Treatment of progressive systemic sclerosis using factor XIII.

A double-blind, randomized crossover trial was carried out in 25 patients with progressive systemic sclerosis to compare the effectiveness and tolerability of treatment with Factor XIII with that of placebo. Patients received twice daily intravenous injections of either Factor XIII or placebo for 3 weeks and, after a wash-out period of 6 weeks, were crossed over to the alternative medication for a further 3 weeks. Assessments made by the physician and patients at the end of each treatment period indicated that Factor XIII was significantly better than placebo in improving the cutaneous manifestations of the disease and these opinions were supported by the significant improvement in the function index which was used to assess the degree of motor disability. Both local and general tolerability of Factor XIII treatment was good and there were no adverse reports.

Manganese-containing superoxide-dismutase deficiency in polymorphonuclear leukocytes of adults with rheumatoid arthritis.

Superoxide dismutase (SOD) is known to regulate the level of superoxide radicals inside cells. The purpose of this work was to investigate the role of SOD activity in tissue damage produced by superoxide radicals. SOD was measured in polymorphonuclear cells of patients with rheumatoid arthritis and controls. The distinct SOD activities, including manganese-containing and copper-zinc-containing enzymes, were evaluated in cytoplasma and mitochondria of human granulocytes. Except for the comparison between total SOD and cytoplasmic copper-zinc SOD, no correlation was found among the different SOD levels. Moreover, a significant decrease was observed only for cytoplasmic manganese-containing enzyme in granulocytes of adults with rheumatoid arthritis. These data confirm the necessity of evaluation of various SOD classes and suggest the interest of biochemical tests in granulocytes for early diagnosis and better comprehension of tissue damage due to inflammation.

[Antinuclear antibodies: analysis of images and classification of immunofluorescence aspects on nuclei isolated from rat hepatocytes]. / Anticorps anti-noyaux: analyse d'images et classification des aspects d'immunofluorescence, sur noyaux isolés d'hépatocytes de rat.

Image analysis and Fourier transformation of the various nuclear immunofluorescence patterns observed while detecting antinuclear antibodies allow an objective and quantitative definition of the fluorescence. They also point out various IF types hidden by the main pattern, without having to dilute the test serum. They make obvious the difference between speckled and reticular patterns, and reveal the existence of intermediate states. The usual nuclear IF patterns (homogeneous, ring, nucleolar, reticulated, speckled and diffuse) may be grouped, according to their photo emission, into nuclear and subnuclear patterns. The first group includes homogeneous, annular and passive nucleolar IF. The second group is composed of speckled, reticulated, mixed, and active nucleolar IF. Alternatively, these aspects may be grouped into three types: homogeneous nuclear IF (homogeneous and ring), heterogeneous nuclear IF (speckled, reticulated and mixed) and nucleolar IF (active or passive). Diffusion can affect or not these aspects and does not apply to a special type or pattern. Image analysis and the study of the image spatial spectrum lead to automated recognition of the IF types, and later on, to the discrimination of antinuclear antibodies.

[Effect of imidazole on the trabecular bone volume of rats with calcium deficiency]. / Action de l'imidazole sur le volume trabéculaire osseux du rat carencé en calcium.

Low-calcium diet induces bone rarefaction in young rats by decreasing trabecular bone volume without any mineralization's defect. Given alone, calcium or imidazol increases, significantly but incompletely, trabecular bone volume. Given together, calcium and imidazol increase trabecular bone volume as well as normal diet does. These results indicate that imidazol acts likely by activating metabolic effects of calcium.

Chronoeffectiveness of indomethacin in four patients suffering from an evolutive osteoarthritis of hip or knee.

During a 4-week span 4 patients suffering from an evolutive osteoarthritis ingested 3 pills/day at fixed clock hours: 0800, 1200 and 2000. One of the weeks was devoted to a (placebo) control span. During the other weeks only one of the 3 ingested pills contained the daily dose of 50 mg indomethacin. This latter, when taken at 1200, had the maximum effect on self-rated pain (decrease of 60% of the 24-h mean, p less than 0.0005) and self-rated stiffness (decrease of 54% of M, p less than 0.005) as well as on mean oral temperature.

[Diagnostic value of ultrastructural study of the synovial membrane in rheumatic diseases]. / Intérêt diagnostique de l'étude ultrastructurale de la synoviale dans les maladies rhumatismales.

This paper deals with diagnosis value of synovium electron microscopic study in inflammatory and metabolic rheumatism. Detection in synovium of hydroxyapatite, Ca pyrophosphate and other biological crystals often need the use of EM. It is also a good diagnosis tool in inherited lipid and glucid metabolism disorders and to establish an anatomic correlation between the osteo-articular localization and the systemic disease. Furthermore EM is able to detect stigmata of previous treatment such as chrysotherapy, immune complexes deposits in tissues, amyloidosis fibrils and even viral or bacterial material.

[Pulmonary lesions in dermatomyositis. A retrospective study of 4 cases]. / L'atteinte pulmonaire au cours de la dermatopolymyosite. Etude rétrospective de 4 observations.

During a retrospective study of the records of 9 patients with dermatomyositis, pulmonary lesions were noted in 4 cases. Dermatomyositis had been diagnosed on clinical, biochemical, electrical and histopathological criteria. Patients with other connective tissue disease associated with dermatomyositis were excluded. In one case the pulmonary lesions preceded the clinical symptoms of dermatomyositis. Two patients had interstitial pneumonia and 2 presented with reticulonodular images suggestive of diffuse interstitial fibrosis. The outcome after corticosteroid and/or immunosuppressive therapy was favourable in 3 cases. It would appear from this study that clinical and radiological signs of pulmonary lesions and respiratory insufficiency are abnormally frequent in dermatomyositis and that the prognosis in such cases is perhaps brighter than is usually believed.

