.


Assuntos
Coccidiose , Doenças das Aves Domésticas , Animais , Galinhas , Estudos Retrospectivos , Doenças das Aves Domésticas/epidemiologia , Autopsia/veterinária , Coccidiose/veterinária
10.
Avian Dis ; 67(4): 349-365, 2024 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-38300657

RESUMO

During a series of pathology surveys in four production complexes of a U.S. broiler integrator, the technical services veterinarians of an animal health company noted a high incidence of severe gizzard erosions and ulcerations (GEU), prompting further clinical investigation and a battery trial. No growth-promoting antibiotics or ionophore coccidiostats were used during the period of these surveys. All used tribasic copper chloride (TBCC) at ≤120 ppm added copper in broiler rations. Clostridium perfringens was isolated from 83% and 67% of gizzard lesions cultured in two complexes, and cecal C. perfringens most probable number determinations were higher in severely affected than in mildly affected or unaffected birds. Histopathology revealed both acellular koilin fusion defects characteristic of copper toxicity, as well as inflammatory cell infiltrates. Intralesional bacilli suggestive of C. perfringens were noted in 78% of affected flocks examined. Species E Aviadenovirus was isolated from one bird in one complex, and that bird had a single intranuclear inclusion body; no other flocks had Adenoviruses isolated or detected on PCR, nor any inclusion bodies. Other viruses detected were thought to be incidental. A pilot study using feed with supplemental copper from TBCC or copper sulfate and challenge with one of the isolated C. perfringens strains reproduced the lesions. A battery study was conducted with an unchallenged negative control group fed a diet with 16 ppm added copper, a group fed the control diet and orally challenged with 108 organisms of a field strain of C. perfringens at 21 and 22 days, and a group treated with the same diet containing 250 ppm added copper from TBCC and orally challenged with C. perfringens. Birds were necropsied at 23 and 28 days. All challenged groups developed lesions, with those receiving both TBCC and C. perfringens having significantly higher gross and histopathological lesion scores than the unchallenged negative controls. Lesions were qualitatively similar to those in the field and contained suspected C. perfringens bacilli. Because the levels of TBCC used in the commercial birds and in the battery trial generally have been considered safe, and because C. perfringens is usually regarded as a pathogen of the lower GI tract, the possible association of these two agents with GEU is a novel observation and warrants further investigation.


Investigaciones sobre el aumento de la incidencia de erosiones y ulceraciones severas en la molleja en pollos de engorde comerciales en los Estados Unidos. Durante una serie de estudios de patología en cuatro complejos de producción de un integrador de pollos de engorde de los Estados Unidos, veterinarios de servicio técnico de una empresa de salud animal observaron una alta incidencia de erosiones y ulceraciones severas de la molleja (GEU), lo que motivó una mayor investigación clínica y un estudio en batería. Durante el período de estas encuestas no se utilizaron antibióticos promotores del crecimiento ni coccidiostáticos ionóforos. Todos utilizaron cloruro de cobre tribásico (TBCC) con un nivel de ≤120 ppm de cobre agregado en raciones para pollos de engorde. Se aisló Clostridium perfringens del 83% y el 67% de las lesiones de molleja cultivadas en dos complejos, y las determinaciones del número más probable de C. perfringens en los sacos ciegos fueron mayores en aves severamente afectadas que en aves levemente afectadas o no afectadas. La histopatología reveló defectos de fusión de la capa córnea acelular característicos de la toxicidad por cobre, así como infiltrados de células inflamatorias. Se observaron bacilos intralesionales sugestivos de C. perfringens en el 78% de las parvadas afectadas examinadas. La especie Aviadenovirus E se aisló de un ave en un complejo, y esa ave tenía un único cuerpo de inclusión intranuclear; en ninguna otra parvada se aislaron o detectaron adenovirus mediante PCR, ni se observaron cuerpos de inclusión. Se pensó que otros virus detectados fueron incidentales. Un estudio piloto que utilizó alimento con cobre suplementario de cloruro de cobre tribásico o sulfato de cobre y con desafío con una de las cepas aisladas de C. perfringens reprodujo las lesiones. Se realizó un estudio de batería con un grupo de control negativo no desafiado alimentado con una dieta con 16 ppm de cobre agregado, un grupo alimentado con la dieta de control y desafiado por vía oral con 108 organismos de una cepa de campo de C. perfringens a los 21 y 22 días, y un grupo tratado con la misma dieta que contenía 250 ppm de cobre agregado de cloruro de cobre tribásico y desafiados por vía oral con C. perfringens. A las aves se les realizó la necropsia a los 23 y 28 días. Todos los grupos desafiados desarrollaron lesiones, y aquellos que recibieron cloruro de cobre tribásico y C. perfringens tuvieron puntuaciones de lesiones macroscópicas e histopatológicas significativamente más altas que los controles negativos no desafiados. Las lesiones eran cualitativamente similares a las del campo y contenían bacilos sospechosos de C. perfringens. Debido a que los niveles de cloruro de cobre tribásico utilizados en las aves comerciales y en el ensayo en batería generalmente se han considerado seguros, y debido a que C. perfringens generalmente se considera un patógeno del tracto gastrointestinal inferior, la posible asociación de estos dos agentes con erosiones y ulceraciones severas de la molleja es una observación reciente y justifica una mayor investigación.


