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1.
Phys Rev Lett ; 132(15): 155102, 2024 Apr 12.
Artículo en Inglés | MEDLINE | ID: mdl-38683000

RESUMEN

We present the first experimental study of plasmoid formation in a magnetic reconnection layer undergoing rapid radiative cooling, a regime relevant to extreme astrophysical plasmas. Two exploding aluminum wire arrays, driven by the Z machine, generate a reconnection layer (S_{L}≈120) in which the cooling rate far exceeds the hydrodynamic transit rate (τ_{hydro}/τ_{cool}>100). The reconnection layer generates a transient burst of >1 keV x-ray emission, consistent with the formation and subsequent rapid cooling of the layer. Time-gated x-ray images show fast-moving (up to 50 km s^{-1}) hotspots in the layer, consistent with the presence of plasmoids in 3D resistive magnetohydrodynamic simulations. X-ray spectroscopy shows that these hotspots generate the majority of Al K-shell emission (around 1.6 keV) prior to the onset of cooling, and exhibit temperatures (170 eV) much greater than that of the plasma inflows and the rest of the reconnection layer, thus providing insight into the generation of high-energy radiation in radiatively cooled reconnection events.

2.
Phys Rev E ; 108(3-2): 035201, 2023 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-37849093

RESUMEN

The ion velocity distribution functions of thermonuclear plasmas generated by spherical laser direct drive implosions are studied using deuterium-tritium (DT) and deuterium-deuterium (DD) fusion neutron energy spectrum measurements. A hydrodynamic Maxwellian plasma model accurately describes measurements made from lower temperature (<10 keV), hydrodynamiclike plasmas, but is insufficient to describe measurements made from higher temperature more kineticlike plasmas. The high temperature measurements are more consistent with Vlasov-Fokker-Planck (VFP) simulation results which predict the presence of a bimodal plasma ion velocity distribution near peak neutron production. These measurements provide direct experimental evidence of non-Maxwellian ion velocity distributions in spherical shock driven implosions and provide useful data for benchmarking kinetic VFP simulations.

3.
Rev Sci Instrum ; 94(6)2023 Jun 01.
Artículo en Inglés | MEDLINE | ID: mdl-37862497

RESUMEN

Neutrons generated in Inertial Confinement Fusion (ICF) experiments provide valuable information to interpret the conditions reached in the plasma. The neutron time-of-flight (nToF) technique is well suited for measuring the neutron energy spectrum due to the short time (100 ps) over which neutrons are typically emitted in ICF experiments. By locating detectors 10s of meters from the source, the neutron energy spectrum can be measured to high precision. We present a contextual review of the current state of the art in nToF detectors at ICF facilities in the United States, outlining the physics that can be measured, the detector technologies currently deployed and analysis techniques used.

4.
Front Physiol ; 13: 1065278, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36545287

RESUMEN

Exercise is recommended as a non-pharmacological therapy for osteoarthritis (OA). Various exercise regimes, with differing intensities and duration, have been used in a range of OA rodent models. These studies show gentle or moderate exercise reduces the severity of OA parameters while high intensity load bearing exercise is detrimental. However, these studies were largely conducted in rats or in mouse models induced by severe injury, age or obesity, whilst destabilization of the medial meniscus (DMM) in mice has become a widely accepted model due to its lower variability, moderate progression and timescale. The present study was undertaken to provide insight into the effect of moderate exercise on early joint pathology in the DMM mouse model. Exercise was induced a week after induction by forced wheel walking for three or 7 weeks. Joints were analyzed by microcomputed tomography and histology. Assessment of skeletal parameters revealed that exercise offered protection against cartilage damage after 7 weeks of exercise, and a temporary protection against osteosclerosis was displayed after 3 weeks of exercise. Furthermore, exercise modified the metaphyseal trabecular microarchitecture of the osteoarthritic leg in both time points examined. Collectively, our findings corroborate previous studies showing that exercise has an important effect on bone in OA, which subsequently, at 8 weeks post-induction, translates into less cartilage damage. Thus, providing an exercise protocol in a surgical mouse model of OA, which can be used in the future to further dissect the mechanisms by which moderate exercise ameliorates OA.

