Etanercept administration prevents the inflammatory response induced by carrageenan in the murine air pouch model.

Rheumatoid arthritis (RA) is one of several inflammatory and autoimmune diseases that affect approximately 1% of world's population. The development of TNF inhibitors in the last decade represents a great advance in the treatment of mild and severe forms of RA. Etanercept is one of these drugs that is useful for RA treatment, but the mechanism of inhibition of the signaling pathway of inflammation was not completely elucidated. This study was conducted to evaluate the anti-inflammatory effect of etanercept in comparison to reference drugs (dexamethasone and indomethacin). Inflammation was induced by subcutaneal administration of carrageenan in the Swiss albino mice using the murine air pouch model. Exudation; leukocytes; myeloperoxidase (MPO); adenosine deaminase (ADA); nitric oxide metabolites (NOx); tumor necrosis factor (TNF); interferon gamma (IFN-γ); interleukins (IL) IL-6, IL-17, IL-10, IL-4, and IL-2; nuclear transcription factor kappa B (NF-κB) activation and apoptosis were evaluated 24 h after the induction of inflammation. Treatment with etanercept significantly inhibited exudate concentrations; leukocyte count; MPO and ADA activities; NOx, TNF, IFN-γ, and IL-17 levels; and NF-kappa B activation (p < 0.05). Etanercept induced apoptosis, reducing the number of viable neutrophils without increasing necrosis (p < 0.05). Our results suggest that the anti-inflammatory mechanism of action of etanercept may be via decrease of NF-κB activation. This effect promoted the reduction of pro-inflammatory cytokines and NOx and the induction of neutrophil apoptosis. The effect of etanercept upon neutrophils apoptosis may indicate the use of this drug therapy in the early stage of rheumatoid arthritis disease.

Clinical and laboratory features of patients with rheumatoid arthritis diagnosed at rheumatology services in the Brazilian municipality of Cascavel, PR, Brazil.

INTRODUCTION: Brazilian epidemiological studies on rheumatoid arthritis are scarce, thus all data currently available originate from the international literature. OBJECTIVES: To determine the incidence and some clinical and laboratory characteristics of patients with rheumatoid arthritis in the municipality of Cascavel, state of Paraná, Brazil. PATIENTS AND METHODS: Data were collected between August 2010 and July 2011 in all health services of the municipality of Cascavel that provided health care in Rheumatology: a university-affiliated hospital, a public outpatient clinic and four private clinics. RESULTS: We identified 38 patients diagnosed with rheumatoid arthritis, resulting in an estimated incidence of 13.4 cases per 100,000 inhabitants/year. Thirty two patients were females, whose mean age was 47.6 years. The age group with the highest incidence was over 40 years. The mean time between first symptoms and diagnosis was 12.4 months. Rheumatoid factor was positive in 68.4% of the patients, and 18.4% already had radiological abnormalities at diagnosis. The pharmacological treatment of patients was also assessed and proved to be in accordance with those found in the literature. CONCLUSION: The incidence of rheumatoid arthritis obtained in the municipality of Cascavel was lower than those reported in international studies.

Estudo clínico e laboratorial de pacientes com artrite reumatoide diagnosticados em serviços de reumatologia em Cascavel, PR, Brasil / Clinical and laboratory features of patients with rheumatoid arthritis diagnosed at rheumatology services in the Brazilian municipality of Cascavel, PR, Brazil

INTRODUÇÃO: Estudos epidemiológicos brasileiros sobre artrite reumatoide são bastante escassos, e os dados existentes hoje são majoritariamente de literatura internacional. OBJETIVOS: Determinar a incidência e algumas características clínicas e laboratoriais de pacientes com artrite reumatoide em Cascavel, PR, Brasil. PACIENTES E MÉTODOS: Os dados foram coletados entre agosto de 2010 e julho de 2011 em todos os serviços de saúde do município que possuíam atendimento na especialidade de reumatologia: um hospital universitário, o Centro Regional de Especialidades do Consórcio Intermunicipal de Saúde do Oeste do Paraná (CRE-CISOP) e quatro clínicas privadas da cidade. RESULTADOS: Foram identificados 38 pacientes com diagnóstico de artrite reumatoide, resultando em uma incidência estimada de 13,4 casos/100.000 habitantes/ano. Trinta e dois pacientes eram do gênero feminino, com média de idade de 47,6 anos. A faixa etária com maior incidência foi > 40 anos. O tempo médio entre os primeiros sintomas e o diagnóstico foi de 12,4 meses. O fator reumatoide foi positivo em 68,4% dos casos, e 18,4% já apresentavam alterações radiológicas no momento do diagnóstico. O tratamento farmacológico dos pacientes também foi avaliado e mostrou estar de acordo com o encontrado na literatura. CONCLUSÃO: A incidência de artrite reumatoide obtida em Cascavel está abaixo das incidências observadas em estudos internacionais.

INTRODUCTION: Brazilian epidemiological studies on rheumatoid arthritis are scarce, thus all data currently available originate from the international literature. OBJECTIVES: To determine the incidence and some clinical and laboratory characteristics of patients with rheumatoid arthritis in the municipality of Cascavel, state of Paraná, Brazil. PATIENTS AND METHODS: Data were collected between August 2010 and July 2011 in all health services of the municipality of Cascavel that provided health care in Rheumatology: a university-affiliated hospital, a public outpatient clinic and four private clinics. RESULTS: We identified 38 patients diagnosed with rheumatoid arthritis, resulting in an estimated incidence of 13.4 cases per 100,000 inhabitants/year. Thirty two patients were females, whose mean age was 47.6 years. The age group with the highest incidence was over 40 years. The mean time between first symptoms and diagnosis was 12.4 months. Rheumatoid factor was positive in 68.4% of the patients, and 18.4% already had radiological abnormalities at diagnosis. The pharmacological treatment of patients was also assessed and proved to be in accordance with those found in the literature. CONCLUSION: The incidence of rheumatoid arthritis obtained in the municipality of Cascavel was lower than those reported in international studies.