Site of invasion revisited: epigenetic drivers of joint destruction in RA

New analytical methods and the increasing availability of synovial biopsies have recently provided unprecedented insights into synovial activation in general and synovial fibroblast (SF) biology in particular. In the course of this development, SFs have become one of the most rapidly evolving and exciting fields of rheumatoid arthritis (RA) research. While their active role in the invasion of RA synovium into cartilage has long been studied, recent studies have brought new aspects of their heterogeneity and propagation in RA. This review integrates old and new evidence to give an overview picture of the processes active at the sites of invasive synovial tissue growth in RA

Proteinases in the joint: clinical relevance of proteinases in joint destruction

Proteinases are involved in essential steps in cartilage and bone homeostasis. Consequently, efforts have been made to establish their potential role in the pathology of rheumatic conditions such as rheumatoid arthritis, osteoarthritis and spondyloarthritis. Matrix metalloproteinases (MMPs) are sensitive markers of disease severity and response to treatment, and therefore they have potential in the assessment of rheumatic diseases. Despite disappointing early results with synthetic inhibitors of MMPs, there is still much scope for developing effective and safe MMPs inhibitors, and consequently to deliver new options to inhibit joint destruction

A framework for sustainable buildings : an application to China

Thesis (S.M.)--Massachusetts Institute of Technology, Dept. of Architecture, 1999.Includes bibliographical references (p. 149-156).A framework has been established to discuss the different topics of Sustainability in the context of buildings. The framework includes the dimensions of time and space and the dimensions of ecology, society, and economy. Buildings are shown to have a substantial share on the total environmental and human health impact of an economy. In an energy efficient building, the impact embodied in the building construction can be dominant over the impacts from building operation. Life cycle assessment is a tool that provides the means for establishing quantitative indicators of sustainability. The different existing impact assessment methods used to aggregate hundreds of different pollutant releases and resource consumption into a few useful indicators are analyzed. Ways of integrating these indicators into the design process are shown and existing design tools and building assessment methods are discussed. A case study on Chinese buildings shows the potential for energy conservation measures as the primary means of directing the Chinese building stock towards a more sustainable path. Developed countries will have to lower their impact on global ecosystems substantially in order to allow countries like China to approach our standard of living. Taking into account the slow turn-over rate of buildings, new buildings have to be at least four times more environmentally effective on a lifetime basis. The necessary data on building materials needs to be made available.by Christoph Ospelt.S.M

Cells of the synovium in rheumatoid arthritis. Synovial fibroblasts

For some time synovial fibroblasts have been regarded simply as innocent synovial cells, mainly responsible for synovial homeostasis. During the past decade, however, a body of evidence has accumulated illustrating that rheumatoid arthritis synovial fibroblasts (RASFs) are active drivers of joint destruction in rheumatoid arthritis. Details regarding the intracellular signalling cascades that result in long-term activation and synthesis of proinflammatory molecules and matrix-degrading enzymes by RASFs have been analyzed. Molecular, cellular and animal studies have identified various interactions with other synovial and inflammatory cells. This expanded knowledge of the distinct role played by RASFs in the pathophysiology of rheumatoid arthritis has moved these fascinating cells to the fore, and work to identify targeted therapies to inhibit their joint destructive potential is underway

Epigenetik bei entzündlichen Systemerkrankungen

In addition to analysis of the genetic code, in recent years more and more studies have concentrated on changes in the epigenetic code. Epigenetic mechanisms determine which genes in a cell are transcribed and thus form the phenotype of a cell. The epigenetic code can be changed by environmental influences, which allows cells to adapt to longstanding changes in the environment. Therefore, it is feasible to assume that epigenetic changes are the molecular basis for long-term effects of the environment on disease development. In particular in tumors and chronic inflammatory diseases epigenetic changes were found to correlate with disease severity and progression. Knowledge about these epigenetic changes might help that epigenetic modifications can be used in the future as biomarkers, prognostic factors and therapeutic targets

Quality criteria of involuntary psychiatric admissions - before and after the revision of the civil code in Switzerland

Background The goal was to investigate the quality in terms of formal and content-based comprehensiveness of the forms for involuntary admission before and after the introduction of the new law (KESR, “Kindes- und Erwachsenenschutzrecht”) for the regulation of involuntary admission. Moreover, the study aimed at assessing if the quality of the admission forms was associated with the professional qualifications of the professionals ordering them. Finally, the patients were characterized. Methods Retrospective evaluation of all commitment reports at the University Hospital of Psychiatry within a six month period before and after the introduction the KESR (N(2012) = 489; N(2013) = 651). Formal and content-related criteria for the commitment certificates were recorded as well as the socio-demographic and clinical data of the cases admitted. There were no exclusion criteria. The data was descriptively evaluated, formal and content-based criteria were compared between groups of admitting professionals. The Chi-Square-Test following Pearson and T-Test were used to test for group differences. Results Formal and content-related quality criteria deficiencies were noted. The best-documented forms came from psychiatrists and emergency physicians, followed by general practitioners and hospital doctors. There have been improvements in the quality of the documents since the new KESR within all professional subsamples. Conclusions Psychiatrists and those who regularly deal with emergency commitments were likely to issue forms of high quality. Due to the considerable consequences associated with involuntary admission for affected individuals, their relatives and also professionals, the considerable deficits in the quality of the documentation must be intensively addressed in training, advanced training, continuing education and in daily routines

Epigenetik bei entzündlichen Systemerkrankungen

Zusammenfassung: In den letzten Jahren wurden neben genetischen Studien immer mehr Analysen von Veränderungen im epigenetischen Code durchgeführt. Epigenetische Mechanismen bestimmen, welche Gene in welcher Zelle transkribiert werden. Damit formen sie den Phänotyp. Der epigenetische Code kann durch Umwelteinflüsse modifiziert werden. Dies ermöglicht den Zellen, sich an lang anhaltende Veränderungen in ihrer Umgebung anzupassen. Daher liegt der Schluss nahe, dass epigenetische Veränderungen die Grundlage für langfristige Auswirkungen von Umwelteinflüssen auf die Gesundheit sein können. Vor allem bei Tumoren und chronisch-entzündlichen Erkrankungen zeigen immer mehr Studien, dass mit dem Krankheitsverlauf epigenetische Veränderungen einhergehen. Das Wissen um epigenetische Veränderungen könnte zukünftig in der Praxis genutzt werden, sowohl als Biomarker und prognostischer Faktor wie auch als therapeutischer Ansatz