Current Arthritis News and Research

Gout is a condition marked by increased levels of uric acid in the blood. The uric acid crystallizes and is deposited in the joints, usually the big toe, and causes significant pain.

Alternatively, studies have shown that high serum uric acid levels appear to lower the risk of developing Parkinson’s disease.

To determine if people with high serum uric acid levels and gout have a lower risk of developing Parkinson’s, researchers from the Arthritis Research Centre of Canada in Vancouver performed a cohort study utilizing data from the British Columbia Linked Health Database and PharmaCare data that provided prescription drug data for people over 65.

The study included data on 11,258 gout patients and 56,199 controls. The study covered the years 1991 through 2004. Of the total study population, 72% were being treated with at least 1 prescription drug during the study period.

During the average 8 year follow-up period, there were 1,182 new cases of Parkinson’s. Among those patients with a history of gout, there was a 30% decrease in the risk of developing Parkinson’s. This was independent of age, sex, prior medical conditions or use of NSAIDs or diuretics.

Researchers have theorized that uric acid exerts antioxidant effects on neurons and can protect against oxidative stress, a prominent contributor to neuron degeneration in Parkinson’s.

As new therapies are developed for treatment of gout by lowering the serum uric acid levels, the researchers cautioned that lowering uric acid levels too much for too long may have harmful neurodegenerative consequences.

Originally posted 2008-12-01 12:00:00. Republished by Old Post Promoter

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Researchers in the United Kingdom recently investigated the incidence of stroke among rheumatoid arthritis (RA) patients. They analyzed data from the United Kingdom General Practice Research Database of over 7 million patients. These records include diagnosis and prescription medication information.

The team looked at histories from 33,191 RA patients compared to 99,570 patients without RA. They analyzed several risk factors including age, sex, smoking, diabetes, body mass index, heart attack, heart failure, kidney failure and cholesterol. They also considered the treatments and therapies used by these patients including corticosteroids and anti-rheumatic drugs.

The conclusion was that, when considering multiple variables, patients with RA have a significantly higher risk of stroke. In addition, traditional risk factors were associated with increased risk of stroke in both RA and non-RA patients. They also found that there was no significant effect on the risk by using anti-rheumatic drugs, although there was a slight increase in risk for those patients using methotrexate.

According to lead investigator Dr. Christopher Edwards, “Rheumatoid arthritis is known to be associated with an increased risk of myocardial infarction. These unique data suggest that the disease is associated with an increased risk of stroke as well. Appropriate risk assessment and intervention for this important cause of morbidity and mortality in rheumatoid arthritis is clearly a critical issue.”

Originally posted 2007-11-26 21:55:59. Republished by Old Post Promoter

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Researchers at Imperial College London published a study in which they found that blocking an immune system trigger molecule made by the human body may lead to development of more effective treatments for rheumatoid arthritis (RA).

In their research paper, the scientists state that the body responds to an infection by turning on a molecular switch which puts the immune system into action.

What they found was that a signal molecule called tenascin-C can trigger the same molecular switch, and that tenascin-C can also activate the immune system.

In addition, they theorize that elevated levels of tenascin-C present in joints may cause the activated immune system to attack the joint which could lead to rheumatoid arthritis.

The researchers also reported that they found another molecular switch, called TLR4, on the surface of immune cells. Previous studies have shown that mice without TLR4 do not have chronic joint inflammation.

Lead author, Dr. Kim Midwood from the Kennedy Institute of Rheumatology at Imperial College London, said: “Rheumatoid arthritis is a debilitating and painful disease and, unfortunately, there is no cure. Furthermore, current treatments are not effective for many patients.”

“We have uncovered one way that the immune system may be triggered to attack the joints in patients with rheumatoid arthritis. We hope our new findings can be used to develop new therapies that interfere with tenascin-C activation of the immune system and that these will reduce the painful inflammation that is a hallmark of this condition,” add Dr. Midwood.

The authors say that the next step will be to work out exactly how tenascin-C increases the level of inflammatory molecules in the human joint, and to find ways to inhibit this action.

