Pharmacodynamic and Pharmacokinetic Evaluation of Soy Lecithin Based Tablet of Boswellic Acid

Background: The oleo-gum resin of Boswellia serrata contains pentacyclic triterpenic acids known as Boswellic acids (BAs) that are responsible for the anti-inflammatory and anti-arthritic activities by inhibition of 5-lipoxygenase. Methods: Soylecithin based tablet formulation of an enriched extract of BAs were formulated and evaluated comparatively with the unformulated extract for bioavailability on rabbits and therapeutic efficacy against arthritis on rats targeting two primary constituent 11-keto ?-boswellic acid (KBA) and 3-O-acetyl 11-keto ?-boswellic acid (AKBA). Total BAs content in the enriched fraction was measured and characterized by HPLC analysis. Soy lecithin based tablet of BAs enriched extract was prepared and evaluated for different parameters. Tablets at 160 and 320 mg/kg, and unformulated extract 160 mg/kg was assessed on CFA-induced arthritic rat model and bioavailability was evaluated on the rabbit. Results: Tablet formulation showed two times higher efficacy in increasing hot plate reaction time, reduction in paw volume, and TNF-? levels compared to unformulated extract signifying enhanced systemic absorption and availability of the BAs at the site of action. The tablet at 320 mg/kg dose showed repair of articular surfaces with small areas of erosion and irregularities in the connective tissue. Plasma samples of rabbit showed identified peaks only for KBA. Conclusion: The soy lecithin based tablet of BAs enriched extract at both doses showed higher peak plasma concentration and AUC compared to unformulated enriched extract. The results of the study substantiated higher efficacy and bioavailability of B. serrata gum resin enriched extract in the form of lecithin based tablet formulation.

In vitro anti-inflammatory, anti-arthritic and anti- proliferative activity of green synthesized silver nanoparticles - Phoenix dactylifera (Rothan dates)

Abstract Traditionally dates is consumed as a rich source of iron supplement and the current research discuss the synthesis of silver nanoparticles (AgNPs) using methanolic seed extract of Rothan date and its application over in vitro anti-arthritic, anti-inflammatory and antiproliferative activity against lung cancer cell line (A549). FTIR result of synthesised AgNPs reveals the presence of functional group OH as capping agent. XRD pattern confirms the crystalline nature of the AgNPs with peaks at 38º, 44º, 64º and 81º, indexed by (111), (200), (220) and (222) in the 2θ range of 10-90, indicating the face centered cubic (fcc) structure of metallic Ag. HR- TEM results confirm the morphology of AgNPs as almost spherical with high surface areas and average size of 42 ± 9nm. EDX spectra confirmed that Ag is only the major element present and the Dynamic light scattering (DLS) assisted that the Z-average size was 203nm and 1.0 of PdI value. Zeta potential showed − 26.5mv with a single peak. The results of the biological activities of AgNPs exhibited dose dependent activity with 68.44% for arthritic, antiinflammatory with 63.32% inhibition and anti-proliferative activity illustrated IC50 value of 59.66 µg/mL expressing the potential of AgNPs to combat cancer

Análise do perfil clínico e epidemiológico de pacientes com artrite psoriásica em ambulatório de reumatologia na Região Amazônica / Clinical and epidemiological profile analysis of patients with psoriatic arthritis in a rheumatology clinic in the Amazon Region

Objetivo: Conhecer o perfil clínico e epidemiológico de pacien- tes portadores de artrite psoriásica de uma região brasileira. Método: Pesquisa observacional, transversal, epidemiológica e documental, baseada na coleta de dados obtidos a partir da análise de 53 prontuários de pacientes cadastrados do Ambu- latório de Reumatologia da Universidade do Estado do Pará, na Região Amazônica. Resultados: Houve predominância do padrão do tipo poliartrite simétrica, sem distinção entre os sexos, com a presença de manifestações extra-articulares, pso- ríase em placas, em uso de metotrexato em doses médias. Con- clusão: Apesar da etiopatogenia da doença ser dependente de fatores genéticos, ambientais e imunológicos e da população amazônica ser muito particular, de uma miscigenação entre eu- ropeus, ameríndios e negros, o perfil clínico e epidemiológicos dos pacientes do Ambulatório de Reumatologia da Universidade do Estado do Pará é semelhante ao das literaturas nacional e internacional.

