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Rheumatoid Arthritis: HELP
Articles from Florida
Based on 180 articles published since 2008

These are the 180 published articles about Arthritis, Rheumatoid that originated from Florida during 2008-2019.
+ Citations + Abstracts
Pages: 1 · 2 · 3 · 4 · 5 · 6 · 7 · 8
1 Editorial Autoimmunity: from black water fever to regulatory function. 2014

Chang, Christopher. ·Division of Allergy and Immunology, Thomas Jefferson University, Nemours/AI duPont Hospital for Children, 1600 Rockland Road, Wilmington, DE 19803, USA. Electronic address: cchang@nemours.org. ·J Autoimmun · Pubmed #24491820.

ABSTRACT: Autoimmunity is a field that has only been around for a little over a century. Initially, it was thought that autoimmunity could not happen, that the body would never turn on itself (i.e. "horror autotoxicus"). It was only around the First World War that autoimmunity was recognized as the pathogenesis of various diseases, including rheumatoid arthritis. The discovery of Compound E led to successful treatment of patients with autoimmune diseases, but it was not till later that the adverse effects of this class of drugs were elucidated. The "modern" age of autoimmunity began around 1945 with the description of blackwater fever, and most of the subsequent research on hemolytic anemia and the role of an autoantibody in its pathogenesis led to a description of the anti-globulin reaction. The lupus erythematous (LE) cell was recognized in the mid-1940s by Hargreaves. His research carried on into the 1960s. Rheumatoid factor was also first described in the 1940s as yet another serum factor with activity against globulin-coated sheep red blood cells. The concept of autoimmunity really gained a foothold in the 1950s, when autoimmune thyroid disease and idiopathic thrombocytopenia were first described. Much has happened since then, and our understanding of autoimmunity has evolved now to include mechanisms of apoptosis, signaling pathway derangements, and the discovery of subsets of T cells with regulatory activity. The modern day study of autoimmunity is a fascinating area of research, and full understanding of the pathogenesis of autoimmune diseases is far from being completely elucidated.

2 Review Gene Delivery to Joints by Intra-Articular Injection. 2018

Evans, Christopher H / Ghivizzani, Steven C / Robbins, Paul D. ·1 Rehabilitation Medicine Research Center, Mayo Clinic , Rochester, Minnesota. · 2 Department of Orthopedics and Rehabilitation, University of Florida College of Medicine , Gainesville, Florida. · 3 Department of Metabolism and Aging, The Scripps Research Institute , Jupiter, Florida. ·Hum Gene Ther · Pubmed #29160173.

ABSTRACT: Most forms of arthritis are incurable, difficult to treat, and a major cause of disability in Western countries. Better local treatment of arthritis is impaired by the pharmacokinetics of the joint that make it very difficult to deliver drugs to joints at sustained, therapeutic concentrations. This is especially true of biologic drugs, such as proteins and RNA, many of which show great promise in preclinical studies. Gene transfer provides a strategy for overcoming this limitation. The basic concept is to deliver cDNAs encoding therapeutic products by direct intra-articular injection, leading to sustained, endogenous synthesis of the gene products within the joint. Proof of concept has been achieved for both in vivo and ex vivo gene delivery using a variety of vectors, genes, and cells in several different animal models. There have been a small number of clinical trials for rheumatoid arthritis (RA) and osteoarthritis (OA) using retrovirus vectors for ex vivo gene delivery and adeno-associated virus (AAV) for in vivo delivery. AAV is of particular interest because, unlike other viral vectors, it is able to penetrate deep within articular cartilage and transduce chondrocytes in situ. This property is of particular importance in OA, where changes in chondrocyte metabolism are thought to be fundamental to the pathophysiology of the disease. Authorities in Korea have recently approved the world's first arthritis gene therapy. This targets OA by the injection of allogeneic chondrocytes that have been transduced with a retrovirus carrying transforming growth factor-β

3 Review Liposome-Based Nanomedicine Therapeutics for Rheumatoid Arthritis. 2017

Rahman, Mahfoozur / Beg, Sarwar / Anwar, Firoz / Kumar, Vikas / Ubale, Ruhi / Addo, Richard T / Ali, Raisuddin / Akhter, Sohail. ·Department of Pharmaceutical Sciences, Shalom Institute of health and allied sciences, SHUATS, Allahabad, India. · University Institute of Pharmaceutical Sciences, Panjab, University, Chandigarh, India. · Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia. · LECOM School of Pharmacy, Bradenton, FL 34211, USA. · Union University, School of Pharmacy, Jackson, TN 38305, USA. · Department of Pharmaceutics and Central Lab, College of Pharmacy, King Saud University, Riyadh, Kingdom of Saudi Arabia. · Le Studium Loire Valley Institute for Advanced Studies, Centre-Val de Loire, France; Centre de Biophysique Moléculaire, Centre National de la Recherche Scientifique, Unité Propre de Recherche 4301, Orléans, France. ·Crit Rev Ther Drug Carrier Syst · Pubmed #29199587.

ABSTRACT: Rheumatoid arthritis (RA) is a very painful severe autoimmune disease with complex pathology characterized by progressive chronic inflammation, and devastation of the synovium, cartilage, and other joint-associated structures. Significant advances in research in the area of pathophysiology, diagnosis, drug development, and targeted delivery have led to improved RA therapy and better patient compliance. Targeted drug delivery using liposomal nanomedicines significantly alleviate the challenges with conventional anti-RA medications such as off-target effects, short biological half-life, poor bioavailability, high dose-related toxicity, etc. Liposomal nanomedicines in RA drug targeting offer the opportunity for passive targeting [based on size and polyethylene glycol (PEG)-ylation-mediated enhanced permeability and retention] and active targeting (ligation with antibody or peptides, etc.) and encapsulation of lipophilic, hydrophilic drugs, and/or combinational drugs. However, it has been found recently that such injectable nanomedicines raise the concern of an adverse immune phenomenon called complement activationrelated pseudo allergy (CARPA) and failure of therapy on multiple doses due to accelerated body clearance caused many by anti-PEG immunoglobulin M. To ensure safety and efficacy of RA therapy, these need to be considered along with the common formulation quality parameters. Here, we discuss nanotherapeutic targeting in RA therapy using liposomes. Liposomal nanoparticles are investigated for individual anti-RA drug categories. CARPA issues and pathophysiology with such nanomedicines are also discussed in detail.

