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  • CAPORALI, ROBERTO  (3)
  • Natural Sciences  (3)
  • 1
    Online Resource
    Online Resource
    Glucocorticoid Effects on Adrenal Steroids and Cytokine Responsiveness in Polymyalgia Rheumatica and Elderly Onset Rheumatoid Arthritis
    Wiley ; 2006
    In:  Annals of the New York Academy of Sciences Vol. 1069, No. 1 ( 2006-06), p. 307-314
    Details
    In: Annals of the New York Academy of Sciences, Wiley, Vol. 1069, No. 1 ( 2006-06), p. 307-314
    Abstract: Abstract:  Polymyalgia rheumatica (PMR) usually exhibits a good clinical response to glucocorticoid (GC) treatment, but early clinical symptoms may create some difficulties in the differential diagnosis with elderly onset rheumatoid arthritis (EORA), particularly in patients complaining of shoulder and pelvic girdle involvement at onset (PMR‐like clinical onset) (EORA/PMR). Since neuroendocrine mechanisms seem to play a pathogenetic role in these clinical conditions, the aim of this study was to evaluate hormone and cytokine responsiveness to GC treatment in these patients. Cortisol (CO), dehydroepiandrosterone sulphate (DHEAS), 17‐OH‐progesterone (PRG), interleukin‐1 receptor antagonist (IL‐1Ra), interleukin‐6 (IL‐6), and tumor necrosis factor‐α (TNF‐α) were evaluated at base line, and 1 month after GC treatment (prednisone 10 mg/day), in 14 PMR, 11 EORA/PMR, and 13 EORA patients (mean age 73 ± 5 years, ± SD, mean disease duration 3 ± 2 months, ± SD). No patient was taking GCs or immunosuppressive agents at base line. Following GC treatment, CO, DHEAS, and PRG decreased significantly in both PMR and EORA/PMR patients ( P 〈 0.05), but not in EORA patients. On the contrary, IL‐1Ra was significantly increased in both PMR and EORA/PMR patients ( P 〈 0.05). IL‐6 and TNF‐α serum levels were significantly decreased in all groups of patients ( P 〈 0.05). In conclusion, PMR and EORA/PMR seem to exhibit similar hormonal variations after GC administration, when compared to EORA patients. These differences suggest a deficient function of the hypothalamic‐pituitary‐adrenal (HPA) axis in PMR and EORA/PMR patients, with a related higher responsiveness to GC treatment. Interestingly, in PMR and EORA/PMR patients, GC treatment was found to downregulate PRG serum levels.
    Type of Medium: Online Resource
    ISSN: 0077-8923 , 1749-6632
    URL: Article
    DOI: 10.1196/annals.1351.029
    RVK:
    TD 7650
    Language: English
    Publisher: Wiley
    Publication Date: 2006
    detail.hit.zdb_id: 2834079-6
    detail.hit.zdb_id: 211003-9
    detail.hit.zdb_id: 2071584-5
    SSG: 11
    Location Call Number Limitation Availability
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  • 2
    Online Resource
    Online Resource
    Is the Course of Steroid‐Treated Polymyalgia Rheumatica More Severe in Women?
    Wiley ; 2006
    In:  Annals of the New York Academy of Sciences Vol. 1069, No. 1 ( 2006-06), p. 315-321
    Details
    In: Annals of the New York Academy of Sciences, Wiley, Vol. 1069, No. 1 ( 2006-06), p. 315-321
    Abstract: Abstract:  Polymyalgia rheumatica (PMR) has a marked preponderance in women. The female sex has been claimed to be a risk factor for longer‐course corticosteroid therapy and to be associated with more severe systemic symptoms and lower hemoglobin levels. Eighty consecutive patients affected by PMR, seen at two tertiary referral centers, were followed‐up for a mean period of 14.9 months after initiating corticosteroid treatment. At presentation, women had longer disease duration and lower hemoglobin levels (both P = 0.05) than men. In contrast, their systemic signs of PMR were less common ( P = 0.01). Women were treated with a slightly higher mean daily dose of prednisone ( P = 0.055), and assumed a significantly higher cumulative dosage of the drug ( P = 0.01). Accordingly, the mean number of steroid‐related side effects was higher among women ( P = 0.003). The number of relapses during steroid treatment ( P = 0.02), but not that of recurrences, was increased in women. ESR, which was raised at presentation, significantly declined during follow‐up to normal values in both subgroups ( P 〈 0.00001 by analysis of variance [ANOVA]). Its decrease was significantly more pronounced in men than in women. Hemoglobin at follow‐up was significantly higher in men than in women at any given time point. In conclusion, sex is probably modulating the response to corticosteroids. This finding emphasizes the need to consider differences between males and females in the clinical and therapeutic approach to PMR patients.
    Type of Medium: Online Resource
    ISSN: 0077-8923 , 1749-6632
    URL: Article
    DOI: 10.1196/annals.1351.030
    RVK:
    TD 7650
    Language: English
    Publisher: Wiley
    Publication Date: 2006
    detail.hit.zdb_id: 2834079-6
    detail.hit.zdb_id: 211003-9
    detail.hit.zdb_id: 2071584-5
    SSG: 11
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Predictive Value of Antibodies to Citrullinated Peptides and Rheumatoid Factors in Anti‐TNF‐α Treated Patients
    Wiley ; 2007
    In:  Annals of the New York Academy of Sciences Vol. 1109, No. 1 ( 2007-08), p. 287-295
    Details
    In: Annals of the New York Academy of Sciences, Wiley, Vol. 1109, No. 1 ( 2007-08), p. 287-295
    Abstract: Abstract :  This article will focus on the relationship between serum levels of anti‐citrullinated peptide antibodies (anti‐CCP) or rheumatoid factor (RF) and clinical response to TNF‐α blockers in order to evaluate whether these antibodies may have a role as serological markers of response to therapy in rheumatoid arthritis (RA). The changes induced in anti‐CCP levels after TNF blocking therapy still remain a controversial issue even though a marked reduction following conventional DMARDs has been reported in early disease. On the other hand, a drop in RF levels during treatment has been reported by many authors. Decreased IgM RF levels seem to parallel clinical response suggesting that this antibody can also be regarded as a marker of response to treatment. Pre‐treatment RF positivity or negativity does not influence response to TNF‐α blocking therapy while high pre‐treatment levels of IgA RF seem to be associated with a poor response rate.
    Type of Medium: Online Resource
    ISSN: 0077-8923 , 1749-6632
    URL: Article
    DOI: 10.1196/annals.1398.034
    RVK:
    TD 7650
    Language: English
    Publisher: Wiley
    Publication Date: 2007
    detail.hit.zdb_id: 2834079-6
    detail.hit.zdb_id: 211003-9
    detail.hit.zdb_id: 2071584-5
    SSG: 11
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
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