Objective: To know the clinical and epidemiologic profile of pso- riatic arthritis patients of a Brazilian region. Method: This is an observational, cross-sectional, epidemiological, and documental study, based on the data obtained from the analysis of the medi- cal records of 53 patients registered on the Rheumatology Cli- nic of the Universidade do Estado do Pará, in the Amazon area. Results: There was a predominance of the symmetrical polyar- ticular pattern, with no sexual distinction, extra articular invol- vement, plaque psoriasis, and treatment withn methotrexate, in medium doses. Conclusion: Despite the etiopathogenesis being dependent on genetic, environmental, and immunological fac- tors, and the population of the Amazon being a mix of Europeans, Amerindians, and black people, the clinical and epidemiological profile of the patients of the Rheumatology clinic of the Univer- sidade do Estado do Pará is similar to the ones described on the national and international literature.

In vitro anti-inflammatory, anti-oxidant and in vivo anti-arthritic properties of stem bark extracts from Nauclea pobeguinii (Rubiaceae) in rats

Objective: To explore the immunomodulatory, anti-inflammatory, anti-oxidant and anti-arthritic activity of aqueous and methanolic extracts of Nauclea pobeguinii stem bark. Methods: For in vitro assays, the production of reactive oxygen species (chemiluminescence technique), the proliferation of T cells (liquid scintillation counter method), as well as the inhibition of cyclooxygenase, lipoxygenase, protein denaturation, and free radicals [DPPH, ABTS and nitric oxide (NO) inhibition methods] were evaluated. For in vivo assays, a polyarthritis model was induced by complete Freund's adjuvant in rats. The aqueous and methanolic extracts of Nauclea pobeguinii stem bark were administered orally at 150 and 300 mg/kg. After 28 days of treatment, the total blood was taken to quantify the hematological parameters and the serum was used to evaluate the biochemical parameters (alanine aminotransferase, aspartate transaminase, phenylalnine ammonialyase, and proteins) and oxidative stress parameters (malondialdehyde, catalase, superoxide dismutase, glutathione and NO), and then the knee joint was removed for histological analysis. Results: The extracts of Nauclea pobeguinii significantly reduced the production of intra- and extracellular reactive oxygen species and decreased T cell proliferation. They had an inhibitory effect on cyclooxygenase, lipoxygenase, and protein denaturation, and both extracts had antioxidant capacity on DPPH, ABTS and NO. Both extracts alleviated joint inflammation and pain sensitivity after complete Freund's adjuvant injection, reduced alanine aminotransferase, aspartate transaminase, alkaline phosphatase, NO and malondialdehyde levels, increased protein concentration, superoxide dismutase, catalase and glutathione activity, and restored the cytoarchitecture of the joint after complete Freund's adjuvant injection. Conclusions: The aqueous and methanolic extracts of Nauclea pobeguinii have immunomodulatory, anti-inflammatory, anti-oxidant and anti-arthritic properties.

In vitro anti-inflammatory, anti-oxidant and in vivo anti-arthritic properties of stem bark extracts from Nauclea pobeguinii (Rubiaceae) in rats