4 Review Rheumatoid Arthritis-Associated Interstitial Lung Disease: Current Concepts. 2017

Brito, Yoel / Glassberg, Marilyn K / Ascherman, Dana P. ·Division of Pulmonary and Critical Care Medicine, University of Miami Miller School of Medicine, Miami, FL, USA. · Division of Rheumatology, University of Miami Miller School of Medicine, Rosenstiel Medical Science Building, 7152, 1600 NW 10th Avenue, Miami, FL, 33136-1050, USA. DAscherman@med.miami.edu. ·Curr Rheumatol Rep · Pubmed #29119259.

ABSTRACT: PURPOSE OF REVIEW: Among the many extra-articular complications of rheumatoid arthritis (RA), interstitial lung disease (ILD) contributes significantly to morbidity and mortality. Prevalence estimates for RA-ILD vary widely depending on the specific clinical, radiographic, and functional criteria used to establish the diagnosis. A key unresolved issue is whether early, subclinical forms of RA-ILD represent a precursor to end stage, fibrotic lung disease. Based on uncertainties surrounding the natural history of RA-ILD, incomplete understanding of underlying disease pathogenesis, and lack of controlled clinical trials, evidence-based therapeutic strategies remain largely undefined. RECENT FINDINGS: Correlative clinico-epidemiological studies have identified key risk factors for disease progression. Complementing these findings, the identification of specific molecular and serological markers of RA-ILD has improved our understanding of disease pathogenesis and established the foundation for predictive biomarker profiling. Experience from case series and cohort studies suggests that newer biological agents such as rituximab may be viable treatment options. RA-ILD continues to have a major impact on "disease intrinsic" morbidity and mortality. Increased understanding of disease pathogenesis and the natural history of subclinical RA-ILD will promote the development of more refined therapeutic strategies.

5 Review What can Sjögren's syndrome-like disease in mice contribute to human Sjögren's syndrome? 2017

Peck, Ammon B / Nguyen, Cuong Q. ·Department of Pathology and Infectious Diseases, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608, USA; Center for Orphan Autoimmune Disorders, College of Dentistry, University of Florida, Gainesville, FL 32608, USA. Electronic address: peck@ufl.edu. · Department of Pathology and Infectious Diseases, College of Veterinary Medicine, University of Florida, Gainesville, FL 32608, USA; Center for Orphan Autoimmune Disorders, College of Dentistry, University of Florida, Gainesville, FL 32608, USA; Department of Oral Biology, College of Dentistry, University of Florida, FL 32608, USA. ·Clin Immunol · Pubmed #28478104.

ABSTRACT: For decades, Sjögren's syndrome (SS) and Sjögren's syndrome-like (SS-like) disease in patients and mouse models, respectively, have been intensely investigated in attempts to identify the underlying etiologies, the pathophysiological changes defining disease phenotypes, the nature of the autoimmune responses, and the propensity for developing B cell lymphomas. An emerging question is whether the generation of a multitude of mouse models and the data obtained from their studies is actually important to the understanding of the human disease and potential interventional therapies. In this brief report, we comment on how and why mouse models can stimulate interest in specific lines of research that apparently parallel aspects of human SS. Focusing on two mouse models, NOD and B6·Il14α, we present the possible relevance of mouse models to human SS, highlighting a few selected disease-associated biological processes that have baffled both SS and SS-like investigations for decades.

6 Review Massage Therapy for Pain and Function in Patients With Arthritis: A Systematic Review of Randomized Controlled Trials. 2017

Nelson, Nicole L / Churilla, James R. ·From the Clinical and Applied Movement Sciences, Brooks College of Health, University of North Florida, Jacksonville, Florida. ·Am J Phys Med Rehabil · Pubmed #28177937.

ABSTRACT: BACKGROUND: Massage therapy is gaining interest as a therapeutic approach to managing osteoarthritis and rheumatoid arthritis symptoms. To date, there have been no systematic reviews investigating the effects of massage therapy on these conditions. DESIGN: Systematic review was used. OBJECTIVES: The primary aim of this review was to critically appraise and synthesize the current evidence regarding the effects of massage therapy as a stand-alone treatment on pain and functional outcomes among those with osteoarthritis or rheumatoid arthritis. METHODS: Relevant randomized controlled trials were searched using the electronic databases Google Scholar, MEDLINE, and PEDro. The PEDro scale was used to assess risk of bias, and the quality of evidence was assessed with the GRADE approach. RESULTS: This review found seven randomized controlled trials representing 352 participants who satisfied the inclusion criteria. Risk of bias ranged from four to seven. Our results found low- to moderate-quality evidence that massage therapy is superior to nonactive therapies in reducing pain and improving certain functional outcomes. It is unclear whether massage therapy is more effective than other forms of treatment. CONCLUSIONS: There is a need for large, methodologically rigorous randomized controlled trials investigating the effectiveness of massage therapy as an intervention for individuals with arthritis.

