Current Rheumatology Reviews - Volume 2, Issue 3, 2006

In this issue of Current Rheumaology Reviews, Farhey and Hess review the concepts of mixed connective tissue disease (MCTD) and undifferentiated connective tissue disease (UCTD) [1]. It is now widely agreed upon the MCTD has a reproducible set of serologic findings, clinical manifestations and statistically validated defined criteria. Once thought to be a benign process, nearly 20% develop pulmonary hyperten Read More

In the last few years there has been an explosion of research into epigenetics and, in particular, the roles of DNA methylation in the normal functioning of the mammalian organism as well as whether changes in methylation status contribute to or cause aberrant gene expression in diseases. While abnormal patterns of DNA methylation in cancer cells have been intensively investigated, little attention has so far been Read More

Systemic lupus erythematosus (SLE) is a complex disease involving many different immune mechanisms, whose pathogenesis is not fully understood. In the past therapeutic interventions have employed medications with multiple immunological targets, making their use as probes of disease mechanisms difficult. For example, prednisone and cyclophosphamide, the most widely used therapies for severe disease until r Read More

Systemic sclerosis (SSc) is a connective tissue disease characterised by widespread vascular lesions and fibrosis of the skin and internal organs. Cardiac involvement is recognised as a poor prognostic factor when clinically evident. Primary myocardial involvement is common in SSc. Increasing evidence strongly suggests that myocardial involvement is related to repeated focal ischaemia leading to myocardial fibrosis Read More

Rheumatoid arthritis (RA) is a common inflammatory rheumatic disease affecting 2-3 times more women as compared to men. The peak incidence of RA in women coincides with the years around menopause when the production of estradiol (E2) and progesterone diminishes. The course of RA is also influenced by hormonal changes. The condition often ameliorates during pregnancy followed by flares after delivery. Animal studi Read More

In Mixed Connective Tissue Disease (MCTD), features of various connective tissue disorders such as systemic lupus erythematosus (SLE), systemic sclerosis (PSSc), dermatomyositis/polymyositis (DM/PM), and occasionally Sjogren's syndrome and rheumatoid arthritis (RA) can coexist and overlap. The picture is marked by the presence of high titer anti-U1 ribonucleoprotein (RNP) antibodies. Over the last 30 years since first Read More

Vascular disease is integral to the pathogenesis of connective tissue diseases. Small vessel vasculitis underlies many clinical manifestations of systemic lupus erythematosus and complicates rheumatoid arthritis and other connective tissue diseases. In contrast, in systemic sclerosis, abnormal vasomotor activity and a proliferative arterial vasculopathy are prominent. Disorders of angiogenesis have been implicated in Read More

Cardiovascular disease remains the leading cause of mortality in the United States. The increased prevalence of atherosclerotic cardiovascular disease is well established in rheumatoid arthritis and systemic lupus erythematosus. Recently, studies of other rheumatic diseases, such as the systemic vasculidities, have also demonstrated accelerated atherosclerotic disease. The detection and delineation of the inflammatory p Read More

Osteoporosis, is a clinical syndrome in which a bone mass decrement greater than that normally expected in an individual of a given age, race, and gender prevails, thus causing bones to thin, become brittle, and liable to fracture. While estrogen therapy (ET) has been applied to postmenopausal women to assist them to maintain or increase their bone density levels, or to slow down the rate at which they lose bone mass, and is ef Read More

Reactive arthritis is triggered by an infection. Much of evidence has been accumulated to prove that the causative microbes or their components may persist in the organism for extended periods, maintaining an active immune response. Therefore, the question about the value of antibiotics has been entertained by several research groups. A number of studies have demonstrated that antibiotics may be useful only if applied Read More