Current Rheumatology Reviews - Volume 5, Issue 4, 2009

Not a day goes by, in my practice, without a patient asking me about a nutritional supplement or an alternative medical therapy in the treatment of their rheumatic diseases. Several published studies have shown that a majority of rheumatic disease patients use alternative therapies in their treatment regimen. As rheumatologists, we deal with patients who have chronic conditions, often painful, and our therapies seldom com Read More

Pain is the most common symptom of rheumatic diseases. Uncontrolled pain has a universal and profoundly negative effect on quality of life. There are still many unanswered questions for researchers to explore. Currently, pharmacological analgesics remain the major therapy. However, such analgesics have well-known side-effects. Various nonpharmacological approaches have been widely used as complementary therapies i Read More

Objective: To systematically review the efficacy of exercise interventions on pain relief in patients with fibromyalgia (FM). Methods: We performed a comprehensive search of 8 western databases and reference lists through March 2009. We included randomized controlled trials (RCTs) with pain as an endpoint, measured by the Fibromyalgia Impact Questionnaire (FIQ) or a visual analogue scale (VAS). The exercise treatments we Read More

Rheumatic disease pain is an important health concern that causes significant distress and functional impairment to many patients. While standard pharmacological treatments with analgesics, antidepressants, and anticonvulsants can provide substantial relief, an increasing proportion of patients are seeking an integrated approach to pain management involving both pharmacological and non-pharmacological treatments. Read More

Non-pharmacologic treatments (NPT) for patients with rheumatologic disease aim to enhance overall health and bodily function. This chapter reviews exercise (including hydrotherapy and balneotherapy), acupuncture, manipulation, massage, and assistive devices as adjunct therapy for different painful diseases including rheumatoid arthritis and fibromyalgia. While some NPTs are justified through numerous studies, other Read More

Osteoarthritis of the knee is a major cause of disability among adults worldwide. Important treatment options include nonpharmacologic therapies, and especially symptom management strategies in which patients take an active role. Among these, mind-body therapies may have particular promise for alleviating the distressful symptoms associated with osteoarthritis of the knee. However, systematic reviews are lacking. Th Read More

Many studies have suggested that metabolic or nutritional factors such as lipids [1, 2], vitamins [3, 4], and glucose [5] may contribute to the pathogenesis of arthritic diseases; however, this is a controversial topic [6-9]. The current “hot topic” of Current Rheumatology Reviews has been selected with the intent of providing readers with a recent overview of the topics pertaining to the implications of nutritional factors in ar Read More

The fatty acids of most relevance to inflammatory processes are the n-6 polyunsaturated fatty acid (PUFA) arachidonic acid, the precursor of inflammatory eicosanoids like prostaglandin E2 and leukotriene B4, and the n-3 PUFAs eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA). EPA and DHA are found in oily fish and fish oils. Eicosanoids derived from the n-6 PUFA arachidonic acid play a role in rheumatoid Read More

Along with its capacity to store energy, the white adipose tissue is a source of cytokines, called “adipocytokines” or “adipokines”, acting by paracrine, autocrine and systemic pathways. However, it is noteworthy that the source of these adipokines in physiological and/or pathological conditions is not restricted to the adipose tissue. The modulation of immunological and inflammatory pathways by adipokines has been Read More

The present paper reviews the main aspects of the health properties of Mediterranean food pattern and its components with particular regard to rheumatoid arthritis. The Mediterranean diet is based on a pattern of eating closely tied to the Mediterranean region and is characterized by an abundance of foods from plant sources, limited meat consumption, moderate amounts of fish, moderate consumption of wine and extr Read More

Dietary supplements are the most popular class of complementary and alternative medicine (CAM) in Japan. In the present review, we describe several characteristics of dietary supplement users in patients with RA in Japan, based on our recent survey. Sixty percent of RA patients used supplements. Prevalence was higher in female than in male patients, and users were younger than non-users, particularly among femal Read More

Members of the peroxisome proliferator-activated receptor (PPAR) family of nuclear receptors are key regulators of glucose and lipid metabolism. Recent studies have demonstrated that PPAR activation plays an important role in inflammatory arthritis. A variety of natural ligands including nutritional elements are known to activate PPARs, suggesting the contribution of dietary nutrients to the regulation of PPAR-mediated ge Read More

Amino acids are not only the building blocks of proteins but are also key regulators of various pathological and physiological processes, including immune responses, in living cells. However, the mechanisms responsible for these effects of amino acids are largely unknown. The regulatory roles of amino acids in the immune system can be considered from two perspectives, namely, the enhancement of the immune response tha Read More

The use of complimentary and alternative medicine (CAM) approaches is becoming increasingly popular among patients with rheumatoid arthritis (RA) and osteoarthritis (OA). Arthritis is a leading cause of work-related disabilities affecting approximately 1.0% of the United States population. The lack of adequate response combined with increased risk of adverse events to conventional therapy in RA or OA patients has prompt Read More

Benzo[a]pyrene (BaP) is a polycyclic aromatic hydrocarbon found in cigarette smoke, grilled meats and byproducts of industrial incineration. BaP exposure through cigarette smoking has been implicated in the pathogenesis of lung and head-and-neck cancers and atherosclerosis. BaP inhalation activates the aryl hydrocarbon receptor (AHR), a transcription factor that induces expression of genes involved in xenobiotic Read More