The effect of propolis supplementation on cardiovascular risk factors in women with rheumatoid arthritis: A double-blind, placebo, controlled randomized clinical trial.

Propolis has gained popularity in recent years because of its beneficial properties, which make it a possible preventative and therapeutic agent as well as a valuable food and cosmetic ingredient. The objective of this study was to evaluate the effects of propolis supplementation on cardiovascular risk factors in women with rheumatoid arthritis. This randomized, double-blind, placebo-controlled clinical trial was performed among 48 patients diagnosed with rheumatoid arthritis. Subjects were randomly assigned to placebo and intervention groups, supplemented with 1000 mg/day of propolis for 12 weeks. Cardiovascular risk factors including, high-sensitivity C-reactive protein (hs-CRP), monocyte chemoattractant protein (MCP-1), Nitric oxide, blood pressure, and lipid profile were assessed pre-and post-intervention. The atherogenic index of plasma value, as well as total cholesterol/high-density lipoprotein cholesterol (HDL-C), triglyceride/HDL-C, and non-HDL-C/HDL-C ratios, were significantly reduced in the intervention group, compared with the placebo group post-intervention (p < 0.05). Moreover, there was a significant reduction in the serum level of hs-CRP in the intervention group when compared with the placebo group (p = 0.001). Furthermore, propolis supplementation could marginally reduce MCP-1 (p = 0.051). These data indicate that propolis supplementation may be a promising treatment strategy for cardiovascular complications among rheumatoid arthritis patients.

Hands and feet radiologic involvements in systemic sclerosis.

AIM: Systemic sclerosis (SSc) is a rare autoimmune disorder characterized by vascular and fibrosing involvement of the skin and internal organs. In this study, we determined the prevalence and characteristics of radiological hands and feet involvements in Iranian SSc patients to identify the associations between clinical features and radiologic findings. METHODS: 43 SSc patients (41 women and 2 men), with a median age of 44.8 years (ranges 26-70 years) and a mean disease duration of 11.8 years (ranges 2-28 years) were studied in this cross-sectional study. RESULTS: 42 patients had radiological changes both in their hands and feet. Only one patient had alteration just in hand. The most frequent changes that we found in hand were Juxta-articular Osteoporosis (93%), Acro-osteolysis (58.2%), and Joint Space Narrowing (55.8%). The prevalence of joint space narrowing or acro-osteolysis was higher in subjects with active skin involvement [modified Rodnan skin score (mRSS) > 14] [16/21 vs. 4/16 for patients with inactive skin involvement (mRSS < 14); p = 0.002]. The most frequent changes that we found in the foot were Juxta-articular Osteoporosis (93%), Acro-osteolysis (46.5%), Joint Space Narrowing (58.1%), and subluxation (44.2%). The presence of anti-ccp antibody was detected in 4 (9.3%), while positive rheumatoid factor was found in 13 (30.2%) of SSc patients. CONCLUSION: This study corroborates that arthropathy is common in SSc patients. The introduction of the specific radiological involvements of SSc needs to be confirmed by further studies, in order to define the appropriate prognosis and treatment of patients.

Genetic Association of VDR gene Apa1 and Taq1 Variants with Scleroderma in an Iranian Northeast Population.

BACKGROUND: Despite vigorous research efforts, the etiology of scleroderma (systemic sclerosis (SSc)) remains still unclear and both genetic and environmental factors clearly contribute to the pathogenesis of scleroderma. Reports of aberrant vitamin D status in scleroderma patients suggest a need for considering the genotype and allele frequencies of VDR gene polymorphisms. This case-control study aimed to investigate the possible association of two common polymorphisms of the VDR gene (ApaI, and TaqI) with susceptibility to scleroderma in an Iranian population. METHODS: Using polymerase chain reaction and restriction fragment length polymorphism (PCRRFLP), ApaI and TaqI polymorphisms in the VDR region were genotyped in 51 patients with scleroderma and 50 healthy controls. Logistic regression analysis was performed to calculate the genotypes odds ratios (ORs) as a measure of association with the presence of scleroderma. Haplotype and linkage disequilibrium analyses were also performed on the detected genotypes. RESULTS: No significant differences were found for the allelic and genotype distributions of ApaI and TaqI polymorphisms between patients with scleroderma and healthy controls (p>0.05). In haplotype analysis, three haplotypes TA, CA, and TC, with a frequency greater than 1% were identified. However, none of them was associated with the risk of scleroderma. CONCLUSION: Our preliminary study showed no evidence of an association between ApaI and TaqI polymorphisms and scleroderma. As the association between VDR polymorphisms and autoimmune diseases varies across the different ethnic populations, further large cohort studies are necessary to confirm the results.

Does propolis have any effect on rheumatoid arthritis? A review study.

