Interleukin-6 in Synovial Fluid as a Tool for Differentiation of Inflammation and Degeneration in Chronic Synovitis and Treatment Selection

Although Osteoarthritis (OA) is a widespread type of arthritis, no cure or medication can halt its natural progression. Only weight loss and physiotherapy can help to relieve pain and preserve function. Chronic un-inflammatory synovitis is not uncommon in OA; however, Inflammatory Arthritis (IA) can also start in middle-aged adults affected by OA. Pain and swelling of the joints, especially in the knee joints, are usual complaints in rheumatological practice where the primary treatment for chronic inflammatory arthritis is disease-modifying antirheumatic drugs (DMARDs). At the same time, persistent chronic synovitis leads to secondary OA due to inflammation, aging, and other factors. Discrimination between chronic synovitis due to inflammation or degeneration poses a significant challenge, especially when specific markers for IA are negative. Interleukin-6 (IL-6) has been a research topic for many scientific publications over the past several years. Although IL-6 production and signaling have been observed in OA, a recently published article shows much more elevated IL-6 concentration in synovial fluid (SF) of symptomatic joints in different types of IA [1]. We decided to clarify the importance of IL-6 concentration in synovial fluid (SF) for diagnostic and treatment purposes.publishersversionPeer reviewe

Comparative analysis of CRT Buffer, GC saliva check buffer tests and laboratory titration to evaluate saliva buffering capacity

OBJECTIVE. The purpose of this study is to evaluate the ability of two commercial strip tests and laboratory titration to detect saliva buffer capacity. MATERIALS AND METHODS. Sixty-four patients were examined. Stimulated saliva was collected and buffer capacity was determined with two different chair-side strip tests in addition to immediate transportation to the laboratory to check the buffering ability by titrating with 0.005 M HCl and measuring pH by digital pH/Ion meter, used as a gold standart. The correlation were analyzed using the Spearman Rank Correlation Test, Cohen's Kappa coefficient and Pearson's Correlation test, p < 0.01. Sensitivity and specificity were used to measure precision of these tests. RESULTS. The response rate was 80%. High buffer capacity was found in 23.4% of cases, medium in 62.5%, and low in 14.1%. The Spearman Rank Correlation coefficient between the titration method and CRT Buffer test was 0.685 and the GC Saliva Check Buffer was 0.837. The Kappa coefficient for the CRT Buffer test was 0.508, while the coefficient for the GC Saliva Check Buffer was 0.752. The Pearson Correlation for the GC Saliva Check was 0.675. The difference is found in the buffer capacity at initial pH and at pH value 3. CONCLUSIONS. Both colorimetric tests correlate with the acid titration method in laboratory and are usable for saliva buffer capacity detection in dental offices. Buffer capacity detected in laboratory at different pH values can provide more information regarding caries risk.publishersversionPeer reviewe

Significance of hypouricaemia in the development of neurodegenerative diseases

Publisher Copyright: © 2021 Sciendo. All rights reserved.Hypouricaemia has received relatively little attention in the literature. As a result, there is lessawareness or understanding of the potential risks of low uric acid levels. Emerging research indi-cates that normal uric acid levels may have an antioxidative and neuroprotective effect. Thisstudy aims to investigate possible associations between hypouricaemia and neurodegenerativedisease. Data was collected from seventy-seven outpatients and inpatients who underwent rou-tine uric acid testing, who were then stratified into patients with and without neurodegenerativedisease. Patients with renal pathologies and patients using uric acid altering medications were ex-cluded from the study. There was a significant difference in the prevalence of Alzheimer’s diseasebetween hypouricemic and normouricemic patients (p= 0.001), however there was no differencein the prevalence of vascular dementia (p= 0.45). This study provides evidence that hypouricae-mia has potential effects on health, specifically on the rate of neurodegenerative diseases suchas Alzheimer’s disease and gives weight to the potential neuroprotective role of uric acid.publishersversionPeer reviewe

Evidence based toothpaste classification, according to certain characteristics of their chemical composition

Toothpastes are daily oral care products, the chemical composition of which is constantly changing due to manufacturer's competition. It becomes more and more difficult for dentists to recommend the best toothpaste and for patients to choose one. The objective of this paper was to draw out recommendations based on the best evidence available and to propose a new classification of toothpastes. Publications were searched in PubMed database (published between 1991-2011, limited to English language articles in dental journals). Recommendations for toothpaste choice and usage were developed from the best evidence available.publishersversionPeer reviewe

