dissertation topics in rheumatoid arthritis

Literature review of rheumatoid arthritis in India

Affiliations.

• 1 Indraprastha Apollo Hospital, New Delhi, India.
• 2 Sri Deepti Rheumatology Centre, Hyderabad, India.
• 3 Evidera, Meta Research, Lexington, MA, USA.
• 4 Pfizer Inc., Mumbai, India.
• 5 Pfizer Inc., New York, NY, USA.
• PMID: 26171649
• DOI: 10.1111/1756-185X.12621

Aim: Rheumatoid arthritis (RA) can lead to severe disability. This literature review assessed the descriptive epidemiology, comorbidities and extra-articular manifestations, functioning abilities and quality of life, and treatment patterns of RA patients in India.

Method: A literature review of all observational studies published from 1985 to 2012 was conducted using MEDLINE and Embase. Quantitative and qualitative findings were summarized.

Results: Twenty-eight studies were identified for data extraction. Seven described the descriptive epidemiology of RA, 14 described comorbidities and extra-articular manifestations, nine described the functioning abilities and quality of life among patients, and 10 provided information on treatments.

Conclusion: This review is confined to studies with small sample sizes, cross-sectional designs, and/or clinical settings that may not be representative of the entire Indian population. There is a need for more robust studies, as conclusions for the entire Indian RA population cannot be drawn from only the current observational studies.

Keywords: India; literature review; rheumatoid arthritis.

© 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

Publication types

• Antirheumatic Agents / adverse effects
• Antirheumatic Agents / therapeutic use*
• Arthritis, Rheumatoid / diagnosis
• Arthritis, Rheumatoid / drug therapy*
• Arthritis, Rheumatoid / epidemiology
• Comorbidity
• Disability Evaluation
• India / epidemiology
• Observational Studies as Topic
• Risk Factors
• Severity of Illness Index
• Treatment Outcome
• Antirheumatic Agents

ORIGINAL RESEARCH article

Ephedra sinica polysaccharides regulate the anti-inflammatory immunity of intestinal microecology and bacterial metabolites in rheumatoid arthritis.

• Shanxi University of Chinese Medicine, Taiyuan, China

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Introduction: Ephedra sinica polysaccharide (ESP) exerts substantial therapeutic effects on rheumatoid arthritis (RA). However, the mechanism through which ESP intervenes in RA remains unclear. A close correlation has been observed between enzymes and derivatives in the gut microbiota and the inflammatory immune response in RA. Methods: A type II collagen-induced arthritis (CIA) mice model was treated with ESP. The therapeutic effect of ESP on CIA mice was evaluated. The anti-inflammatory and cartilage-protective effects of ESP were also evaluated. Additionally, metagenomic sequencing was performed to identify changes in carbohydrate-active enzymes and resistance genes in the gut microbiota of the ESP-treated CIA mice. Liquid chromatography-mass spectrometry and gas chromatography-mass spectrometry were performed to observe the levels of serum metabolites and short-chain fatty acids in the gut. Spearman’s correlational analysis revealed a correlation among the gut microbiota, antibiotic-resistance genes, and microbiota-derived metabolites. Results: ESP treatment significantly reduced inflammation levels and cartilage damage in the CIA mice. It also decreased the levels of pro-inflammatory cytokines interleukin (IL)-6, and IL-1-β and protected the intestinal mucosal epithelial barrier, inhibiting inflammatory cell infiltration and mucosal damage. Here, ESP reduced the TLR4, MyD88, and TRAF6 levels in the synovium, inhibited the p65 expression and pp65 phosphorylation in the NF-κB signaling pathway, and blocked histone deacetylase (HDAC1 and HDAC2) signals. ESP influenced the gut microbiota structure, microbial carbohydrate-active enzymes, and microbial resistance related to resistance genes. ESP increased the serum levels of L-tyrosine, sn-glycero-3-phosphocholine, octadecanoic acid, N-oleoyl taurine, and decreased N-palmitoyl taurine in the CIA mice. Conclusion: ESP exhibited an inhibitory effect on RA. Its action mechanism may be related to the ability of ESP to effectively reduce pro-inflammatory cytokines levels, protect the intestinal barrier, and regulate the interaction between mucosal immune systems and abnormal local microbiota. Accordingly, immune homeostasis was maintained and the inhibition of fibroblast-like synoviocyte (FLS) proliferation through the HDAC/TLR4/NF-κB pathway was mediated, thereby contributing to its anti-inflammatory and immune-modulating effects.

