Search PubMed⌕ Search

Biomedical subjects

M D Smith

Publications and source records attributed to M D Smith.

At least 91 records · Page 5Linked to original sources
PubMed2001

Love and the commitment problem in romantic relations and friendship.

On the basis of the proposition that love promotes commitment, the authors predicted that love would motivate approach, have a distinct signal, and correlate with commitment-enhancing processes when relationships are threatened. The authors studied romantic partners and adolescent opposite-sex friends during interactions that elicited love and threatened the bond. As expected, the experience of love correlated with approach-related states (desire, sympathy). Providing evidence for a nonverbal display of love, four affiliation cues (head nods, Duchenne smiles, gesticulation, forward leans) correlated with self-reports and partner estimates of love. Finally, the experience and display of love correlated with commitment-enhancing processes (e.g., constructive conflict resolution, perceived trust) when the relationship was threatened. Discussion focused on love, positive emotion, and relationships.

Adolescent↗
PubMed2001

A dose-escalation study to assess the efficacy and safety of sildenafil citrate in men with erectile dysfunction.

OBJECTIVE: To assess the efficacy and safety of sildenafil citrate (Viagra, Pfizer Inc., USA) in a double-blind, placebo-controlled, dose-escalation study over a period of 26 weeks in men with erectile dysfunction of a broad spectrum of aetiology. PATIENTS AND METHODS: In all, 315 patients from five countries were randomized to receive treatment with placebo (156 men) or sildenafil (159 men). Significant concomitant medical conditions were hypertension (20%), a history of pelvic surgery (19%), diabetes mellitus (15%), and ischaemic heart disease (10%). Patients randomized to treatment received a starting dose of 25 mg of sildenafil or matching placebo, which could be increased to 50 mg and then to 100 mg of sildenafil, based on efficacy and tolerability. Assessments of efficacy comprised the 15-item International Index of Erectile Function (IIEF), including question three (ability to achieve an erection) and question four (ability to maintain an erection), a partner questionnaire, an overall efficacy question, and event-log data. RESULTS: After 12 weeks of treatment, 26%, 32% and 42% of patients were taking 25, 50 and 100 mg of sildenafil, respectively. A similar distribution of doses was reported after 26 weeks of treatment. Treatment with sildenafil significantly improved the patients' abilities to achieve and maintain an erection compared with treatment with placebo (P < 0.001). Scores for four of the five sexual function domains of the IIEF (erectile function, orgasmic function, intercourse satisfaction and overall satisfaction) also improved significantly (P < 0.001). There was a significant improvement in the mean score for the erectile function domain, regardless of the aetiology of erectile dysfunction (P < 0.001). After 12 weeks and 26 weeks of treatment, 82% and 79% of patients receiving sildenafil reported improved erections, compared with 24% and 23% of patients receiving placebo, respectively (P < 0.001). Treatment-related adverse events were mild to moderate and occurred in 27% of patients receiving sildenafil, compared with 8% of patients receiving placebo. CONCLUSION: Sildenafil is an effective and well-tolerated treatment for men with erectile dysfunction of a broad spectrum of aetiology.

Administration, Oral↗
PubMed2001

Echocardiographic follow-up study of the Ross procedure in older versus younger patients.

OBJECTIVES: This study was designed to determine echocardiographic follow-up results of the Ross procedure in older adult patients with aortic valve disease. BACKGROUND: The excellent long-term results of the Ross procedure from several institutions have indicated that the pulmonary autograft may be the best available substitute for the diseased aortic valve in children and adolescents. The advantages of this operation include optimal hemodynamics and elimination of thromboembolic complications. These features may benefit older adult patients as well. METHODS: We reviewed data from 49 consecutive patients who had a Ross procedure between 1991 and 1996. Preoperative and postoperative Doppler echocardiographic studies were available for 44 patients (22 men, 22 women; mean [+/-SD] age 36 +/- 14 years) who were grouped into <40 (n = 25) and > or =40 years old (n = 19). Measurements included left ventricular diastolic volume (LVDV), mass, and ejection fraction (EF); a peak pressure gradient across autograft in the aortic position and homograft in the pulmonary position; and valvular regurgitation. RESULTS: The mean length of echocardiographic follow-up was 36 +/- 16 months. Postoperatively, there was a reduction in LVDV and left ventricular mass in both age groups: 153 +/- 99 mL to 111 +/- 72 mL (P =.015) and 210 +/- 93 g to 152 +/- 54 g (P =.002) for younger patients, 174 +/- 115 mL to 126 +/- 43 mL (P =.17) and 233 +/- 71 g to 215 +/- 65 g (P =.19) for older patients. No significant change in EF was noted in the younger age group. However, in the older age group a significant decrease to EF <25% was found in 2 patients 1 year after surgery. Moderate autograft regurgitation was also detected in 2 patients: 1 in each age group. Pressure gradients across the autograft remained within the normal range in both age groups. Two younger patients had severe homograft stenosis with peak gradients of 100 and 62 mm Hg. The older patients did not demonstrate homograft dysfunction. CONCLUSIONS: The Ross procedure can be performed in selected older adults with aortic valve disease and provides durable valves in both aortic and pulmonic positions for at least 3 years after surgery but may result in less favorable left ventricular remodeling compared with that in the younger patients. Further follow-up will be necessary to determine the long-term outcome of the Ross procedure in this older adult patient population.

