gamma delta-Lymphocytes in the peripheral blood of patients with rheumatoid arthritis--correlation with clinical and laboratory parameters of the disease and with the treatment used.

Rheumatoid arthritis (RA) is a chronic, autoimmune disease in the pathogenesis of which T-lymphocytes are believed to play a crucial role. The aim of this work was to investigate a subpopulation of gamma delta-lymphocytes in the peripheral blood of patients with RA in the context of chosen parameters of the disease. Moreover, we studied the influence of disease modifying antirheumatic drugs (DMARDs) on the number of gamma delta-lymphocytes in the peripheral blood of patients with RA. The gamma delta-lymphocytes were studied using monoclonal anti-delta 1 antibodies labelled with fluorescein (Becton Dickinson) then counted under a fluorescence microscope (Olympus). We found a significant increase in the number of gamma delta-lymphocytes in the peripheral blood of patients with RA as compared with normal controls. The highest numbers were observed in patients with RA and extraarticular manifestation of the disease. Treatment with DMARDs led to a gradual normalisation of the elevated values of gamma delta-lymphocytes.

Nabumetone induces less gastrointestinal mucosal changes than diclofenac retard.

The aim of the study was to compare the efficacy and the effects on the mucosa of the gastrointestinal tract (GIT) of nabumetone and diclofenac retard in patients with osteoarthritis (OA). An open, multicentre, randomised, comparative, endoscopy-blind parallel group study included 201 patients with nabumetone and 193 patients with diclofenac retard suffering from moderate to severe OA of the knee or hip joint. Twelve clinical efficacy variables were assessed and a portion of the population underwent gastroduodenoscopy. All patients exhibited significant improvement in pain severity and pain relief (p < 0.001 and p < 0.0001, respectively) but there were no differences between the groups for all the efficacy variables. Eleven per cent of patients on nabumetone and 19% on diclofenac experienced GIT side-effects. Sixty-nine patients with nabumetone and 61 with diclofenac underwent gastroduodenoscopy. The differences in the mucosal grade for the oesophagus, stomach and duodenum at baseline were not significant. In the oesophagus there were significantly less changes after treatment with nabumetone (p = 0.007) than with diclofenac; there were similar findings in the stomach (p < 0.001) but the difference in the duodenum was not significant. This study indicates that nabumetone and diclofenac retard have similar efficacy in the treatment of OA, but nabumetone has significantly fewer GIT side-effects.

[Rapid clinical course of glomerulonephritis accompanying postinfectious reactive arthritis]. / Pozakazne reaktywne zapalenie stawów z zewnatrzwlosniczkowym klebuszkowym zapaleniem nerek o gwaltownym przebiegu klinicznym.

A case of 17 years old patient, hospitalized for evaluation of bilateral ankle arthritis and polyarticular arthralgia, that developed soon after upper respiratory tract infection, was described. In few weeks of hospitalization, rapid progress of glomerulonephritis in course of reactive arthritis, was observed. In spite of treatment with antibiotics, steroids and immunosuppressive agents, patient's state showed no improvement. After 3 months extracorporeal dialysis became necessary. Now patient is waiting for renal transplantation.

Circulating intercellular adhesion molecule 1 in rheumatoid arthritis--relationship to systemic vasculitis and microvascular injury in nailfold capillary microscopy.

Intercellular adhesion molecule-1 (ICAM-1) is a membrane bound molecule that plays an important role in the pathogenic inflammatory responses observed in vasculitis. The aim of this study was to determine whether levels of soluble ICAM-1 sICAM-1) shedding into the circulation reflect the vascular injury found in nailfold capillaroscopy as well as systemic vasculitis in RA patients. We determined serum levels of sICAM-1 and soluble interleukin-2 receptor (sIL-2R) by an enzyme-linked immunosorbent assay in 79 RA patients. Serum levels of sICAM-1 were significantly increased in RA patients compared to 30 healthy controls. RA patients with clinical signs of systemic vasculitis showed significantly higher levels of sICAM-1 than those without vascular involvement. Although no significant correlation between sICAM-1 levels and the capillaroscopy findings were found, 75% of the patients with severe vascular changes in capillaroscopy exceeded normal sICAM-1 cut off value. Serum sICAM-1 concentrations correlated significantly with the erythrocyte sedimentation rate and serum sIL-2R, but not with the duration of RA, radiological stages, Ritchie index, age or type of treatment. These findings suggest that increased levels of sICAM-1 in serum of RA patients reflect systemic vascular involvement rather than a local vascular injury.

