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Biomedical subjects

P Creamer

Publications and source records attributed to P Creamer.

31 records · Page 2Linked to original sources
PubMed1996

Quantitation of IL-2Rp75 (CD122) expression on mononuclear cells in rheumatic disease.

OBJECTIVE: To compare expression of the p75 chain of the interleukin-2 receptor (IL-2Rp75, CD122) on peripheral and synovial mononuclear cells in rheumatoid and non-rheumatoid inflammatory arthritis. METHODS: Peripheral blood (PBMC) and synovial (SFMC) mononuclear cells were isolated from subjects with rheumatoid arthritis (n = 16) and non-rheumatoid inflammatory arthritis (n = 12). PBMC were isolated from six healthy controls. Expression of CD122 was examined using indirect immunofluorescence and quantitative flow cytometry. RESULTS: There was no difference in IL-2Rp75 expression on PBMC from rheumatoid arthritis patients, non-rheumatoid arthritis patients, and controls. In subjects with rheumatoid arthritis there was no difference in IL-2Rp75 expression on PBMC and SFMC. However, in the non-rheumatoid arthritis group there was an increase in IL-2Rp75 expression on SFMC compared with PBMC (P = 0.0032). On SFMC there was a greater expression of IL-2Rp75 in non-rheumatoid arthritis than in rheumatoid arthritis (P = 0.0007). Expression was greater on CD8 positive cells and in subjects with shorter duration of disease. CONCLUSIONS: The p75 chain of the IL-2 receptor, an important T cell activation antigen, is not upregulated in synovial fluid. This appears to be a disease specific defect and provides further support for the concept of "frustrated" or incomplete T cell activation in this disease.

Arthritis↗
PubMed1996

Pain mechanisms in osteoarthritis of the knee: effect of intraarticular anesthetic.

OBJECTIVE: The causes of pain in osteoarthritis (OA) remain unclear. We examined the effect of intraarticular (IA) local anesthetic (LA) on pain perception in OA knee to test the hypothesis that pain arises from structures in contact with the intraarticular surface. The effect of intervention on one knee on perception of pain in the other was also studied. METHODS: Using a single blind, blind observer design, 20 subjects with bilateral symptomatic OA knee were randomized to receive either IA LA (bupivacaine 0.25%, 5 ml) or placebo into the most painful knee. Pain from both knees was assessed at 1 h, 24 h, and 7 days using a 100 mm visual analog scale (VAS). Pain descriptors using a standardized questionnaire (McGill) were recorded. RESULTS: At 1 h there was a significant fall in pain in LA knees (median VAS 61.5 to 0.0; p = 0.007). The change at VAS was significantly different between knees receiving LA and placebo (median change -45.5 vs +3.5; p = 0.03). 6/10 LA knees scored 0 on VAS at 1 h. Noninjected knees also showed a fall in pain scores. For knees contralateral to those receiving LA, the fall was from median 28.0 to 1.0 (p = 0.08). The reduction in pain was much less in knees contralateral to those receiving placebo (median 43.5 to 38.0), though the difference between the changes did not reach statistical significance. VAS scores remained below baseline for 7 days, though this difference was not significant. McGill pain scores fell in the LA group (for all categories of pain), but did not change in the placebo group. CONCLUSION: Pain in some cases of OA knee can be abolished by IA LA, suggesting that the structures responsible for pain are in contact with the intraarticular environment. As well, interventions in one knee have significant effects on pain perception in the contralateral knee.

Aged↗
PubMed1994

Intra-articular hyaluronic acid in osteoarthritis of the knee: an investigation into mechanisms of action.

The objective of this study was to investigate mechanisms of action of intra-articular hyaluronic acid in osteoarthritis (OA) of the knee. Twelve patients with bilateral knee OA and synovial effusions entered a randomized, single-blind, blind observer study. Hyaluronic acid ("Hyalgan", Fidia SpA, Italy) or placebo were given by intra-articular injection weekly for 5 weeks. Assessments included clinical indices and imaging (magnetic resonance imaging (MRI) and 99m Tc bone scanning) before and after the course of injections. In addition, synovial fluid keratan sulfate (KS), chondroitin sulfate (CS) and C-propeptide of type II collagen (CPII) were measured. MRI and 99m Tc scanning showed no change in either treated or placebo knees over the 6-week study period. A fall in KS levels occurred in treated knees compared with placebo (Wilcoxon paired test, P = 0.1), although this did not reach significance perhaps due to small sample numbers). Ten out of 12 treated knees showed a fall in KS, compared with four out of 12 placebo knees. CS and CPII levels did not change significantly. Intra-articular injection of hyaluronic acid did not result in any improvement in the clinical indices compared to the placebo. In conclusion, assessment of cartilage markers may be of value when studying novel therapies in OA. MRI appearances remain remarkably stable over a 6-week period.

