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1.
PLoS Negl Trop Dis ; 12(6): e0006545, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29870527

RESUMEN

BACKGROUND: Toxoplasmosis is a cosmopolitan infection caused by an intracellular obligatory protozoan, Toxoplasma gondii. Infection to this parasite in immunocompetent patients is usually asymptomatic, but today it is believed that the infection can be a risk factor for a variety of diseases, including rheumatoid arthritis (RA). RA is an autoimmune disease and the most common type of inflammatory arthritis that is a major cause of disability. The aim of this systematic review and meta-analysis was to address the association between RA and toxoplasmosis in light of the available research. METHODS: Based on the keywords, a systematic search of eight databases was conducted to retrieve the relevant English-language articles. Then, the studies were screened based on the inclusion and exclusion criteria. The random effect model was used to calculate the odds ratio (OR) using forest plot with 95% confidence interval (CI). RESULTS: Overall, 4168 Individual, extracted from 9 articles were included for systematic review evaluation, with 1369 RA patients (46% positive toxoplasmosis) and 2799 individuals as controls (21% positive toxoplasmosis). Then, eight articles (10 datasets) were used for meta-analysis (1244 rheumatoid arthritis patients and 2799 controls). By random effect model, the combined OR was 3.30 (95% CI: 2.05 to 5.30) with P < 0.0001. CONCLUSION: Although toxoplasmosis could be considered as a potential risk factor for rheumatoid arthritis, more and better quality studies are needed to determine the effect of T. gondii infection on induction or exacerbation of RA. Our study was registered at the International Prospective Register of Systematic Reviews (PROSPERO; code: CRD42017069384).


Asunto(s)
Artritis Reumatoide/parasitología , Toxoplasmosis/epidemiología , Toxoplasmosis/inmunología , Anticuerpos Antiprotozoarios/sangre , Artritis Reumatoide/epidemiología , Humanos , Oportunidad Relativa , Estudios Prospectivos , Factores de Riesgo , Estudios Seroepidemiológicos , Toxoplasma/inmunología , Toxoplasmosis/complicaciones
2.
Rev Bras Reumatol Engl Ed ; 57(5): 461-465, 2017.
Artículo en Inglés, Portugués | MEDLINE | ID: mdl-29037316

RESUMEN

Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disease, with a progressive course, characterized by chronic synovitis that may evolve with deformities and functional disability, and whose early treatment minimizes joint damage. Its etiopathogenesis is not fully elucidated but comprises immunologic responses mediated by T helper cells (Th1). An apparent minor severity of RA in patients from regions with lower income could be associated with a higher prevalence of gut parasites, especially helminths. Strictly, a shift in the immune response toward the predominance of T helper cells (Th2), due to the chronic exposure to helminths, could modulate negatively the inflammation in RA patients, resulting in lower severity/joint injury. The interaction between the immunological responses of parasitic helminths in rheumatoid arthritis patients is the purpose of this paper.


Asunto(s)
Artritis Reumatoide/inmunología , Artritis Reumatoide/parasitología , Helmintiasis/inmunología , Helmintiasis/complicaciones , Humanos , Inmunomodulación , Factores Protectores , Índice de Severidad de la Enfermedad , Células TH1/inmunología , Células TH1/parasitología , Células Th2/inmunología , Células Th2/parasitología
3.
Rev. bras. reumatol ; Rev. bras. reumatol;57(5): 461-465, Sept.-Oct. 2017.
Artículo en Inglés | LILACS | ID: biblio-899455

RESUMEN

Abstract Rheumatoid arthritis (RA) is a systemic autoimmune inflammatory disease, with a progressive course, characterized by chronic synovitis that may evolve with deformities and functional disability, and whose early treatment minimizes joint damage. Its etiopathogenesis is not fully elucidated but comprises immunologic responses mediated by T helper cells (Th1). An apparent minor severity of RA in patients from regions with lower income could be associated with a higher prevalence of gut parasites, especially helminths. Strictly, a shift in the immune response toward the predominance of T helper cells (Th2), due to the chronic exposure to helminths, could modulate negatively the inflammation in RA patients, resulting in lower severity/joint injury. The interaction between the immunological responses of parasitic helminths in rheumatoid arthritis patients is the purpose of this paper.