Objective: To explore the immunomodulatory, anti-inflammatory, anti-oxidant and anti-arthritic activity of aqueous and methanolic extracts of Nauclea pobeguinii stem bark.Methods: For in vitro assays, the production of reactive oxygen species (chemiluminescence technique), the proliferation of T cells (liquid scintillation counter method), as well as the inhibition of cyclooxygenase, lipoxygenase, protein denaturation, and free radicals [DPPH, ABTS and nitric oxide (NO) inhibition methods] were evaluated. For in vivo assays, a polyarthritis model was induced by complete Freund's adjuvant in rats. The aqueous and methanolic extracts of Nauclea pobeguinii stem bark were administered orally at 150 and 300 mg/kg. After 28 days of treatment, the total blood was taken to quantify the hematological parameters and the serum was used to evaluate the biochemical parameters (alanine aminotransferase, aspartate transaminase, phenylalnine ammonialyase, and proteins) and oxidative stress parameters (malondialdehyde, catalase, superoxide dismutase, glutathione and NO), and then the knee joint was removed for histological analysis. Results: The extracts of Nauclea pobeguinii significantly reduced the production of intra- and extracellular reactive oxygen species and decreased T cell proliferation. They had an inhibitory effect on cyclooxygenase, lipoxygenase, and protein denaturation, and both extracts had antioxidant capacity on DPPH, ABTS and NO. Both extracts alleviated joint inflammation and pain sensitivity after complete Freund's adjuvant injection, reduced alanine aminotransferase, aspartate transaminase, alkaline phosphatase, NO and malondialdehyde levels, increased protein concentration, superoxide dismutase, catalase and glutathione activity, and restored the cytoarchitecture of the joint after complete Freund's adjuvant injection. Conclusions: The aqueous and methanolic extracts of Nauclea pobeguinii have immunomodulatory, anti-inflammatory, anti-oxidant and anti-arthritic properties.

Anti-arthritic-related metal bioavailability for optimal compatibility ratio of Aconiti Radix Cocta and Paeoniae Radix Alba / 中国中药杂志

Trace metals deficiency or excess are associated with the etiology and pathogenesis of rheumatoid arthritis(RA). Aconiti Radix Cocta(A) and Paeoniae Radix Alba(B) are commonly used together for the treatment of RA. In this study, we aim to determine anti-arthritic-related metal bioavailability in the compatibility of herb A and B for avoiding metal deficiency or excess, and optimize the combination ratio of herb A and B, accordingly. Anti-arthritic-related metal bioaccessibility were evaluated by in vitro simulator of all gastrointestinal tract(including mouth, stomach, small and large intestines), and the roles of gastrointestinal digestive enzymes and intestinal microflora were investigated. Anti-arthritic-related metal bioavailability was assessed by the affinity adsorption with liposomes. The results indicated that compatibility proportion of corresponding herbal plants, gastrointestinal digestion and microbial metabolic, which could affect metal digestion and absorption. The optimal compatibility proportion of 1 A∶1 B is recommended, according to the dose of anti-arthritic-related metal bioavailability, which is often chosen for clinical practice of RA therapy. Thus, anti-arthritic-related metal bioavailability might be the key active substances for RA treatment.

In Vitro Anti-arthritic Activity Of Kashaya Of Sida Cordifolia Linn.

Arthritis is a form of joint disorder that involves inflammation of one or more joints. It is very common condition especially in women and older people. Ayurveda has contributed a lot for the management of arthritic conditions. The plant Bala, identified as Sida cordifolia Linn. is a widely used drug in many of the Ayurvedic formulations especially in those for arthritic conditions. Kashaya (decoction) is one of the commonly prescribed preparations in Ayurveda. Present study was aimed to assess the anti-arthritic activity of Kashaya (decoction) of root of Sida cordifolia Linn. by inhibition of protein denaturation method and Inhibition of proteinase enzyme activity. Kashaya of roots of Bala was prepared as per standard procedure and was used to induce protein denaturation in Bovine serum albumin and to inhibit the activity of proteinase enzyme, trypsin. The absorbance was read by spectrophotometer to evaluate the percentage of inhibition in both the procedures. Each experiment was done in triplicates. The results were compared with standard drug Diclofenac sodium. Sida cordifolia Linn. showed dose dependent inhibitory activity and highest activity was seen in 500µg/ml concentration in both the experiments. The result showed that root of Sida cordifolia Linn. is having anti-arthritic property. Further studies can be carried out with other formulations of Bala like Choorna (powder), Swarasa (juice) etc. to compare their anti-arthritic activity. The study supports the classical use of plant Bala in various formulations in the treatment of arthritis.