Rheumatoid arthritis (RA) is a chronic autoimmune disease in which inflammation and oxidative stress play a key role in its pathophysiology. Complementary therapies along with medications may be effective in the control of RA. Propolis is a natural substance extracted from beehives, which have confirmed anti-inflammatory and antioxidant effects. The present study aimed to review the possible effects of propolis on inflammation, oxidative stress, and lipid profile in patients with RA. English articles in online databases such as PubMed­Medline, AMED, Google Scholar, EMBASE, Scopus, and Web of Science databases were searched. Pieces of evidence show that supplementation with propolis may have therapeutic effects on RA patients. Due to increased inflammation and oxidative stress in the affected joints of RA patients, propolis could inhibit the inflammatory cascades by inhibiting the nuclear factor kappa B pathway and reducing reactive oxygen species, malondialdehyde, and interleukin-17 by increasing some antioxidants. Therefore, inflammation and pain reduce, helping improve and control RA in patients. Further investigations are required with larger sample sizes and different doses of propolis to demonstrate the definite effects of propolis on various aspects of RA.

The effect of propolis supplementation on inflammatory factors and oxidative status in women with rheumatoid arthritis: Design and research protocol of a double-blind, randomized controlled.

BACKGROUNDS AND AIMS: Rheumatoid arthritis (RA), is immune-inflammatory disease which is associated with great pain and disability. Overproduction of pro-inflammatory cytokines and oxidative stress play an important role in RA pathogenesis and related outcomes. The aim of this study was to evaluate the effects of propolis on inflammatory biomarkers and oxidative stress status in RA patients. METHODS/DESIGN: Randomized, placebo-controlled, and double-blind clinical trial aiming to recruit 48 patients with RA. Block randomization will be used. An intervention group will receive 500 mg/twice a day propolis capsules for 3 months and control group will receive the placebo for the same dose and duration. The oxidative stress status (malondialdehyde (MDA), total antioxidant capacity (TAC), total oxidant status (TOS), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx)), and inflammatory biomarkers (interleukin-17 (IL-17), Tumor necrosis factor alpha (TNF-α), High-sensitivity C-reactive protein (hs-CRP)), lipid profile (total cholesterol (TC), high density lipoprotein (HDL-c), low density lipoprotein (LDL-c), and triglyceride (TG)) and also physical activity, anthropometric indices, clinical and nutritional status will be measured at beginning and end of this study. The primary analysis will be based on theintention-to-treat principle. DISCUSSION: If this randomized clinical trial shows the reduction in inflammatory cytokines and oxidative stress and improves clinical outcome, it would provide evidence for other clinical trials to evaluate the efficacy of propolis supplementation in RA patients.

Dietary inflammatory index and healthy eating index-2015 are associated with rheumatoid arthritis.

OBJECTIVE: Many arthritic patients have the belief that dietary habits can worsen or ameliorate their symptoms. Whether diet quality can modify the risk of rheumatoid arthritis (RA) is an issue of continued scientific debate and interest. Therefore, we aimed to examine the association between both overall diet quality and the overall diet inflammatory potential on the risk of RA. DESIGN: Overall diet quality and the overall inflammatory potential of the diet were evaluated with the use of Dietary Inflammatory Index (DII) and the Healthy Eating Index (HEI)-2015, respectively. Both DII and HEI-2015 scores were calculated based on a validated semi-quantitative FFQ. Multivariable-adjusted odds of RA were calculated across tertiles of HEI, and energy-adjusted DII (E-DII) scores using binary logistic regression. SETTING: Mashhad, Iran. PARTICIPANTS: Fifty newly diagnosed RA cases and 100 well-matched healthy people controls. RESULTS: Individuals in the highest tertile of DII scores, indicating the most pro-inflammatory diet, were about three times more likely to have RA than those in the lowest tertile (OR: 2·99; 95 % CI 1·08, 8·24; P-trend: 0·037), whereas individuals in the highest tertile of HEI scores, indicating more top dietary quality, had a significantly lower odds of RA than those in the lowest tertile (OR: 0·33; 95 % CI 0·12, 0·87; P-trend: 0·024). CONCLUSIONS: Our findings show that E-DII and HEI-2015 are positively and negatively associated, respectively, with the odds of RA in a convenience sample of Iranians. These results highlight the importance of overall diet quality in modulating the risk of RA.

Major dietary patterns and food groups in relation to rheumatoid arthritis in newly diagnosed patients.

BACKGROUND: Evidence suggests that dietary patterns might act as environmental triggers in the development of chronic disorders such as rheumatoid arthritis (RA). However, data regarding the relationship between food patterns and RA are still limited and conflicting. In the current study, the authors aim to evaluate a link between major dietary patterns and RA in new case patients. METHODS: This study was conducted in a case-control manner on 50 patients with newly diagnosed RA and 100 healthy individuals living in Mashhad, Iran. The individuals' dietary intake was assessed using a validated food frequency questionnaire (FFQ). The major dietary patterns were identified using factor analysis based on data from FFQ. Multivariable-adjusted logistic regression models were used to measure the associations between patterns and RA. RESULTS: Three major dietary patterns were identified. High-level adherence to Western pattern had a positive association with RA (multivariable-adjusted OR tertile 3 vs. 1:1.95; 95% CI: 1.09-3.92; p-trend: .046), while the healthy pattern was inversely related to RA (multivariable-adjusted OR tertile 3 vs. 1:0.12; 95% CI: 0.03-0.44; p-trend: .001). No significant association was observed between the traditional pattern and RA. CONCLUSIONS: Our findings revealed that people with dietary behaviors close to the Western dietary pattern are more likely to develop the disease. However, adhering to healthy and well-balanced dietary patterns rich in whole grains, low-fat dairies, white meats, eggs, fruits, vegetables, tea, and vegetable oils was found to be inversely correlated with the risk of RA.