7 Review Effect of tocilizumab on neutrophils in adult patients with rheumatoid arthritis: pooled analysis of data from phase 3 and 4 clinical trials. 2017

Moots, Robert J / Sebba, Anthony / Rigby, William / Ostor, Andrew / Porter-Brown, Benjamin / Donaldson, Francis / Dimonaco, Sophie / Rubbert-Roth, Andrea / van Vollenhoven, Ronald / Genovese, Mark C. ·Department of Musculoskeletal Biology, Institute of Ageing and Chronic Disease, University of Liverpool, Liverpool, UK. · Department of Rheumatology, University of South Florida, Tampa, FL. · Medicine/Microbiology and Immunology, Geisel School of Medicine at Dartmouth, Lebanon, NH, USA. · Department of Rheumatology, Addenbrookes Hospital, Cambridge. · Roche Products Limited, Welwyn Garden City, UK. · Department of Internal Medicine, University of Cologne, Cologne, Germany. · Department of Medicine, Karolinska Institute, Stockholm, Sweden. · Division of Rheumatology, Stanford University Medical Center, Palo Alto, CA, USA. ·Rheumatology (Oxford) · Pubmed #28013198.

ABSTRACT: Objectives: To investigate changes in neutrophil count and occurrences of infection in RA patients treated with the IL-6 receptor-α inhibitor tocilizumab (TCZ). Methods: Data were pooled from patients who received i.v. TCZ (4 mg/kg + MTX, 8 mg/kg ± DMARDs, 10 mg/kg) or placebo + DMARDs in phase 3/4 clinical trials, long-term extensions or a pharmacology study. Neutrophil counts were measured routinely according to the Common Toxicity Criteria for Adverse Events grades; TCZ dosing was adjusted if necessary. Covariates associated with decreased neutrophil counts were assessed with multivariate regression analysis. Infection rates within 30 days of neutrophil count changes were calculated per 100 patient-years of TCZ exposure. Results: In placebo-controlled parts of trials, more TCZ-treated than placebo-treated patients had grade 1/2 or 3/4 neutrophil counts (TCZ: 28.2%/3.1%; placebo: 8.9%/0.2%). In placebo-controlled trials + long-term extensions, 4171 patients provided 16204.8 patient-years of TCZ exposure. Neutrophil counts decreased through week 6 from baseline [mean ( s . d .) change, -2.17 (2.16) × 10 9 /l) and remained stable thereafter. Rates (95% CI) of serious infections within 30 days of normal [4.66 (4.31, 5.03)], grade 1/2 [2.48 (1.79, 3.34)] and 3/4 [2.77 (0.34, 10.01)] neutrophil counts were similar. Baseline neutrophil count <2 × 10 9 /l and female gender were associated with grade 3/4 neutrophil counts [odds ratio (OR) (95% CI): 19.02 (6.76, 53.52), 2.55 (1.40, 4.66)]. Patients who stopped TCZ in response to decreased neutrophil count returned more quickly to normal levels than patients who reduced or continued their dose. Conclusion: Decreases in neutrophil counts in patients taking TCZ do not appear to be associated with serious infections and are normalized by current risk mitigation guidelines.

8 Review Extrahepatic Manifestations of Hepatitis C: A Meta-analysis of Prevalence, Quality of Life, and Economic Burden. 2016

Younossi, Zobair / Park, Haesuk / Henry, Linda / Adeyemi, Ayoade / Stepanova, Maria. ·Center for Liver Diseases, Department of Medicine, Inova Fairfax Hospital, Falls Church, Virginia; Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia. Electronic address: zobair.younossi@inova.org. · University of Florida College of Pharmacy, Gainesville, Florida. · Betty and Guy Beatty Center for Integrated Research, Inova Health System, Falls Church, Virginia. · Center for Outcomes Research in Liver Diseases, Washington, District of Columbia. ·Gastroenterology · Pubmed #26924097.

ABSTRACT: BACKGROUND & AIMS: Hepatitis C virus (HCV) infection has hepatic and extrahepatic manifestations with various costs and impairments to health-related quality of life (HRQL). We performed a meta-analysis to determine the prevalence of extrahepatic manifestations in patients with HCV infection, how these impair HRQL, and their costs. METHODS: We performed systematic reviews of the literature using MEDLINE, CINAHL, and the Cochrane Systematic Review Database, from 1996 through December 2014, to identify studies of the following extrahepatic manifestations of HCV infection: mixed cryoglobulinemia, chronic kidney or end-stage renal disease, type 2 diabetes, B-cell lymphoma, lichen planus, Sjögren's syndrome, porphyria cutanea tarda, rheumatoid-like arthritis, or depression. We performed a separate meta-analysis for each condition to determine prevalence rates of extrahepatic manifestations of HCV infection and their effects on HRQL. We determined the annual costs (inpatient, outpatient, and pharmacy) associated with extrahepatic manifestations of HCV infection. RESULTS: In an analysis of data from 102 studies, we found the most common extrahepatic manifestations to be diabetes (in 15% of patients) and depression (in 25% of patients). HRQL data showed that HCV infection had negative effects on overall physical and mental health. Total direct medical costs of extrahepatic manifestations of HCV infection, in 2014 US dollars, were estimated to be $1506 million (range, $922 million-$2208 million in sensitivity analysis). CONCLUSIONS: In a systematic review and meta-analysis we determined the prevalence, risks, and costs associated with extrahepatic manifestations of HCV infection. These estimates should be added to the liver-related burden of disease to obtain a more accurate assessment of the total burden of chronic HCV infection. Prospective, real-world studies are needed to increase our understanding of the total clinical and economic effects of HCV infection and treatment on patients and society.

9 Review Potential Therapy for Rheumatoid Arthritis and Sjögren Syndrome With Human Chorionic Gonadotropin. 2016

Rao, C V. ·Department of Cellular Biology and Pharmacology, Molecular and Human Genetics and Obstetrics and Gynecology, Reproduction and Development Program, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA crao@fiu.edu. ·Reprod Sci · Pubmed #26239386.

