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Biomedical subjects

S Accardo

Publications and source records attributed to S Accardo.

At least 73 records · Page 4Linked to original sources
PubMedDate not supplied

Treatment of Lyme arthritis.

The efficacy of different therapeutic regimens for Lyme arthritis is reviewed. The first treatment for Lyme arthritis, intramuscular benzathine penicillin 2.4 million units weekly for 3 weeks, had a success rate of 35%. Another study employed intravenous penicillin G at a dosage of 20 million units daily for 10 days, which cured 55% of patients. Intravenous ceftriaxone has been shown to be superior to penicillin with a response rate of 94%. However, these results have been challenged in recent reports. Oral doxycycline or amoxicillin in association with probenecid seems to work equally well although neuroborreliosis was more frequent following treatment with amoxicillin. An anecdotal report indicates the usefullness of long-term benzathine penicillin for chronic Lyme arthritis. Long-term antibiotic therapy, which is recommended also for Reiter's syndrome, may be useful for eradicating the sanctuaries of Borrelia burgdorferi. Disease-modifying drugs such as hydroxychloroquine or sulphasalazine, a drug which is commonly used in reactive arthritis following enteric infections, may be of value in Lyme arthritis resistant to antibiotics but have not been tested to date. The role of intraarticular injections of steroids or synovectomy is still controversial. Antibiotic treatment is the cornerstone of Lyme arthritis treatment. Additional interventions should be studied for patients with Lyme arthritis resistant to antibiotics.

Animals↗
PubMedDate not supplied

[Macroglobulin alpha-2 in synovial fluid: relationship with reactants of the acute phase of rheumatoid arthritis].

Metalloproteinases (e.g. collagenase, elastase, stromelysin) are present in large amount in synovial fluid (SF) during rheumatoid arthritis (RA) and are actively involved in articular tissue damage. alpha 2-Macroglobulin (alpha 2M) functions as a "molecular trap" for proteinases and is considered the major inhibitor of metalloproteinases. We found increased concentrations of alpha 2M in SF of RA patients, significantly related to acute phase reactants, local inflammatory parameters and joint damage. The alpha 2M ratio between, RA SF and control SF, was found higher than between RA serum and control serum, indicating a selective localization and activity of alpha 2M in inflamed joint. The relationship between alpha 2M and the inflammatory parameters, including IL-6, is discussed.

Acute Disease↗
PubMedDate not supplied

Sex hormones, HLA and rheumatoid arthritis.

Recent evidence indicates that the HLA system might, in some way, regulate androgen concentrations. Male patients affected by rheumatoid arthritis have been shown to possess low serum testosterone levels associated with a particular HLA haplotype. Furthermore, androgen receptors have been recently described in macrophage-like synoviocytes that are HLA-DR positive. Since androgens generally are immunosuppressive, the possible mechanisms of their action in rheumatoid arthritis are here reviewed and discussed. It has now become evident that the well known relationship between sex hormones and the immune system is more complex than was previously suspected.

Arthritis, Rheumatoid↗
PubMedDate not supplied

Alkaline phosphatase activity in the serum of patients with rheumatoid arthritis.

Alkaline phosphatase (ALP) activity was determined in the serum of 145 patients with rheumatoid arthritis (RA) and of 56 patients with osteoarthritis (OA). The mean ALP concentration was 226.9 U/L in RA and 168.7 U/L in OA (p less than 0.001). The prevalence of hyperphosphatasemia was 28% in RA vs 7.1% in OA (p less than 0.01). ALP concentrations significantly correlated with the erythrocyte sedimentation rate (p less than 0.05). Eighteen out of 46 (39%) rheumatoid patients in whom ALP isoenzymes determination was performed showed a predominant liver fraction and 10 (22%) a predominant bone fraction. In women, both ALP and its bone isoenzyme correlated with the number of joints involved by RA. During the followup, major changes of the type of predominant ALP isoenzyme were observed.

Adult↗
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Plasma and synovial fluid lanthanides in rheumatoid arthritis: variations after intra-articular therapy.