Adolescent↗
PubMed2001

Association of clinical, radiological and synovial immunopathological responses to anti-rheumatic treatment in rheumatoid arthritis.

OBJECTIVES: To compare immunohistochemical scoring with clinical scoring and radiology for the assessment of rheumatoid arthritis (RA) disease activity, synovial tissue (ST) biopsied arthroscopically was assessed from 18 patients before and after commencement of disease-modifying anti-rheumatic drug (DMARD) therapy. METHODS: Lymphocytes, macrophages, differentiated dendritic cells (DC), vascularity, tumour necrosis factor (TNF) alpha and interleukin-1beta levels were scored. Clinical status was scored using the American College of Rheumatology (ACR) core set and serial radiographs were scored using the Larsen and Sharp methods. Histopathological evidence of activity included infiltration by lymphocytes, DC, macrophages, tissue vascularity, and expression of lining and sublining TNFalpha. These indices co-varied across the set of ST biopsies and were combined as a synovial activity score for each biopsy. RESULTS: The change in synovial activity with treatment correlated with the ACR clinical response and with decreased radiological progression by the Larsen score. The ACR response to DMARD therapy, the change in synovial activity score and the slowing of radiological progression were each greatest in patients with high initial synovial vascularity. CONCLUSIONS: The data demonstrate an association between clinical, radiological and synovial immunopathological responses to anti-rheumatic treatment in RA. High ST vascularity may predict favourable clinical and radiological responses to treatment.

Aged↗
PubMed2001

Treatment-induced remission in rheumatoid arthritis patients is characterized by a reduction in macrophage content of synovial biopsies.

OBJECTIVES: To document the change in synovial membrane macrophage and T-lymphocyte content in rheumatoid arthritis (RA) patients who achieve remission induced by disease-modifying anti-rheumatic drugs (DMARDs). METHODS: Arthroscopic synovial biopsies were taken from four to seven sites around a knee joint in 13 patients with RA before and at regular intervals after commencing treatment with a DMARD. The cellular content of synovial membrane biopsies taken at regular intervals for a period of up to 3 yr after commencing treatment was quantitated by routine histopathology and immunohistochemical labelling with anti-macrophage (CD68) and anti-T lymphocyte (UCHL-1) antibodies. Synovial biopsies were quantitated with a validated semiquantitative scoring system and video image analysis. RESULTS: Nine patients obtained clinical remission, as defined by American College of Rheumatology (ACR) criteria. The changes that occurred in the synovial biopsies included a reduction in lining layer thickness, reduced vascularity and cellular infiltrate. The most significant reduction in cellular infiltrate was in the lining layer macrophages, with less dramatic change in the subintimal macrophage infiltrate. Although there was a reduction in CD45 Ro-positive T lymphocytes in the synovial membranes of patients who attained ACR-defined disease remission, it was less significant than the reduction in macrophage content of the synovial membranes and tended to plateau at a reduced level of T-cell infiltration. CONCLUSIONS: Remission in RA patients is characterized by a predominant reduction in macrophage content of the synovial membrane, suggesting that current DMARDs may target this cell and its inflammatory mediators.

Aged↗
PubMed2001

Successful treatment of rheumatoid arthritis is associated with a reduction in synovial membrane cytokines and cell adhesion molecule expression.