ABSTRACT: Autoimmune diseases such as rheumatoid arthritis (RA) and Sjögren syndrome (SS) ameliorate during pregnancy, through dampening (immunotolerance) of the maternal immune system which protects the fetus from rejection. A large number of studies have shown that human chorionic gonadotropin (hCG) contributes to this tolerance. Studies on animal models have reaffirmed that hCG treatment mimics the benefits of pregnancy. Based on the scientific evidence, randomized clinical trials comparing hCG with current therapies and/or placebo are recommended for RA, SS, and for other autoimmune diseases such as, type 1 diabetes and ankylosing spondylitis, which also get better during pregnancy and hCG treatment seems to help.

10 Review Rheumatoid Arthritis-Associated Interstitial Lung Disease and Idiopathic Pulmonary Fibrosis: Shared Mechanistic and Phenotypic Traits Suggest Overlapping Disease Mechanisms. 2015

Paulin, Francisco / Doyle, Tracy J / Fletcher, Elaine A / Ascherman, Dana P / Rosas, Ivan O. ·Interstitial Lung Disease Clinic, Hospital María Ferrer, Buenos Aires, Argentina. · Pulmonary and Critical Care Division, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. · Cornell University, Ithaca, NY, USA. · Division of Rheumatology, University of Miami Miller School of Medicine, Miami, FL, USA. ·Rev Invest Clin · Pubmed #26696331.

ABSTRACT: The prevalence of clinically evident interstitial lung disease in patients with rheumatoid arthritis is approximately 10%. An additional 33% of undiagnosed patients have interstitial lung abnormalities that can be detected with high-resolution computed tomography. Rheumatoid arthritis-interstitial lung disease patients have three times the risk of death compared to those with rheumatoid arthritis occurring in the absence of interstitial lung disease, and the mortality related to interstitial lung disease is rising. Rheumatoid arthritis-interstitial lung disease is most commonly classified as the usual interstitial pneumonia pattern, overlapping mechanistically and phenotypically with idiopathic pulmonary fibrosis, but can occur in a non-usual interstitial pneumonia pattern, mainly nonspecific interstitial pneumonia. Based on this, we propose two possible pathways to explain the coexistence of rheumatoid arthritis and interstitial lung disease: (i) Rheumatoid arthritis-interstitial lung disease with a non-usual interstitial pneumonia pattern may come about when an immune response against citrullinated peptides taking place in another site (e.g. the joints) subsequently affects the lungs; (ii) Rheumatoid arthritis-interstitial lung disease with a usual interstitial pneumonia pattern may represent a disease process in which idiopathic pulmonary fibrosis-like pathology triggers an immune response against citrullinated proteins that promotes articular disease indicative of rheumatoid arthritis. More studies focused on elucidating the basic mechanisms leading to different sub-phenotypes of rheumatoid arthritis-interstitial lung disease and the overlap with idiopathic pulmonary fibrosis are necessary to improve our understanding of the disease process and to define new therapeutic targets.

11 Review Impact of physiological, pathological and environmental factors on the expression and activity of human cytochrome P450 2D6 and implications in precision medicine. 2015

He, Zhi-Xu / Chen, Xiao-Wu / Zhou, Zhi-Wei / Zhou, Shu-Feng. ·a Guizhou Provincial Key Laboratory for Regenerative Medicine, Stem Cell and Tissue Engineering Research Center & Sino-US Joint Laboratory for Medical Sciences, Guizhou Medical University , Guiyang , Guizhou , China . · b Department of General Surgery , The First People's Hospital of Shunde, Southern Medical University , Shunde , Foshan , Guangdong , China , and. · c Department of Pharmaceutical Science , College of Pharmacy, University of South Florida , Tampa , FL , USA. ·Drug Metab Rev · Pubmed #26574146.

ABSTRACT: With only 1.3-4.3% in total hepatic CYP content, human CYP2D6 can metabolize more than 160 drugs. It is a highly polymorphic enzyme and subject to marked inhibition by a number of drugs, causing a large interindividual variability in drug clearance and drug response and drug-drug interactions. The expression and activity of CYP2D6 are regulated by a number of physiological, pathological and environmental factors at transcriptional, post-transcriptional, translational and epigenetic levels. DNA hypermethylation and histone modifications can repress the expression of CYP2D6. Hepatocyte nuclear factor-4α binds to a directly repeated element in the promoter of CYP2D6 and thus regulates the expression of CYP2D6. Small heterodimer partner represses hepatocyte nuclear factor-4α-mediated transactivation of CYP2D6. GW4064, a farnesoid X receptor agonist, decreases hepatic CYP2D6 expression and activity while increasing small heterodimer partner expression and its recruitment to the CYP2D6 promoter. The genotypes are key determinants of interindividual variability in CYP2D6 expression and activity. Recent genome-wide association studies have identified a large number of genes that can regulate CYP2D6. Pregnancy induces CYP2D6 via unknown mechanisms. Renal or liver diseases, smoking and alcohol use have minor to moderate effects only on CYP2D6 activity. Unlike CYP1 and 3 and other CYP2 members, CYP2D6 is resistant to typical inducers such as rifampin, phenobarbital and dexamethasone. Post-translational modifications such as phosphorylation of CYP2D6 Ser135 have been observed, but the functional impact is unknown. Further functional and validation studies are needed to clarify the role of nuclear receptors, epigenetic factors and other factors in the regulation of CYP2D6.

