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1.
Korean Journal of Medicine ; : 337-340, 2021.
Article in Korean | WPRIM | ID: wpr-902246

ABSTRACT

Anti-nuclear antibodies (ANAs) are autoantibodies against nuclear substances or other cellular components. ANA tests are used in the diagnostic process to screen patients with suspected rheumatic or autoimmune diseases. ANA-associated diseases are characterized by a high titer of antinuclear antibodies and include systemic lupus erythematosus, systemic sclerosis, and mixed connective tissue diseases. ANA test results must be cautiously interpreted as they can be positive not only in infections and oncological diseases but also for the healthy general population. The ANA test mainly uses the indirect immunofluorescence test, and the results are expressed in terms of the final titer and pattern. The ANA test can increase diagnostic value when used in conjunction with the evaluation of disease-related clinical symptoms.

2.
Journal of Rheumatic Diseases ; : 225-233, 2021.
Article in English | WPRIM | ID: wpr-900590

ABSTRACT

Objective@#Both hypouricemia and hyperuricemia are reportedly associated with reduced kidney function. This study investigated the association between uric acid levels and the risk of reduced renal function in men and women. @*Methods@#We conducted a cross-sectional study using data from a government-funded health examinee cohort of a Korean genome and epidemiological study. A total of 172,970 participants (58,981 men, 113,989 women) aged 40∼79 years were included. A logistic regression test was performed, and the odds ratio (OR) and 95% confidence interval (CI) were calculated to examine the relationship between stratified uric acid levels and the frequency of chronic kidney disease. @*Results@#As the uric acid level increased, the risk of reduced renal function increased. Moreover, for uric acid levels ≤2.0 mg/dL, the risk of reduced renal function was higher than that of the reference group. Among the total, man, and woman groups, a statistically significant association was observed in men (OR 1.71, 95% CI 0.945∼3.111, OR 5.003, 95% CI 1.405∼17.809, and OR 1.377, 95% CI 0.696∼2.724, respectively). @*Conclusion@#The OR of reduced renal function according to uric acid levels formed a J-shaped curve in both genders.

3.
Journal of Rheumatic Diseases ; : 143-149, 2021.
Article in English | WPRIM | ID: wpr-900582

ABSTRACT

Objective@#High disease activity of ankylosing spondylitis (AS) is associated with poor sleep quality. The purpose of this study was to identify which of the representative tools for evaluating the disease activity of AS best reflect the quality of sleep. @*Methods@#A total of 107 AS patients were enrolled in the study and the sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Age, sex, concomitant medication, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) level, Beck Depression Inventory second edition (BDI-II), Bath ankylosing spondylitis disease activity index (BASDAI), ankylosing spondylitis disease activity score (ASDAS)-ESR, ASDAS-CRP, pain visual analog scale, Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) were analyzed as covariates. @*Results@#Overall, 65% (70/107) of subjects reported poor sleep quality (PSQI>5). There was a positive correlation between the sleep quality and disease activity as measured by the BASDAI, ASDAS-ESR, and ASDAS-CRP. In addition, the BASDAI demonstrated good correlations with ISI, ESS, and BDI-II, respectively. However, only BASDAI showed reliable correlation with PSQI among the disease activity parameters of AS (adjusted odd ratio 5.36, p=0.023). @*Conclusion@#BASDAI is the most reliable parameter of disease activity associated with the sleep quality in patients with AS.

4.
Journal of Rheumatic Diseases ; : 225-233, 2021.
Article in English | WPRIM | ID: wpr-892886

ABSTRACT

Objective@#Both hypouricemia and hyperuricemia are reportedly associated with reduced kidney function. This study investigated the association between uric acid levels and the risk of reduced renal function in men and women. @*Methods@#We conducted a cross-sectional study using data from a government-funded health examinee cohort of a Korean genome and epidemiological study. A total of 172,970 participants (58,981 men, 113,989 women) aged 40∼79 years were included. A logistic regression test was performed, and the odds ratio (OR) and 95% confidence interval (CI) were calculated to examine the relationship between stratified uric acid levels and the frequency of chronic kidney disease. @*Results@#As the uric acid level increased, the risk of reduced renal function increased. Moreover, for uric acid levels ≤2.0 mg/dL, the risk of reduced renal function was higher than that of the reference group. Among the total, man, and woman groups, a statistically significant association was observed in men (OR 1.71, 95% CI 0.945∼3.111, OR 5.003, 95% CI 1.405∼17.809, and OR 1.377, 95% CI 0.696∼2.724, respectively). @*Conclusion@#The OR of reduced renal function according to uric acid levels formed a J-shaped curve in both genders.

