PubMed · 2669600
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J M Jacquemier, M Pages, S Lassoued. 1989. [Methotrexate in rheumatic practice].. https://pubmed.ncbi.nlm.nih.gov/2669600/
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HLA-B27 confers a very strong genetic predisposition to development of a reactive arthritis after infection by bacteria such as Salmonella typhimurium. This study examines the role of HLA-B27 in the initiation of the earliest host activities after exposure to Salmonella, namely activation of the immediate early genes in the epithelial cells. Our major finding is that in Hela cells, the expression of c-fos was induced by Salmonella invasion only when the cells expressed the transfected HLA-B27 gene, but not the HLA-A1 gene or a truncated HLA-B27 gene lacking the exons encoding the cytoplasmic domain. C-fos is potentially capable of complexing with members of the c-jun family to become the AP-1 transcription complex. Parallel to c-fos expression, we found that only with the HLA-B27 transfectant was there expression of AP-1. AP-1 potentially controls the expression of a large number of genes. On screening a panel of proinflammatory molecules, we found that Salmonella invasion induced expression of monocyte chemoattractant protein-1 in the HLA-B27 cells. Since each of these separate positive findings belong to the same cascade of events after cell activation, together they reinforce the hypothesis that HLA-B27 plays a modulatory role in the early signal transduction events induced by Salmonella invasion. This hypothesis adds another item to the list of allele-specific activities carried out by HLA class I molecules. If similar activation also occurs in the joints, it may play a major role in arthritis.
OBJECTIVE: To determine whether an intervention by trained persons with arthritis could have a positive impact on retention of information, confidence, and examination skills of medical students. METHODS: Second-year medical students were introduced to the musculoskeletal examination as part of their Introduction to Clinical Medicine course by viewing a video (n = 93) or were taught the joint examination by a trained arthritis educator after viewing the video (n = 88). Each group was tested before and after the intervention about arthritis information, confidence, and attitude about arthritis and also evaluated for the ability to carry out a musculoskeletal examination. RESULTS: Retention of information and confidence of both groups increased as a result of the intervention. However, students who received the arthritis educator intervention increased their scores significantly in comparison. Musculoskeletal examination skills of the students receiving the arthritis educator intervention were also significantly greater than the control group. CONCLUSION: An intervention by arthritis educators improved the retention of information, confidence, and examination skills of second-year medical students significantly compared with the standard educational approach. The impact of the intervention persisted for at least two weeks.