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3.
Immunol Invest ; 49(1-2): 88-105, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31549885

RESUMO

Background: Human leukocyte antigen (HLA)-G antigens are inducible non-classical major histocompatibility complex class Ib molecules which play an important role in the regulation of inflammatory processes and immunomodulation in autoimmune diseases. There are controversial reports on the impact of HLA-G gene polymorphisms on rheumatoid arthritis (RA). This study aimed at examining the impact of 14 base pair (bp) ins/del (rs66554220) and +3142G>C (rs1063320) polymorphisms and correlating these with soluble HLA-G (sHLA-G) levels to understand the susceptibility to RA in our sample cohort.Methods: Genomic DNA from 140 RA patients and 125 healthy controls was isolated using the salting out method. The genotyping of two polymorphisms of HLA-G (+3142G>C and 14 bp ins/del) was done by polymerase chain reaction restriction fragment length polymorphism (PCR-RFLP) and PCR method, respectively. Levels of sHLA-G were estimated by ELISA and disease activity was calculated by disease activity score (DAS28-ESR).Results: The HLA-G +3142G>C polymorphism was found to be associated with a decreased risk of RA as attributed to recessive inheritance tested model results (OR = 0.4, 95%C.I. = 0.2-0.9, p = .0313*, GG + GC versus CC). Our finding did not support an association between HLA-G 14 bp ins/del variant and risk/protection of RA. The sHLA-G levels were significantly lower in +3142GG and +3142GC RA patients as compared to healthy controls.Conclusion: HLA-G +3142G>C gene polymorphism might decrease the risk of occurrence of RA in our sample cohort as +3142CC genotype is associated with increased sHLA-G levels.Abbreviations: HLA-G: human leukocyte antigen-G; RA: rheumatoid arthritis; MHC: major histocompatibility complex; UTR: untranslated region; URR: upstream regulatory region; SLE: systemic lupus erythematous; PCR-RFLP: polymerase chain reaction restriction fragment length polymorphism; sHLA-G: soluble HLA-G; bp: base pair; ACR/EULAR: American College of Rheumatology/European League against Rheumatism; RF: rheumatoid factor; Anti-CCP: anti-cyclic citrullinated peptide; DAS28-ESR: Disease Activity Score 28- Erythrocyte Sedimentation Rate; TJC: tender joint count; SJC: swollen joint count; ESR: erythrocyte sedimentation rate; PGA: patient global assessment; HTN: hypertension; DM: diabetes mellitus; TB: tuberculosis; IEC: Institute Ethics Committee; ELISA: enzyme linked immunosorbent assay; ROC: receiver operating characteristics; AUC: area under curve; SNP: single nucleotide polymorphism; MTX: methotrexate; DMARDs: disease modifying anti-rheumatic drugs; Treg: regulatory T cells; IL: interleukinUnits: soluble HLA-G: Units/mL {U/mL}.

5.
Eur J Rheumatol ; 7(1): 52, 2019 Sep 05.
Artigo em Inglês | MEDLINE | ID: mdl-31556872
6.
J Clin Neurosci ; 65: 17-22, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-31080004

RESUMO

Pain sensitivity is a recognized feature of fibromyalgia syndrome (FMS) but the contribution of spinal nociceptive circuitry to this phenomenon is unknown. Therefore, the objectives were to study the changes in spinal nociception i.e. nociceptive flexion reflex (NFR) in patients with FMS and to investigate correlation if any, between NFR threshold, pain duration and tender points in FMS. One hundred and three patients with FMS and 74 healthy volunteers participated in the study. To record NFR, sural nerve was stimulated in the retro malleolar region and the reflex response was recorded from the short head of biceps femoris muscle. NFR was elicited at significantly lower [21.0(18.0-25.0)V] thresholds in FMS group when compared to healthy subjects [30.0(24.75-35.0)V; p = 0.001] indicating hyperalgesic response to electrocutaneous stimulation in FMS patients. The latency and other parameters of NFR were comparable in both the groups. No significant correlation was found among NFR threshold and pain duration or tender points. On the basis of results of present study, it may be concluded that the functional deficit of the spinal nociceptive system can contribute to hyperalgesia in FMS. This is first study that correlates a marker of central hyper-excitability (NFR threshold) with clinical symptoms (pain duration and tender points) of FMS.