5.
Phys Rev Lett ; 129(19): 195002, 2022 Nov 04.
Artículo en Inglés | MEDLINE | ID: mdl-36399755

RESUMEN

The application of an external 26 Tesla axial magnetic field to a D_{2} gas-filled capsule indirectly driven on the National Ignition Facility is observed to increase the ion temperature by 40% and the neutron yield by a factor of 3.2 in a hot spot with areal density and temperature approaching what is required for fusion ignition [1]. The improvements are determined from energy spectral measurements of the 2.45 MeV neutrons from the D(d,n)^{3}He reaction, and the compressed central core B field is estimated to be ∼4.9 kT using the 14.1 MeV secondary neutrons from the D(T,n)^{4}He reactions. The experiments use a 30 kV pulsed-power system to deliver a ∼3 µs current pulse to a solenoidal coil wrapped around a novel high-electrical-resistivity AuTa_{4} hohlraum. Radiation magnetohydrodynamic simulations are consistent with the experiment.

6.
Rev Sci Instrum ; 93(10): 103505, 2022 Oct 01.
Artículo en Inglés | MEDLINE | ID: mdl-36319371

RESUMEN

Areal density is one of the key parameters that determines the confinement time in inertial confinement fusion experiments, and low-mode asymmetries in the compressed fuel are detrimental to the implosion performance. The energy spectra from the scattering of the primary deuterium-tritium (DT) neutrons off the compressed cold fuel assembly are used to investigate low-mode nonuniformities in direct-drive cryogenic DT implosions at the Omega Laser Facility. For spherically symmetric implosions, the shape of the energy spectrum is primarily determined by the elastic and inelastic scattering cross sections for both neutron-deuterium and neutron-tritium kinematic interactions. Two highly collimated lines of sight, which are positioned at nearly orthogonal locations around the OMEGA target chamber, record the neutron time-of-flight signal in the current mode. An evolutionary algorithm is being used to extract a model-independent energy spectrum of the scattered neutrons from the experimental neutron time-of-flight data and is used to infer the modal spatial variations (l = 1) in the areal density. Experimental observations of the low-mode variations of the cold-fuel assembly (ρL0 + ρL1) show good agreement with a recently developed model, indicating a departure from the spherical symmetry of the compressed DT fuel assembly. Another key signature that has been observed in the presence of a low-mode variation is the broadening of the kinematic end-point due to the anisotropy of the dense fuel conditions.

7.
Rev Sci Instrum ; 93(8): 083520, 2022 Aug 01.
Artículo en Inglés | MEDLINE | ID: mdl-36050061

RESUMEN

The ion temperature varying during inertial confinement fusion implosions changes the amount of Doppler broadening of the fusion products, creating subtle changes in the fusion neutron pulse as it moves away from the implosion. A diagnostic design to try to measure these subtle effects is introduced-leveraging the fast time resolution of gas Cherenkov detectors along with a multi-puck array that converts a small amount of the neutron pulse into gamma-rays, one can measure multiple snapshots of the neutron pulse at intermediate distances. Precise measurements of the propagating neutron pulse, specifically the variation in the peak location and the skew, could be used to infer time-evolved ion temperature evolved during peak compression.

8.
Phys Rev E ; 105(5-2): 055205, 2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35706215

RESUMEN

The apparent ion temperature and mean velocity of the dense deuterium tritium fuel layer of an inertial confinement fusion target near peak compression have been measured using backscatter neutron spectroscopy. The average isotropic residual kinetic energy of the dense deuterium tritium fuel is estimated using the mean velocity measurement to be ∼103 J across an ensemble of experiments. The apparent ion-temperature measurements from high-implosion velocity experiments are larger than expected from radiation-hydrodynamic simulations and are consistent with enhanced levels of shell decompression. These results suggest that high-mode instabilities may saturate the scaling of implosion performance with the implosion velocity for laser-direct-drive implosions.