The team’s research was been published in the journal Nature Medicine.

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In a previous post we discussed the findings of a research team from the Mayo Clinic in Rochester, Minnesota on the relationship between rheumatoid arthritis (RA) and the risk of developing cardiovascular disease. Their report indicated that there are risk factors that can identify RA patients who are at high risk for development of cardiovascular disease.

Dr. Sherine Gabriel of the Mayo Clinic, lead author of the previous study, and her colleagues have issued another report on the link between RA and cardiovascular disease. This report, published in the January, 2008 issue of the Annals of Rheumatic Diseases, looked at the frequency of traditional cardiovascular risk factors to determine the impact of these factors on selected cardiovascular events, such as heart attack, heart failure and cardiovascular-related death.

The study group consisted of 603 rheumatoid arthritis patients and 603 patients without RA.

Initially, both groups had similar cardiovascular risks. During the follow up periods, 15 years for the RA group, 17 years for the non-RA group, the RA patients were more likely to lose weight, and less likely to develop abnormally high or low levels of cholesterol.

The team did find that gender, smoking and personal cardiac history resulted in different cardiovascular risk impacts on RA vs. non-RA patients. Specifically, men who smoked and had a personal cardiac history had a lower increase in risk of cardiovascular disease than non-RA males that smoked and had a personal cardiac history.

This indicates that there are different mechanisms in rheumatoid arthritis patients that lead to cardiovascular disease. The weaker effect of some of the traditional risk factors indicates that traditional approaches for controlling cardiovascular risks may not have the same benefit for RA patients.

The report concluded that additional research is needed to detect the underlying factors that determine rheumatoid arthritis-associated cardiovascular disease and mortality so therapeutic approaches can be developed.

Originally posted 2008-01-08 18:06:30. Republished by Old Post Promoter

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Kawasaki disease is an inflammation of the blood vessels known as vasculitis. It typically develops in young children with over 80% of patients under the age of 5, affects boys more than girls, and a higher percentage are of Asian ancestry. This inflammation can lead to severe inflammatory heart and blood vessel damage.

According to the American Heart Association, Kawasaki disease is the most common cause of pediatric coronary artery disease with more than 4,000 new diagnoses each year. As many as a quarter of those will develop cardiac problems.

A recently completed 25-year follow up study has shown that coronary artery bypass grafting (CABG), or bypass surgery, provides long-term benefits for adolescents and children who have Kawasaki disease with cardiac involvement.

To evaluate the long-term success in patients who had undergone CABG surgery, Dr. Soichiro Kitamura, of the National Cardiovascular Center in Osaka, Japan, and his colleagues followed 114 patients for up to 25 years. All of the patients had bypass surgery between the ages of 1 and 19 years old.

Of these 114 patients, 95% were still alive 25 years later, and most of them were free from any limitations in daily activities, according to Dr. Kitamura. Even though the number of cardiac events increased through the 25 year follow-up, the majority of the events were managed successfully.

There were five deaths among the patients that were tracked, all cardiac in nature. All of these patients had a history of heart attack and frequent irregular heart beat.

At the conclusion of follow-up, three quarters of the surviving patients were taking one to six medications. They were all taking aspirin. Other medications included warfarin, ACE inhibitors, angiotensin receptor blockers, calcium antagonists, diuretics, nitrates, statins, and beta-blockers.

All of the survivors were symptom free at the last checkup and 80% did not have any limitations in performing daily activities. Most could play sports.

The researchers stated that Kawasaki disease has been increasingly treated with early gamma-globulin administration and PCI instead of surgery, although the long-term benefits of these therapies remain unknown.

According to the researchers, “prolonged observation is mandatory for these patients. By employing early additional therapeutic procedures such as percutaneous coronary intervention (PCI) and redo operations, the patients’ survival and quality of life were favorably influenced during 25 postoperative years.”

Dr. Kitamura performed the first bypass grafts in patients with Kawasaki disease in the late 1970s and early 1980s.

The research was published online in Circulation: Journal of the American Heart Association.

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