OBJECTIVE: To investigate the change in synovial membrane cytokine content and cell adhesion molecule expression in sequential biopsies from the same knee joint of patients with rheumatoid arthritis, before and following anti-rheumatic drug treatment and to assess the relationship of these changes with clinical responses to the drug treatment. METHODS: A selected group of patients with rheumatoid arthritis, some of whom had achieved a disease remission based on American College of Rheumatology (ACR) criteria, were included in this study. Sequential synovial biopsies obtained before and throughout the treatment period were studied by immunohistochemical labelling techniques for the cellular content, production of a range of pro- and anti-inflammatory cytokines and the expression of cell adhesion molecules. The staining was quantitated using computer-assisted digital image analysis. RESULTS: There was a decrease in tumour necrosis factor-alpha (TNFalpha) and interleukin-1beta (IL-1beta) production in the synovial membrane lining and sublining of all patients who responded to treatment. The changes in IL-1 receptor antagonist production were variable. Paradoxically, there was a trend to decreased synovial membrane production of the anti-inflammatory cytokines, IL-10 and transforming growth factor-beta (TGFbeta), while IL-4 was not detectable in any of the synovial membrane biopsies. A significant reduction in the density and total amount of E-selectin expression in the synovial membrane was seen. Similarly, intercellular adhesion molecule-1 (ICAM-1) expression in the lining and sublining was decreased in those patients who had a significant clinical response to drug treatment or attained disease remission. There were no consistent or significant changes seen in the expression of other cell adhesion molecules in the synovial membranes of these patients. CONCLUSIONS: Successful drug treatment of rheumatoid arthritis patients is characterized at the synovial membrane level by a decrease in TNFalpha, IL-10 and TGFbeta production. Some (E-selectin and ICAM-1) but not all (P-selectin, VCAM-1, PECAM-1) cell adhesion molecules are modulated in patients who respond clinically to drug treatment. E-selectin and ICAM-1 may be important targets for the development of future drug treatments for rheumatoid arthritis.

Aged↗
PubMed2001

Sr3ZnPtO6 and Sr3CdPtO6.

The flux synthesis of single crystals of the isostructural compounds tristrontium zinc platinum hexaoxide, Sr(3)ZnPtO(6), and tristrontium cadmium platinum hexaoxide, Sr(3)CdPtO(6), is reported. The compounds adopt the pseudo-one-dimensional rhombohedral K(4)CdCl(6) structure type, and feature chains of face-shared distorted ZnO(6) or CdO(6) trigonal prisms and PtO(6) octahedra, surrounded by columns of Sr(2+) ions. All transition metals are located on the threefold axis of symmetry, while the Sr(2+) cations lie on twofold axes.

Journal Article↗
PubMed2001

Measurement of cytokine and adhesion molecule expression in synovial tissue by digital image analysis.

OBJECTIVE: Digital image analysis (DIA) offers the opportunity to quantify the stained area and staining intensity when synovial tissue (ST) is investigated by immunohistochemical analysis. This study aimed at determining the sensitivity of DIA compared with semiquantitative analysis (SQA). METHODS: Paired ST samples were obtained from the knee joint of 10 patients with rheumatoid arthritis (RA) with active disease and after follow up when complete clinical remission was achieved. ST samples of 10 subjects with non-inflammatory knee pain served as controls. Immunohistochemistry with antibodies against interleukin 1beta (IL1beta) and vascular cell adhesion molecule 1 (VCAM-1) was applied using two staining protocols with 3-amino-9-ethylcarbazole (AEC) or p-diethylaminobenzaldehyde (DAB) as dye. All sections were analysed semiquantitatively (0-4) and DIA of up to a maximum of 60 high power fields (HPF). The average integrated optical density was calculated as the product of the stained area (corrected for total tissue area) and the optical density. RESULTS: Both SQA and DIA enabled the assessment of differences in IL1beta and VCAM-1 expression between ST from active RA, RA in remission, and controls. SQA and DIA showed excellent correlations (IL1beta rs=0.867; p<0.0001: VCAM-1 rs=0.828; p<0.0001). A limited analysis of one region with six HPF still allowed adequate discrimination compared with an extended analysis of three regions with a total of 60 HPF. In general, the red dye (AEC) resulted in better discrimination than the brown (DAB) staining. CONCLUSION: DIA offers a reliable, reproducible, and sensitive analysis of ST sections stained for cytokines and adhesion molecules.

Adult↗
PubMed2001

Analysis of the cell infiltrate and expression of matrix metalloproteinases and granzyme B in paired synovial biopsy specimens from the cartilage-pannus junction in patients with RA.