Resumo A artrite reumatoide (AR) é uma doença inflamatória autoimune, sistêmica, de curso progressivo, caracterizada por exuberante sinovite crônica, que pode gerar deformidades e incapacidade funcional, cujo tratamento precoce minimiza o dano às juntas. Sua etiopatogenia ainda não está completamente elucidada, mas compreende respostas imunológicas com a participação de células T auxiliares (Th1). Uma aparente menor gravidade da AR em pacientes de regiões com menor renda poderia estar associada a maior prevalência de parasitoses intestinais, especialmente as helmintíases. A rigor, um desvio na resposta imune para o predomínio de células T auxiliares (Th2), decorrente da exposição crônica a helmintos, modularia negativamente a inflamação em doentes com AR, e levaria a menor gravidade e dano articular. A revisão de aspectos da influência da reposta imunológica nas parasitoses intestinais, especialmente as helmintíases, em pacientes com artrite reumatoide é o objetivo desse trabalho.


Asunto(s)
Humanos , Artritis Reumatoide/inmunología , Artritis Reumatoide/parasitología , Helmintiasis/inmunología , Índice de Severidad de la Enfermedad , Células Th2/inmunología , Células Th2/parasitología , Células TH1/inmunología , Células TH1/parasitología , Inmunomodulación , Factores Protectores , Helmintiasis/complicaciones
4.
Curr Rheumatol Rev ; 13(2): 80-85, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27412603

RESUMEN

Parasitic infections are among the oldest and most common infections in humans. Host defense alterations caused by autoimmune diseases or immunosuppressive drugs can cause modifications of the symptoms: indolent parasites can be reactivated, asymptomatic patients may experience new symptoms, or mild or moderate symptoms can become serious and, rarely, may lead to death. In recent years, new drugs have been used in the treatment of rheumatoid arthritis (RA), causing a greater level of immunosuppression and, therefore, more concerns regarding the risk of serious parasitic diseases. Of note, experimental studies have demonstrated that the immunomodulation induced by infection with helminths can minimize the occurrence and severity of rheumatoid arthritis. Products derived from helminths (such as glycoprotein ES-62) can exert favorable effects in RA patients via their anti-inflammatory actions. Greater knowledge of these substances may serve as a basis for the development of new treatments for RA. The full impact of parasitic diseases on patients with rheumatoid arthritis remains controversial, and further studies are warrented.


Asunto(s)
Artritis Reumatoide/parasitología , Enfermedades Parasitarias/complicaciones , Animales , Humanos
5.
Lupus ; 26(4): 348-354, 2017 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-27488471

RESUMEN

Nematode infections have been observed to inversely correlate with autoimmune disorders. Recently, we have shown the absence of filarial infection in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE) who live in filarial-endemic areas. The mechanism(s) by which filarial-infected individuals are protected against the development of RA or SLE are unknown. In mice CIA, an experimental model for RA, ES-62, an execratory product of rodent filarial nematode , has been shown to improve arthritis through suppression of the IL-17 pathway. A total of 160 individuals, 40 each of endemic normal, filarial-infected cases, SLE and RA patients, from filarial-endemic areas, were enrolled in the study. Plasma levels of IL17-A, IFN-α and TNF-α were quantified by enzyme-linked immunosorbent assay (ELISA). RA and SLE patients displayed significantly higher plasma IL-17A, IFN-α and TNF-α levels compared to endemic normal and infected individuals. Furthermore, IL-17A levels were significantly low in participants with filarial infection compared to endemic controls ( p < 0.05). Interestingly, plasma IL-17A levels correlated inversely with circulating filarial antigen (CFA) ( p = 0.004, Spearman r = -0.51). Filarial infection was associated with low plasma IL-17A levels, a mechanism by which it possibly protects individuals in filarial-endemic areas from the development of autoimmune disorders like RA and SLE.


Asunto(s)
Artritis Reumatoide/inmunología , Filariasis/inmunología , Interleucina-17/sangre , Lupus Eritematoso Sistémico/inmunología , Adolescente , Adulto , Anciano , Animales , Artritis Reumatoide/sangre , Artritis Reumatoide/parasitología , Niño , Modelos Animales de Enfermedad , Regulación hacia Abajo , Femenino , Filariasis/sangre , Humanos , Interferón-alfa/sangre , Interleucina-17/inmunología , Lupus Eritematoso Sistémico/sangre , Lupus Eritematoso Sistémico/parasitología , Ratones , Persona de Mediana Edad , Factor de Necrosis Tumoral alfa/sangre , Adulto Joven
6.
Lupus ; 23(6): 577-87, 2014 May.
Artículo en Inglés | MEDLINE | ID: mdl-24763541

RESUMEN

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that is mainly directed to the joints, affecting the synovial membrane, the cartilage and also the bone. This disease affects 1% to 2% of the world population and is associated with significant morbidity and increased mortality. RA experimental models have allowed a great deal of information to be translated to the corresponding human disease. This review summarizes some of the most relevant findings targeting immunomodulation in arthritis. Some general guidelines to choose an adequate experimental model and also our experience with arthritis are supplied.