12 Review Clinical guidelines for management of dry eye associated with Sjögren disease. 2015

Foulks, Gary N / Forstot, S Lance / Donshik, Peter C / Forstot, Joseph Z / Goldstein, Michael H / Lemp, Michael A / Nelson, J Daniel / Nichols, Kelly K / Pflugfelder, Stephen C / Tanzer, Jason M / Asbell, Penny / Hammitt, Katherine / Jacobs, Deborah S. ·University of Louisville Department of Ophthalmology and Vision Science, Louisville, KY. Electronic address: foulksgary@gmail.com. · Corneal Consultants of Colorado, Denver, CO. · University of Connecticut Health Center Division of Ophthalmology, Farmington, CT. · Rheumatology Associates of South Florida, Boca Raton, FL. · Tufts University School of Medicine, Boston, MA. · Georgetown University, Washington, DC. · HealthPartners Medical Group, St. Paul, MN. · University of Alabama Birmingham School of Optometry (formerly University of Houston School of Optometry, Houston, TX). · Baylor College of Medicine, Houston, TX. · University of Connecticut School of Dental Medicine, Farmington, CT. · Icahn School of Medicine at Mount Sinai, NewYork, NY. · Sjogren's Syndrome Foundation, Bethesda, MD. · Boston Foundation for Sight, Needham, MA. ·Ocul Surf · Pubmed #25881996.

ABSTRACT: PURPOSE: To provide a consensus clinical guideline for management of dry eye disease associated with Sjögren disease by evaluating published treatments and recommending management options. DESIGN: Consensus panel evaluation of reported treatments for dry eye disease. METHODS: Using the 2007 Report of the International Workshop on Dry Eye (DEWS) as a starting point, a panel of eye care providers and consultants evaluated peer-reviewed publications and developed recommendations for evaluation and management of dry eye disease associated with Sjögren disease. Publications were graded according to the American Academy of Ophthalmology Preferred Practice Pattern guidelines for level of evidence. Strength of recommendation was according to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) guidelines. RESULTS: The recommendations of the panel are briefly summarized herein. Evaluation should include symptoms of both discomfort and visual disturbance as well as determination of the relative contribution of aqueous production deficiency and evaporative loss of tear volume. Objective parameters of tear film stability, tear osmolarity, degree of lid margin disease, and ocular surface damage should be used to stage severity of dry eye disease to assist in selecting appropriate treatment options. Patient education with regard to the nature of the problem, aggravating factors, and goals of treatment is critical to successful management. Tear supplementation and stabilization, control of inflammation of the lacrimal glands and ocular surface, and possible stimulation of tear production are treatment options that are used according to the character and severity of dry eye disease. SUMMARY: Management guidelines for dry eye associated with Sjögren's disease are presented.

13 Review Pulmonary manifestations of Sjögren syndrome, systemic lupus erythematosus, and mixed connective tissue disease. 2015

Mira-Avendano, Isabel C / Abril, Andy. ·Department of Pulmonary Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 32224, USA. Electronic address: Mira.isabel@mayo.edu. · Department of Rheumatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL 33224, USA. ·Rheum Dis Clin North Am · Pubmed #25836642.

ABSTRACT: Interstitial lung disease is a common and often life-threatening manifestation of different connective tissue disorders, often affecting its overall prognosis. Systemic lupus erythematosus, Sjögren syndrome, and mixed connective tissue disease, although all unique diseases, can have lung manifestations as an important part of these conditions. This article reviews the different pulmonary manifestations seen in these 3 systemic rheumatologic conditions.

14 Review Mouse Models of Primary Sjogren's Syndrome. 2015

Park, Young-Seok / Gauna, Adrienne E / Cha, Seunghee. ·Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, Gainesville, FL32610, USA. scha@dental.ufl.edu. ·Curr Pharm Des · Pubmed #25777752.

ABSTRACT: Sjogren's syndrome (SjS) is a chronic autoimmune disorder characterized by immune cell infiltration and progressive injury to the salivary and lacrimal glands. As a consequence, patients with SjS develop xerostomia (dry mouth) and keratoconjunctivitis sicca (dry eyes). SjS is the third most common rheumatic autoimmune disorder, affecting 4 million Americans with over 90% of patients being female. Current diagnostic criteria for SjS frequently utilize histological examinations of minor salivary glands for immune cell foci, serology for autoantibodies, and dry eye evaluation by corneal or conjunctival staining. SjS can be classified as primary or secondary SjS, depending on whether it occurs alone or in association with other systemic rheumatic conditions, respectively. Clinical manifestations typically become apparent when the disease is relatively advanced in SjS patients, which poses a challenge for early diagnosis and treatment of SjS. Therefore, SjS mouse models, because of their close resemblance to the human SjS, have been extremely valuable to identify early disease markers and to investigate underlying biological and immunological dysregulations. However, it is important to bear in mind that no single mouse model has duplicated all aspects of SjS pathogenesis and clinical features, mainly due to the multifactorial etiology of SjS that includes numerous susceptibility genes and environmental factors. As such, various mouse models have been developed in the field to try to recapitulate SjS. In this review, we focus on recent mouse models of primary SjS xerostomia and describe them under three categories of spontaneous, genetically engineered, and experimentally induced models. In addition, we discuss future perspectives highlighting pros and cons of utilizing mouse models and current demands for improved models.