5.
Journal of Rheumatic Diseases ; : 143-149, 2021.
Article in English | WPRIM | ID: wpr-892878

ABSTRACT

Objective@#High disease activity of ankylosing spondylitis (AS) is associated with poor sleep quality. The purpose of this study was to identify which of the representative tools for evaluating the disease activity of AS best reflect the quality of sleep. @*Methods@#A total of 107 AS patients were enrolled in the study and the sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI). Age, sex, concomitant medication, erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP) level, Beck Depression Inventory second edition (BDI-II), Bath ankylosing spondylitis disease activity index (BASDAI), ankylosing spondylitis disease activity score (ASDAS)-ESR, ASDAS-CRP, pain visual analog scale, Insomnia Severity Index (ISI), and Epworth Sleepiness Scale (ESS) were analyzed as covariates. @*Results@#Overall, 65% (70/107) of subjects reported poor sleep quality (PSQI>5). There was a positive correlation between the sleep quality and disease activity as measured by the BASDAI, ASDAS-ESR, and ASDAS-CRP. In addition, the BASDAI demonstrated good correlations with ISI, ESS, and BDI-II, respectively. However, only BASDAI showed reliable correlation with PSQI among the disease activity parameters of AS (adjusted odd ratio 5.36, p=0.023). @*Conclusion@#BASDAI is the most reliable parameter of disease activity associated with the sleep quality in patients with AS.

6.
The Korean Journal of Internal Medicine ; : S264-S272, 2021.
Article in English | WPRIM | ID: wpr-875496

ABSTRACT

Background/Aims@#We investigated the distribution of serum uric acid (SUA) levels and estimated the prevalence of hyperuricemia and hypouricemia in the Korean population. @*Methods@#This cross-sectional study used data from the Korean Genome and Epidemiology Study and included 172,970 participants (58,981 men and 113,989 women) aged 40 to 79 years. Hypouricemia and hyperuricemia were defined as SUA level ≤ 2.0 mg/dL and > 7 mg/dL, respectively. The prevalence of hyperuricemia and hypouricemia was evaluated by age and sex. @*Results@#The mean SUA levels were significantly higher in men than in women (5.71 ± 1.27 mg/dL vs. 4.21 ± 0.96 mg/dL, p < 0.001). The mean SUA levels and prevalence of hyperuricemia increased with age in women but not in men. The overall prevalence of hyperuricemia and that in men and women was 50.82, 133.25, and 8.17 per 1,000 persons, respectively; the overall prevalence of hypouricemia and that in men and women was 4.16, 1.10, and 5.75 per 1,000 persons, respectively. The prevalence of hypouricemia in men was similar across all age groups; however, that in women was the highest in the age group of 40 to 49 years and the lowest in the age group of 50 to 59 years. @*Conclusions@#The distribution of SUA levels and prevalence of hyperuricemia and hypouricemia differed according to age and sex. Age and sex should be considered in studies on uric acid-related diseases.

7.
Korean Journal of Medicine ; : 337-340, 2021.
Article in Korean | WPRIM | ID: wpr-894542

ABSTRACT

Anti-nuclear antibodies (ANAs) are autoantibodies against nuclear substances or other cellular components. ANA tests are used in the diagnostic process to screen patients with suspected rheumatic or autoimmune diseases. ANA-associated diseases are characterized by a high titer of antinuclear antibodies and include systemic lupus erythematosus, systemic sclerosis, and mixed connective tissue diseases. ANA test results must be cautiously interpreted as they can be positive not only in infections and oncological diseases but also for the healthy general population. The ANA test mainly uses the indirect immunofluorescence test, and the results are expressed in terms of the final titer and pattern. The ANA test can increase diagnostic value when used in conjunction with the evaluation of disease-related clinical symptoms.