Assessment of beta-2-microglobulin concentration in serum and urine in rheumatoid arthritis.

Assessment of beta-2-microglobulin (beta-2-M) concentration in serum and urine was made in 50 patients with rheumatoid arthritis (RA). The most often noticed pathology was proteinuria. We observed a significant increase of beta-2-M concentration in serum of patients without rheumatoid factor and in patients with proteinuria. In all patients the concentration of beta-2-M in urine was significantly higher than in the controls. We did not observe any influence after treatment on beta-2-M concentration. The increase of the concentration of beta-2-M may be a marker for the early damage of kidney in RA.

Apoptosis in autoimmune diseases.

Physiological cell death (apoptosis) is a natural mechanism for the removal of redundant and abnormal cells, in the absence of inflammation, during normal development. This review focuses on recent developments concerning connections between defective regulation of programmed cell death and aethiology of autoimmune diseases. The pharmacological manipulation of apoptosis maybe will offer new possibilities for the prevention and treatment of these illnesses.

Piroxicam and poststeroidal damage of articular cartilage.

The experiment was carried out in five groups of rats with 12 animals in each one. In three groups articular cartilage osteoarthrosis like damage was accomplished by intramuscular injection of Dexamethason once per week. The rest of animals with exception of the controls were given Piroxicam each day by gastric tube. In the group of rats receiving only Dexamethason we observed extensive destructive changes in the cartilage. In rats receiving Dexamethason and Piroxicam (mainly in the group with higher dosage) histological changes were significantly less than in the group receiving only steroid. The intensity of glycosaminoglycan (GAG) histochemical reactions were significantly higher. In the cartilage of rats receiving only Piroxicam degenerative changes were not found, and GAG contents were similar to the control group. Our results suggest an increase of GAG biosynthesis in articular cartilage after Piroxicam in experimental, poststeroidal damage.

Von Willebrand factor antigen in assessment of vasculitis in patients with connective tissue diseases.

Von Willebrand factor antigen (vWF:Ag) is synthesized and secreted by endothelial cells. In the present study we tried to assess the relationship between plasma level of vWF:Ag and vascular damage in patients with vasculitis. The study was carried out on 59 patients with connective tissue diseases. Vasculitis was diagnosed by biopsies of the skin. The patients with vasculitis had a significantly elevated level of vWF:Ag; however, no significant correlation between the amount of plasma vWF:Ag and the degree of vasculitis was found. The obtained results show that the plasma level of vWF:Ag may reflect the presence of vascular, especially endothelial, damage in patients with connective tissue diseases.

[Advances in pathogenesis of anemia in rheumatoid arthritis]. / Postepy patogenetyczne w niedokrwistosci w reumatoidalnym zapaleniu stawów.

The growing importance of anaemia in rheumatoid arthritis (RA) let us to analyze the problems connected with etiopathology and diagnosis of this disease. The main attention was put on iron metabolism disturbances in the pathomechanism of the anaemia in RA.

Serum alpha-1-antitrypsin and alpha-1-antichymotrypsin after surgical treatment and during postoperative clinical course of human gastric cancer.