15 Review The OMERACT MRI in Arthritis Working Group - Update on Status and Future Research Priorities. 2015

Østergaard, Mikkel / Bird, Paul / Gandjbakhch, Frédérique / Eshed, Iris / Haugen, Ida K / Haavardsholm, Espen A / Lillegraven, Siri / Foltz, Violaine / Glinatsi, Daniel / Peterfy, Charles / Ejbjerg, Bo / Bøyesen, Pernille / Mease, Philip J / Hermann, Kay-Geert / Emery, Paul / Genant, Harry K / Conaghan, Philip G. ·From the Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark; University of New South Wales, Sydney, Australia; Department of Rheumatology, Pitié-Salpêtrière Hospital, APHP, Université Paris 6-UPMC, Paris, France; Sheba Medical Center, Tel Aviv University, Tel Aviv, Israel; Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway; Spire Sciences, Boca Raton, Florida, USA; Department of Rheumatology, Slagelse Hospital, Slagelse, Denmark; Division of Rheumatology Research, Swedish Medical Center, University of Washington School of Medicine; and Seattle Rheumatology Associates, Seattle, Washington, USA; Department of Radiology, Charité University Hospital, Berlin, Germany; Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds; National Institute for Health Research (NIHR) Leeds Musculoskeletal Biomedical Research Unit, Leeds, UK; University of California, San Francisco, and Synarc Inc., San Francisco, California, USA. M. Østergaard, MD, PhD, DMSc, Professor of Rheumatology, Copenhagen Center for Arthritis Research, Center for Rheumatology and Spine Diseases, Glostrup Hospital and Department of Clinical Medicine, University of Copenhagen; P. Bird, BMed (Hons), FRACP, PhD, Grad Dip MRI, Senior Lecturer, University of NSW; F. Gandjbakhch, MD, Practicing Rheumatologist, Department of Rheumatology, Pitié-Salpêtrière, APHP, Université Paris 6-UPMC; I. Eshed, MD, Professor of Radiology, Sheba Medical Center, Tel Aviv University; I.K. Haugen, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; E.A. Haavardsholm, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital; S. Lillegraven, MD, PhD, Postdoctoral Researcher, Department of Rheumatology, Diakonhjemmet Hospital, University of Oslo; V. Foltz, MD, Practicing Rheumatologist, ·J Rheumatol · Pubmed #25684771.

ABSTRACT: OBJECTIVE: To provide an update on the status and future research priorities of the Outcome Measures in Rheumatology (OMERACT) magnetic resonance imaging (MRI) in arthritis working group. METHODS: A summary is provided of the activities of the group within rheumatoid arthritis (RA), psoriatic arthritis (PsA), and osteoarthritis (OA), and its research priorities. RESULTS: The OMERACT RA MRI score (RAMRIS) evaluating bone erosion, bone edema (osteitis), and synovitis is now the standard method of quantifying articular pathology in RA trials. Cartilage loss is another important part of joint damage, and at the OMERACT 12 conference, we provided longitudinal data demonstrating reliability and sensitivity to change of the RAMRIS JSN component score, supporting its use in future clinical trials. The MRI group has previously developed a PsA MRI score (PsAMRIS). At OMERACT 12, PsAMRIS was evaluated in a randomized placebo-controlled trial of patients with PsA, demonstrating the responsiveness and discriminatory ability of applying the PsAMRIS to hands and feet. A hand OA MRI score (HOAMRIS) was introduced at OMERACT 11, and has subsequently been further validated. At OMERACT 12, good cross-sectional interreader reliability, but variable reliability of change scores, were reported. Potential future research areas were identified at the MRI session at OMERACT 12 including assessment of tenosynovitis in RA and enthesitis in PsA and focusing on alternative MRI techniques. CONCLUSION: MRI has been further developed and validated as an outcome measure in RA, PsA, and OA. The group will continue its efforts to optimize the value of MRI as a robust biomarker in rheumatology clinical trials.

16 Review Seizing the clinical presentation in adult onset Still's disease. An extensive literature review. 2015

Narula, Neha / Narula, Tathagat / Abril, Andy. ·Department of Rheumatology, Mayo Clinic, Jacksonville, FL, United States. Electronic address: Narula.neha@mayo.edu. · Pulmonary Critical Care, RCCSMA, Jacksonville, FL, United States. · Department of Rheumatology, Mayo Clinic, Jacksonville, FL, United States. ·Autoimmun Rev · Pubmed #25617819.

ABSTRACT: Adult onset Still's disease is an inflammatory disorder with a wide clinical presentation ranging from arthralgia and arthritis to rash and high-grade fever. Etiology of this rare disorder remains a mystery. We present two cases at the extreme ends of clinical presentation diagnosed with AOSD along with literature review for the same. Case one was self limiting, requiring only NSAIDS as treatment. The other was an unusual central nervous system manifestation of repeated seizures that were only responsive to pulse dose of methylprednisolone. Both met Yamaguchi criteria for adult onset Still's disease.

17 Review Eponyms in cardiothoracic radiology: part III--interstitium. 2014

Mohammed, Tan-Lucien H / Saettele, Megan R / Saettele, Timothy / Patel, Vikas / Kanne, Jeffrey P. ·Department of Radiology, College of Medicine, University of Florida, Gainesville, FL. Electronic address: mohammed10@gmail.com. · Department of Radiology, University of Missouri-Kansas City, Kansas City, MO. · Department of Pulmonary Medicine, University of Texas, MD Anderson Cancer Center, Houston, TX. · Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, WI. ·Curr Probl Diagn Radiol · Pubmed #24932752.

ABSTRACT: Eponyms serve the purpose of honoring individuals who have made important observations and discoveries. As with other fields of medicine, eponyms are frequently encountered in radiology, particularly in chest radiology. However, inappropriate use of an eponym may lead to potentially dangerous miscommunication. Moreover, an eponym may honor the incorrect person or a person who falls into disrepute. Despite their limitations, eponyms are still widespread in the medical literature. Furthermore, in some circumstances, more than one individual may have contributed to the description or discovery of a particular anatomical structure or disease, whereas in others, an eponym may have been incorrectly applied initially and propagated for years in the medical literature. Nevertheless, radiologic eponyms are a means of honoring those who have made lasting contributions to the field of radiology, and familiarity with these eponyms is critical for proper reporting and accurate communication. In addition, the acquisition of some historical knowledge about those whose names are associated with various structures or pathologic conditions conveys a sense of humanity in the science of medicine. In this third installment of this series, the authors discuss a number of chest radiology eponyms as they relate to the pulmonary interstitium, including relevant clinical and imaging features, as well biographical information of the respective eponym's namesake.

18 Review Regulatory T-cell vaccination independent of auto-antigen. 2014

Pascual, David W / Yang, Xinghong / Holderness, Kathryn / Jun, SangMu / Maddaloni, Massimo / Kochetkova, Irina. ·Department of Infectious Diseases and Pathology, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA. · Department of Immunology and Infectious Diseases, Montana State University, Bozeman, MT, USA. ·Exp Mol Med · Pubmed #24626168.