In vivo anti-arthritic and antioxidant effects from the standardized ethanolic extract of Moussonia deppeana

ABSTRACT Moussonia deppeana (Schltdl. & Cham.) Klotzsch ex Hanst., Gesneriaceae, known as tlachichinole, is a Mexican medicinal plant used for treatment of chronic inflammation-related diseases such as arthritis. In this paper, the main metabolite verbascoside was quantified in ethanolic extract; anti-arthritic and antioxidant activities were also evaluated in Complete Freund's Adjuvant induced arthritis in mice, with complete hematological evaluation, and oxidative stress measure in edema and ganglionic tissues on day 28. In popliteal ganglion, CD4+ lymphocytes and tumor necrosis factor alpha concentration were measured in addition to histological analysis. Ethanolic extract contained 79.2 mg of verbascoside/g extract, and this extract at 450 mg/kg generated an inhibition of 24% over paw edema development and increased body weight gain on final day. For hematological parameters, same dose decreased total leukocytes and lymphocytes, as well as decreased oxidation rate over biomolecules in edema and ganglionic tissues, and increased antioxidant enzyme activity. In ganglionic tissue, CD4+ lymphocytes and tumor necrosis factor alpha level showed no differences at any tested dose compared to complete Freund's adjuvant untreated group. Histological analysis of popliteal ganglion revealed moderate reduction of follicular hyperplasia, leukocyte infiltration and lipid inclusions at 450 mg/kg dose. Ethanolic extract of M. deppeana possesses anti-edematous activity associated to a moderate reduction in follicular hyperplasia, with immune-modulatory and antioxidant effects during experimental arthritis in mice.

Heliopsis longipes: anti-arthritic activity evaluated in a Freund's adjuvant-induced model in rodents

ABSTRACT This study assesses the anti-arthritic effect of the affinin-enriched (spilanthol, main alkamide) hexane extract from the roots of Heliopsis longipes (A. Gray) S.F. Blake, Asteraceae, on a Freund adjuvant-induced arthritis model in rodents. The extract was orally administered at a dose of 2, 6.6, or 20 mg/kg; a significant edema-inhibitory activity in the acute and chronic phases was observed with a dose of 2 and 20 mg/kg, respectively. The extract showed higher anti-inflammatory and anti-arthritic effects than the reference drug phenylbutazone (80 mg/kg). Moreover, the extract prevented the occurrence of secondary lesions associated to this pharmacological model.

Inhibitory effect of the extract of Phellodendron amurense ruprecht root on collagen-induced arthritis in mice / 中国结合医学杂志

<p><b>OBJECTIVE</b>To investigate whether the dried root of Phellodendron amurense Ruprecht (Phellodendri cortex; PC) extract improves arthritic symptoms through anti-inflammatory and immune-modulatory effects in collagen-induced arthritis in mice.</p><p><b>METHODS</b>Rheumatoid arthritis (RA) was induced in male DBA/1 mice by immunization with type II collagen (ColII). CIA mice were divided into 5 groups (n=10 per a group) with normal, CIA control, PC extract (50 mg/kg and 100 mg/kg)-treated, and meloxicam (50 mg/kg)-treated as the reference drug. The PC extract or meloxicam were administered orally in CIA mice once a day for 14 days after arthritis induction. Arthritic score, levels of anti-ColII IgGantibody, prostaglandin E(PGE), tumor necrosis factor (TNF)-α, and interleukin (IL)-17 in the sera of CIA mice were measured. Histopathological changes in the ankle joints of CIA mice were also analyzed by staining with hematoxylin and eosin (H and E), safranin-O and immunohistochemistry using anti-TNF-α and anti-IL-17 antibodies.</p><p><b>RESULTS</b>The arthritic score was increased in CIA mice in a time-dependent manner, as were the serum levels of anti-ColII IgGantibody, PGE, TNF-α, and IL-17. However, the oral administration of PC extract at 50 and 100 mg/kg in CIA mice significantly decreased the arthritic scores, and the serum levels of anti-ColII IgG, PGE, TNF-α, and IL-17 compared with those in the CIA group (P<0.05 or P<0.01). Furthermore, histopathological improvement of the joint architecture in CIA mice was observed after administration of PC extract. PC extract also significantly inhibited the expression of TNF-α and IL-17 in the joints of CIA mice by suppressing the expression of their mRNA and proteins.</p><p><b>CONCLUSION</b>PC extract may improve the pathological progression of RA through the inhibition of joint destruction by synovial inflammation and immune-stimulation, therefore, it would be a potential anti-arthritic agent in RA.</p>