OBJECTIVES: Examination of synovial tissue (ST) obtained at surgery because of end stage destructive rheumatoid arthritis (RA) showed that macrophages and fibroblasts are the major cell types at the cartilage-pannus junction (CPJ). This study aimed at defining the cell infiltrate and mediators of joint destruction in ST selected at arthroscopy from the CPJ in patients with RA who did not require joint surgery. METHODS: Paired synovial biopsy specimens were obtained at arthroscopy from ST adjacent to the CPJ and the suprapatellar pouch from the knee joints of 17 patients with RA. Immunohistological analysis was performed using monoclonal antibodies to detect T cells, B cells, plasma cells, macrophages, fibroblast-like synoviocytes, mast cells, and granzyme B+ cytotoxic cells as well as the expression of metalloproteinase (MMP)-1, MMP-3, and MMP-13. The sections were evaluated by computer assisted image analysis and semiquantitative analysis. RESULTS: The cell infiltrate comprised mainly T cells, macrophages, and plasma cells. The ST was also infiltrated by the other cell types, but at lower numbers. Expression of MMPs was abundant, especially MMP-3. The features of ST at the CPJ were generally similar to those at the suprapatellar pouch. CONCLUSIONS: The synovium at the CPJ in patients with RA who did not require joint surgery exhibits, in general, the same type of cell infiltrate and expression of MMPs and granzymes as ST from the suprapatellar pouch. The pathological changes that have been described at the CPJ in patients with RA with end stage, destructive disease may well reflect the transition to a process in which macrophages, fibroblast-like synoviocytes, and other cell types become increasingly important.

Adult↗
PubMed2001

Molecular identification and characterization of the platelet ADP receptor targeted by thienopyridine antithrombotic drugs.

ADP plays a critical role in modulating thrombosis and hemostasis. ADP initiates platelet aggregation by simultaneous activation of two G protein-coupled receptors, P2Y1 and P2Y12. Activation of P2Y1 activates phospholipase C and triggers shape change, while P2Y12 couples to Gi to reduce adenylyl cyclase activity. P2Y12 has been shown to be the target of the thienopyridine drugs, ticlopidine and clopidogrel. Recently, we cloned a human orphan receptor, SP1999, highly expressed in brain and platelets, which responded to ADP and had a pharmacological profile similar to that of P2Y12. To determine whether SP1999 is P2Y12, we generated SP1999-null mice. These mice appear normal, but they exhibit highly prolonged bleeding times, and their platelets aggregate poorly in responses to ADP and display a reduced sensitivity to thrombin and collagen. These platelets retain normal shape change and calcium flux in response to ADP but fail to inhibit adenylyl cyclase. In addition, oral clopidogrel does not inhibit aggregation responses to ADP in these mice. These results demonstrate that SP1999 is indeed the elusive receptor, P2Y12. Identification of the target receptor of the thienopyridine drugs affords us a better understanding of platelet function and provides tools that may lead to the discovery of more effective antithrombotic therapies.

Adenosine Diphosphate↗
PubMed2001

Efficacy of sildenafil citrate for the treatment of erectile dysfunction in men taking serotonin reuptake inhibitors.

OBJECTIVE: This study was an evaluation of whether sildenafil citrate is effective for the treatment of erectile dysfunction in men taking concomitant serotonin-reuptake-inhibiting antidepressants. METHOD: A retrospective subanalysis of combined data from 10 phase II/III double-blind, placebo-controlled, fixed- and flexible-dose trials (12-26 weeks) identified a group of men with erectile dysfunction receiving 5 to 200 mg/day of sildenafil (N=65) or placebo (N=33) and concomitant serotonin-reuptake-inhibiting antidepressants. Efficacy was measured by responses to questions from the International Index of Erectile Function on ability to achieve erection, ability to maintain erection, ejaculation frequency, orgasm frequency, and sexual desire. RESULTS: Patients with erectile dysfunction receiving sildenafil and concomitant serotonergic antidepressants had significantly greater improvements in ability to achieve and maintain an erection, frequency of ejaculation, and orgasm frequency than did patients receiving placebo, without increased sexual desire. CONCLUSIONS: Sildenafil significantly improved erectile dysfunction in patients taking concomitant serotonergic antidepressants.

Major Depressive Disorder↗
PubMed2001

Prevention of corticosteroid induced osteoporosis in inpatients recently discharged from a tertiary teaching hospital.