Assuntos
Bacillus , Cloretos , Doenças das Aves Domésticas , Animais , Cobre , Galinhas , Moela das Aves , Incidência , Projetos Piloto , Doenças das Aves Domésticas/epidemiologia , Clostridium perfringens , Firmicutes
11.
Artigo em Inglês | MEDLINE | ID: mdl-37934127

RESUMO

OBJECTIVES: To investigate, in anti-cyclic citrullinated peptide antibody positive individuals with musculoskeletal symptoms but no clinical synovitis (CCP+ at-risk), the additional value of ultrasound (US) for the prediction of inflammatory arthritis (IA). Furthermore, to define a concise US protocol for feasible risk prediction. METHODS: Demographic and clinical data were collected in 417 CCP+ at-risk (Leeds CCP cohort) with a baseline US scan assessing synovitis and bone erosions in 36 joints, and a follow-up duration ≥24 months. Multivariable binary regression models for IA development at 24 months evaluated routine clinical variables associated with IA alone ("clinical" model) and combined with a 36-joint US scanning protocol ("clinical-US extended" model). A "clinical-US short" model was developed. RESULTS: At 24 months, 92/417 (22.1%) CCP+ at-risk developed IA (median time: 7 months, IQR : 3-12). The "clinical-US extended" model performed better than the "clinical" model (AUC 0.788 vs AUC 0.731 respectively, p< 0.001) with an odds ratio for IA development of 3.18 (95% IC 1.80-5.63) for US synovitis and 2.54 (95% IC 1.21-5.37) for bone erosions. The "clinical-US short" model, which retained the wrists, knees and MTP5 joints, performed better (AUC 0.782) than the "clinical" model (p< 0.001) and similarly (difference in Akaike information criteria <2) to the "clinical-US extended" model. CONCLUSIONS: US provides valuable information for predicting progression to IA in CCP+ individuals both alone and in addition to clinical variables. US synovitis was associated with a threefold increase risk of IA development. A concise US protocol of 6 joints provides clinically feasible risk prediction in CCP+ at-risk.

12.
Int J Mol Sci ; 24(19)2023 Oct 07.
Artigo em Inglês | MEDLINE | ID: mdl-37834418

RESUMO

Psoriatic arthritis (PsA) is a heterogenous systemic inflammatory disorder that affects peripheral joints and skin, but also causes inflammation at entheseal sites, digits (dactylitis) and the axial skeleton. Despite considerable advances, our understanding of the pathogenesis and management of PsA is hampered by its complex clinical expression. We enrolled patients who met the ClASsification for Psoriatic Arthritis (CASPAR) criteria for PsA (n = 17), and healthy controls (n = 13). The lipid profile, C-reactive protein (CRP) and Dickkopf-related protein 1 (DKK-1) circulating levels were measured for all subjects. For the patients with PsA, (1) the erosive character of the articular disease was assessed by a musculoskeletal ultrasound and (2) the cardiovascular risk was evaluated using the Systematic Coronary Risk Evaluation (SCORE) chart and the ultrasound measurement of the carotid intima-media thickness. A higher titer of serum DKK-1 was associated with the presence of erosions (p < 0.005) and the cIMT correlated with DKK-1 levels in patients with PsA (r = 0.6356, p = 0.0061). Additionally, we observed a positive correlation between increased cIMT and CRP (r = 0.5186, p = 0.0329). Our results suggest that DKK-1 could be used as an early biomarker for the erosive character of the articular disease and for the assessment of the cardiovascular risk in PsA patients.


