Biomedical subjects

S Aotsuka

Publications and source records attributed to S Aotsuka.

79 records · Page 5Linked to original sources

PubMedDate not supplied

A retrospective study of the fluctuation in serum levels of anti-cyclic citrullinated peptide antibody in patients with rheumatoid arthritis.

OBJECTIVE: To investigate the fluctuation in serum levels of anti-cyclic citrullinated peptide antibody (anti-CCP) retrospectively in patients with rheumatoid arthritis (RA). METHODS: Serum levels of anti-CCP were measured retrospectively in 131 patients with RA and 90 patients with non-RA rheumatic diseases using a commercially available kit. All sera were collected from patients during the 22-year period, 1982-2004. To analyze the fluctuation in anti-CCP levels, 17 RA patients were selected on the basis of showing a significantly higher anti-CCP level in a serum sample taken at the first visit (> 80 U/ml), and availability of preserved serum samples that had been taken from each patient at 10 time points. RESULTS: The test gave a sensitivity of 88% (115/131) and a specificity of 81% (73/90). The longitudinal study of 17 RA patients showed that anti-CCP levels were elevated at the first visit in 12 (71%) patients and then decreased gradually, whereas those in the other five (29%) patients fluctuated substantially. In both cases, anti-CCP levels tended to fluctuate in parallel with the erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) level, reflecting the spontaneous aggravation of arthritis and the efficacy of anti-rheumatic drugs. The courses of three representative RA patients are illustrated in detail along with their therapeutic regimens, and these further confirm the correlation of anti-CCP levels with laboratory parameters (ESR and CRP) as well as the activity of arthritis. CONCLUSION: Measurement of serum anti-CCP levels was found to be useful for not only the diagnosis but also the management of RA.

Antibodies, Antinuclear↗

PubMedDate not supplied

Down-regulation by eel calcitonin of interleukin-1 release and production by peripheral blood monocytes from patients with rheumatoid arthritis.

To clarify the reason for the therapeutic efficacy of Elcatonin (eCT), an eel calcitonin derivative, in rheumatoid arthritis (RA), we studied the effect of eCT on the extracellular (EC) release and intracellular (IC) production of interleukin-1 (IL-1) by peripheral blood monocytes from patients with RA. In vitro treatment of RA monocytes with eCT reduced predominantly the EC release of both IL-1 alpha and IL-1 beta. Moreover, EC release and IC production of IL-1 alpha and IL-1 beta by monocytes from RA patients who received non-steroidal anti-inflammatory drugs (NSAIDs) plus eCT (CT group) were significantly lower than in those who received NSAIDs only (NSAID group). The anti-rheumatic effect of eCT may be mediated via the inhibition of EC release and the IC production of IL-1 from RA patients.

Adult↗

PubMedDate not supplied

Clinical significance of the serum lipoprotein(a) level in patients with systemic lupus erythematosus: its elevation during disease flare.

OBJECTIVE: To determine the clinical significance of serum lipoprotein(a) [Lp(a)] levels in patients with systemic lupus erythematosus (SLE). METHODS: Serum Lp(a) levels in 77 patients with SLE were measured by turbidimetric immunoassay. RESULTS: The median serum Lp(a) levels in all the SLE patients (14.4 mg/dl) and in those with active disease (Group A; 19.6 mg/dl, n = 39) at admission were significantly higher than those in healthy subjects (11.9 mg/dl, p < 0.05 and p < 0.001, respectively). The serum Lp(a) levels in SLE patients correlated directly with the serum cholesterol (p < 0.001) and urinary protein (p < 0.001) levels and inversely with the serum albumin levels (p < 0.02). Analysis limited to Group A patients with renal disease (Group A + RD, n = 28) revealed that the median serum Lp(a) level at the time of admission (OM) was significantly higher than those at 6 months before (-6M, p < 0.01) and at 6 months after admission (+6M, p < 0.01). Moreover, the serum Lp(a) level decrease from 0M to +6M in Group A+RD correlated significantly with the serum albumin level increase (p < 0.05). Multiple regression analysis demonstrated that the serum albumin level increment, the SLEDAI score decrement, the cholesterol level at 0M and the total dose of oral corticosteroids administered during the 0M to +6M period contributed independently and significantly to the serum Lp(a) level decrement from 0M to +6M in Group A + RD. CONCLUSION: Our study is the first to reveal that hypoalbuminemia appearing during disease flare plays an important role in increasing the serum Lp(a) levels in lupus patients with renal disease and shows that corticosteroid treatment reduced the elevated serum Lp(a) levels almost to original levels.

Adolescent↗

PubMedDate not supplied

Comparable histological appearance of synovitis in seropositive and seronegative rheumatoid arthritis.

OBJECTIVE AND METHODS: To compare the histological characteristics of the synovium between seropositive and seronegative rheumatoid arthritis (RA), synovial tissue was obtained from 19 patients with rheumatoid factor-positive (RF+) RA, 11 with rheumatoid factor-negative (RF-)RA and 11 non-RA controls. RESULTS: There were no differences in the frequency of each histological feature or histological scores between RF+ and RF-RA. However, significant differences in the frequency of histological findings such as lining cell proliferation and inflammatory cell infiltration were found both between RF+ RA and non-RA controls, and between RF-RA and non-RA controls. Analysis of clinical parameters and histology in all RA patients revealed that the level of serum C-reactive protein and the erythrocyte sedimentation rate were directly correlated with the inflammatory cellular infiltration score. Immunohistological staining using a monoclonal antibody against IgM rheumatoid factor (RF) was positive in some plasma cells in the synovium of both RF+ and RF-RA patients, while no IgM-RF-positive cells were observed in the synovium of non-RA controls. CONCLUSION: RF serostatus does not necessarily reflect the histology of synovial inflammation.