Keywords: Rheumatoid arthritis, Gut Microbiota, systemic metabolism, TLR4/HDAC/NF-κB pathway, Ephedra sinica polysaccharide

Received: 09 Apr 2024; Accepted: 07 May 2024.

Copyright: © 2024 MA, Xiuhong, Peng, Wei, Wen, Liu, Song, Wang, Zhang and Peng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY) . The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence: Yanmiao MA, Shanxi University of Chinese Medicine, Taiyuan, China Wei Xiuhong, Shanxi University of Chinese Medicine, Taiyuan, China Jiehao Peng, Shanxi University of Chinese Medicine, Taiyuan, China Fuxia Wei, Shanxi University of Chinese Medicine, Taiyuan, China Ya Wen, Shanxi University of Chinese Medicine, Taiyuan, China Mingran Liu, Shanxi University of Chinese Medicine, Taiyuan, China Bo Song, Shanxi University of Chinese Medicine, Taiyuan, China Yonghui Wang, Shanxi University of Chinese Medicine, Taiyuan, China Yumin Zhang, Shanxi University of Chinese Medicine, Taiyuan, China Tao Peng, Shanxi University of Chinese Medicine, Taiyuan, China

Disclaimer: All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.

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Dissertations / Theses on the topic 'Osteoporosis; Rheumatoid arthritis'

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Kalla, Asgar Ali. "Osteoporosis in rheumatoid arthritis." Master's thesis, University of Cape Town, 1989. http://hdl.handle.net/11427/26297.

Kälvesten, Johan. "Automatic image analysis for decision support in rheumatoid arthritis and osteoporosis." Doctoral thesis, Linköpings universitet, Centrum för medicinsk bildvetenskap och visualisering, CMIV, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-113680.

Al-Dehaimi, Abdulwahed. "Evaluation of galactosyl hydroxylysine as a marker of bone resorption." Thesis, University of Sheffield, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.364314.

O'Brien, Elizabeth Ann. "Regulation of osteoclast activity : differential adhesion of osteoclasts to the bone surface." Thesis, University of Liverpool, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.343930.

Kanczler, Janos Michael. "The role of the reactive oxygen species-generating enzyme, xanthine oxidoreductase, in cytokine- and hormone-induced bone resorption." Thesis, University of Bath, 1999. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.311172.

Albogami, Mohammed Mater. "Bone loss in osteoporosis and rheumatoid arthritis diseases : the effects of disease mechanisms, age, gender and ethnic origin on responsiveness to treatment." Thesis, Queen Mary, University of London, 2014. http://qmro.qmul.ac.uk/xmlui/handle/123456789/8901.

Wright, Nicole C. "The Association between Rheumatoid Arthritis, Bone Strength, and Body Composition within the Women's Health Initiative." Diss., The University of Arizona, 2010. http://hdl.handle.net/10150/195197.

Hauser, Barbara. "Mechanism of bone loss in rheumatic diseases." Thesis, University of Edinburgh, 2016. http://hdl.handle.net/1842/22823.

Silva, Raissa Gomes da. "Avaliação da composição corporal e densidade mineral ósseo em mulheres com artrite reumatóide." Universidade de São Paulo, 2007. http://www.teses.usp.br/teses/disponiveis/5/5145/tde-31052007-165929/.

Kagwiria, Rosebeth [Verfasser], and Lars [Gutachter] Nitschke. "Evaluation of the nuclear receptor Retinoic Acid Receptor related Orphan Receptor α (RORα) as a regulator of osteoclastogenesis in rheumatoid arthritis and osteoporosis / Rosebeth Kagwiria ; Gutachter: Lars Nitschke." Erlangen : Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU), 2017. http://d-nb.info/1140228609/34.

Tanja, Janković. "Uticaj terapije inhibitora faktora tumorske nekroze na mineralnu koštanu gustinu i koštane biohemijske markere-prokolagen tip 1N-terminalni propeptid i beta-crosslaps kod bolesnica sa reumatoidnim artritisom." Phd thesis, Univerzitet u Novom Sadu, Medicinski fakultet u Novom Sadu, 2020. https://www.cris.uns.ac.rs/record.jsf?recordId=112400&source=NDLTD&language=en.