Asunto(s)
Artritis Experimental/inmunología , Artritis Reumatoide/inmunología , Autoinmunidad , Proteínas de Choque Térmico/inmunología , Helmintos/inmunología , Vitamina D/inmunología , Animales , Artritis Experimental/metabolismo , Artritis Experimental/parasitología , Artritis Reumatoide/metabolismo , Artritis Reumatoide/parasitología , Células Dendríticas/inmunología , Células Dendríticas/metabolismo , Células Dendríticas/parasitología , Proteínas de Choque Térmico/metabolismo , Interacciones Huésped-Parásitos , Humanos , Linfocitos T Reguladores/inmunología , Linfocitos T Reguladores/metabolismo , Linfocitos T Reguladores/parasitología , Vitamina D/metabolismo
7.
Travel Med Infect Dis ; 11(6): 412-20, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23972958

RESUMEN

Patients under immunosuppressive therapy with tumor necrosis factor alpha (TNF-α) antagonists are vulnerable to various opportunistic infections including leishmaniasis. We present a case series of 8 travellers developing cutaneous leishmaniasis whilst on TNF-α antagonist treatment and review the literature on aspects of cutaneous leishmaniasis developing in patients treated with TNF-α antagonists. We make interim recommendations regarding the drug therapy used to maintain remission in travellers with rheumatoid disease travelling to leishmania prone areas. Despite having a medical condition requiring continued rheumatological review the interval to diagnosis appears not to be reduced compared to that described in non-rheumatoid patients. Rheumatologists and family doctors should be aware of the need for post-travel surveillance for leishmaniasis in rheumatoid patients on TNF-alpha antagonist treatment.


Asunto(s)
Antiinflamatorios/uso terapéutico , Antiprotozoarios/uso terapéutico , Artritis Reumatoide/parasitología , Leishmaniasis Cutánea/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores , Adulto , Artritis Reumatoide/tratamiento farmacológico , Femenino , Humanos , Leishmaniasis Cutánea/complicaciones , Masculino , Persona de Mediana Edad
8.
Biomed Res Int ; 2013: 316980, 2013.
Artículo en Inglés | MEDLINE | ID: mdl-23509709

RESUMEN

It was previously reported by our group that infection with Taenia crassiceps reduces incidence and severity of inflammatory and autoimmune experimental diseases like type 1 diabetes and experimental autoimmune encephalomyelitis. In this research, we set out to study whether infection with T. crassiceps would affect the development of experimental rheumatoid arthritis (RA). We found that mice infected with the parasite and induced with experimental RA showed similar clinical scores as the noninfected experimental RA group; systemic cytokines were not affected while anti-CII Abs were higher in the infected group. Histological evaluation showed damage in both infected and noninfected experimental RA-induced groups and although some surface molecules such as PDL-2 and MR which are associated with immunomodulatory mechanisms were upregulated in the infected and RA-induced group as compared to the noninfected RA group, they did not exert any changes in the outcome of experimental RA. Thus, we determined that infection with T. crassiceps does not influence the outcome of experimental RA.


Asunto(s)
Artritis Experimental/inmunología , Artritis Reumatoide/inmunología , Teniasis/inmunología , Animales , Artritis Experimental/complicaciones , Artritis Experimental/parasitología , Artritis Reumatoide/complicaciones , Artritis Reumatoide/parasitología , Enfermedades Autoinmunes/inmunología , Membrana Celular/metabolismo , Modelos Animales de Enfermedad , Inmunoglobulina G/inmunología , Inflamación , Interferón gamma/metabolismo , Macrófagos Peritoneales/inmunología , Masculino , Ratones , Ratones Endogámicos BALB C , Ratones Transgénicos , Taenia , Teniasis/complicaciones
12.
Clin Rheumatol ; 26(8): 1344-5, 2007 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-16865310

RESUMEN

Visceral leishmaniasis (VL) is a severe disease that can develop in immunocompromised patients. Antitumor necrosis factor-alpha (TNF-alpha) treatment of rheumatoid arthritis can result in clinical benefits, but with an increased risk of opportunistic infections. Leishmania infection in patients treated with TNF-alpha antagonists is extremely rare; for this reason, we report a patient with VL after etanercept treatment who had an unfavorable outcome.