9.
Phys Rev Lett ; 128(19): 195002, 2022 May 13.
Artículo en Inglés | MEDLINE | ID: mdl-35622051

RESUMEN

This Letter presents the first observation on how a strong, 500 kG, externally applied B field increases the mode-two asymmetry in shock-heated inertial fusion implosions. Using a direct-drive implosion with polar illumination and imposed field, we observed that magnetization produces a significant increase in the implosion oblateness (a 2.5× larger P2 amplitude in x-ray self-emission images) compared with reference experiments with identical drive but with no field applied. The implosions produce strongly magnetized electrons (ω_{e}τ_{e}≫1) and ions (ω_{i}τ_{i}>1) that, as shown using simulations, restrict the cross field heat flow necessary for lateral distribution of the laser and shock heating from the implosion pole to the waist, causing the enhanced mode-two shape.

10.
Rev Sci Instrum ; 92(4): 043543, 2021 Apr 01.
Artículo en Inglés | MEDLINE | ID: mdl-34243465

RESUMEN

Diagnosing plasma magnetization in inertial confinement fusion implosions is important for understanding how magnetic fields affect implosion dynamics and to assess plasma conditions in magnetized implosion experiments. Secondary deuterium-tritium (DT) reactions provide two diagnostic signatures to infer neutron-averaged magnetization. Magnetically confining fusion tritons from deuterium-deuterium (DD) reactions in the hot spot increases their path lengths and energy loss, leading to an increase in the secondary DT reaction yield. In addition, the distribution of magnetically confined DD-triton is anisotropic, and this drives anisotropy in the secondary DT neutron spectra along different lines of sight. Implosion parameter space as well as sensitivity to the applied B-field, fuel ρR, temperature, and hot-spot shape will be examined using Monte Carlo and 2D radiation-magnetohydrodynamic simulations.

11.
Rev Sci Instrum ; 92(3): 033529, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33819982

RESUMEN

Three-dimensional reconstruction algorithms have been developed, which determine the hot-spot velocity, hot-spot apparent ion temperature distribution, and fuel areal-density distribution present in laser-direct-drive inertial confinement fusion implosions on the OMEGA laser. These reconstructions rely on multiple independent measurements of the neutron energy spectrum emitted from the fusing plasma. Measurements of the neutron energy spectrum on OMEGA are made using a suite of quasi-orthogonal neutron time-of-flight detectors and a magnetic recoil spectrometer. These spectrometers are positioned strategically around the OMEGA target chamber to provide unique 3D measurements of the conditions of the fusing hot spot and compressed fuel near peak compression. The uncertainties involved in these 3D reconstructions are discussed and are used to identify a new nTOF diagnostic line of sight, which when built will reduce the uncertainty in the hot-spot apparent ion temperature distribution from 700 to <400 eV.

12.
Rev Sci Instrum ; 92(3): 033521, 2021 Mar 01.
Artículo en Inglés | MEDLINE | ID: mdl-33820051

RESUMEN

We report on a recently developed laser-probing diagnostic, which allows direct measurements of ray-deflection angles in one axis while retaining imaging capabilities in the other axis. This allows us to measure the spectrum of angular deflections from a laser beam, which passes through a turbulent high-energy-density plasma. This spectrum contains information about the density fluctuations within the plasma, which deflect the probing laser over a range of angles. We create synthetic diagnostics using ray-tracing to compare this new diagnostic with standard shadowgraphy and schlieren imaging approaches, which demonstrates the enhanced sensitivity of this new diagnostic over standard techniques. We present experimental data from turbulence behind a reverse shock in a plasma and demonstrate that this technique can measure angular deflections between 0.06 and 34 mrad, corresponding to a dynamic range of over 500.