Antibodies, Monoclonal↗

PubMedDate not supplied

Clinical significance of serum thrombomodulin levels in patients with systemic rheumatic diseases.

OBJECTIVE: To determine the soluble thrombomodulin (TM) level in the sera of patients with systemic rheumatic diseases and to analyze its relationship with clinical and laboratory parameters in patients with systemic lupus erythematosus (SLE). METHODS: Serum levels of TM were measured by an enzyme-linked immunosorbent assay in 124 patients with SLE and in 237 patients with systemic rheumatic diseases other than SLE. RESULTS: The frequency of patients with high TM levels (> or = 4.5 FU/ml) was 21% in SLE, 16% in rheumatoid arthritis (RA), 12% in Sjögren's syndrome (SS), and 4% in systemic sclerosis (SSc). The TM levels were significantly higher in SLE patients with the following abnormalities in their past history or present illness: persistent proteinuria, cellular casts, positive anti-dsDNA antibodies (p < 0.001), hypoalbuminemia, decreased creatinine clearance (Ccr), positive anti-Sm antibody, positive immune complex, leukopenia (p < 0.01), pericarditis, oral ulcer, fluorescent anti-nuclear antibody (FANA), decreased C3 and arthralgia (p < 0.05). The serum TM levels in SLE showed a direct correlation with the urinary protein level (p < 0.01) and serum creatinine level (p < 0.01), and an inverse correlation with the serum albumin level (p < 0.01) and complement C3 level (p < 0.05). In SLE patients with active disease, the median TM level at the time of admission (5.9 FU/ml) was significantly higher than at 6 months before admission (3.8 FU/ml, p < 0.01) and at 6 months after admission (4.2 FU/ml, p < 0.001). Moreover, elevation and reduction of the TM level in lupus patients with active disease parallelled that of the SLE disease activity index (SLEDAI). In two representative SLE cases, one with lupus nephritis (LN) and the other with thrombocytopenia without LN, elevated TM levels at disease flare were reduced along with the amelioration of the disease by administration of corticosteroids. CONCLUSIONS: The serum TM level is closely associated with SLE activity and appears to be useful as a new disease activity parameter of SLE.

Adult↗

PubMedDate not supplied

Progressive multifocal leukoencephalopathy resembling central nervous system systemic lupus erythematosus.

A 21-year-old woman with a 6-year history of SLE presented with a speech disturbance and right hand clumsiness along with manifestations of active disease suggesting central nervous system SLE. Despite aggressive treatment for SLE, her neurological condition worsened. MRI demonstrated low intensity in T1-weighted images and high intensity in T2-weighted images in the white matter of the bilateral cerebrum and cerebellum, compatible with progressive multifocal leukoencephalopathy (PML). Intraspinal administration of interferon-beta seemed to slow the deterioration of her MRI and neurological findings. However, she eventually developed decerebrate rigidity and died due to candidemia. DNA of the JC virus was detected in the autopsied brain by the polymerase chain reaction technique. PML should always be borne in mind when examining patients with SLE showing neurological abnormalities.

Adult↗

PubMedDate not supplied

Increased levels of matrix metalloproteinase-3 in sera from patients with active lupus nephritis.

OBJECTIVE: To determine the matrix metalloproteinase-3 (MMP-3) levels in sera from patients with systemic lupus erythematosus (SLE) and to analyse the relationships between MMP-3 and clinical and laboratory features. METHODS: Serum MMP-3 levels were measured by an enzyme immunoassay in 124 patients with SLE and 237 patients with other systemic rheumatic diseases. RESULTS: The frequencies of patients with high MMP-3 levels were 76% in SLE and 82% in rheumatoid arthritis (RA). The level of MMP-3 in the SLE patients was 193.0 +/- 171.5 ng/ml (mean +/- SD) and was almost equal to the level in the RA patients (259.5 +/- 255.6 ng/ml). The MMP-3 levels were significantly higher in SLE patients who had a history of the following abnormalities: persistent proteinuria, cellular casts, anti-double stranded DNA antibodies, decreased C3, decreased creatinine clearance (p < 0.001), circulating immune complex (p < 0.01), malar rash, hypoalbuminemia, or decreased C4 (p < 0.05). The serum MMP-3 level in patients with SLE at admission showed direct correlations with serum uric acid, total cholesterol (p < 0.001), triglyceride, the white blood cell count, and the neutrophil count (p < 0.05), as well as inverse correlations with the total protein (p < 0.01), and IgG (p < 0.05). In SLE patients with active renal disease, the median MMP-3 level at admission and that at 6 months after admission were significantly higher than that at 6 months before admission. CONCLUSIONS: The increased level of serum MMP-3 in SLE is closely associated with clinical features relevant to lupus nephritis, suggesting that it plays a role in the pathogenesis of this condition.

Adolescent↗