8.
Korean Journal of Medicine ; : 170-175, 2020.
Article | WPRIM | ID: wpr-836670

ABSTRACT

Systemic lupus erythematosus (SLE) is a chronic inflammatory autoimmune disease that affects various organs. SLE patients have an increased risk of infection compared to the general population. Immunosuppressive agents commonly used in SLE increase the risk of infection. Vaccination is a good way to reduce the risk of infection. However, some SLE patients are concerned that vaccination may worsen lupus disease activity or cause side effects. The latest SLE patient vaccination data were reviewed in this study, which focused on the safety, immunogenicity, and efficacy of influenza, pneumococcal, tetanus, hepatitis A, herpes zoster, and human papillomavirus vaccines. Korean immunization recommendations were also compared to those of other countries.

9.
The Korean Journal of Internal Medicine ; : 998-1003, 2020.
Article | WPRIM | ID: wpr-831811

ABSTRACT

Background/Aims@#The safety and efficacy of febuxostat in patients with stage 4–5 chronic kidney disease (CKD) are still unclear owing to a lack of studies in these patients. Therefore, we aimed to evaluate the effect of febuxostat on renal function, general safety, and efficacy in gout patients with stage 4–5 CKD. @*Methods@#Among 739 patients who had been administered febuxostat from May 2012 to December 2016 at a single hospital in Korea, 370 patients who had been monitored for 1 year were analyzed. Serum uric acid levels and estimated glomerular filtration rate (eGFR) of patients with gouty arthritis were collected at baseline and 1 year after febuxostat administration. @*Results@#Among the 370 patients, 280 patients were stage 1–3 CKD, 63 patients were stage 4–5 CKD, and 27 patients were on dialysis. The eGFR of 63 patients with stage 4–5 CKD, excluding dialysis patients, was 19.84 ± 7.08 mL/min/1.73 m2 when they began to take febuxostat and 23.49 ± 16.67 mL/min/1.73 m2 after 12 months (p = 0.13). The urate-lowering effect after 12 months of febuxostat medication showed statistical significance (8.96 ± 2.31 mg/dL at baseline and 4.88 ± 1.68 mg/dL after 12 months, p < 0.01). The difference in incidence of adverse events among patients with stage 1–3 CKD, those with stage 4–5 CKD, and those on dialysis was not significant. @*Conclusions@#Febuxostat demonstrated renal safety and good urate-lowering efficacy in gout patients with stage 4–5 CKD, who are not yet on dialysis.

10.
Osteoporosis and Sarcopenia ; : 173-178, 2020.
Article in English | WPRIM | ID: wpr-903014

ABSTRACT

Objectives@#Osteoporosis and fracture are known complications of systemic lupus erythematosus (SLE). We assessed the prevalence and risk factors for osteoporosis in patients with SLE. @*Methods@#A total of 155 female SLE patients were recruited retrospectively in 5 university hospitals. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and the fracture risk assessment tool (FRAX) for high-risk osteoporotic fractures was calculated with and without BMD. @*Results@#The mean age was 53.7 ± 6.8 years, and osteoporotic fractures were detected in 19/127 (15.0%) patients. The proportion of patients having a high-risk for osteoporotic fractures in the FRAX with and without BMD, and osteoporosis by the World Health Organization (WHO) criteria were 25 (16.1%), 24 (15.5%), and 51 (32.9%), respectively, and 48.0–68.6% of them were receiving treatment. On multivariate logistic analysis, nephritis (odds ratio [OR] 11.35) and cumulative dose of glucocorticoid (OR 1.1) were associated with high-risk by the FRAX with BMD, and low complement levels (OR 4.38), erythrocyte sedimentation rate (ESR) (OR 1.04), and cumulative dose of glucocorticoid (OR 1.05) were associated with osteoporosis by the WHO criteria in patients with SLE. @*Conclusions@#Among Korean female patients with SLE, the proportion of patients having a high-risk of osteoporotic fractures by the FRAX tool was 15.5%–16.1% and the proportion of patients having osteoporosis by the WHO criteria was 32.9%. In SLE, nephritis, low level of complement, ESR, and cumulative dose of glucocorticoids may contribute to fracture risk.

