These results confirm the antioxidative properties of the study drug, indicating that nimesulide, beside its known anti-inflammatory properties, also shows an evident antioxidative activity that adds further supportive evidence to its key role in the treatment of OA patients (thanks to the absence of degenerative effects on cartilage).
Erkrankungen Key words • ▶ balneology • ▶ health-related quality-of-life • ▶ musculoskeletal pain • ▶ pain • ▶ pain intensity eingereicht: 25 . 02 . 2011 angenommen: 06 . 06 . 2011 Bibliografi e DOI http://dx.Zusammenfassung ▼ Fragestellung: Ziel der vorliegenden prospektiven Interventionsstudie ist die Untersuchung der Nachhaltigkeit von physikalischen Kuranwendungen und gleichzeitiger Radonbehandlung bei Patienten mit degenerativem Wirbelsäulensyn-drom auf Schmerzbefi nden, Funktionskapazität betroff ener Gelenke, Schmerzmedikamentenverbrauch, Befi ndlichkeit und Krankenstände im Jahr vor sowie nach der Kur. Methode: 222 Patienten mit kombinierter Radon/physikalischer Therapie im Rahmen eines stationären Kuraufenthaltes nahmen an der Studie teil und wurden nach einer Eingangsuntersuchung vor Beginn, unmittelbar nach der Kur, sowie 3, 6 und 12 Monate nach Kur zu Schmerz, Funktionseinschränkung, Befi ndlichkeit und Schmerzmittelverbrauch befragt. Ebenfalls erhoben wurden Krankenstandstage im Jahr vor sowie im Jahr nach der Kur. Ergebnisse: Die Schmerzintensität nahm bis zum 12 monatigen Nachbefragungszeitpunkt sig nifi kant ab. Die Funktionskapazität verbesserte sich signifi kant bis 6 Monate nach Therapieende. Der Anteil der Patienten, die keine Schmerzmittel einnahmen, erhöhte sich während des gesamten Beobachtungszeitraumes. Die Krankenstandstage verringerten sich signifi kant im Jahr nach der Kur im Vergleich zum Jahr davor. Ca. 29 % aller Patienten wies eine Verbesserung im Befi ndlichkeitszustand bis zu einem Jahr nach der Kur auf. Schlussfolgerung: Zusammenfassend zeigt sich im Rahmen dieser Studie insgesamt bei allen gewählten Outcomes eine mittel-bis langfristige Verbesserung. Abstract ▼
In chronic inflammatory processes like rheumatoid arthritis (RA) and cardiovascular diseases (CVD) the role of pteridines and chemokines in the immune response is of great interest. The objectives of the study were to obtain information about an involvement of specific chemokines on the inflammatory process in patients with RA and CVD with activated production of the pteridine neopterin. 113 patients with RA according to American College of Rheumatology criteria including 24.8% suffering from CVD were included in the study (23% male, 77% female). For the assessment of monocyte activation and chemotaxis as well as the proinflammatory influence of chemokines on B-cells and angiogenesis in RA, neopterin and the chemokines CCL2, CXCL13 and CX3CL1 were measured by radio-and enzyme-immunoassays in serum. Neopterin and chemokines were all found in high concentrations. Neopterin significantly correlated with all chemokines: CXCL13 (r s = 0.368; p <0.0001), CX3CL1 (r s = 0.241; p <0.02), CCL2 (r s = 231; p <0.02), demonstrating high neopterin levels in RA patients to have a strong association to the chemokine induced chemotaxis of B-cells (CXCL13) and mononuclear cells (CX3CL1, CCL2). Significantly elevated concentrations of neopterin and CXCL13 were seen in patients with RA plus CVD compared to RA without CVD (p <0.03). The high incidence of cardiovascular diseases in rheumatoid arthritis seems to be associated with enhanced mononuclear (neopterin, CCL2) and B-cell activation (CXCL13), and as a consequence increased immune system activity.
In obese rheumatoid arthritis (RA) patients inflammatory mechanisms and cardiovascular secondary disorders are possibly related to changed expression of adipocytokines. Various adipocytokines and inflammatory parameters were examined in 112 patients (23.2% men; 76.8% women) suffering from RA: leptin, adiponectin, visfatin, sCD40 L, CRP, and ESR. Average BMI was 27.6 (+/-5.6). Leptin and BMI as well as visfatin and BMI correlated positively, BMI and adiponectin, however, showed a negative correlation. Significant differences between normal-weight and obese RA patients were found in both leptin and adiponectin measurements. Visfatin showed a positive correlation with CRP; sCD40 ligand which is a marker for increased T-cell activity correlated with CRP and ESR. Patients with low adiponectin levels (<10 microg/ml) more often suffered from cardiovascular diseases (28.6%) than those with enhanced adiponectin (14.3%). Increased pro-inflammatory leptin and decreased anti-inflammatory adiponectin in obese RA patients can be associated with RA activity and enhanced cardiovascular risk.
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