Assuntos
Fibromialgia/fisiopatologia , Hiperalgesia/fisiopatologia , Nociceptividade/fisiologia , Limiar da Dor/fisiologia , Adulto , Doença Crônica , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Dor/fisiopatologia , Reflexo/fisiologia
7.
Drug Discov Ther ; 13(2): 96-100, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31080209

RESUMO

Oligoarticular arthritis (inflammation of upto 4 joints) has a wide range of infectious and non-infectious etiologies. The aim of our study was to identify the features which could help in the differentiation of infectious from non-infectious arthritis. The study was prospective and observational, and included 100 patients with oligoarticular inflammatory arthritis. The final diagnosis was made using standard diagnostic criteria and the patients were categorized into infectious and non-infectious groups. Among the 100 patients who were recruited, the following final diagnosis were made: peripheral spondyloarthritis (n = 37), axial spondyloarthritis (n = 11), tuberculosis (n = 19), brucellosis (n = 6), septic arthritis (n = 6), gouty arthritis (n = 5), early rheumatoid arthritis (n = 5), non-tubercular mycobacteria (n = 2), SLE (n = 2), post-chikungunya arthritis (n = 2), acute lymphocytic leukaemia (n = 1), pachydermoperiostosis (n = 1), sarcoidosis (n = 1) and juvenile idiopathoic arthritis (n = 1). The patients were categorized into two groups: infectious (33) and non-infectious (60). The presence of monoarthritis, clinically-significant weight loss, hepatomegaly, splenomegaly and erosive arthritis were significantly more common in the infectious group as compared to the non-infectious group.


Assuntos
Artrite Infecciosa/epidemiologia , Artrite/classificação , Doenças não Transmissíveis/epidemiologia , Adolescente , Adulto , Artrite/diagnóstico , Artrite Gotosa/diagnóstico , Artrite Gotosa/epidemiologia , Artrite Infecciosa/diagnóstico , Artrite Juvenil/diagnóstico , Artrite Juvenil/epidemiologia , Artrite Reumatoide/diagnóstico , Artrite Reumatoide/epidemiologia , Brucelose/diagnóstico , Brucelose/epidemiologia , Feminino , Humanos , Índia , Lúpus Eritematoso Sistêmico/diagnóstico , Lúpus Eritematoso Sistêmico/epidemiologia , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Sarcoidose/epidemiologia , Espondilartrite/diagnóstico , Espondilartrite/epidemiologia , Centros de Atenção Terciária , Tuberculose/diagnóstico , Tuberculose/epidemiologia , Adulto Jovem
8.
Restor Neurol Neurosci ; 37(1): 41-59, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-30714983

RESUMO

BACKGROUND: Recovery of patients with rheumatoid arthritis (RA) depends on several physical and psychological factors, besides pharmacological treatment. Co-morbid depression adversely affects the outcome in RA. Usual medical therapies have a limited scope and fail to cure the psychological component of the disease. With advanced therapeutic options, achieving a state of remission has become the treatment goal, yoga based mind body intervention (MBI) may provide a holistic approach in its treatment dimension. Hence, MBIs are the need of hour as majority of diseases have a psychosomatic component. OBJECTIVE: To explore the effect of Yoga based MBI on disease specific inflammatory markers and depression severity in active RA patients on routine disease modifying anti-rheumatic drugs (DMARDs) therapy. METHODS: A total of 72 RA patients were randomized into 2 groups: yoga group (yoga with DMARDs) and control group (DMARDs only). Blood samples were collected pre and post intervention for primary outcome measurements of systemic biomarkers. Disease activity score 28, erythrocyte sedimentation rate (DAS28ESR) and health assessment questionnaire disability index (HAQ-DI) were used to assess disease activity and functional status respectively at pre and post intervention time-points. Secondary outcome, depression severity, was assessed by Beck Depression Inventory II scale (BDI-II) at 2 weekly intervals during 8 weeks of the study interventional plan. RESULTS: After 8 weeks of yoga based MBI, there was significant decrease in the severity of RA as seen by reduction in levels of various systemic inflammatory markers as well as in DAS28ESR (p-value <0.0001; effect size = 0.210) and HAQ-DI (p-value 0.001; effect size = 0.159). Also, yoga group experienced a statistically significant time dependent step-wise decline in depression symptoms over the period of 8 weeks as compared to control group (p-value <0.0001; effect size = 0.5). Regression analysis showed greater reduction in the scores of BDI-II with DAS28ESR (R2 = 0.426; p <  0.0001) and HAQ-DI (R2 = 0.236; p = 0.003) in yoga group. CONCLUSIONS: Yoga, a mind body intervention re-established immunological tolerance by aiding remission at molecular and cellular level along with significant reduction in depression. Thus in this severe autoimmune inflammatory arthritis with a major psychosomatic component, yoga can be used as a complementary/adjunct therapy.


