Current Rheumatology Reviews - Volume 3, Issue 4, 2007

One of the most frustrating complications of Behcet's disease is the ‘Neuro-Behcet's Syndrome’. Manifested by a combination of factors including headache, motor symptoms, cerebeller dysfunction, dysarthria, sensory alterations, cognitive impairment, seizures and peripheral neuropathy, its management has not adequately been explored. Historically, neuro-Behcet's has been managed with colchicine, corticosteroids, and im Read More

Gene expression studies represent a new and challenging approach that allows molecular dissection of complex diseases such as rheumatoid arthritis (RA). Optimally, gene analysis should be conducted in isolated populations of cells so that the differential gene expression may be directly correlated with transcription of genes. RA fibroblasts constitute the majority of the expanding synovial cell mass in the RA joint, and alter Read More

Pyridinoline is a crosslink synthesized in collagen that has generally been used as a biochemical marker for bone metabolism. In addition, as pyridinoline is more abundant in cartilage and synovium than in the other tissues, there is extensive literature describing pyridinoline as a biochemical marker for cartilage destruction and metabolism, or arthritis. This paper will review the use of pyridinoline as a biochemical Read More

It is well recognised that age is a primary risk factor for the development of osteoarthritis (OA), but the mechanisms by which ageing contributes to an increased susceptibility to OA are poorly understood. Reactive oxygen species seem to play a key role in this process by acting on cellular and extracellular levels. According to the redox status of the biological medium, they can be regulators or dysregulators of the mitochondrial Read More

In rheumatoid arthritis (RA), the chronically inflamed joint undergoes profound phenotypical changes. Aside synovial inflammation and cartilage degeneration, subchondral bone erosions emerge early in the course of disease and are associated with functional impairment in RA patients. Chronic joint inflammation injures the bone as consequence of two key pathophysiological mechanisms: On the one hand, the proliferati Read More

Systemic lupus erythematosus (SLE) is a serious medical illness with frequent renal involvement at disease onset. Although predominantly affecting young women, SLE often first presents during childhood. Previous studies have suggested that patients with disease onset in childhood have a worse prognosis. Renal involvement in SLE is the major determinant of long-term outcome; the ten-year survival in children with lupus n Read More

Systemic sclerosis (SSc) has a genetic component as demonstrated by familial clustering, by twin studies (showing higher concordance for antinuclear antibody positivity among monozygotic versus dizygotic pairs), and by HLA associations. Identification of the specific genes involved and their mechanism of conferring disease susceptibility or influencing disease expression is under intense study. Several polymorphisms in Read More

Neuro-Behcet's syndrome consists of acute type and chronic progressive type (primary progressive and secondary progressive). Attacks of acute type neuro-Behcet's syndrome are sometimes self-limiting. However, when the neurological manifestations are progressive and severe, administration of corticosteroid is necessary. In addition, infliximab and interferon alpha might also be effective in acute type neuro-Beh Read More

Patients with functional somatic syndromes such as fibromyalgia (FM) and chronic fatigue syndrome (CFS) are frequently seen in primary care as well as in various medical specialties. Despite a controversy between ‘lumpers’ and ‘splitters’ regarding these syndromes, many authors assume that FM and CFS patients show more communalities than differences. Stress system dysfunctioning and associated abnormal pain proce Read More

Rheumatoid vasculitis (RV) is an uncommon but severe complication of rheumatoid arthritis (RA) that can cause skin disorders, such as rash, cutaneous ulcerations and gangrene, neuropathy, eye symptoms, and systemic inflammation. Although the molecular mechanisms underlying RV in RA are unclear, it is well known that a chronic imbalance in the expression of chemokines and proinflammatory cytokines is important Read More

New cartilage and bone formation potentially leading to joint and spine ankylosis is an important feature of the human spondyloarthritides. Increasing evidence suggests that inflammation and remodeling of the joint are at least partially independent processes. Patient cohort data have not demonstrated an effect of the current therapeutic strategies, including anti-tumor necrosis factor on these important aspects of spo Read More