13.
Phys Rev Lett ; 125(14): 145001, 2020 Oct 02.
Artículo en Inglés | MEDLINE | ID: mdl-33064539

RESUMEN

In experiments performed with the OMEGA EP laser system, magnetic field generation in double ablation fronts was observed. Proton radiography measured the strength, spatial profile, and temporal dynamics of self-generated magnetic fields as the target material was varied between plastic, aluminum, copper, and gold. Two distinct regions of magnetic field are generated in mid-Z targets-one produced by gradients from electron thermal transport and the second from radiation-driven gradients. Extended magnetohydrodynamic simulations including radiation transport reproduced key aspects of the experiment, including field generation and double ablation front formation.

14.
Ann Rheum Dis ; 71(6): 1049-54, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22294633

RESUMEN

OBJECTIVES: Proteinase-activated receptor 2 (PAR(2)) is a G protein-coupled receptor activated by serine proteinases with proinflammatory activity. A study was undertaken to investigate the presence and functional significance of PAR(2) expression on rheumatoid arthritis (RA)-derived leucocyte subsets. METHODS: Venous blood was obtained from patients with RA and osteoarthritis (OA) as well as healthy control subjects. Surface expression of PAR(2) on peripheral blood mononuclear cells (PBMCs) was analysed by flow cytometry and interleukin 6 (IL-6) generation by ELISA. RESULTS: Patients with RA had elevated but variable surface expression of PAR(2) on CD14+ monocytes compared with control subjects (median (1st to 3rd quartiles) 1.76% (0.86-4.10%) vs 0.06% (0.03-0.81%), p<0.0001). CD3+ T cells showed a similar pattern with significantly higher PAR(2) expression in patients with RA compared with controls (3.05% (0.36-11.82%) vs 0.08% (0.02-0.28%), p<0.0001). For both subsets, PAR(2) expression was significantly higher (p<0.00001) in patients with high levels of disease activity: PAR(2) expression for both CD14+ and CD3+ cells correlated to C reactive protein and erythrocyte sedimentation rate. Furthermore, in a cohort of patients with newly diagnosed RA, elevated PAR(2) expression in both CD14+ and CD3+ cells was significantly reduced 3 months after methotrexate or sulfasalazine treatment and this reduction correlated significantly with the reduction in the 28-joint Disease Activity Scale score (p<0.05). PAR(2) expression on cells from patients with OA was low, similar to levels seen in control subjects. Generation of IL-6 by monocytes in response to a selective PAR(2) agonist was significantly greater in patients with RA than in patients with OA and control subjects (p<0.05). CONCLUSIONS: These findings are consistent with a pathogenic role for PAR(2) in RA.


Asunto(s)
Artritis Reumatoide/inmunología , Monocitos/inmunología , Receptor PAR-2/inmunología , Adulto , Anciano , Anciano de 80 o más Años , Artritis Reumatoide/metabolismo , Complejo CD3/metabolismo , Células Cultivadas , Estudios Transversales , Femenino , Citometría de Flujo , Expresión Génica/inmunología , Humanos , Interleucina-6/inmunología , Interleucina-6/metabolismo , Receptores de Lipopolisacáridos/metabolismo , Masculino , Persona de Mediana Edad , Monocitos/metabolismo , Osteoartritis/inmunología , Osteoartritis/metabolismo , Receptor PAR-2/genética , Receptor PAR-2/metabolismo
15.
Genes Immun ; 6(3): 211-6, 2005 May.
Artículo en Inglés | MEDLINE | ID: mdl-15789055