In vitro and In vivo Anti-Arthritic Activity of Combined Ethanolic Extracts of Pisonia grandis and Cardiospermum halicacabum in Wistar Rats.

The combined Bi-herbal ethanolic extract (BHE) made up of equal quantities of leaves of Pisonia grandis and Cardiospermum halicacabum was evaluated for its synergistic in vitro and in vivo Anti-arthritic effects and was compared with its individual ethanolic extracts of Pisonia grandis (EPG) and Cardiospermum halicacabum (ECH). The inhibition of protein denaturation, membrane stabilization and proteinase enzyme inhibition were studied as in vitro and Freund’s adjuvant arthritis model in Wistar rats was used to study the in vivo Anti-arthritic activity. The three extracts (BHE, EPG, and ECH) at the dose level of 300mg/kg b.w.in 2%CMC were ingested orally to the CFA treated rats once daily for 40 days and the percentage inhibition of the paw volume increase due to the drug treatment was calculated. All the three plant extracts exhibited dose dependent stabilization of the RBC membranes, inhibition of protein denaturation and protease inhibition. The BHE has got a significant reduction in the paw volume and oedema when comparable to EPG and ECH in these intoxicant treated animals. These observed effects may be due to its inhibition of free radical production due to the immunological and inflammatory reactions or minimizing protein denaturation or proteinase enzyme or stabilizing the membranes.

Papel de la neoformación ósea perióstica en eldesempeno˜ de los criterios CASPAR paradiagnóstico de artritis psoriásica / Role of periosteal new-bone formation in the performance of CASPAR diagnostic criteria for psoriatic arthritis

Objetivo: Determinar el rendimiento de los criterios CASPAR modificados (CASPARm),cuando se remplaza la NFOY por la NFOP.Métodos: Se evaluaron 72 pacientes con psoriasis, 25 de ellos tenían PsA. Se calculó el gradode acuerdo interobservador para la NFOP y la sensibilidad, especificidad y los valores predictivosde la NFOP, NFOY, los criterios CASPAR y CASPARm.Resultados: Se encontró un acuerdo del 87%, kappa 0,56 IC 95% (0,311-0,818). La NFOP fue elsigno radiológico más frecuente con respecto a la NFOY, en los pacientes con PsA: 24/25 vs.7/25. La NFOP tuvo mejor sensibilidad pero menos especificidad en los pacientes con PsA.No hubo diferencia entre la especificidad y sensibilidad en los criterios CASPAR y CASPARm.Conclusiones: La NFOP incluida en los criterios CASPARm puede ser de utilidad en el diagnósticode la PsA. Los 2 sets de criterios podrían ser utilizados en la clasificación de pacientescon PsA. La frecuencia incrementada de la NFOP en pacientes con PsA podría favorecersu inclusión en los criterios de clasificación al facilitar la interpretación del componenteradiológico...