11.
Journal of Rheumatic Diseases ; : 96-99, 2020.
Article in English | WPRIM | ID: wpr-816664

ABSTRACT

OBJECTIVE: This study aimed to evaluate the relationship between serum immunoglobulin G4 (IgG4) levels and the presence and disease activity of rheumatoid arthritis (RA).METHODS: The study enrolled 128 participants (RA, 96; healthy controls, 17; osteoarthritis, 11; and IgG4-related disease, 4) between March 2014 and July 2017. Blood samples were collected prior to the commencement of treatment, and serum IgG4 levels were determined using a nephelometric assay (levels ≥135 mg/dL were considered elevated). The levels of serum IgG4 and the ratio of IgG4/total IgG in patients with RA were compared with those in healthy controls, patients with osteoarthritis, and patients with IgG4-related disease. Furthermore, the relationship between serum IgG4 levels and RA disease activity was evaluated.RESULTS: Among the 96 patients with RA, the mean (±standard deviation) serum IgG4 level was 48.0±45.4 mg/dL; 6 (6.3%) patients had elevated serum IgG4 levels. However, none of the healthy controls or patients with osteoarthritis had elevated serum IgG4 levels. The mean serum IgG4/IgG ratio in patients with RA was 3.5%±2.8% (range, 0.2%~16.9%). Using Spearman's correlation coefficient analysis, a significant correlation was found between serum IgG4 levels and the Disease Activity Score-28 with erythrocyte sedimentation rate (r, 0.245; p=0.016).CONCLUSION: There was an increased frequency of elevated serum IgG4 levels in patients with RA, and the levels were correlated with RA disease activity.

12.
Osteoporosis and Sarcopenia ; : 173-178, 2020.
Article in English | WPRIM | ID: wpr-895310

ABSTRACT

Objectives@#Osteoporosis and fracture are known complications of systemic lupus erythematosus (SLE). We assessed the prevalence and risk factors for osteoporosis in patients with SLE. @*Methods@#A total of 155 female SLE patients were recruited retrospectively in 5 university hospitals. The bone mineral density (BMD) was measured by dual-energy X-ray absorptiometry, and the fracture risk assessment tool (FRAX) for high-risk osteoporotic fractures was calculated with and without BMD. @*Results@#The mean age was 53.7 ± 6.8 years, and osteoporotic fractures were detected in 19/127 (15.0%) patients. The proportion of patients having a high-risk for osteoporotic fractures in the FRAX with and without BMD, and osteoporosis by the World Health Organization (WHO) criteria were 25 (16.1%), 24 (15.5%), and 51 (32.9%), respectively, and 48.0–68.6% of them were receiving treatment. On multivariate logistic analysis, nephritis (odds ratio [OR] 11.35) and cumulative dose of glucocorticoid (OR 1.1) were associated with high-risk by the FRAX with BMD, and low complement levels (OR 4.38), erythrocyte sedimentation rate (ESR) (OR 1.04), and cumulative dose of glucocorticoid (OR 1.05) were associated with osteoporosis by the WHO criteria in patients with SLE. @*Conclusions@#Among Korean female patients with SLE, the proportion of patients having a high-risk of osteoporotic fractures by the FRAX tool was 15.5%–16.1% and the proportion of patients having osteoporosis by the WHO criteria was 32.9%. In SLE, nephritis, low level of complement, ESR, and cumulative dose of glucocorticoids may contribute to fracture risk.

13.
Immune Network ; : e4-2019.
Article in English | WPRIM | ID: wpr-740210

ABSTRACT

Long noncoding RNAs (lncRNAs) are non-protein coding RNAs of more than 200 nucleotides in length. Despite the term “noncoding”, lncRNAs have been reported to be involved in gene expression. Accumulating evidence suggests that lncRNAs play crucial roles in the regulation of immune system and the development of autoimmunity. lncRNAs are expressed in various immune cells including T lymphocytes, B lymphocytes, macrophages, neutrophils, dendritic cells, and NK cells, and are also involved in the differentiation and activation of these immune cells. Here, we review recent studies on the role of lncRNAs in immune regulation and the differential expression of lncRNAs in various autoimmune diseases.