Assuntos
Antirreumáticos/uso terapêutico , Artrite Reumatoide/terapia , Depressão/terapia , Ioga , Adulto , Artrite Reumatoide/epidemiologia , Artrite Reumatoide/imunologia , Artrite Reumatoide/psicologia , Biomarcadores/sangue , Terapia Combinada , Comorbidade , Depressão/epidemiologia , Depressão/imunologia , Feminino , Humanos , Inflamação/epidemiologia , Inflamação/imunologia , Inflamação/psicologia , Inflamação/terapia , Masculino , Pessoa de Meia-Idade , Índice de Gravidade de Doença , Método Simples-Cego , Resultado do Tratamento
9.
Nucl Med Commun ; 39(9): 803-808, 2018 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29994932

RESUMO

OBJECTIVE: To evaluate the treatment response of lutetium-177 tin colloid radiosynovectomy (Lu-RSV) in patients with inflammatory knee joint conditions refractory to conventional treatment. PATIENTS AND METHODS: Overall, 29 knee joints in 29 patients with chronic synovitis caused by various inflammatory knee joint diseases refractory to conventional therapy were included in this prospective study. All patients were assessed clinically for pain, tenderness, joint swelling, mobility, analgesic intake, and blood pool activity on bone scan. Different scores were assigned to all these parameters. RSV of knee joint was done using intra-articular injection of Lu tin colloid. Response was assessed at 3 months using various clinical parameter scores and blood pool bone scan as mentioned before and categorized as responders and nonresponders on the basis of change in percentage of cumulative scores. RESULTS: Of the 29 joints, 21 were responders and eight were nonresponders at 3 months after RSV. There was a statistically significant reduction in clinical parameters cumulative scores at follow-up when compared with baseline (P<0.0001). Blood pool scintigraphy also showed decrease in blood pool activity compared with the baseline. There was statistically significant association between the responder group and absence of radiological abnormality. CONCLUSION: Lu tin colloid synovectomy is a useful treatment modality in patients with chronic inflammatory knee joint conditions refractory to conventional treatment. Patients with shorter duration of disease and normal or minor radiographic findings are better candidates for RSV.


Assuntos
Articulação do Joelho/cirurgia , Lutécio/química , Lutécio/uso terapêutico , Osteoartrite do Joelho/cirurgia , Radioisótopos/química , Radioisótopos/uso terapêutico , Sinovectomia/métodos , Estanho/química , Adulto , Coloides , Feminino , Humanos , Lutécio/efeitos adversos , Masculino , Osteoartrite do Joelho/terapia , Radioisótopos/efeitos adversos , Sinovectomia/efeitos adversos , Falha de Tratamento
11.
BMJ Case Rep ; 20182018 May 12.
Artigo em Inglês | MEDLINE | ID: mdl-29754136

RESUMO

A 22-year-old man presented with symmetric polyarthritis, pruritus and deviation of angle of mouth to the right side since the last 7 years. His symptoms were persistent despite receiving ayurvedic medications and symptomatic therapy. Examination revealed dry skin, cutaneous nodules, xanthelasma, periarticular non-tender swellings, pitting oedema of hands and feet and lower motor neuron type right facial palsy. Haematological investigations revealed eosinophilia and skin biopsy had cutaneous eosinophilic infiltration. The constellation of above findings comprises the nodules, eosinophilia, rheumatism, dermatitis and swelling syndrome. It a rare syndrome with few reported cases in literature. The patient was started on oral corticosteroids which was subsequently tapered and methotrexate therapy. His polyarthritis and skin rashes resolved with therapy. He has been followed-up for 2 years and is presently asymptomatic for the last 1 year.