Adjuvants, Immunologic↗
PubMed1994

Acute inflammatory polyarthritis in association with tamoxifen.

The antioestrogen drug tamoxifen is widely used to treat breast carcinoma. We report three cases in which its use was temporally related to the development of an acute inflammatory polyarthritis resembling RA; a side-effect not previously reported. Possible mechanisms for such an effect are discussed.

Acute Disease↗
PubMed1992

Seronegative systemic lupus erythematosus.

We have presented a patient with severe clinical SLE but negative serological tests. This diagnostic difficulty, together with a presentation limited to the skin and an initial response to high dose steroids probably lead to a delay in starting immunosuppression. The finding of a retinopathy was important in deciding on therapy. An excellent response to immunosuppression was seen, with full recovery.

Adult↗
PubMed1992

Measurement of HLA class I expression in ankylosing spondylitis.

The importance of HLA-B27 in the pathogenesis of ankylosing spondylitis is uncertain: current evidence favours a role for the B27 molecule itself. The possibility that quantitative differences in HLA-B27 expression may exist between patients with ankylosing spondylitis, family members, and control subjects positive for B27 was examined using appropriate monoclonal antibodies, flow cytometry, and a 'model lymphocyte' coated with a known number of mouse immunoglobulin binding sites. No differences were found between the groups. HLA-A2, examined for comparison, was expressed in greater amounts than HLA-B27, but each contributed only 10-20% of the total class I antigens. Homozygotes expressed twice the amount of antigen expressed by heterozygotes. Synovial lymphocytes expressed more class I antigens than peripheral lymphocytes.

Family↗
PubMed1990

Erosive osteoarthritis: is it a separate disease entity?

Erosive osteoarthritis (EOA) characteristically involves the hands of middle-aged women. The diagnosis is essentially radiological and depends upon the presence of articular surface erosions. This study investigates whether this radiological feature is a marker of a specific clinical entity. From a series of 500 consecutive patients attending a rheumatology clinic with symptomatic limb joint osteoarthritis, 24 were identified by radiological criteria to have EOA. These were age-sex matched with 24 patients from the same series who presented with osteoarthritis of the hand. Those with EOA had nearly twice as many radiographically abnormal joints in the hands as the controls (274: 144). This was almost entirely due to an increase in distal (134: 68) and proximal (79: 24) interphalangeal joint involvement, 71% of which were erosive. Erosions were found apart from the hands in both elbows of one patient with EOA. Otherwise only minor differences were present between the two groups in terms of distribution and incidence of osteoarthritic changes. There were no distinguishing serological or other clinical differences. This study has demonstrated that erosions in EOA are associated with more severe hand disease but are not apparently a marker of a separate disease entity. EOA appears to be an aggressive acute form of hand osteoarthritis and may represent the hand equivalent of similar forms of osteoarthritis in the shoulder, hip and knee.

Adult↗
PubMed1990

Spondyloarthropathies.

The spondyloarthropathies are disorders characterised mainly by sacroiliitis (with or without spondylitis), peripheral oligoarthritis, enthesopathy, absence of rheumatoid factor, certain extra-articular features such as iritis, and increased prevalence of HLA-B27. The diagnosis should be considered in patients, especially young people, with low back pain. A history of psoriasis, bowel dysfunction, eye problems and peripheral joint inflammation should point to the diagnosis.

Diagnosis, Differential↗
PubMed1987

Restoration of active haemopoiesis in a patient with myelofibrosis and subsequent termination in acute myeloblastic leukaemia: case report and review of the literature.

A patient with polycythaemia vera developed typical myelofibrosis after 15 yr. After a further 8 months, during which time she was pancytopenic and transfusion-dependent, a slow spontaneous recovery in haemopoiesis occurred and the full blood count became normal. 6 months later pancytopenia recurred and soon afterwards the patient developed acute myeloblastic leukaemia from which she died. The evolution of bone marrow morphology and isotopic studies. Only 2 previous reports of this kind of transformation exist in the literature, although restoration of normal or polycythaemic haemopoiesis has been reported in 8 patients with myelofibrosis. It is likely that these transformations occur because of alterations in stem cell behaviour rather than as a result of therapy.

Acute Disease↗