Assuntos
Artrite Psoriásica , Humanos , Biomarcadores , Proteína C-Reativa , Espessura Intima-Media Carotídea , Ultrassonografia
13.
Front Immunol ; 14: 1251034, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37868981

RESUMO

Introduction: Evidence-based data suggest that under inflammatory conditions, classical monocytes are the main source of osteoclasts and might be involved in bone erosion pathophysiology. Here, we analyze the transcriptomic profile of classical monocytes in erosive and non-erosive rheumatoid arthritis patients in order to better understand their contribution to bone erosion. Methods: Thirty-nine premenopausal RA patients were consecutively enrolled and divided into two groups based on the presence of bone erosions on hand joints. Classical monocytes were isolated from peripheral blood through negative selection, and RNA-seq was performed using a poly-A enrichment kit and Illumina® platform. Classical monocytes transcriptome from healthy age-matched women were also included to identify differentially expressed genes (DEGs). Therefore, gene sets analysis was performed to identify the enriched biological pathways. Results: RNA-seq analysis resulted in the identification of 1,140 DEGs of which 89 were up-regulated and 1,051 down-regulated in RA patients with bone erosion compared to those without bone erosions. Among up-regulated genes, there was a highlighted expression of IL18RAP and KLF14 related to the production of pro-inflammatory cytokines, innate and adaptive immune response. Genes related to collagen metabolism (LARP6) and bone formation process (PAPPA) were down-regulated in RA patients with erosions. Enriched pathways in patients with erosions were associated with greater activation of immune activation, and inflammation. Interestingly, pathways associated with osteoblast differentiation and regulation of Wnt signaling were less activated in RA patients with erosions. Conclusion: These findings suggest that alterations in expression of monocyte genes related to the inflammatory process and impairment of bone formation might have an important role in the pathophysiology of bone erosions in RA patients.


Assuntos
Artrite Reumatoide , Monócitos , Humanos , Feminino , Monócitos/metabolismo , Transcriptoma , Inflamação/genética , Inflamação/metabolismo , Perfilação da Expressão Gênica
14.
Ther Adv Musculoskelet Dis ; 15: 1759720X231174534, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37780955

RESUMO

Background: Biological DMARDs (bDMARDs) have been proven to prevent joint damage and bone erosions. Nevertheless, approximately 15% of rheumatoid arthritis (RA) patients on bDMARDs will progress despite good control of joint inflammation. Objectives: The objective of our study is to investigate the factors associated with radiological progression of patients treated with bDMARDs. Design: We conducted a retrospective analysis of longitudinally collected data on RA patients starting bDMARDs. Methods: Presence or development of new erosions was assessed by a skilled rheumatologist at the time of the visit (baseline and 12 months thereafter). To determine the predictors of erosions, we employed multivariable logistic regression models. Discriminatory capacity for the prediction of new erosion development was assessed with receiver operating characteristic (ROC) curve, which was based on the logistic regression model. Results: A total of 578 RA patients starting bDMARDs were included in the study. Overall, 46 patients (approximately 10%) had radiographic progression (at least one new erosion) at 12 months of follow-up. The factors independently associated with higher risk of developing new erosions while on bDMARD were younger age, high disease activity at baseline, not being treated with cDMARDs, and presenting with erosions at baseline. In addition, we built a predictive model that can accurately foresee new erosions (AUC 0.846) in patients receiving bDMARDs. Conclusion: We found that baseline erosive disease, higher disease activity during treatment, younger age, and monotherapy were the factors independently associated with the development of bone erosions. Our study may inform future targeted intervention in RA patients at risk of radiographic progression.

15.
Biology (Basel) ; 12(10)2023 Oct 09.
Artigo em Inglês | MEDLINE | ID: mdl-37887030

RESUMO

Several rheumatologic diseases are primarily distinguished by their involvement of bone tissue, which not only serves as a mere target of the condition but often plays a pivotal role in its pathogenesis. This scenario is particularly prominent in chronic inflammatory arthritis such as rheumatoid arthritis (RA) and spondyloarthritis (SpA). Given the immunological and systemic nature of these diseases, in this review, we report an overview of the pathogenic mechanisms underlying specific bone involvement, focusing on the complex interactions that occur between bone tissue's own cells and the molecular and cellular actors of the immune system, a recent and fascinating field of interest defined as osteoimmunology. Specifically, we comprehensively elaborate on the distinct pathogenic mechanisms of bone erosion seen in both rheumatoid arthritis and spondyloarthritis, as well as the characteristic process of aberrant bone formation observed in spondyloarthritis. Lastly, chronic inflammatory arthritis leads to systemic bone involvement, resulting in systemic bone loss and consequent osteoporosis, along with increased skeletal fragility.