The usefulness of alpha-1-antitrypsin (A1AT) and alpha-1-antichymotrypsin (A1AChy) in monitoring the adequacy of surgical treatment in patients with gastric cancer was studied. In 32 patients A1AT and A1AChy serum levels were studied before and after radical or palliative surgery at regular intervals during a 3-50-month follow-up. After palliative surgery, A1AT and A1AChy concentrations were significantly higher than in patients treated radically who showed a decreasing tendency of both antiproteases. In patients with progressive disease after surgery an increase of both antiproteases was observed. A1AT and A1AChy levels in the remission group tended to decrease but the values did not normalize as compared to healthy subjects. It was suggested that the increasing levels of A1AT and A1AChy during chemotherapy after radical surgery for gastric cancer may point to the progress of the disease.

[Bactericidal properties of granulocytes and plasma in patients with rheumatoid arthritis complicated by urinary tract infections]. / Wlasciwosci bakteriobójcze granulocytów i osocza u chorych na reumatoidalne zapalenie stawów powiklane zakazeniem dróg moczowych.

26 patients with rheumatoid arthritis complicate by infection of urinary tract, have been decreased bactericidal activity of granulocytes. No changes has been noted in the bactericidal activity of plasma. These results suggested that neutrophils in rheumatoid synovial membrane plays important role of inflammation processes.

[Effect of rheumatoid arthritis complicated by urinary tract infections on the activity of lysozyme in the serum of patients]. / Wplyw reumatoidalnego zapalenia stawów powiklanego zakazenia dróg moczowych na aktywnosc lizozymu w surowicy chorych.

In 26 patients suffering from rheumatoid arthritis complicated by urinary tract infections the normal lysozyme activity has been observed in the blood serum. After 14 days lasting therapy with nonsteroid antiinflammatory drugs no changes in the enzyme activity have been observed.

Clinical application of D-penicillamine in ankylosing spondylitis: a 9-month study.

The lack of effective therapy of ankylosing spondylitis is a reason to search a better kind of treatment. Trials to use D-penicillamine are scarce and usually limited to a short time of observation. We studied 49 patients with ankylosing spondylitis non-responding to classical therapy. Before and during treatment periodically complex clinical and laboratory tests were performed. During 9 months of therapy a significant decrease of score and involvement of vertebral column movement measured by several tests were observed. No side effects of treatment were found during this period. It is probably partly connected with the dosage of D-penicillamine which was used. It should be underlined that during 9 months of therapy, no relapse was observed in any case. The efficacy of D-penicillamine therapy was found not only in the peripheral form of ankylosing spondylitis but also in central one. However, the therapy was more effective in the former. It seems that D-penicillamine may be an effective and safe drug in the therapy of ankylosing spondylitis.

[Phagocytic function of neutrophils in patients with rheumatoid arthritis complicated by urinary tract infections]. / Funkcja fagocytarna granulocytów u chorych na reumatoidalne zapalenie stawów powiklane zakazeniem dróg moczowych.

In 26 patients with rheumatoid arthritis complicated by infection of urinary tract the phagocytic function of granulocytes has been evaluated. The results obtained indicate that the phagocytic function of peripheral blood granulocytes is in patients with rheumatoid arthritis normal. Above function is not altered by infections of urinary tract.

[A case of primary cardiac myosarcoma]. / Przypadek pierwotnego pråzkowanokomórkowego miesaka serca.

The case of the very rare, primary malignant neoplasm of a cardiac origin was presented. Authors discussed diagnostic difficulties and clinical symptoms of a disease.

Serum level of parathyroid hormone in certain rheumatic diseases.

The mechanism of joint destruction in rheumatic diseases is a complex and not fully known phenomenon in which many factors probably take part. The hormones which regulate the bone metabolism may be engaged in this process. In this study the serum level of the parathyroid hormone was correlated with the degree of joint destruction observed in rheumatoid arthritis, ankylosing spondylitis and osteoarthritis. Besides the degree of joint changes (radiologic aspects) the extension of the pathological process and duration of disease were also considered and the serum and urine level of calcium and phosphorus was analyzed. Similar patterns of the parameter investigated were observed in the rheumatic diseases studied and in healthy persons.