T suppressor lymphocytes regulation of adjuvant arthritis in two inbred strains of rats.

Adjuvant arthritis can be induced by a single injection of Freund's complete adjuvant (FCA) in the highly susceptible Lewis (LEW) rat strain, but not the resistant Wistar A.G. (WAG) strain. This strain-dependent susceptibility to the disease is correlated with differences in T suppressor cells regulation. In WAG rats, indeed, the in vitro response in LEW alloantigens was highly inhibited 11 days after FCA injection, while LEW rats in vitro response to WAG alloantigens was slightly increased. Furthermore, spleen cells from WAG rats given FCA 4 days before exhibited T cell-mediated active suppression of WAG in vitro response to LEW alloantigens when they were co-cultured with WAG normal spleen cells. This suppression was abolished by removal of T cells on nylon wool column. A previous irradiation of these T cells also inhibited their suppressive effect, suggesting that FCA-induced suppression might be due to soluble suppressor factor(s). On the other hand T cells from FCA treated LEW rats did not produce any modification of LEW in vitro response to WAG alloantigens. This suggests that the severe arthritis induced in LEW rats could be correlated with a defect of their suppressor cells functions, while in WAG rats FCA activated suppressor T cells could control the disease.

[Role of pregnancy and related conditions on experimental arthritis of the rat (author's transl)]. / Effet de la gestation et d'états apparentés sur la polyarthrite expérimentale du rat type Pearson.

Pregnancy in Rat induces, as in humans suffering from rheumatoid arthritis, a striking improvement of adjuvant arthritis. This improvement is not associated with an enhancement of corticosteronemia; it does not appear either in pseudo-pregnancy, or in experimental deciduoma. It could rather be related to an immune mechanism; an enhancement of T suppressor lymphocytes associated to a decrease of T helper lymphocyte activity in peripheral blood as suggested by a high response to ConA and low response PHA and PWM during arthritis plus pregnancy. The influence of hormonal factors on recirculation and/or activity of peripheral lymphocytes is not excluded.

Comparison of effects of D. Penicillamine and dexamethasone on the articular and non articular lesions in immune connective tissue disease induced in rabbits.

The effect of D. Penicillamine (DP) at the dose of 50 mg/kg/day, on an immune induced connective tissue disease in rabbit, is compared to that of dexamethasone (Dexa) at the doses of 0.15 and 0.075 mg/kg/day. This model includes polyarthritis and lesions of connective tissue of liver, kidneys and lungs. The result of immunization is initially a non-specific macrophage infiltration and secondarily a specific lymphocyte and plasma-cell infiltration. In short treatment, high dose of Dexa inhibits the non-specific and specific responses while DP modifies only non specific response. In long treatment, Dexa at low dose and DP inhibit the two responses. Data suggest that, in vivo, macrophages is the target cell of DP.

[Evolution of connective tissue diseases with anti-ribonucleoprotein antibodies (in 28 patients) (author's transl)]. / Evolution des connectivites avec anticorps anti-ribonucléoprotéine. Signification pronostique des anticorps anti-RNP (chez 28 malades).

Follow-up of 28 patients with connective tissue diseases with anti-RNP antibodies revealed that the disease had followed a benign course in 19 cases and a more severe course (including one fatal outcome) in 9 cases. Severe symptoms were mainly renal, neurological, psychic, and articular in nature. The association of anti-DNA antibodies and or low blood complement levels was confirmed as being of poor prognostic significance. Correlating the clinical picture with the severity of the cases demonstrated one case of the severe form in 8 minor connective tissue diseases (arthralgia, Raynaud's syndrome, swollen fingers), three severe forms (including one death) in 9 cases of mixed diseases, and 5 severe forms in the 11 patients with isolated connective tissue disease. Minor connective tissue syndromes retain an overall favourable prognosis, but they may become severe. The poor prognosis of the juvenile forms and those related to scleroderma also has to be emphasised.

[Synovial folds of the knee (plica synoviales). Treatment under arthroscopy]. / Les brides synoviales du genou (plica synoviales). Traitement sous arthroscopie.

The authors report on synovial folds of the knee examined by arthroscopy. 60 arthroscopies in 59 patients showed a plica synoviale. The authors recount the different anatomical types. A suprapatellar plica is found in all the cases and a lateropatellar plica is found in 7 out of 60 cases. The suprapatellar plica forms a fibrous fold which is sometimes completely folded off (6.6%) but more often it is an incomplete fold: internal (66.6%), external (21.6%) or annular (15%). In some cases arthroscopy reveals cartilaginous lesions associated with the plica. 18 patients out of 37 showed lesions of secondary chondromalacia. Endoscopic resection offers a possibility of treatment for this condition. The results of this operation were good or excellent in 64.7% of the patients without cartilaginous complications and in 40% of the patients who had a lesion of their cartilages. In the discussion the authors present the possible physiopathology of this syndrome and the presenting symptoms.

Lymphocyte nuclear refringence in two inbred strains of rat. Modifications of NRT during adjuvant arthritis.

Nuclear refringence test (NRT) was studied in two inbred strains of rats: Lewis (LEW) and Wistar AG (WAG), the first develops a severe arthritis while the later only slight inflammation. Before adjuvant injection, a good NRT to ConA, PHA and Isoprinosine was observed in LEW but a poor one in WAG. After adjuvant injection a striking difference appears between the two strains concerning ConA response: in LEW the response is significantly lower on day 14, while in WAG the initial poor response is not modified. These data suggest that in WAG the suppressor T lymphocytes are already activated in vivo and are no longer responsive in vitro. The responses to PHA and Isoprinosine are parallel in both strains, the NRT response diminishes on day 14 in LEW and on day 21 in WAG.