Subject(s)
Autoimmune Diseases , Autoimmunity , B-Lymphocytes , Clinical Coding , Dendritic Cells , Gene Expression , Immune System , Killer Cells, Natural , Macrophages , Neutrophils , Nucleotides , RNA , RNA, Long Noncoding , T-Lymphocytes
14.
Allergy, Asthma & Immunology Research ; : 212-221, 2019.
Article in English | WPRIM | ID: wpr-739400

ABSTRACT

PURPOSE: Nonsteroidal anti-inflammatory drugs (NSAIDs) are common cause of severe cutaneous adverse reactions (SCARs). The present study aimed to investigate the characteristics of SCARs induced by NSAIDs in the Korean SCAR registry. METHODS: A retrospective survey of NSAID-induced SCARs recorded between 2010 and 2015 at 27 university hospitals in Korea was conducted. Clinical phenotypes of SCARs were classified into Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), SJS-TEN overlap syndrome and drug reaction with eosinophilia and systemic symptoms (DRESS). Causative NSAIDs were classified into 7 groups according to their chemical properties: acetaminophen, and propionic, acetic, salicylic, fenamic and enolic acids. RESULTS: A total of 170 SCARs, consisting of 85 SJS, 32 TEN, 17 SJS-TEN overlap syndrome and 36 DRESS reactions, were induced by NSAIDs: propionic acids (n=68), acetaminophen (n=38), acetic acids (n=23), salicylic acids (n=16), coxibs (n=8), fenamic acids (n=7), enolic acids (n=5) and unclassified (n=5). Acetic acids (22%) and coxibs (14%) accounted for higher portions of DRESS than other SCARs. The phenotypes of SCARs induced by both propionic and salicylic acids were similar (SJS, TEN and DRESS, in order). Acetaminophen was primarily associated with SJS (27%) and was less involved in TEN (10%). DRESS occurred more readily among subjects experiencing coxib-induced SCARs than other NSAID-induced SCARs (62.5% vs. 19.7%, P = 0.013). The mean time to symptom onset was longer in DRESS than in SJS or TEN (19.1 ± 4.1 vs. 6.8 ±1.5 vs. 12.1 ± 3.8 days). SCARs caused by propionic salicylic acids showed longer latency, whereas acetaminophen- and acetic acid-induced SCARs appeared within shorter intervals. CONCLUSIONS: The present study indicates that the phenotypes of SCARs may differ according to the chemical classifications of NSAIDs. To establish the mechanisms and incidences of NSAID-induced SCARs, further prospective studies are needed.


Subject(s)
Acetaminophen , Acetates , Acetic Acid , Anti-Inflammatory Agents, Non-Steroidal , Cicatrix , Classification , Cyclooxygenase 2 Inhibitors , Diethylpropion , Drug Hypersensitivity , Drug Hypersensitivity Syndrome , Hospitals, University , Incidence , Korea , Phenotype , Propionates , Prospective Studies , Retrospective Studies , Salicylates , Salicylic Acid , Stevens-Johnson Syndrome
15.
Allergy, Asthma & Immunology Research ; : 709-722, 2019.
Article in English | WPRIM | ID: wpr-762152

ABSTRACT

PURPOSE: Severe cutaneous adverse reactions (SCARs), including Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and drug reaction with eosinophilia and systemic symptoms (DRESS) to antiepileptic drug (AED), are rare, but result in significant morbidity and mortality. We investigated the major culprit drugs, clinical characteristics, and clinical course and outcomes of AED-induced SCARs using a nationwide registry in Korea. METHODS: A total of 161 patients with AED-induced SCARs from 28 referral hospitals were analyzed. The causative AEDs, clinical characteristics, organ involvements, details of treatment, and outcomes were evaluated. We compared the clinical and laboratory parameters between SJS/TEN and DRESS according to the leading causative drugs. We further determined risk factors for prolonged hospitalization in AED-induced SCARs. RESULTS: Carbamazepine and lamotrigine were the most common culprit drugs causing SCARs. Valproic acid and levetiracetam also emerged as the major causative agents. The disease duration and hospital stay in carbamazepine-induced SJS/TEN were shorter than those in other AEDs (P< 0.05, respectively). In younger patients, lamotrigine caused higher incidences of DRESS than other drugs (P= 0.045). Carbamazepine, the most common culprit drug for SCARs, was associated with a favorable outcome related with prolonged hospitalization in SJS (odds ratio, 0.12; 95% confidence interval, 0.02-0.63, P= 0.12), and thrombocytopenia was found to be a risk factor for prolonged hospitalization in DRESS. CONCLUSION: This was the first large-scale epidemiological study of AED-induced SCARs in Korea. Valproic acid and levetiracetam were the significant emerging AEDs causing SCARs in addition to the well-known offending AEDs such as carbamazepine and lamotrigine. Carbamazepine was associated with reduced hospitalization, but thrombocytopenia was a risk factor for prolonged hospitalization. Our results suggest that the clinical characteristics and clinical courses of AED-induced SCARs might vary according to the individual AEDs.