OBJECTIVE: To determine the medical conditions for which oral corticosteroids are prescribed and to determine the frequency and type of osteoporosis prophylaxis offered to these patients. METHODS: Medical records of all inpatients for the period March to October 1999 who were documented in pharmacy records as either having received continuous oral steroids for at least 3 months or who had at least 4 courses of oral steroids per year were examined for the following data: age, sex, medical condition for which steroids were required, dose and duration of steroid therapy, whether they were offered bone mineral density (BMD) scans, and whether they were offered drug prophylaxis for steroid induced osteoporosis and the type of drug prophylaxis offered. Followup telephone calls were made to verify patients' use of prophylactic treatment and to validate the chronic use of oral corticosteroids. Use of BMD testing was also validated by comparing the list of patients in this study with the records of bone densitometer units in the area. RESULTS: A total of 189 medical records were examined: 38% were women (n = 72) and 62% were men (n = 117), with an age range of 19-91 years; 73% were taking continuous steroid therapy, the remaining 27% had multiple courses of prednisolone through the year. Steroids were prescribed for respiratory (n = 82, 43%), rheumatological (n = 74, 39%), hematological (n = 16, 8%), dermatological (n = 8, 4%), and gastrointestinal conditions (n = 7, 4%). Chronic obstructive airway disease was the most common respiratory condition for which steroids were prescribed (77, 94%), and polymyalgia rheumatica (36%) and inflammatory arthritis (41%) were the most common rheumatological conditions for which steroids were prescribed. In total, 47% (n = 89) were offered BMD scans while 53% (n = 100) were not. Of the 100 patients not offered BMD scans, 21 (21%) were receiving some form of drug prophylaxis, while 79% of patients were not taking any form of drug prophylaxis. Prophylaxis consisted of calcitriol (64%), alendronate (11%), calcitriol and calcium (7%), calcium alone (7%), alendronate and calcium (3%), etidronate and calcium (2%), alendronate, calcitriol and calcium (1%), alendronate and calcitriol (1%), and hormone replacement therapy (4%). Rheumatologists utilized both BMD testing and prophylactic treatment twice as often in patients taking chronic oral corticosteroid treatment than other specialty physicians. CONCLUSION: Compared to literature reports, the use of prophylaxis for corticosteroid induced osteoporosis was relatively high at this teaching hospital, with a surprisingly large number of patients receiving this treatment with no monitoring by BMD measurements.

Administration, Oral↗
PubMed2001

Duckweed based wastewater treatment (DWWT): design guidelines for hot climates.

Conventional wastewater treatment systems are expensive in either investment or running costs. On the other hand, waste stabilisation ponds may be unable to meet effluent standards for nutrients. Wastewater treatment using duckweed therefore becomes more significant as an option capable of achieving effluent standards and generating revenue from selling the duckweed. However existing duckweed based wastewater treatment (DWWT) systems have high land requirements despite being able to reduce concentrations of organic compounds and pathogens to acceptable levels. Improved guidelines for the design of DWWT are necessary to obtain a reliable and cost-effective wastewater treatment plant using duckweed. This guideline provides a DWWT design program using spreadsheets for different configurations of wastewater treatment units using duckweed. The design program developed suggests that a combination of anaerobic ponds, DWWT systems and maturation ponds can minimise land requirements and capital costs while achieving specified effluent standards. In order to achieve effluent standards, the land required is typically from 1.5 to 1.8 m2/capita (excluding associated facilities), capital costs are in the range from 7.9 to 9.7 USD/capita, with a retention time from 15 to 18 days. Income generation is dependent mainly on the social and cultural acceptability of duckweed use within the community.

Adsorption↗
PubMed2001

Missing a therapeutic window of opportunity: an audit of patients attending a tertiary teaching hospital with potentially osteoporotic hip and wrist fractures.