16.
Biology (Basel) ; 12(9)2023 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-37759662

RESUMO

Matrix metalloproteinases (MMPs) are a group of proteolytic enzymes which are members of the zinc endopeptidase family. They have the ability to degrade extracellular matrix elements, allowing for the release of binding molecules and cell migration. Although metalloproteinases regulate numerous physiological processes within the cornea, overexpression of metalloproteinase genes and an imbalance between the levels of metalloproteinases and their inhibitors can contribute to the inhibition of repair processes, the development of inflammation and excessive cellular proliferation. The involvement of MMPs in the pathogenesis of dystrophic corneal diseases needs clarification. Our analyses focus on the involvement of individual metalloproteinases in the pathogenesis of recurrent corneal erosions and highlight their impact on the development of corneal epithelial basement membrane dystrophy (EBMD). We hypothesize that abnormalities observed in patients with EBMD may result from the accumulation and activation of metalloproteinases in the basal layers of the corneal epithelium, leading to basement membrane degradation. A barrier formed from degradation materials inhibits the normal migration of epithelial cells to the superficial layers, which contributes to the development of the aforementioned lesions. This hypothesis seems to be lent support by the elevated concentrations of metalloproteinases in the corneal epithelium of these patients found in our previous studies on the relationships between MMPs and recurrent corneal erosions.

17.
Int J Rheum Dis ; 26(11): 2195-2205, 2023 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-37731289

RESUMO

INTRODUCTION: To investigate the radiological and laboratory features of bone and cartilage losses in premenopausal women with rheumatoid arthritis (RA). METHODS: This case-control study is the continuation of a study that was conducted on 48 women with RA and 48 matched healthy volunteers. All RA patients were previously subjected to clinical examination, disease activity assessment using the 28-joint Disease Activity Score (DAS28) and Clinical Disease Activity Index (CDAI), serological tests, dual-energy X-ray absorptiometry measuring bone mineral density (BMD), and plain X-ray of both hands. Added to these, matrix metalloproteinase 3 (MMP-3) and cartilage oligomeric matrix protein (COMP) were measured by enzyme-linked immunosorbent assay. RESULTS: There were statistically significant differences between patients and controls regarding COMP and MMP-3, being higher in patients (p < .001). COMP and MMP-3 have significant positive correlation with serum levels of anti-cyclic citrullinated peptide (anti-CCP) and anti-carbamylated protein (anti-CarP). The original Sharp erosion score was positively correlated with the serum level of the studied antibodies and disease duration, but no significant correlation was found with either COMP, MMP-3, or DAS-28. Spine BMD and Z score were negatively correlated with disease activity and anti-CarP. There were significant positive relationhsips between indices of local cartilage and bone loss and the indices of systemic bone loss. MMP-3 had no correlation with indices of local cartilage and bone loss and disease activity scores. CONCLUSIONS: The pathogenic mechanism of hand joint damage involved the three studied autoantibodies namely, rheumatoid factor, anti-CCP and anti-CarP antibodies. Anti-CarP antibody was involved in the reduction of BMD of the spine. The association between systemic osteoporosis and hand joint damage pointed to a common pathogenic mechanism.


Assuntos
Artrite Reumatoide , Metaloproteinase 3 da Matriz , Humanos , Feminino , Estudos de Casos e Controles , Anticorpos Antiproteína Citrulinada , Artrite Reumatoide/diagnóstico por imagem , Autoanticorpos , Densidade Óssea , Cartilagem/patologia
18.
Cureus ; 15(7): e41905, 2023 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-37583717