RESUMEN

Interleukin (IL)-18 is an important mediator of innate and adaptive immunity. We searched for an association of IL-18 promoter single-nucleotide polymorphisms (SNP) with rheumatoid arthritis (RA) in Caucasians. The entire study population was composed of two independent cohorts from Germany (n=200) and Scotland (n=410). Presence of IL-18 SNP at positions -607 and -137 was determined by allele-specific PCR in 327 RA patients and 283 healthy donors (HD). Diplotype distributions of both loci were in Hardy-Weinberg equilibrium (HWE) in the German and Scottish HD cohorts. In contrast, locus -607 was in HW disequilibrium in German, and locus -137 in Scottish RA patients. Diplotypic exact chi(2) tests suggested that -607CC was overrepresented in German, and -137CC in Scottish RA patients, but conservative chi(2) trend analyses could not prove any significant disease association of these single loci. SNP -607 and -137 were in strong linkage disequilibrium. The -607C(*)-137C haplotype was more prevalent in German RA (3.2 vs 1.2%) and in Scottish RA patients (4.1 vs 0.9%) than in the respective HD cohorts. These observations suggest that SNP of both positions contribute to the genetic background of RA pathogenesis.


Asunto(s)
Artritis Reumatoide/genética , Interleucina-18/genética , Polimorfismo Genético , Regiones Promotoras Genéticas , Artritis Reumatoide/metabolismo , Alemania , Haplotipos , Humanos , Interleucina-18/metabolismo , Escocia , Población Blanca
16.
Rheumatology (Oxford) ; 42(11): 1295-8, 2003 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-12867583

RESUMEN

OBJECTIVES: Fibrosis, a feature of systemic sclerosis (SSc), is more severe in the diffuse compared with the limited disease variant. Interleukin 10 (IL-10) is an anti-inflammatory cytokine which reduces type 1 collagen mRNA levels in human fibroblasts. The 5' flanking region of the IL-10 gene is highly polymorphic, with three single base pair substitutions at position -1082(G/A), -819(C/T) and -592(C/A), which results in differential IL-10 production. The GCC/GCC genotype is associated with high IL-10 production while the ATA/ATA genotype with low production. We postulated that there would be a difference in IL-10 polymorphisms in patients with limited (lSSc) and diffuse (dSSc) disease. METHODS: Patients with limited (lSSc, n = 89) or diffuse (dSSc, n = 51) disease plus controls (n = 94) were recruited. DNA was isolated from peripheral blood and polymorphisms analysed using amplification refractory mutation system (ARMS) polymerase chain reaction (PCR). RESULTS: dSSc patients were less likely to carry the genotype indicative of high IL-10 production when compared with controls (controls vs dSSc; 29 vs 4%, chi2 = 15.7, 5 df, P = 0.005) and lSSc patients (lSSc vs dSSc; 21 vs 4%, chi2 = 17.5, 5 df, P = 0.002). There was no difference between control and lSSc patients. While there was no difference between controls and lSSc haplotypes, the GCC haplotype distribution did differ significantly between controls and dSSc patients (controls vs dSSc; 54 vs 36%, chi2 = 11.2, 2 df, P = 0.001). A significant difference was also observed between lSSc and dSSc haplotype distribution (lSSc vs dSSc; 48 vs 36%, chi2 = 13.5, 2 df, P < 0.001). CONCLUSION: We demonstrate that IL-10 genotypes associated with high IL-10 production are under-represented in dSSc. This may have implications in the disease pathology.


Asunto(s)
Interleucina-10/genética , Esclerodermia Difusa/genética , Esclerodermia Limitada/genética , ADN/genética , Femenino , Genotipo , Haplotipos , Humanos , Masculino , Persona de Mediana Edad , Mutación/genética , Reacción en Cadena de la Polimerasa/métodos , Polimorfismo Genético , Esclerodermia Difusa/metabolismo , Esclerodermia Limitada/metabolismo
17.
Ann Rheum Dis ; 61(8): 678-81, 2002 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-12117671

