Rheumatoid arthritis

Rheumatoid arthritis (RA) is a common systemic, inflammatory, rheumatic disease of unknown etiology manifest by a chronic symmetric polyarthritis, particularly involving the small distal joints. Pathogenesis may involve inappropriate T-cell activation or lack of appropriate inhibition, although newer theories center on the importance of cytokines and membrane proteins that signal T-cells. Diagnosis is predicated on clinical assessment rather than extensive testing or exclusion of other illnesses, although well-known mimics of RA should be considered. The presence of objective synovitis in a "rheumatoid distribution" lasting more than 6 weeks is required for confident diagnosis. Treatment should be directed at maintaining function, reducing pain and preventing irreversible joint damage. Options include nonpharmacologic therapy, such as physical and occupational therapy, pharmacologic options such as analgesics, antiinflammatory therapies and second-line agents (or disease-modifying agents for rheumatic disease, DMARDs) and surgery. Newer approaches, including "biologics" aimed at interrupting cytokine effects and combinations of second-line agents, offer exciting potential for improving outcomes in RA. The prognosis of RA is highly variable and not reliably predictable in the individual patient early in disease.     

表皮生长因子信号转导的复杂性与生物学效应多样性

表皮生长因子(epidermal growth factor,EGF)是1955年9月美国纳什维尔市范德比大学医学院Stanley Cohen等在试验中偶然发现的一种能直接刺激表皮生长角化的因子。随后进一步证明EGF对多种组织来源的细胞增殖有明显的促进作用。由于EGF的发现及随后的研究成果,Cohen等两位科学家     

Rheumatoid factor induction in the mouse: sex differences and the effect of the sex steroids

Female CBA mice produced a significantly higher plasma rheumatoid factor (RF) response to Salmonella typhosa lipopolysaccharide than did male mice. The peak level in females was observed on day 5-6 after injection and in males on day 7-8. Elevated RF levels continued to be detected more than 30 days later. A second injection of LPS, 38 days after the first, to assess the secondary response, had no more than an additive effect on plasma RF concentration, although the day of peak response was earlier by two days in both sexes. Administration of oestradiol-17 beta by Silastic implant brought forward the day of peak response by two days in both sexes although it reduced its amplitude considerably. Testosterone had little effect on the peak concentrations achieved in both sexes, but did produce a slower decay in plasma RF level. This investigation indicates that the sex hormones can influence the response to LPS, a polyclonal B cell activator. This may have implications for the sex differences seen in autoimmune diseases.     

Dopaminergic Agents in Rheumatoid Arthritis

Journal of Neuroimmune Pharmacology - Clinical evidences suggest a causal relationship between rheumatoid arthritis (RA) and the dopaminergic system, and several studies described an alteration of...