Interleukin 18 gene promoter polymorphisms in Latvian patients with rheumatoid arthritis

Copyright: Copyright 2011 Elsevier B.V., All rights reserved.Interleukin 18 (IL-18) is a proinflammatory cytokine involved in the pathogenesis of rheumatoid arthritis (RA). There are controversial reports suggesting that IL-18 promoter polymorphisms may be an independent marker of RA susceptibility. The aim of the present study was to determine whether polymorphisms of the IL-18 gene promoter in positions -607 (rs 1946519) and -656 (rs 1946518) are associated with RA, and its characteristics in the Latvian population. We examined 105 patients with RA diagnosed according to the criteria of the American College of Rheumatology. DNA and phenotypic data from a healthy control population was obtained from Genome Database of Latvian Population. Genotypes were obtained by direct sequencing. Single-nucleotide polymorphisms (SNPs) were studied and frequencies of alleles and genotypes were compared between patients and controls. A P value less than 0.05 was accepted as statistically significant. There were no significant differences in the distribution of alleles and genotypes between RA patients and the control group. The frequencies of IL-18-607C/A and -656G/T genotypes differed between patients and the control group in women (P = 0.084 and 0.097). Heterozygous genotypes -607CA and -656GT occurred more frequently in the RA group than in the control (P = 0.046, P = 0.060), and this difference was also significant for the only women groups (P = 0.041,P = 0.054). The heterozygous states -607CA and -656GT of IL-18 gene affect susceptibility to RA. On the basis of investigated IL-18 polymorphisms, female patients with RA seem to represent a separate disease subgroup.publishersversionPeer reviewe

The Link between Hypouricemia and Neurodegenerative Disorders

The potential danger to patients’ health due to hypouricemia has only recently become a research topic of interest. While it has been established that normal uric acid levels have antioxidative and neuroprotective properties, the loss of these functions with uric acid levels below the normal range have been studied only recently and findings suggest potential detrimental effects on the brain and cognitive abilities. The purpose of this study is to look at potential connections between hypouricemia and neurodegenerative disorders such as Alzheimer’s disease and vascular dementia. Seventy-seven inpatients and outpatients with routine uric acid testing were included and further stratified into patients with neurodegenerative disease and patients without neurodegenerative disease. The results showed that rates of Alzheimer’s disease differ between patients with hypouricemia and normal uric acid levels, however this association was not found for patients with vascular dementia. This provides evidence for potential effects of hypouricemia and raises the question for further research define a safe range of serum uric acid

McKittrick-Wheelock Syndrome: A Case Report

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Genetic Aspects of Rheumatoid Arthritis. Doctoral Thesis