ABSTRACT: To date, efforts to treat autoimmune diseases have primarily focused on the disease symptoms rather than on the cause of the disease. In large part, this is attributed to not knowing the responsible auto-antigens (auto-Ags) for driving the self-reactivity coupled with the poor success of treating autoimmune diseases using oral tolerance methods. Nonetheless, if tolerogenic approaches or methods that stimulate regulatory T (Treg) cells can be devised, these could subdue autoimmune diseases. To forward such efforts, our approach with colonization factor antigen I (CFA/I) fimbriae is to establish bystander immunity to ultimately drive the development of auto-Ag-specific Treg cells. Using an attenuated Salmonella vaccine expressing CFA/I fimbriae, fimbriae-specific Treg cells were induced without compromising the vaccine's capacity to protect against travelers' diarrhea or salmonellosis. By adapting the vaccine's anti-inflammatory properties, it was found that it could also dampen experimental inflammatory diseases resembling multiple sclerosis (MS) and rheumatoid arthritis. Because of this bystander effect, disease-specific Treg cells are eventually induced to resolve disease. Interestingly, this same vaccine could elicit the required Treg cell subset for each disease. For MS-like disease, conventional CD25(+) Treg cells are stimulated, but for arthritis CD39(+) Treg cells are induced instead. This review article will examine the potential of treating autoimmune diseases without having previous knowledge of the auto-Ag using an innocuous antigen to stimulate Treg cells via the production of transforming growth factor-β and interleukin-10.

19 Review A roadmap to promote clinical and translational research in rheumatoid arthritis-associated interstitial lung disease. 2014

Doyle, Tracy J / Lee, Joyce S / Dellaripa, Paul F / Lederer, James A / Matteson, Eric L / Fischer, Aryeh / Ascherman, Dana P / Glassberg, Marilyn K / Ryu, Jay H / Danoff, Sonye K / Brown, Kevin K / Collard, Harold R / Rosas, Ivan O. ·Division of Pulmonary and Critical Care Medicine Brigham and Women's Hospital, Harvard Medical School, Boston, MA. · Division of Pulmonary and Critical Care Medicine, University of California San Francisco School of Medicine, San Francisco, CA. · Division of Rheumatology, Immunology, and Allergy Brigham and Women's Hospital, Harvard Medical School, Boston, MA. · Department of Surgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA. · Division of Rheumatology, Mayo Clinic College of Medicine, Rochester, MN. · Division of Rheumatology, National Jewish Health and University of Colorado, Denver, CO. · Division of Rheumatology, University of Miami Miller School of Medicine, Miami, FL. · Division of Pulmonary Medicine, University of Miami Miller School of Medicine, Miami, FL. · Division of Pulmonary and Critical Care Medicine, Mayo Clinic College of Medicine, Rochester, MN. · Division of Pulmonary and Critical Care Medicine, Johns Hopkins University School of Medicine, Baltimore, MD. · Autoimmune Lung Center and Interstitial Lung Disease Program, National Jewish Health, Denver, CO. · Lovelace Respiratory Research Institute, Albuquerque, NM. Electronic address: irosas@rics.bwh.harvard.edu. ·Chest · Pubmed #24590021.

ABSTRACT: Rheumatoid arthritis (RA) is a systemic inflammatory disorder affecting approximately 1.3 million adults in the United States. Approximately 10% of these individuals with RA have clinically evident interstitial lung disease (RA-ILD), and an additional one-third demonstrate subclinical ILD on chest CT scan. The risk of death for individuals with RA-ILD is three times higher than for patients with RA without ILD, with a median survival after ILD diagnosis of only 2.6 years. Despite the high prevalence and mortality of RA-ILD, little is known about its molecular features and its natural history. At present, we lack a standard validated approach to the definition, diagnosis, risk stratification, and management of RA-ILD. In this perspective, we discuss the importance of clinical and translational research and how ongoing research efforts can address important gaps in our knowledge over the next few years. Furthermore, recommendations are made to design multicenter collaborative studies that will expedite the development of clinical trials designed to decrease the significant morbidity and mortality associated with RA-ILD.

20 Review The value of animal models to study immunopathology of primary human Sjögren's syndrome symptoms. 2014

Donate, Amy / Voigt, Alexandria / Nguyen, Cuong Q. ·Department of Infectious Diseases and Pathology, University of Florida College of Veterinary Medicine, 2015 SW 16th Ave, Gainesville, FL 32611, USA. ·Expert Rev Clin Immunol · Pubmed #24506531.

ABSTRACT: Sjögren's syndrome (SjS) is a complex chronic autoimmune disease of multifactorial etiology that results in eventual loss of secretory function in the exocrine glands. The challenges towards finding a therapeutic prevention or treatment for SjS are due primarily to a lack of understanding in the pathophysiological and clinical progression of the disease. In order to circumnavigate this problem, there is a need for appropriate animal models that resemble the major phenotypes of human SjS and deliver a clear underlying biological or molecular mechanism capable of defining various aspects for the disease. Here, we present an overview of SjS mouse models that are providing insight into the autoimmune process of SjS and advance our focus on potential diagnostic and therapeutic targets.

21 Review Conflict of interest in online point-of-care clinical support websites. 2014

Amber, Kyle T / Dhiman, Gaurav / Goodman, Kenneth W. ·Ethics Program, University of Miami Miller School of Medicine, Miami, Florida, USA. ·J Med Ethics · Pubmed #24493079.