Asunto(s)
Artritis Reumatoide/tratamiento farmacológico , Artritis Reumatoide/parasitología , Inmunoglobulina G/efectos adversos , Factores Inmunológicos/efectos adversos , Leishmaniasis Visceral/inducido químicamente , Artritis Reumatoide/complicaciones , Etanercept , Resultado Fatal , Femenino , Grecia , Humanos , Huésped Inmunocomprometido , Leishmaniasis Visceral/inmunología , Persona de Mediana Edad , Receptores del Factor de Necrosis Tumoral
13.
Semin Arthritis Rheum ; 36(4): 262-3, 2007 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-17067660

RESUMEN

OBJECTIVES: To present the data supporting the possible relationship of ocular toxoplasmosis to antitumor necrosis factor-alpha (TNF-alpha) therapy in patients with rheumatoid arthritis (RA). METHODS: A Medline search was performed using the words "toxoplasmosis, anti-TNF-alpha antagonists, chorioretinitis." We report 2 RA patients who developed ocular toxoplasmosis while receiving anti-TNF-alpha therapy. RESULTS: In addition to our patients with toxoplasmic chorioretinitis, there are 2 published cases of cerebral toxoplasmosis during treatment with anti-TNF-alpha agents. CONCLUSION: The risk of serious toxoplasmic infection during anti-TNF-alpha therapy for RA should be recognized.


Asunto(s)
Anticuerpos Monoclonales/efectos adversos , Antirreumáticos/efectos adversos , Artritis Reumatoide/tratamiento farmacológico , Toxoplasmosis Ocular/inducido químicamente , Adulto , Animales , Artritis Reumatoide/parasitología , Coriorretinitis/parasitología , Femenino , Humanos , Infliximab , Masculino , Toxoplasma , Factor de Necrosis Tumoral alfa/antagonistas & inhibidores
15.
Infect Dis Clin North Am ; 15(2): 335-61, vii, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11447699

RESUMEN

Patients with systemic lupus erythematosus have a higher infection rate than the general population. It is estimated that at least 50% of them will suffer a severe infectious episode during the course of the disease. Improvements in the control of the disease are discussed in this article.


Asunto(s)
Artritis Reumatoide/microbiología , Infecciones Bacterianas/prevención & control , Lupus Eritematoso Sistémico/microbiología , Enfermedades Parasitarias/prevención & control , Virosis/prevención & control , Artritis Reumatoide/parasitología , Artritis Reumatoide/virología , Humanos , Lupus Eritematoso Sistémico/parasitología , Lupus Eritematoso Sistémico/virología , Vacunación
16.
Scand J Immunol ; 53(6): 610-4, 2001 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-11422910

RESUMEN

Acanthamoeba polyphaga (AP) is ubiquitous in nature and frequently infects humans. AP has some features, such as persistence, which makes it an attractive candidate in studies of a possible infectious aetiology in rheumatoid arthritis (RA). In this study the occurrence of AP-specific antibodies was compared between RA patients and matched controls.


Asunto(s)
Acanthamoeba/inmunología , Anticuerpos Antiprotozoarios/biosíntesis , Artritis Reumatoide/inmunología , Artritis Reumatoide/parasitología , Adulto , Anciano , Animales , Enfermedad Crónica , Femenino , Técnica del Anticuerpo Fluorescente Indirecta , Humanos , Inmunoglobulina A/biosíntesis , Inmunoglobulina G/biosíntesis , Inmunoglobulina M/biosíntesis , Masculino , Persona de Mediana Edad
18.
Brain Behav Immun ; 15(4): 401-10, 2001 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-11782106

RESUMEN

Schizophrenia and rheumatoid arthritis share an impressive number of similarities. Both are chronic, relapsing diseases of unknown etiology. Both became prominent in the early 19th century and have prevalences of approximately 1% in North America and Europe. Both run in families, have pairwise concordance rates of approximately 30% among monozygotic twins, and are more common among individuals born in urban areas. For both diseases, studies have reported greater exposure to cats in childhood than in controls. Both diseases have been associated with similar class II HLA antigens. Both have also been suspected of having infectious etiology, with similar agents--retroviruses, herpesviruses including EBV, and Toxoplasma gondii--having been associated in some cases. Since there is also a well-documented inverse correlation between these two diseases, it is possible that they share a common infectious and/or immune etiology and that once a person gets one of the diseases then they are relatively immune to the other.