Subject(s)
Humans , Anticonvulsants , Carbamazepine , Cicatrix , Drug Hypersensitivity Syndrome , Epidemiologic Studies , Hospitalization , Incidence , Korea , Length of Stay , Mortality , Referral and Consultation , Risk Factors , Stevens-Johnson Syndrome , Thrombocytopenia , Valproic Acid
17.
The Korean Journal of Internal Medicine ; : 823-828, 2018.
Article in English | WPRIM | ID: wpr-715650

ABSTRACT

BACKGROUND/AIMS: Anti-C-reactive protein (CRP) antibody has been introduced as a potential biologic marker in Systemic lupus erythematosus (SLE). The aim of study is to evaluate the level of anti-CRP antibody in patients with SLE. METHODS: This study investigated the relationship between levels of anti-CRP antibodies and disease activity markers, such as complement, anti-double-stranded DNA antibody, and SLE disease activity index in 34 patients with SLE. RESULTS: The serum anti-CRP antibody levels of the patients with SLE were significantly higher than those of the healthy controls (11.3 ± 5.6 µg/mL vs. 9.1 ± 2.8 µg/mL). The percentages of the positive anti-CRP antibody were 52.9% in SLE and 27.8% in controls. Disease duration of SLE showed significant correlation with the anti-CRP antibody (r = 0.234, p = 0.026). However no significant relationship was observed between the levels of anti-CRP antibodies and disease activity markers. CONCLUSIONS: These data show that the anti-CRP antibody levels of the patients with SLE were significantly higher than those of healthy controls. We observed that the presence of the anti-CRP anti-CRP antibody was not associated with disease activity of SLE.


Subject(s)
Humans , Antibodies , Biomarkers , Complement System Proteins , DNA , Lupus Erythematosus, Systemic
18.
The Korean Journal of Internal Medicine ; : 203-210, 2018.
Article in English | WPRIM | ID: wpr-918998

ABSTRACT

BACKGROUND/AIMS@#To investigate medication nonadherence in Korean patients with rheumatoid arthritis (RA) and analyze related factors.@*METHODS@#A total of 292 patients with RA participated in this study. Medication nonadherence, intentional or unintentional, was gauged via self-reported questionnaire. Patient perceptions of illness, treatment beliefs, and moods were measured via Brief Illness Perception Questionnaire, Beliefs about Medicines Questionnaire, and Patient Health Questionnaire-2, respectively. Demographic and clinical data were also collected. Multinomial regression analysis was used to assess the impact of demographic, clinical, and psychological factors on medication nonadherence.@*RESULTS@#The medication nonadherence rate was 54.1% (intentional, 21.6%; unintentional, 32.5%). Intentional nonadherence was reported most often in patients treated daily drugs (nonsteroidal anti-inflammatory drugs and/or disease-modifying antirheumatic drugs) (24.2%), and unintentional nonadherence was highest in patients receiving methotrexate (33.3%) (p = 0.872). In univariate analysis, beliefs in necessity and concerns of medication differed significantly in adherent and nonadherent patients (intentional or unintentional). When controlling for other factors that may impact medication nonadherence, less belief in necessity of medication (odds ratio [OR], 0.81; 95% confidence interval [CI], 0.68 to 0.95) and greater emotional response to disease (OR, 1.19; 95% CI, 1.01 to 1.40) were important predictors of intentional nonadherence.@*CONCLUSIONS@#Medication nonadherence is common in Korean patients with RA. Less belief in necessity of medication and greater emotional response to disease were identified as key factors prompting intentional nonadherence. These factors may be strategically targeted to improve medication adherence rates and subsequent clinical outcomes.