Eggardt, Tizia Johanna [Verfasser]. "Prädiktive Faktoren für die Entwicklung einer sekundären Glukokortikoid-induzierten Osteoporose bei Patienten mit rheumatoider Arthritis: Eine Parameteranalyse / Tizia Johanna Eggardt." Berlin : Medizinische Fakultät Charité - Universitätsmedizin Berlin, 2019. http://d-nb.info/1201649153/34.

Hsiao, Hung-Bo, and 蕭宏柏. "Ameliorative effects of kinsenoside on endotoxic shock, rheumatoid arthritis and osteoporosis in mice." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/65637810305540667596.

Fournier-Roussy, Jean-Pascal. "Évolution de la gestion pharmacologique de la polyarthrite rhumatoïde et impact sur le risque de fracture ostéoporotique non vertébrale." Thèse, 2014. http://hdl.handle.net/1866/13043.

Fonseca, Ana Cláudia Oliveira. "Aspetos bioquímicos das doenças músculo-esqueléticas." Master's thesis, 2019. http://hdl.handle.net/10284/8735.

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New immunotherapy for rheumatoid arthritis successful in mice

A promising immunotherapy for rheumatoid arthritis is proving successful in mouse models. Rheumatoid arthritis, known as rheumatism, has so far had no effective treatment. Research of Daniëlle ter Braake of the Faculty of Veterinary Medicine is a step in the right direction. On May 21, 2024, ter Braake will defend her PhD thesis at Utrecht University.

The new technique uses nanoparticles, which influence the immune system in a very targeted way. The treatment proves effective not only in preventing rheumatoid arthritis, but also in treating symptoms in mice.

Existing treatments

Current therapies for rheumatoid arthritis focus on improving patients' quality of life by relieving symptoms. The downside of these drugs is that they do not target and affect the entire immune system. As a result, patients become susceptible to other diseases. The so-called antigen-specific immunotherapies from ter Braake and colleagues' research could provide an excellent solution for this.

From mouse model to humans

"When you place one puzzle piece on one side, ten more come loose on the other", ter Braake says of autoimmunity research. "A treatment for humans is still far away. More research is needed for that. However, the technique found is a fundamental step in immunology to make treatments better in the long run."

Scientists can now research whether this therapy also works for other autoimmune models

The nanoparticles are an important factor. They act as tiny envelopes for the drug and ensure that exactly the right link in the immune system is targeted. Thus, the treatment prevents harmful side effects to the immune system. This principle is promising and can now be tested for other autoimmune models.

Daniëlle ter Braake MSc

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Utrecht University Heidelberglaan 8 3584 CS Utrecht The Netherlands Tel. +31 (0)30 253 35 50

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May 6, 2024

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Study provides guidelines to doctors for individual treatment of wrist fractures

by Claes Björnberg, Umea University

A doctoral thesis by Viktor Schmidt, Umeå University can hopefully help doctors to provide better information to patients after wrist fractures. It can determine which treatment is most appropriate for each individual patient.

The thesis shows that the alignment in which a wrist fracture heals in is important in terms of early results (1 year after the injury). After that, there is a continued gradual recovery, and a decade after the injury, most patients are fully recovered in function, regardless of the alignment in which the fracture healed. By identifying unstable fractures and following guidelines that promote early surgery, short-term outcomes are likely to improve.

A broken wrist, or distal radius fracture as it is called in technical terms, is the most common skeletal injury. A well-functioning wrist is important to be able to work and engage in activities of daily living. Treatment after such an injury is aimed at restoring function by recreating anatomical alignment and providing the patient with adequate rehabilitation.

The first study examined results one year after injury.

"We could see a correlation where malalignments led to poorer results in terms of range of motion, grip strength and self-rated problems," says Schmidt, Department of Diagnostics and Intervention.

The second work analyzed whether a continued movement in the skeletal injury between emergency room visits and return visits had any impact on stability.

"We found that this movement, which we have chosen to call 'marginal secondary displacement,' is an important parameter to take into account in order for the skeletal injury to heal in a good position."

The third study followed up on the patients from the first study, a decade later. It showed that the results continue to improve over time and that after more than a decade, the patients were restored in terms of range of motion, grip strength and self-reported outcomes, regardless of the position in which the bone injury had healed. The final study investigated the potential consequences of the fast tracks introduced in the Swedish national guidelines of distal radius fractures.

"We compared the treatment that was given with how they would have been treated if the guidelines had been followed. We found that if the fast-track program had been followed, more patients would have been treated with early surgery and a delayed operation could have been avoided in the majority of cases," says Schmidt, who defends his thesis on May 8.

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