OBJECTIVE: To establish the rate of and the predictors for performance of a bone mineral density (BMD) test and the treatment of osteoporosis in an at-risk cohort of patients attending a tertiary teaching hospital with fracture possibly related to osteoporosis. METHODS: A list of all patients between ages 40 and 85 who had been admitted to a tertiary teaching hospital in the last 18 mo with hip fracture or seen in the accident and emergency department with a wrist fracture over the last 30 mo was obtained from computer records; those patients were invited to participate in the audit. In a followup telephone questionnaire, they were queried about potential risk factors for osteoporosis and subsequent fracture, the performance of a BMD test, any information received on osteoporosis and the source of this information, and the prescription of any treatment for osteoporosis. RESULTS: In total, 218 patients were included in the audit from a potential 374 eligible patients. The majority were female (78%), with hip and wrist fractures in 42% and 58%, respectively; 32% subsequently had BMD measured and 39% were offered treatment for osteoporosis. Ninety-four percent of patients had heard of osteoporosis, with the major source of information being the media (83%) and friends (23%), with little information from the medical profession (34%). The major predictors for a patient to have a subsequent BMD test were female sex (OR 3.4, 95% CI 1.3-9.9), history of a previous fracture after the age of 50 (OR 2.3, 95% CI 1.0-5.6), family history of osteoporosis (OR 3.5, 95% CI 1.3-9.5), or the use of concurrent medications with a potential to cause osteoporosis (OR 2.5, 95% CI 1.1-5.8). The main predictors of treatment for osteoporosis being offered were age (risk increased by 1.04 for every year of life), abnormal result on the BMD test (OR 19, 95% CI 6-60), history of fracture after the age of 50 (OR 2.6, 95% CI 1.1-6.7), and a history of fracture with minimal trauma (OR 2.6, 95% CI 1.1-4.2). There was a range of treatments offered, with calcium supplementation alone accounting for 60% of treatments. CONCLUSION: Osteoporosis was overlooked by medical practitioners responsible for the care of this at-risk patient cohort, with little evidence of the medical profession offering information, further investigation, or treatment of patients who presented with a probable osteoporotic fracture of the hip or wrist. This suggests that greater education of the accident and emergency and orthopedic medical staff as well as the general public is required concerning this opportunity to investigate and treat symptomatic osteoporosis.

Adult↗
PubMed2001

Effects of pulse methylprednisolone on macrophage chemotactic protein-1 and macrophage inflammatory protein-1alpha in rheumatoid synovium.

OBJECTIVE: To determine the effect of pulse methyprednisolone (PMP; 1000 mg) on the expression of monocyte chemoattractant protein (MCP)-1 and macrophage inflammatory protein (MIP)-1alpha in rheumatoid synovial membrane. METHODS: Seven patients with rheumatoid arthritis (RA) were studied. Arthroscopically-directed synovial biopsies were taken before and 24 hours after treatment with intravenous PMP. Synovial membranes were stained by immunohistochemical techniques with monoclonal antibodies against MCP-1, MIP-1alpha and CD68 (a macrophage marker). Quantitation of staining was performed by computer-assisted color video image analysis. RESULTS: PMP therapy was associated with a rapid (within 24 hours) and substantial decrease in the expression of MCP-1 and MIP-1alpha expression by a mean of 55% (p = 0.05) and 45% (p = 0.03), respectively, with no effect on CD68 expression in the synovial lining layer. There was no significant change in MCP-1, MIP-1alpha or CD68 expression in the synovial sublining. CONCLUSION: PMP therapy rapidly reduces MCP-1 and MIP-1alpha levels in the synovial lining layer without a fall in macrophage numbers. It thus appears that the initial effect of PMP is that of reducing macrophage activation.

Aged↗
PubMed2001

The TGF beta receptor endoglin in systemic sclerosis.

Immunohistochemical, flow cytometric and ELISA studies were performed to examine the expression of endoglin (CD105, a TGF beta receptor) on dermal endothelial cells, peripheral blood monocytes and free and bound serum levels in patients with systemic sclerosis as compared with appropriate controls. Endoglin was found to be significantly upregulated on dermal blood vessels in patients with scleroderma (and in patients with inflammatory skin disorders) as compared to healthy skin (p < 0.05). In contrast, there was no significant difference in endoglin expression on circulating blood monocytes between scleroderma patients and patients with a rheumatic disoder or healthy control subjects; however, endoglin expression was upregulated on monocytes in inflammatory joint fluid from patients with rheumatoid arthritis. Endoglin expression on monocytes was also influenced by isolation techniques and during whole blood culture. No differences were found in circulating free or bound endoglin levels between scleroderma patients and healthy controls. In conclusion, endoglin expression on dermal endothelial cells was significantly enhanced in scleroderma but levels on circulating monocytes and in the serum were within normal limits. The functional significance of this upregulation is uncertain but may reflect endothelial activation in scleroderma.

Aged↗