ObjectivesTo determine the changes in the diagnostic performance of the CASPAR criteria when a different radiological finding is included: the periosteal new bone formation (PoBF) in proximal or distal phalanges in conventional X-ray.MethodsA total of 72 patients with psoriasis were evaluated, of whom 25 had psoriatic arthritis (PsA). With the participation of one radiologist and one rheumatologist the interobserver agreement was calculated in order to assess the presence of PoBF. The sensitivity, specificity and predictive values were calculated for: juxta-articular new bone formation (JaBF), PoBF, CASPAR criteria, and CASPAR modified (CASPARm), which included the PoBF as radiological criteria. The reference standard for PsA diagnosis was the clinical judgment of the rheumatologist.ResultsThere was an 87% inter-observer agreement, with a Kappa of 0.56 with 95% CI: 0.311-0.818. PoBF was the most frequent radiological finding in 24/25 compared to JaBF in 7/25 patients. In isolation PoBF had a better sensitivity but lower specificity for discriminating PsA than JaBF. There was no difference between the sensitivity and specificity of CASPAR vs. CASPARm.ConclusionsThe PoBF in the CASPAR criteria may be useful for the classification of PsA. Because there is no difference in sensitivity, specificity and predictive values between CASPAR and CASPARm, the two set of criteria may be used in the diagnosis of psoriatic arthritis. Due to the high frequency of PoBF in patients with PsA and the little impact of this finding in the sensitivity and specificity, the weight given to radiological component in CASPAR criteria should be reassessed, allowing them to adapt better to the behavior of the disease in our environment...

Leprosy neuropathy: clinical presentations / Neuropatia da lepra: apresentacoes clinicas

Leprosy is a chronic infectious peripheral neuropathy caused by Mycobacterium leprae. The different clinical presentations of the disease are determined by the quality of the host immune response. Early detection of leprosy and treatment by multidrug therapy are the most important steps in preventing deformity and disability. Thus the early recognition of the clinical leprosy presentation is essential. Mononeuritis, mononeuritis multiplex (MM), polyneuritis (MM summation) are the most frequent. The frequent anesthetic skin lesions are absent in the pure neuritic leprosy presentation form. Isolated peripheral nerve involvement is common, including the cranial ones. Arthritic presentation is occasionally seen, usually misdiagnosed as rheumatoid arthritis. Attention should be given to autonomic dysfunctions in leprosy. There are clinical presentations with severe neuropathic pain - painful small-fiber neuropathy. Leprous late-onset neuropathy (LLON) clinical presentation should be considered facing a patient who develop an inflammatory neuropathy many years after a previous skin leprosy treatment.

A hanseníase é uma neuropatia periférica infecciosa, crônica, causada pelo Mycobacterium leprae. As diferentes apresentações clínicas são determinadas pela qualidade da resposta imune do hospedeiro. O diagnóstico precoce e a multi-droga terapia são os passos mais importantes na prevenção de deformidades e incapacidades. Dessa forma, o reconhecimento precoce da apresentação clínica da hanseníase é essencial. Mononeurites, mononeurites múltipla (MM), polineurite (superposição de MM) são as mais frequentes. As frequentes lesões anestésicas de pele estão ausentes na forma neurítica pura. Comprometimento de nervo isolado é comum, inclusive os cranianos. Apresentação com artrite é ocasionalmente vista, erroneamente diagnosticada como artrite reumatóide. Atenção deve ser dada às disfunções autonômicas na hanseníase. Há apresentações clínicas com dor neuropática grave - neuropatia dolorosa de pequenas fibras. Neuropatia de início tardio (LLON) é apresentação clínica que deve ser considerada frente a paciente que desenvolve neuropatia inflamatória muitos anos depois de tratamento prévio da lepra cutânea.

Reactive Arthritis in a Patient with Chlamydia trachomatis Infection / 대한정형외과학회잡지

The authors report a case of reactive arthritis that was caused by sexual contact as below example. A 36-year-old male visited our center due to sudden pain in wrist joint, the 3rd finger, knee joint, and achilles tendon. There were no specific abnormalities for the immunoserologic tests and magnetic resonance imaging; however, we found a positive test result for the polymerase chain reaction test of urine that identified Chlamydia trachomatis. Through considering the patient's medical history and various examinations, we considered the possibility of reactive arthritis, to the exclusion of alternate diagnosis. According to the our diagnosis, the patient was treated with antibiotics and nonsteroidal anti-inflammatory drugs and we found that the patient was getting better. Therefore the authors think that we have to contemplate the possibility of reactive arthritis and treat appropriately in patients with similar symptoms.