RESUMEN

OBJECTIVES: To determine the distribution of transforming growth factor beta1 (TGFbeta1) genotypes at codon 10 (+869 polymorphism) and codon 25 (+915 polymorphism) in patients with scleroderma (SSc). Differences between diffuse and limited SSc (dSSc and lSSc) were also investigated. METHODS: Patients with lSSc (n=89) and dSSc (n=63) were compared with 147 controls. DNA was isolated from peripheral blood and polymorphisms at codons 10 (C/T) and 25 (G/C) of the TGFbeta1 gene analysed by polymerase chain reaction and sequence specific oligonucleotide probing. RESULTS: Significantly more patients with SSc than controls carried allele C at codon 10 (controls v SSc, 38% v 48%, chi(2)=8.2, 1df, p=0.004), OR=1.95 (95% CI 1.16 to 3.27). The difference remained when patients with SSc were split into those with limited or diffuse disease, (controls v dSSc, chi(2)=5, 1df, p=0.02 and controls v lSSc, chi(2)=6, 1df, p=0.013). The patients with SSc had significantly more subjects heterozygous at codon 10 (controls v SSc, chi(2)=45, 1df, p<0.0001). Possession of allele C at codon 10 gave an OR=4.8 (95% CI 2.8 to 8.4). No difference in allele frequency was seen between patients with SSc and controls at codon 25. More patients with SSc than controls carried the GG genotype (controls v SSc, 80% v 88%, chi(2)=7, 2df, p=0.027). Possession of allele G gave an OR=1.7 (95% CI 0.5 to 5.9). There was no difference between diffuse and limited disease at either codon. CONCLUSIONS: These results suggest that patients with SSc are genetically predisposed to high TGFbeta1 production. These polymorphisms do not, however, explain the difference in the clinical phenotypes of limited and diffuse SSc.


Asunto(s)
Polimorfismo Genético , Esclerodermia Sistémica/genética , Factor de Crecimiento Transformador beta/genética , Codón , Frecuencia de los Genes , Genotipo , Humanos , Sondas de Oligonucleótidos , Reacción en Cadena de la Polimerasa/métodos
18.
Cytokine ; 13(2): 109-12, 2001 Jan 21.
Artículo en Inglés | MEDLINE | ID: mdl-11145851

RESUMEN

A highly polymorphic AT rich repeat exists in the 3' flanking region of the IL-6 gene. Using Genescan analysis we studied this region of the IL-6 gene in 55 normals and 95 patients with rheumatoid arthritis (RA). The influence of alleles on need for early major joint surgery in RA patients was assessed. We identified nine alleles of which, G8, G7 and G4 were the most common (37% vs 36% vs 13%). RA surgery patients had an increase in the frequency of G7 compared to non-surgery and control populations (46% vs 27% vs 34%, respectively) and a decrease in G8 (22% vs 46% vs 43%, respectively). RA patients homozygous for G8 had a lower ESR than those homozygous for G7 (23 mm/h vs 36 mm/h) although this was not significant. We have determined these alleles and their distribution in a normal and RA population. Initial findings suggest G8 may be associated with lower erythrocyte sedimentation rate (ESR) and less severe RA. Although trends in allele distribution were observed, further studies in larger cohorts are required.


Asunto(s)
Artritis Reumatoide/genética , Interleucina-6/genética , Polimorfismo Genético , Alelos , Sedimentación Sanguínea , Genotipo , Homocigoto , Humanos , Estadística como Asunto
19.
Ann Rheum Dis ; 59(9): 695-9, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-10976082