Epidemiology of Vasculitides in Khorasan Province, Iran.

Vasculitides are a heterogeneous group of more than 20 diseases defined by inflammation and destruction of blood vessels. We aimed to study the demographic characteristics of the primary vasculitides in the North East of Iran. We retrospectively studied the medical records of patients diagnosed with any kind of vasculitis at the Clinic and Department of Rheumatology of the Imam Reza Hospital, Mashhad, Iran between January 1, 2002, and December 31, 2012. Patients were classified according to the American College of Rheumatology 1990 criteria for the classification of vasculitis and the 2012 Revised International Chapel Hill Consensus Conference Nomenclature of Vasculitides. A total of 721 patients (51.5% male, 48.5% female) with a diagnosis of primary vasculitis was identified. The frequency distributions of vasculitic disorders were as follows: Behcet's disease, 63.6%; cutaneous leukocytoclastic angiitis, 8.2%; granulomatosis with polyangiitis (Wegener's), 6.8%; Takayasu's arteritis. 6%; giant cell arteritis, 4%; polyarteritis nodosa, 2.1%; microscopic polyangiitis, 0.6%; eosinophilic granulomatosis with polyangiitis (Churg-Strauss), 1.8%; cryoglobulinemic vasculitis, 0.3%; and IgA vasculitis (Henoch-Schonlein purpura), 3.5%. In our population, the most common forms of vasculitis are Behcet's disease, cutaneous leukocytoclastic angiitis, and granulomatosis with polyangiitis (Wegener's).

The effect of hydroxychloroquine on symptoms of knee osteoarthritis: a double-blind randomized controlled clinical trial.

BACKGROUND: Osteoarthritis is a degenerative joint disorder of articular cartilage and is the most common type of arthritis in the elderly. There are only a few reports regarding the use of Hydroxychloroquine in the treatment of osteoarthritis. METHODS: To investigate the effects of Hydroxychloroquine on the symptoms of mild to moderate knee osteoarthritis (Kellgren and Lawrence grade II and III), we performed a double-blind, placebo-controlled study in 44 patients. The patients were randomly assigned to two groups: one group received Hydroxychloroquine pills (200 mg twice daily) and the other group received placebo pills. Symptoms were assessed by the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) at baseline and at the end of weeks 4, 8, 12, 16, 20, and 24. RESULTS: Approximately, 98% of the patients were women at an average age of 47 years. There was no significant difference in the baseline characteristics between the two groups. In the placebo group, maximum improvement occurred at the 4(th) week; and during the remaining time, there was no significant improvement. In the Hydroxychloroquine group, maximum improvement occurred at the 8(th) week and persisted over the entire remaining follow-up period. There were significant differences between the two groups regarding the degree of reduction in the WOMAC total score and the WOMAC subscales scores of pain, stiffness, and function at the end of weeks 4, 8, 12, 16, 20, and 24. CONCLUSION: Hydroxychloroquine conferred significant improvement in the symptoms of mild to moderate knee osteoarthritis in our patients and may, accordingly, be recommended for knee osteoarthritis treatment.

Urine Monocyte Chemoattractant Protein-1(UMCP-1) as a Biomarker of Renal Involvement in Systemic Lupus Erythematosus.

OBJECTIVES: Lupus nephritis (LN) is frequently associated with a poor long-term prognosis. Renal biopsy is the diagnostic method of choice in this condition. Urine biomarkers have been mentioned in the diagnosis of LN. The study(,)s purpose was to evaluate the performance of urinary monocyte chemoattractant protein 1(UMCP-1) as a biomarker of renal involvement in systemic lupus erythematosus. MATERIALS AND METHODS: Forty-one recently diagnosed systemic lupus erythematosus patients (8 male and 33 female) without renal involvement (group 1) and twenty six patients (8 male and 18 female) with LN (group 2), proven by biopsy, were recruited to this study. UMCP-1 sensitivity and specificity for identifying biopsy-proven nephritis were calculated, and a receiver operating characteristic (ROC) curve was constructed to quantify how definitely UMCP-1 distinguishes between patients with and without LN. RESULTS: The mean value of UMCP-1 levels were 733.07 pg/ml ± 1282.54 and 144.16 pg/ml ± 137.90 in patients with and without LN respectively. The UMCP-1 level was significantly higher in group 2 than group 1. There was no significant correlation between UMCP-1 and 24-hour urine protein (r = 0.031, P= 0.874). The area under the ROC curve was 0.727 with a CI 95% of 0.597 to 0.857 (P=0.002). Using a cut-off value of 82 pg/ml,UMCP-1 had a sensitivity of 88.5% and a specificity of 46.3% for identifying LN. CONCLUSION: UMCP-1 can serve as a biomarker of LN although further longitudinal studies of these biomarkers are required in LN.