Cytogenetic alterations in rheumatoid arthritis patients treated with methotrexate and dry olive leaf extract

Oxidative stress and inflammation are DNA instability factors for rheumatoid arthritis (RA) patients. The aims of this study were to evaluate cytogenetic alterations in Peripheral Blood Lymphocytes (PBL) in two groups of RA patients: the early and the long-term RA group; and to examine potential of concomitant treatment with Methotrexate (MTX) and Dry olive leaf extract (DOLE) against cytogenetic damage in RA patients after a 3-weeks treatment. A total of 32 RA patients and 10 healthy individuals were included. RA patients were equally divided into four groups: two groups with early phase RA (one treated with MTX alone, the other in combination with DOLE); and two long-term phase RA groups (group with active disease and group with low disease activity)-both treated with MTX and DOLE combination. PBL cultures were screened for chromosome aberrations and micronuclei frequencies. Significantly increased frequencies of micronuclei were shown in active phase RA disease (both early and long-term) but not in the group with low disease activity, as compared to controls. Chromosome aberrations were detected for all 4 RA groups. The highest frequencies of micronuclei and chromosome aberrations were found in the long-term active RA group. After 3 weeks-treatment, there were no significant decrease of the micronuclei frequencies compared to baseline, although they were reduced in all RA groups, except for the group with the long-term active disease. High level of cytogenetic damage in RA patients was concordant with duration and activity of the RA disease. At 3 weeks of therapy, neither the combined treatment (MTX+DOLE), nor MTX alone did not affect the frequency of micronuclei formation

Ultrasonography of the first metatarsophalangeal joint in gout

Introduction. About one half of the first gout attacks occur in the first metatarsophalangeal joint (MTPJ1); in the disease course this joint is practically inevitably affected. Radiographic evidence of bone erosions is the indication for hypouricaemic therapy in order to prevent joint destruction and nephropathy. Advantages of ultrasonography (US) comparing to conventional x-ray findings in depicting early bone erosions in various inflammatory arthropathies have been demonstrated by several studies. Objective. The aims of this study were to compare US and x-ray findings in the detection of MTPJ1 erosions in patients with gout, to correlate sonographic and clinical features, and to detect possible characteristic sonographic features of gout. Methods. Thirty patients (60 MTPJ1) with primary gout (ACR) and 10 age-matched control subjects (20 MTPJ1) with different inflammatory arthropathies were clinically evaluated. Standard dorsiplantar weight bearing and lateral weight bearing x-ray views of both feet were taken. US was performed and interpreted by an independent sonographer on the presence of bone erosions, synovial fluid, synovial hypertrophy, Doppler signal and hyperechoic spots. Statistical analysis was performed (Spearman and Pearson correlation coefficient, Wilcoxon and χ2 test.) Results. Twenty-four studied MTPJ1 had evidence of erosions, 17 only on US and seven both on x-ray and on US (Z=-4.123; p=0.000). US findings showed that hyperechoic spots were the most prominent feature of gouty MTPJ1 (χ2=40.909; p=0.000), followed by erosions and synovial fluid presentation. Conclusion. US of MTPJ1 in gout discovers significantly more erosions than x-ray, which may have therapeutic implications. The evidence of hyperechoic spots (surrogate crystals) of the different size, number and orientation is a major sonographic feature of the MTPJ1 in gout, which may be of importance in the diagnosis of certain cases (low serum urate, unavailable synovial fluid or the urate crystals absence)

Prevalence of spondyloarthritis and its subtypes - are they really comparable?

Introduction/Objective. Increasing spondyloarthritis (SpA) prevalence in the last several decades cannot be attributed to disease manifestations alone. The objective of this paper is to review the prevalence of SpA and its subtypes: ankylosing spondylitis (AS), psoriatic arthritis (PsA), reactive arthritis (ReA), SpA related to inflammatory bowel disease (IBD) and undifferentiated SpA (UnSpA). Methods. MEDLINE literature search was done via PubMed, Google Scholar, and Embase databases, using terms for spondyloarthritis, and prevalence, with an additional hand searching. Results. As compared with southern European countries, northern European countries (Scotland, Sweden, France) showed lower SpA prevalence rates (0.21–0.45% vs. 1.06% and 1.35% in Italy and Turkey, respectively). The lowest world SpA prevalence was in African and Southeast Asian countries (0–0.19%), and the highest was in Alaska (2.5%). The widest variability in PsA prevalence was in Europe (northern 0.02–0.19%, southern 0.42%). The lowest world PsA prevalence was in Japan (0.001%), followed by China (0.01–0.10%). The European ReA prevalence ranged from 0.04% in Greece to 0.10% in Serbia and Germany, and the European UnSpA prevalence varied from 0.02% in Serbia to 0.67% in Germany; the highest world UnSpA prevalence was in Lebanon (3.4%). Studies aimed at estimating the SpA prevalence differed in sampling strategy and confirmation criteria, different cutoffs for age groups inclusion, presentation of standardized or row results, etc. Conclusion. Variation in the SpA prevalence cannot be attributed to genetic or geographic distribution only. Differences in methodology of studies add to the diversification, described more in-depth in this review

Dry Olive Leaf Extract in Combination with Methotrexate Reduces Cell Damage in Early Rheumatoid Arthritis PatientsA Pilot Study

The effects of co-administration of dry olive leaf extract (DOLE) with standard methotrexate (MTX) therapy on the parameters of cell damage and inflammation in patients with early and long-term rheumatoid arthritis (RA) were evaluated at baseline, 3 and 6weeks. Patients were assigned to groups: the early phase RA group on MTX monotherapy (E MTX), and the two RA groups that received co-treatment with DOLE and MTX: early (E MTX+DOLE) and long-term phase patients (L-t MTX+ DOLE). Baseline values indicated increased parameters of cell damage and disruption of redox balance in all groups. After three weeks the E MTX+DOLE group maintained high catalase activity, exhibited decrease of lipid peroxidation and protein damage indicatorsthiols and nitrites, while levels of DNA damage and pro-inflammatory interleukin-6 were significantly reduced. In E MTX group catalase activity remained unaltered while significant lipid peroxidation and DNA damage reductions were seen only after six weeks. L-t MTX+DOLE group showed only modest alterations of cell damage parameters during six weeks. Combined administration of DOLE with MTX contributes to faster reduction of cell damage, restores oxidative balance and improves interleukin-6 suppression during high disease activity in early phase RA, but not in long term patients. Copyrigh