ABSTRACT: Point-of-care evidence-based medicine websites allow physicians to answer clinical queries using recent evidence at the bedside. Despite significant research into the function, usability and effectiveness of these programmes, little attention has been paid to their ethical issues. As many of these sites summarise the literature and provide recommendations, we sought to assess the role of conflicts of interest in two widely used websites: UpToDate and Dynamed. We recorded all conflicts of interest for six articles detailing treatment for the following conditions: erectile dysfunction, fibromyalgia, hypogonadism, psoriasis, rheumatoid arthritis and Crohn's disease. These diseases were chosen as their medical management is either controversial, or they are treated using biological drugs which are mostly available by brand name only. Thus, we hypothesised that the role of conflict of interest would be more significant in these conditions than in an illness treated with generic medications or by strict guidelines. All articles from the UpToDate articles demonstrated a conflict of interest. At times, the editor and author would have a financial relationship with a company whose drug was mentioned within the article. This is in contrast with articles on the Dynamed website, in which no author or editor had a documented conflict. We offer recommendations regarding the role of conflict of interest disclosure in these point-of-care evidence-based medicine websites.

22 Review The role of parotidectomy in Sjögren's syndrome. 2014

Madero-Visbal, Rafael / Milas, Zvonimir. ·MD Anderson Cancer Center, Orlando, 1400 S Orange Avenue, Orlando, FL 32806, USA. ·Oral Maxillofac Surg Clin North Am · Pubmed #24287196.

ABSTRACT: Sjögren's syndrome, a chronic and progressive autoimmune disorder mainly characterized by xerophthalmia, xerostomia, and parotid enlargement, is primarily managed medically, but some patients will require surgical management. Patients with Sjögren's syndrome have an increased risk of non-Hodgkin lymphoma. Superficial parotidectomy is indicated for diagnostic purposes and can be therapeutic in limited circumstances. Surgical indications for parotidectomy in Sjögren's syndrome include recurrent parotitis refractory to medical management; salivary gland malignancy; and severe, refractory pain. Surgical complications include transient or permanent facial nerve injury, post-operative pain, persistent inflammation of remnant parotid tissue, Frey syndrome, and facial scarring.

23 Review The important role of T cells and receptor expression in Sjögren's syndrome. 2013

Karabiyik, A / Peck, A B / Nguyen, C Q. ·Department of Pathology and Infectious Diseases, College of Veterinary Medicine, University of Florida, Gainesville, FL, USA. ·Scand J Immunol · Pubmed #23679844.

ABSTRACT: Sjögren's syndrome (SjS), an autoimmune disease characterized by exocrine gland dysfunction leading to dry mouth and dry eye diseases, is typified by progressive leucocyte infiltrations of the salivary and lacrimal glands. Histologically, these leucocyte infiltrations generally establish periductal aggregates, referred to as lymphocytic foci (LF), which occasionally appear as germinal centre (GC)-like structures. The formation and organization of these LF suggest an important and dynamic role for helper T cells (TH), specifically TH1, TH2 and the recently discovered TH17, in development and onset of clinical SjS, considered a B cell-mediated hypersensitivity type 2 disease. Despite an ever-increasing focus on identifying the underlying aetiology of SjS, defining factors that initiate this autoimmune disease remain a mystery. Thus, determining interactions between infiltrating TH cells and exocrine gland tissue (auto-)antigens represents a fertile research endeavour. This review discusses pathological functions of TH cells in SjS, the current status of TH cell receptor gene rearrangements associated with human and mouse models of SjS and potential future prospects for identifying receptor-autoantigen interactions.

24 Review Animal models in autoimmune diseases: lessons learned from mouse models for Sjögren's syndrome. 2012

Lee, Byung Ha / Gauna, Adrienne E / Pauley, Kaleb M / Park, Yun-Jong / Cha, Seunghee. ·Department of Oral and Maxillofacial Diagnostic Sciences, University of Florida College of Dentistry, JHMHSC, Gainesville, FL 32610, USA. ·Clin Rev Allergy Immunol · Pubmed #22105703.

ABSTRACT: The mouse model is the one of the most frequently used and well-established animal models, and is currently used in many research areas. To date, various mouse models have been utilized to elucidate underlying causes of multifactorial autoimmune conditions, including pathological immune components and specific signaling pathways. This review summarizes the more recent mouse models for Sjögren's syndrome, a systemic autoimmune disease characterized by lymphocytic infiltration in the exocrine glands, such as the salivary and lacrimal glands, and loss of secretory function, resulting in dry mouth and dry eyes in patients. Although every Sjögren's syndrome mouse model resembles the major symptoms or phenotypes of Sjögren's syndrome conditions in humans, the characteristics of each model are variable. Moreover, to date, there is no single mouse model that can completely replicate the human conditions. However, unique features of each mouse model provide insights into the roles of potential etiological and immunological factors in the development and progression of Sjögren's syndrome. Here, we will overview the Sjögren's syndrome mouse models. Lessons from these mouse models will aid us to understand underlying immune dysregulation in autoimmune diseases in general, and will guide us to direct future research towards appropriate diagnostic and therapeutic strategies.

25 Review MicroRNAs in rheumatoid arthritis. 2011

Ceribelli, Angela / Nahid, Md A / Satoh, Minoru / Chan, Edward K L. ·Department of Oral Biology, University of Florida, Gainesville, FL 32610-0424, USA. aceribelli@dental.ufl.edu ·FEBS Lett · Pubmed #21600203.

ABSTRACT: Rheumatoid arthritis (RA) is a chronic and severe autoimmune disease that affects joint tissues, bone, and cartilage. However, the pathogenesis of RA is still unclear. Autoantibodies such as rheumatoid factor and anti-cyclic citrullinated peptide are useful tools for early diagnosis, monitoring disease activity, and predicting prognosis. Recently, many groups have focused their attention on the role of microRNAs in the pathogenesis of RA, as well as a potential biomarker to monitor RA. In fact, the expression of some microRNAs, such as miR-146a, is upregulated in different cell types and tissues in RA patients. MicroRNAs in RA could also be considered as possible future targets for new therapeutic approaches.