Asunto(s)
Artritis Reumatoide/etiología , Artritis Reumatoide/inmunología , Esquizofrenia/etiología , Esquizofrenia/inmunología , Artritis Reumatoide/parasitología , Antígenos de Histocompatibilidad Clase II/inmunología , Humanos , Esquizofrenia/parasitología , Toxoplasmosis/inmunología , Virosis/inmunología
19.
Clin Exp Rheumatol ; 16(3): 303-4, 1998.
Artículo en Inglés | MEDLINE | ID: mdl-9631754

RESUMEN

Human anisakidosis is a parasitic infection caused by the larvae of Anisakis simplex. Classical clinical manifestations include epigastric pain, occlusion, diffuse abdominal pain, appendicitis, and anaphylactoid reactions. Arthralgias or arthritis have been infrequently reported. We present three patients with proven hypersensitivity to A. simplex together with rheumatologic complaints after ingestion of parasitized fishes. A. simplex must be considered in the differential diagnosis of arthralgias/ arthritis especially if associated with urticaria.


Asunto(s)
Anafilaxia/parasitología , Anisakiasis/inmunología , Anisakis/inmunología , Artritis Reumatoide/parasitología , Alimentos Marinos/efectos adversos , Adulto , Anafilaxia/complicaciones , Animales , Anisakiasis/complicaciones , Anticuerpos Antihelmínticos/inmunología , Artritis Reumatoide/inmunología , Femenino , Enfermedades de los Peces/parasitología , Humanos , Masculino , Persona de Mediana Edad , Urticaria/inmunología , Urticaria/parasitología
20.
Bull Acad Natl Med ; 174(6): 743-51; discussion 751-4, 1990.
Artículo en Francés | MEDLINE | ID: mdl-2271983

RESUMEN

Parasitic rheumatism is a rare condition characterized by inflammatory joint manifestations due to a parasitic infestation without parasites into joint cavity, (but, with circulating immune complexes, in serum, and synovial fluid; and with immunoglobulins and complement deposits in synovium in some cases reported in the literature). The number of parasites (now 15) which can induce such an arthritis by immune mechanisms is steadily increasing. In all, but few cases of parasitic rheumatism, usual parasitic manifestations (diarrhea, abdominal pain, nausea...) are mild or absent; but, if present, they are a very good criteria to evoke the diagnosis. Clinical pictures of arthritis induced by parasitic infestation are very polymorphic, and non specific of the involved parasite; they seem to depend on genetic predisposition: the symptoms are monoarticular, pauciarticular, or polyarticular, involving small, medium, and or large joints. They can mimic the clinical picture of different inflammatory rheumatic diseases. The most striking feature of parasitic rheumatism is the failure of antirheumatic agents (especially non steroidal anti-inflammatory agents), contrasting with the dramatic efficacy of specific anti-parasitic treatment. The proof of the responsibility of parasitic infestation by indirect mechanism is given by an exceptional case report of a patient with arthritis, dramatically cured after removal of larvae from Anisakiasis gastric granuloma. To explain the uncommon occurrence of this variety of reactive arthritis, due to parasitic infestation, despite the high prevalence of parasitic infestation in the world, hypothesis of genetic predisposition seems valuable. Among 34 well documented reported cases of parasitic rheumatism in the literature, HLA B 27 antigen has been researched in 13; out of these 13, HLA B 27 is absent in 9; in 7 out of these 9, clinical picture is symmetrical polyarthritis. Out of the 13 cases, HLA B 27 is present in 4: In all these 4 cases, clinical picture is asymmetrical pauciarthritis, mimicking arthritis of Reiter's disease.


Asunto(s)
Artritis Reumatoide/parasitología , Enfermedades Parasitarias , Animales , Humanos , Infecciones por Nematodos , Infecciones por Protozoos
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