RESUMEN

OBJECTIVES: To determine the influence of interleukin 1alpha (IL1alpha), IL1beta, and IL1 receptor antagonist gene polymorphisms on disease outcome as assessed by the need for major joint surgery within 15 years of diagnosis. PATIENTS AND METHODS: 50 patients with rheumatoid arthritis (RA) who required major joint surgery (hip, knee, or shoulder arthroplasty) within a 15 year period of disease diagnosis and 50 patients with RA with disease duration greater than 15 years and no major surgery were recruited together with 66 normal west of Scotland controls. Genomic DNA and polymerase chain reaction were used to determine polymorphisms in the genes for IL1alpha, IL1beta, and IL1 receptor antagonist. For all patients with RA recruited to the study, HLA-DR beta1 gene status was recorded as was the erythrocyte sedimentation rate (ESR) at the first ever clinic visit. RESULTS: No difference in the allele frequencies or genotypes of the IL1alpha and IL1 receptor antagonist gene polymorphisms was found between the controls and patients with RA, with or without previous surgery. IL1beta allele 2 was overrepresented in patients with RA who had undergone surgery compared with patients who had not (40% v 27%, chi(2)=4, 1df, p=0.04). ESR at the first ever clinic visit was significantly higher in those carrying allele 2 (36 mm/1st h v 22 mm/1st h, p=0.04). When patients, with or without previous surgery, who did not carry two disease associated HLA-DR beta1 alleles were compared, an increase in allele 2 was observed in the surgery cohort (42% v 25%, chi(2)=4.8, 1df, p=0.03). CONCLUSIONS: Patients who require major joint surgery were found to carry the IL1beta allele 2 more often than expected. Patients with this allele also had a higher initial ESR. This may be useful in predicting early surgery in patients who do not carry two disease associated HLA-DR beta1 alleles. Although these findings are interesting, further functional and epidemiological studies to confirm these observations are required.


Asunto(s)
Artritis Reumatoide/genética , Artritis Reumatoide/cirugía , Interleucina-1/genética , Polimorfismo Genético , Anciano , Alelos , Artritis Reumatoide/sangre , Artroplastia de Reemplazo , Sedimentación Sanguínea , Estudios de Casos y Controles , Femenino , Predisposición Genética a la Enfermedad , Antígenos HLA-DR/análisis , Cadenas HLA-DRB1 , Humanos , Proteína Antagonista del Receptor de Interleucina 1 , Masculino , Persona de Mediana Edad , Pronóstico , Estudios Retrospectivos , Sialoglicoproteínas/genética
20.
Ann Rheum Dis ; 58(2): 114-7, 1999 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-10343527

RESUMEN

OBJECTIVE: To determine the value of HLA DR beta 1 disease associated epitope (DAE) and erythrocyte sedimentation (ESR) in predicting the need for major joint replacement in rheumatoid arthritis (RA). METHODS: Sixty five RA patients who had undergone hip, knee or shoulder arthroplasty within 15 years of disease onset and 65 who had not. HLA DR beta 1 genotype was determined by polymerase chain reaction. ESR at first hospital visit was noted. RESULTS: Significantly more patients with two DAE required surgery, (32% v 9%), chi 2 = 13.9, p = 0.001, odds ratio = 5.4 (95% CI: 1.8, 16). Sensitivity was poor, 32%, specificity high, 91%. Presentation ESR was higher in surgery patients compared with non-surgery patients, 52 mm 1st h v 25 mm 1st h, p < 0.001, but was independent of DAE status. Sensitivity of an ESR of 30 mm 1st h was 75%, specificity 53%. CONCLUSION: The presence of two DAE is a risk factor for major joint surgery in RA and is independent of ESR, whereas in those with one or no DAE, a high ESR is an important predictor.


Asunto(s)
Artritis Reumatoide/genética , Artritis Reumatoide/inmunología , Antígenos HLA-DR/genética , Anciano , Alelos , Artritis Reumatoide/sangre , Artritis Reumatoide/cirugía , Artroplastia , Sedimentación Sanguínea , Estudios de Casos y Controles , Epítopos/genética , Femenino , Genotipo , Cadenas HLA-DRB1 , Humanos , Masculino , Persona de Mediana Edad , Reacción en Cadena de la Polimerasa , Valor Predictivo de las Pruebas , Factores de Riesgo , Sensibilidad y Especificidad
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