RESUMO

AIM: This investigation was carried out to evaluate the color stability of a nanocomposite restorative material and the erosive potential of carbonated soft drinks (Coca-Cola; The Coca-Cola Company, Atlanta, Georgia, United States) and packaged orange juice (Real Fruit Power Orange; Dabur Ltd, Ghaziabad, Uttar Pradesh, India) on its surface micromorphology. MATERIALS AND METHODS: Sixty discs (2mm thick and 10mm diameter) of nanocomposite material (Herculite Précis; KaVo Kerr, Brea, California, United States) were prepared using a silicon cylindrical mold. Initially, all the specimens were stored in artificial saliva in five Petri dishes; 12 specimens in each dish. In the Petri dishes, the specimens were immersed in the respective beverages once or twice a day. Before and after each immersion, the specimens were stored in artificial saliva at room temperature. Artificial saliva was changed each day, i.e., every 24 hours. The whole procedure was carried out for three months and then evaluated for color stability using a spectrophotometer and surface micromorphology using a scanning electron microscope. Now, the exposure of specimens to aerated drinks (Coca-Cola) and packaged orange juice (Real Orange) was put to a halt, and specimens were kept continuously in artificial saliva. This procedure was carried out for one month and then evaluated for color stability. The information was analyzed using PASW Statistics for Windows, Version 18.0 (Released 2009; SPSS Inc., Chicago, United States). A p-value of 0.05 was considered significant. RESULTS: The p-value after three months, which is < 0.001 (p<0.05) indicates that the mean color difference values for groups I, II, III, IV, and V show a statistically significant change between the five groups, and similarly, the p-value after one month, which is < 0.001 (p<0.05) indicates that the mean color difference values for groups I, II, III, IV, and V show a statistically significant change between the five groups. Specimens immersed in the carbonated drink twice a day showed clinically more color change than packaged orange juice and artificial saliva on the composite restorative material. Coca-Cola, an aerated drink, was shown to have a higher erosive potential on the composite restorative material than Real Fruit Power Orange and fake saliva. CONCLUSION: The findings are consistent with the hypothesis that repeated exposure to carbonated beverages (such as Coca-Cola and packaged juice) degrades the surface qualities of dental restorations.

19.
Semin Arthritis Rheum ; 63: 152247, 2023 12.
Artigo em Inglês | MEDLINE | ID: mdl-37595510

RESUMO

OBJECTIVES: To analyze longstanding polyarticular juvenile idiopathic arthritis (pJIA) for possible associations between localized bone damage (erosions), and systemic bone loss. Besides, to compare the systemic bone mass of pJIA with healthy controls. METHODS: Thirty-four pJIA women and 99 healthy controls (HC) were included. Radius and tibia of all subjects were scanned by HR-pQCT. Volumetric bone mineral density (vBMD), bone microarchitecture, and -finite element parameters were analyzed. Patients underwent HR-pQCT of 2nd and 3rd metacarpophalangeal (MCP) and proximal interphalangeal (PIP) joints of the dominant hand, for bone erosions quantification. RESULTS: The mean age of patients was 31.5 ± 7.4yrs with a mean disease duration of 21.7 ± 9.2yrs. Bone erosions were detectable in 79% of patients. The number of bone erosions was positively correlated with cortical porosity (Ct.Po) at tibia (r = 0.575, p = 0.001), and radius (r = 0.423, p = 0.018); and negatively correlated with cortical vBMD at tibia (r=-0.420, p = 0.015). In a logistic regression analysis, adjusted for anti-CCP, the presence of bone erosions was independently associated with Ct.Po at radius (p = 0.018) and cortical vBMD at tibia (p = 0.020). Moreover, cortical and trabecular vBMD, trabecular number, and µ-finite element parameters were decreased in patients compared to HC (p < 0.05). CONCLUSION: Bone erosions in longstanding pJIA women were associated with decreased cortical bone parameters, and these patients showed systemic bone impairment at peripheral sites compared with healthy controls.


Assuntos
Artrite Juvenil , Osteoporose , Humanos , Feminino , Adulto Jovem , Adulto , Artrite Juvenil/complicações , Artrite Juvenil/diagnóstico por imagem , Densidade Óssea , Rádio (Anatomia) , Tomografia Computadorizada por Raios X , Tíbia/diagnóstico por imagem , Absorciometria de Fóton
20.
Cureus ; 15(8): e43926, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-37614825

RESUMO

Our purpose is to provide a comprehensive investigation into the incidence, treatment modalities, and visual prognosis of epithelial-related complications in corneal refractive surgeries, including laser-assisted in situ keratomileusis (LASIK), photorefractive keratectomy (PRK), and small incision lenticule extraction (SMILE). A systematic search of multiple databases was conducted by two independent examiners using various search terms related to epithelial-related complications and corneal refractive surgeries. A total of 91 research articles were included, encompassing a sample size of 66,751 eyes across the three types of surgeries. The average incidence of epithelial-related complications varied across the different types of corneal refractive surgeries. LASIK had an average incidence of 4.9% for epithelial defects, while PRK and SMILE had lower rates of 3.3% and 3.9%, respectively. Our findings indicate that SMILE has a lower incidence of epithelial defects compared to LASIK, potentially due to the less invasive nature of lenticule incision in SMILE. Visual prognosis after epithelial complications (EC) is generally favorable, with various supportive care and surgical interventions leading to significant improvements in postoperative visual acuity and full recovery. Understanding the incidence rates and management approaches for epithelial-related complications can guide clinicians in enhancing patient safety, refining surgical techniques, and optimizing postoperative outcomes in corneal refractive surgeries.

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