Assuntos
Corticosteroides/uso terapêutico , Dermatite/diagnóstico , Edema/diagnóstico , Eosinofilia/diagnóstico , Paralisia Facial/diagnóstico , Metotrexato/uso terapêutico , Doenças Reumáticas/diagnóstico , Dermatite/tratamento farmacológico , Edema/tratamento farmacológico , Eosinofilia/tratamento farmacológico , Paralisia Facial/tratamento farmacológico , Articulações dos Dedos/anormalidades , Humanos , Masculino , Doenças Reumáticas/tratamento farmacológico , Nódulo Reumatoide , Síndrome , Resultado do Tratamento , Adulto Jovem
12.
Clin Exp Rheumatol ; 36(4): 581-588, 2018.
Artigo em Inglês | MEDLINE | ID: mdl-29465355

RESUMO

OBJECTIVES: ARL15 is a novel susceptibility gene identified in a recent GWAS in a north Indian rheumatoid arthritis (RA) cohort. However, the role of ARL15 or ARF family genes in RA aetiology remains unknown. Therefore, we aimed to i) establish the expression of ARL15 in rheumatoid arthritis synovial fibroblasts (RASF) and ii) its functional characterisation by assessing its effects on major inflammatory cytokines and interacting partners using a knockdown approach. METHODS: RASF were cultured from synovial tissue obtained from RA patients (n=5) and osteoarthritis (OA) patients (n=3) serving as controls. Expression of ARL15, ARF1 and ARF6 in RASF was checked by semi-quantitative PCR and western blots; and altered expression of ARL15, if any, by induction of RASF with TNF using real-time PCR. The effect of ARL15 on the expression of adiponectin, adiponectin receptor I, IL6 and GAPDH and on cell mobility by invasion and migration assays were assessed by siRNA mediated gene knockdown. RESULTS: Expression of ARL15, ARF1 and ARF6 was confirmed in RASF and OASF samples but ARL15 expression remained unaltered on TNF induction. Notably, ARL15 knockdown resulted in downregulation of IL6 and GAPDH, upregulation of adiponectin and adiponectin receptor I genes; and significant reduction in migration and invasion of RASF. Genemania showed significant interactions of ARL15 with genes responsible for insulin resistance and phospholipase D. CONCLUSIONS: This first report on ARL15 expression in RASF and its likely role in inflammation and metabolic syndromes through a TNF independent pathway, encourages hypothesis-free studies to identify additional pathways underlying RA disease biology.


Assuntos
Fatores de Ribosilação do ADP/fisiologia , Artrite Reumatoide/etiologia , Membrana Sinovial/metabolismo , Fator 1 de Ribosilação do ADP/genética , Fatores de Ribosilação do ADP/genética , Artrite Reumatoide/metabolismo , Fibroblastos/metabolismo , Humanos , Interleucina-6/genética
13.
Arthritis Res Ther ; 20(1): 18, 2018 01 30.
Artigo em Inglês | MEDLINE | ID: mdl-29382374

RESUMO

BACKGROUND: Role of Th9 cells and interleukin-9 (IL-9) in human autoimmune diseases such as psoriasis and ulcerative colitis has been explored only very recently. However, their involvement in human rheumatoid arthritis (RA) is not conclusive. Pathogenesis of RA is complex and involves various T cell subsets and neutrophils. Here, we aimed at understanding the impact of IL-9 on infiltrating immune cells and their eventual role in synovial inflammation in RA. METHODS: In vitro stimulation of T cells was performed by engagement of anti-CD3 and anti-CD28 monoclonal antibodies. Flow cytometry was employed for measuring intracellular cytokine, RORγt in T cells, evaluating apoptosis of neutrophils. ELISA was used for measuring soluble cytokine, Western blot analysis and confocal microscopy were used for STAT3 phosphorylation and nuclear translocation. RESULTS: We demonstrated synovial enrichment of Th9 cells and their positive correlation with disease activity (DAS28-ESR) in RA. Synovial IL-9 prolonged the survival of neutrophils, increased their matrix metalloprotienase-9 production and facilitated Th17 cell differentiation evidenced by induction of transcription factor RORγt and STAT3 phosphorylation. IL-9 also augmented the function of IFN-γ + and TNF-α + synovial T cells. CONCLUSIONS: We provide evidences for critical role of IL-9 in disease pathogenesis and propose that targeting IL-9 may be an effective strategy to ameliorate synovial inflammation in RA. Inhibiting IL-9 may have wider impact on the production of pathogenic cytokines involved in autoimmune diseases including RA and may offer better control over the disease.