19.
The Korean Journal of Internal Medicine ; : 612-621, 2018.
Article in English | WPRIM | ID: wpr-714630

ABSTRACT

BACKGROUND/AIMS: Grape seed proanthocyanidin extract (GSPE) has been reported to have a beneficial effect on regulating inf lammation. However, the anti-inflammatory mechanism of GSPE remains unclear. The aim of this study was to verify the influence of GSPE on the Toll-like receptor 4 (TLR4)-mediated signaling pathway in the regulation of murine autoimmune arthritis. METHODS: Collagen-induced arthritis (CIA) was induced in dilute brown non-agouti (DBA)/1J mice. The mice were treated with GSPE (0 or 100 mg/kg) intraperitoneally. The severity of arthritis was assessed clinically, biochemically, and histologically. Immunostaining for TLR4 was performed. The expressions of TLR4 and downstream signaling molecules were analyzed by Western blot. The effect of GSPE on lipopolysaccharide (LPS)-induced TLR4 activation was also evaluated using RAW264.7 cells and fibroblast-like synoviocytes (FLSs) from patients with rheumatoid arthritis and from those with osteoarthritis. RESULTS: GSPE attenuated the clinical severity of arthritis and decreased histological damage. GSPE treatment reduced the number of TLR4-stained cells in the synovium of mice with CIA. GSPE also downregulated the expression of TLR4, myeloid differentiation factor 88 (MyD88) and phosphorylated IκBα synovial protein in CIA mice. Concurrently, GSPE inhibited the nuclear translocation of nuclear factor-κB (NF-κB) subunits (p65 and p50). LPS-induced TLR4 activation was suppressed by GSPE in human FLS as well as in murine macrophages in vitro. CONCLUSIONS: Our results demonstrated that GSPE ameliorated CIA by regulating the TLR4-MyD88-NF-κB signaling pathway.


Subject(s)
Animals , Humans , Mice , Arthritis , Arthritis, Experimental , Arthritis, Rheumatoid , Blotting, Western , In Vitro Techniques , Macrophages , Myeloid Differentiation Factor 88 , Osteoarthritis , Synovial Membrane , Toll-Like Receptor 4 , Vitis
20.
Tissue Engineering and Regenerative Medicine ; (6): 297-306, 2017.
Article in English | WPRIM | ID: wpr-643925

ABSTRACT

Wound healing is composed of a complex process that requires harmonies of various cell populations where fibroblasts play the main role. Oligomeric procyanidins (OPC) are main components of grape (Vitis vinifera) seed extracts, and recent studies showed OPC's effects on inflammation, cell migration, and proliferation. We investigated the effect of OPC on fibroblasts to regulate wound healing process. Human dermal fibroblast known as Hs27 cells were treated with various concentrations of OPC (0, 2.5, 5, 10, and 20 µg/µl). Cell cytotoxicity was evaluated by the Cell Counting Kit assay, and the expression levels of secreted procollagen were analyzed. Procollagen levels in OPC treated cells exposed to transforming growth factor beta 1 (TGF-β1) or ascorbic acid were evaluated using Western blot and immunocytochemistry. Relative mRNA expressions of procollagen, molecular chaperone such as HSP47, P4H were determined by real-time PCR in OPC treated cells. OPC showed no cytotoxicity on Hs27 cells at every concentration but inhibited procollagen secretion in a dose-dependent manner. The inhibitory effect also appeared under TGF-β1 induced collagen overproduction. Immunocytochemistry showed that higher levels of intracytoplasmic procollagen were accumulated in TGF-β1 treatment group, whereas ascorbic acid induced a release of accumulated procollagen under OPC treatment. The mRNA expressions of procollagen, molecular chaperone were not affected by OPC, but procollagen level was increased when exposed to TGF-β1. OPC inhibits procollagen secretion from fibroblasts with no effects on cell proliferations even under the environment of TGF-b1-induced collagen overproduction. OPC could regulate the diseases and symptoms of abnormal overabundant collagen production.


Subject(s)
Humans , Ascorbic Acid , Blotting, Western , Cell Count , Cell Movement , Collagen , Collagen Type I , Fibroblasts , Immunohistochemistry , Inflammation , Molecular Chaperones , Proanthocyanidins , Procollagen , Real-Time Polymerase Chain Reaction , RNA, Messenger , Transforming Growth Factor beta , Vitis , Wound Healing
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