Promocijas darbs izstrādāts Rīgas Austrumu klīniskās universitātes slimnīcas klīnikā Linezers, Reimatoloģijas centrā, Latvijas Biomedicīnas pētījumu un studiju centrā. Aizstāvēšana: 2012. gada 18. jūnijā plkst. 14.00 Rīgas Stradiņa universitātes Internās medicīnas Promocijas padomes atklātā sēdē Rīgā, Dzirciema ielā 16, Hipokrāta auditorijā.Reimatoīdais artrīts (RA) ir hroniska destruktīva locītavu iekaisuma slimība ar būtisku personisku, sociālu un ekonomisku ietekmi. Atšķirības starp etnisku grupu risku saslimt ar RA, slimības gaitas neviendabīgums un variācijas klīniskās, radioloģiskās un laboratorijas pārbaudēs liecina, ka vairāki faktori ietekmē RA rašanos un progresēšanu. Būtiska nozīme te ir ģenētiskajam komponentam. Darba galvenais mērķis bija izpētīt ģenētisko faktoru saistību ar RA izpausmēm Latvijas populācijā. Darbā apkopoti dati par RA slimniekiem, noteiktas slimības stadijas, aktivitāte un smaguma pakāpes saskaņā ar aktuāliem slimības vērtēšanas kritērijiem. Pirmo reizi Latvijā RA slimnieku populācijai ir tipizēti ģenētiskie polimorfismi PTPN22 gēnā (rs2476601), KLF12 gēnā (rs1324913), TNFA gēna promoterā -308 pozīcijā (rs1800629), IL6 gēna promoterā -174 pozīcijā (rs1800795), IL18 gēna promoterā -607, -656 pozīcijā (rs1946519, rs1946518), IL10 gēna promoterā -592, -819, -1082 pozīcijā (rs1800872, rs1800871, rs1800896) un iegūtā informācija attiecināta uz slimības fenotipiskām izpausmēm. Pētījumā iegūti ticami rezultāti par ģenētisko marķieru asociāciju ar uzņēmību pret RA, to aktivitāti un smagumu. Apkopojot pētījuma datus par RA ģenētiskajiem marķieriem, ir redzams, ka viens noteikts polimorfisms ir saistāms ar dažādu slimības pazīmju attīstību. Tajā pašā laikā pie noteikta fenotipa formēšanas piedalās dažādi ģenētiskie faktori. PTPN22 1858C/T, KLF12C/A, IL6 un IL18 polimorfismu esamība Latvijas iedzīvotājiem ir saistīta ar risku saslimt ar RA. Antivielu esamību var ietekmēt KLF12C/A un IL6 polimorfismi. Iespējamie priekšvēstneši erozīvai slimībai ir PTPN22 1858T alēli nesošie genotipi un KLF12 A alēles homozigotiskais genotips. TNFA genotipi var iespaidot slimības patoģenēzi saistībā ar slimības sākšanās vecumu, savukārt IL10 promotera polimorfismi var ietekmēt slimības aktivitāti. Šajā pētījumā ir apvienotas vairākas zinātņu nozares – ģenētika, bioloģija, medicīna. Iegūtie rezultāti ir salīdzināmi ar līdzīgu starptautisku pētījumu datiem. Zināšanas par asociāciju starp ģenētiskajiem faktoriem un slimību papildina jau zināmos datus par RA etioloģiju un patoģenēzi, par faktoriem, kuri saistīti ar RA aktivitāti, smagumu un prognozi; palīdz RA agrīnā diagnostikā, slimības izpausmes prognozēšanā un ārstēšanas plānošanā ar potenciālu klīnisko un ekonomisko ieguvumu

Ģenētiskie aspekti reimatoīdā artrīta gadījumā. Promocijas darba kopsavilkums

The study was performed in Riga Eastern Clinical University Hospital, Clinic Linezers, Rheumatology Center, Latvian Biomedical Research and Study Center. Defence: at the session of the Promotion Council of the Department of Internal Diseases in the Hippocrates Auditorium of Riga Stradins University (Dzirciema Street 16, Riga) on 18 June 2012 at 14:00.Rheumatoid arthritis (RA) is a chronic inflammatory destructive joints disease with essential personal, social and economic impact. Differences between ethnic groups in susceptibility to RA, disease heterogeneity and variations in clinical, radiological and laboratory findings suggest that several factors influence the occurrence and progression of RA. The genetic component has a large impact. The aim of the study was to investigate the association of genetic factors on manifestations of RA in Latvian population. Doctoral thesis summarizes the data about RA patients. Be defined stages of the disease, activity and severity of disease according to current evaluation criteria. This is the first time genotyping was performed in Latvia for population of patients with RA for PTPN22 gene (rs2476601), KLF12 gene (rs1324913), TNFA gene promoter -308 position (rs1800629), IL6 gene promoter position -174 (rs1800795), IL18 gene promoter -607, -656 position (rs1946519, rs1946518), IL10 gene promoter -592, -819, -1082 position (rs1800872, rs1800871, rs1800896) and the information received was attributed to the phenotypic manifestations of the disease. The study obtained reliable results about the association of the genetic markers with RA susceptibility, activity and severity. Summarizing data about genetic markers, it is evident that one polymorphism affects development of various symptoms of the disease. At the same time different genetic factors participate in the formation of the particular phenotype. PTPN22 1858C/T, KLF12C/A, IL6 and IL18 polymorphisms are associated with susceptibility to RA in Latvian population. KLF12C/A and IL6 polymorphisms may affect antibodies status. PTPN22 1858T allele bearing genotypes and KLF12 A allele homozygous genotype are possibly the forerunners of erosive disease. TNFA genotypes may influence disease pathogenesis, depending on the age of disease onset and IL10 promoter polymorphisms may influence disease activity. This study combines several scientific fields – genetics, biology, medicine. The results obtained are comparable with similar international studies. Knowledge about the association between genetic factors and disease supplement existing information about etiology and pathogenesis of RA, factors that affect disease activity, severity and prognosis, help in early diagnosis of RA, in prediction of disease manifestations and treatment planning with potential clinical and economic benefits