Evaluation of anti-inflammatory activities of ethanolic extract of Annona muricata leaves

Traditionally, the leaves of Annona muricata L., Annonaceae, are used to treat headaches, fever, toothache, cough and asthma. The decoction of the leaves has parasiticide, antirheumatic and antineuralgic effects when used internally, while the cooked leaves, applied topically, fight rheumatism and abscesses. The aim of this study was to investigate acute and chronic anti-inflammatory potential of an ethanolic leaf extract of A. muricata (AML) in animal models. The ethanolic extract of A. muricata leaf extract was prepared and administered orally to experimental animals used. The anti-inflammatory activity was determined by xylene-induced ear edema in mice and Complete Freund's adjuvant (CFA)-induced arthritis in rats. The results demonstrated that AML is effective for both acute and chronic inflammation. It also significantly attenuated both TNF-α and IL-1β levels in CFA-induced arthritis model. Thus, these results have suggested that AML possesses both anti-inflammatory and anti-arthritic activities. The findings also suggest that AML presents notable anti-arthritic activity that may be mediated by suppressing pro-inflammatory cytokines.

A clinical study of leflunomide and methotrexate therapy in psoriatic arthritis / 中华内科杂志

Objective To evaluate the efficacy and safety profile of methotrexate (MTX), leflunomide (LEF) and low-dose MTX and LEF (MTX + LEF) combined treatment for psoriatic arthritis (PsA). Methods This was a 24 weeks, two-center, open-labeled, controlled trial All subjects fulfilled the moll and wright criteria for definite PsA. Subjects were given one of the 3 regimens, MTX, or LEF, or MTX + LEF. The primary end point was proportion of psoriatic arthritis response criteria(PsARC)response. The secondary end point was proportion of modified 20% improvement of American College of Rheumatolngy (ACR20) response. Results At week 24, the percent of patients achieving PsARC in MTX, LEF and MTX + LEF group were 75.0% ,68. 8% ,83.3% respectively, and the percent of patients achieving ACR20 were 66. 7% ,50. 0% ,83. 3% respectively. At week 24, tender joint counts, swollen joint counts, patient's assessment of pain, patient's global assessment (PGA), physician' s global assessment, health assessment questionnaire(HAQ)were significantly improved compared with base-line values(P <0. 05). At week 24, the improvement of patient's assessment of pain, HAQ, ESR were better in the MTX + LEF group compared with LEF group while the improvement of patient's assessment of pain, PGA, HAQ, ESR were better in the MTX group compared with LEF group (P < 0. 05). The incidence of treatment related adverse events was 38.5%, 38. 9% and 35% in MTX, LEF and MTX + LEF group respectively. There was no serious adverse reactions. Conclusion Low dose MTX + LEF regimen showed similar good efficacy and safety profde for PsA patients.

Effects of Intra-articular Injection of Agmatine and Clonidine into the Knee Joint Cavity on the Induction and Maintenance of Arthritic Pain in Rats / 대한마취과학회지

BACKGROUND: Previous studies suggest that systemic administration of agmatine, endogenous ligand for imidazoline receptors has anti-hypernociceptive effects in experimental animal. However the peripheral effects of agmatine on inflammatory pain have not yet been elucidated. Here we examined the effects of intra-articular injection of agmatine in the induction and maintenance phase of arthritic pain. In addition, we sought to determine the potential contribution of imidazoline and alpha(2)-adrenergic receptors to the antinociceptive effects using clonidine which is mixed alpha(2)-adrenoceptor and imidazoline receptor agonist. METHODS: To induce arthritis in rats, 2% lambda-carrageenan (50microliter, in saline) was injected into the joint of the right hind limb under enflurane anesthesia. Either agmatine (10, 50, 100microgram/40microliter) or clonidine (10, 50, 100microgram/40microliter) was injected into the knee joint cavity immediately before or 4 hr after carrageenan injection. Weight load tests were performed to measure pain-related behavior in freely walking rats. RESULTS: The intraarticular injection of agmatine into the knee joint had no effects in the both phase of induction and maintenance of arthritic pain at any dose tested. However, injection of clonidine reversed arthritic pain, when injected 4 h after carrageenan injection. CONCLUSIONS: In rats, agmatine has no peripheral effect on inflammatory pain and imidazoline receptors in the periphery may not contribute to the anti-inflammatory pain.