Assuntos
Artrite Reumatoide/imunologia , Diferenciação Celular/imunologia , Interleucina-9/imunologia , Neutrófilos/imunologia , Membrana Sinovial/imunologia , Células Th17/imunologia , Adulto , Apoptose/imunologia , Artrite Reumatoide/metabolismo , Artrite Reumatoide/patologia , Sobrevivência Celular/imunologia , Células Cultivadas , Citocinas/imunologia , Citocinas/metabolismo , Feminino , Humanos , Interleucina-9/metabolismo , Masculino , Pessoa de Meia-Idade , Neutrófilos/metabolismo , Neutrófilos/patologia , Membrana Sinovial/metabolismo , Linfócitos T/imunologia , Linfócitos T/metabolismo , Linfócitos T/patologia , Células Th17/metabolismo
14.
J Clin Diagn Res ; 11(9): ED12-ED13, 2017 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-29207721

RESUMO

Anorectum is a rare site for primary melanoma. It is an aggressive cancer with poor prognosis. The diagnosis is often delayed due to non-specific signs and symptoms. Clinically, it is often misdiagnosed as hemorrhoids. The cytological diagnosis can be challenging especially when melanin pigment is sparse or absent. Herein, we present a rare case of anorectal melanoma which was initially misdiagnosed as hemorrhoids. A final correct diagnosis was made on cytology when later on the patient developed inguinal metastasis.

15.
J Clin Diagn Res ; 11(7): ED06-ED07, 2017 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-28892909

RESUMO

Chondroid syringoma, also known as benign mixed tumour of the skin, is a rare benign adnexal tumour. It is a biphasic tumour, composed of both epithelial and mesenchymal components and constitutes <0.01% of all primary skin tumours. It is mostly located in the head and neck region, followed by the hand, foot, axillary region, abdomen, penis, vulva and scrotum. The arm is a rare site of involvement. Making a correct diagnosis of chondroid syringoma is important to guide the clinician in optimal management. We present a case of chondroid syringoma on the left arm in a 37-year-old male. Fine-needle aspiration was performed and diagnosed as chondroid syringoma, which was confirmed on histopathology. This case highlights the importance of considering chondroid syringoma in the evaluation of subcutaneous swellings of the arm and the role of Fine-Needle Aspiration Cytology (FNAC) in diagnosing this uncommon tumour.

17.
J Clin Diagn Res ; 11(5): ED05-ED06, 2017 May.
Artigo em Inglês | MEDLINE | ID: mdl-28658776

RESUMO

Acinic cell carcinoma is a rare tumour comprising 1%-3% of all salivary gland neoplasms. Acinic Cell Carcinoma Papillary Cystic Variant (ACC-PCV) is a distinct subtype and shows variegated appearance on cytology. It is important to differentiate it from other malignant lesions because of its poor prognosis. We describe a case of 20-year-old female with swelling on left cheek for the last four months. Fine needle aspiration was done and diagnosed as intermediate grade mucoepidermoid carcinoma on cytology. Histological study of the resected tumour showed features of ACC-PCV. We are presenting this case to illustrate the diagnostic problems encountered in cytology and important points to be kept in mind while reporting FNA of salivary gland tumours.

18.
Urol Ann ; 9(1): 96-98, 2017.
Artigo em Inglês | MEDLINE | ID: mdl-28216942

RESUMO

Isolated bone marrow metastasis of testicular tumor is very rare. Here, we report this case of a 21-year-old male who was admitted to our hospital with generalized body pain, which was severe and weakness for one month. He had a history of an operative intervention for the left testicular mass about 6 months ago which was diagnosed as mixed germ cell tumor on histopathological examination. The blood investigations showed anemia, low platelets, and elevated tumor markers. Bone marrow aspiration and biopsy examination showed metastatic deposits of mixed germ cell tumor. There were no foci of disease in any other part of the body. The patient was given chemotherapy, i.e. cisplatin, etoposide, and bleomycin. After completion of chemotherapy, there was drastic improvement in pain and weakness. A repeat examination of bone marrow done after 3 month was free of tumor.

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