Lanthanides (Ln), or rare earth elements, are detectable in trace amounts in organisms. Increased concentrations of Ln have been observed in rheumatoid arthritis (RA) in plasma (pl) and synovial fluid (Sf). We have evaluated pl and Sf concentrations of Ln (in particular La, Nd, Ce, Yb, Lu, Eu), in rheumatoid arthritis patients, before and after intra-articular steroid injection. Increased pl and Sf concentrations of Ln were confirmed in RA. No detectable synovial fluid concentrations of Ln were observed in healthy controls. A statistically significant Ln reduction (p less than 0.001) was observed in Sf 3 and 6 days after local steroid injection and in pl after 6 days. The decrease in Ln concentrations in Sf and pl, after antiphlogistic therapy, reflects the reduction of the inflammatory condition.

Adult↗
PubMedDate not supplied

Estrogens, the immune response and autoimmunity.

Estrogens appear to play a central role in the immune response and immune-mediated diseases. Recent studies have shown the presence of estrogen receptors on the cells involved in the immune response, namely thymocytes, macrophages and endothelial cells. Particular attention has been focused on the dose-dependent influence of estrogen on the immune response, which appears to be related to the clinical symptoms of autoimmunity (i.e. the effects of pregnancy or oral contraceptive pills). The influence of estrogens on cytokine production by target cells, through interference with their transcriptional activity, has also been the focus of various studies. The effect of estrogens on the expression of the protooncogenes and oncosuppressor genes involved in programmed cell death (apoptosis) might also be relevant to human autoimmunity, in particular the uncontrolled synovial lining cell hyperplasia associated with rheumatoid arthritis and the prolonged T-cell survival in systemic lupus erythematosus. Estrogen-induced immunomodulation is a subject of growing interest and stimulating research.

Animals↗
PubMedDate not supplied

Increased prevalence of antibodies to adenovirus and respiratory syncytial virus in polymyalgia rheumatica.

Serum antibodies to a panel of 13 viruses and to Mycoplasma pneumoniae and Chlamydia psittaci were tested in 17 patients with polymyalgia rheumatica (PMR) and in 17 age- and sex-matched controls with osteoarthritis seen in the same rheumatological clinic. Antibodies to adenovirus (ADV) and respiratory syncytial virus (RSV) were significantly more prevalent in PMR. These antibodies were titred in 26 patients with PMR, including those evaluated in the pilot study (17 women, 9 men, mean age 72.5 years), and in 26 controls. 25/26 PMR patients tested positive for antibodies to ADV vs. 12/26 controls (p = 0.0002) and the concentration was higher in patients than in controls (p < 0.01). Antibodies to RSV were present in all PMR patients and in 12/26 controls (p = 0.00005) and their concentration was higher in patients than in controls (p < 0.01). Serial determinations performed in 18 PMR patients showed that the antibody titer did not change significantly. These data suggest that a trivial infection may trigger PMR in elderly people, with ADV and RSV among the possible microorganisms involved.

Adenoviridae↗
PubMedDate not supplied

Macrophages, synovial tissue and rheumatoid arthritis.

Macrophage-like synoviocytes originate in the bone marrow, like other mononuclear phagocytes, and are constantly replaced via the circulation. In rheumatoid synovium sections, 80-100% of the synovial lining cells are macrophage-like cells functioning as antigen processing- and antigen-presenting cells to T lymphocytes. Monocyte and lymphocyte traffic into the rheumatoid arthritis (RA) synovium is mediated by adhesion molecules such as endothelial-leukocyte adhesion molecule-1 (ELAM-1), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecules-1 and -2 (ICAM-1 and ICAM-2), as well as monocyte chemotactic protein 1 (MCP-1) and beta 2 integrins (CD11 a,b,c/CD18). Macrophage-like cells in the RA synovium are highly activated based on their morphology, surface class II HLA antigen expression, and synthesis of cytokines such as interleukin-1 beta (IL-1 beta), tumor necrosis factor alpha (TNF-alpha), interleukin-6 (IL-6), granulocyte-macrophage colony-stimulating factor (GM-CSF), macrophage CSF, and transforming growth-factor beta (TGF-beta). Evidence for type 1 (higher affinity) and type 2 (lower affinity) androgen (ARs) and estrogen receptors (ERs) on macrophage-like synoviocytes in either male or female synovial samples from both RA patients and controls has been reported. In particular, ERs have also been found on CD8+CD29+ CD45R0+ T lymphocytes (memory), infiltrating rheumatoid synovial tissues. Sex hormones have been found to influence macrophage activity in experimental and clinical conditions such as RA. Generally estrogens have immunostimulatory effects, whereas androgens are immuno-suppressive.(ABSTRACT TRUNCATED AT 250 WORDS)

Arthritis, Rheumatoid↗