Effects of NOS Inhibitors on Arthritis and Arthritic Pain in Rats

Among the arthritis symptoms, chronic pain is the most serious, and it can profoundly affect the quality of human life. Unfortunately, the mechanism of development in arthritis and arthritic pain has not yet been precisely elucidated. Accumulating evidence indicates that nitric oxide (NO) plays a pivotal role in nociceptive processing in the spinal cord. However, the modulation mechanism of NO in the peripheral site of arthritis and arthritic pain has not been clarified. Therefore, I determined in the present study which nitric oxide synthase (NOS) was involved in the induction of arthritis and arthritic pain. Monoarthritis was induced by intra-articular injection of carrageenan (2%, 50 microliter) into rats, and resulted in the reduction of weight load on the injected leg, increase of knee joint diameter and inflammatory response. Pre-treatment of rats with L-N6-(1-iminoethyl)-lysine (L-NIL, 500 microgram, in 50 microliter), an inhibitor of inducible NOS (iNOS), partially prevented the induction of pain-related behavior and partially reduced inflammatory response in the synovial membrane in the knee joint. These results suggest that iNOS in the knee joint may play an important role in the induction of pain-related behavior and inflammation, and that NO produced by iNOS may be associated with nociceptive signaling in the peripheral site.

Effects of aqueous joint extracts during CIA development on the HUVEC proliferation and expression of VEGF / 中国免疫学杂志

Objective:To investigate the effects of extracts of aqueous joint during CIA development on the HUVEC proliferation in vitro and expression of VEGF Methods: 3H TaR incorporation was used to estimate the HUVEC proliferation by extracts of aqueous joint and VEGF, and was used cultured in an absolutely serum free medium Results:Extracts of aqueqous joint during CIA development stimulated proliferation of HUVEC and this proliferation was inhibited by the anti VEGF neutralizing antibody Conclusion:The expression of VEGF in the extracts of the aqueous joint during an early stage of CIA development increased and expressed biologically active

A Study of Tibio / 대한정형외과학회잡지

The object of this study was 336 Korean patients with degenerative arthritic knees and 1000 Koreans with normal knees who had visited the department of orthopaedic surgery of Hanyang University hospital during the period fmm January, 1980 to June, 1981. The purpose of this study was to investigate the changes of tibio-femoral angles and metaphysealdia physeal angles in response to the degenerative changes of the knees. By the roentgenogram, tibio-femoral angles and metaphyseal-diaphyseal angles were measured and those angles were analized statistically. The results were as follows 1. In young age group, the incidence of the degenerative arthritic knees was more frequent in male than in female. However, in the middle and older age groups, the incidence was higher in female than in male. 2. The mean value of tibio-femoral angle of the degenerative arthritic knees was −3.41°±0.22. It was about 1° varus compared with the normal mean value of −4.46°±0.27. The mean value of tibio-femoral angle in normal Korean was reduced appmximately 3°±5°valgus compared with the Westem normal peoples: 3. In general, the valgus tendency appeared a little more in the knees of female than in those of male. 4. The varus tendency was in pmportion to the degree of the aggrevation of the degenerative arthritis in the knees. 5. The mean value of metaphyseal-diaphyseal angle in normal Korean was 3.53°±0.24. It was 3°–4° varus compared with the Western normal peoples. 6.The varus was increased more in the standing position, in the state of weight bearing position, than in the supine position.