[Diagnostic value of arthography in knee joint diseases. IV. Meniscus dysplasia, meniscus degeneration and cartilage degeneration in positive contrast arthrogram].
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Now, it is becoming known that the mechanisms of cartilage matrix destruction such as roles of degradative enzymes and cytokines. It is important to develop the reliable biomarkers to detect the early stage of cartilage destruction. The biomarker could be useful tool not only to understand the progression of joint destruction in osteoarthritis and rheumatoid arthritis but also to develop new treatment.
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Mesenchymal stem cells have the capacity to differentiate into a variety of connective tissue cells including bone, cartilage, tendon, muscle and adipose tissue. These multipotent cells have been isolated from bone marrow and from other adult tissues including skeletal muscle, fat and synovium. Because of their multipotentiality and capacity for self renewal adult stem cells may represent units of active regeneration of tissues damaged as a result of trauma or disease. In certain degenerative diseases such as osteoarthritis (OA) stem cells are depleted, and have reduced proliferative capacity and reduced ability to differentiate. The delivery of stem cells to these individuals may therefore enhance repair or inhibit the progressive destruction of the joint. We have developed methods for the delivery of mesenchymal stem cell preparations taken from bone marrow to the injured knee joint. This treatment has the potential to stimulate regeneration of cartilage and retard the progressive destruction of the joint that typically occurs following injury.
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BACKGROUND: Human leucocyte antigen (HLA) genes predict disease severity in psoriasis (HLA-Cw6) and rheumatoid arthritis (shared epitope (SE)), but the situation is unclear for psoriatic arthritis (PsA). AIM: To determine the association of the HLA-Cw6 and HLA-DRB1 gene with disease severity in a large UK cohort with PsA. METHODS: Genotyping of the HLA-Cw and HLA-DRB1 loci was undertaken in DNA samples from patients with PsA (n = 480). Stratification and regression analysis were used within the PsA cases to determine whether HLA-Cw6, HLA-DRB1 or the presence of the SE alleles predicted disease severity as measured by the Health Assessment Questionnaire score, the total number of damaged or involved joints adjusted for disease duration and disease-modifying antirheumatic treatments. RESULTS: HLA-Cw6 was found to be in linkage disequilibrium with HLA-DRB1*07 (r(2) = 0.46). Patients with PsA who carried both HLA-Cw6 and HLA-DRB1*07 had fewer damaged or involved joints (41% fewer damaged (95% CI 23% to 55%, p = 0.02) and 31% fewer involved joints (95% CI 16% to 44%, p<0.001)) compared with those who carried neither HLA-Cw6 nor HLA-DRB1*07 alleles. Those who carried either HLA-Cw6 or HLA-DRB1*07 alleles alone had no evidence of a reduction in joint involvement. The SE, HLA-DRB1*03 and HLA-DRB1*04 alleles did not predict severity using these outcome measures. CONCLUSION: Patients with PsA carrying both HLA-Cw6 and HLA-DRB1*07 alleles have a less severe course of arthritis. This suggests that a protective locus lies on a haplotype marked by these alleles. No association was detected with disease severity and SE status.
The safety and efficacy of treatment with cefamandole were evaluated in 77 patients (from 33 institutions) with serious bone and joint infections. The antibiotic was given intramuscularly or intravenously in doses ranging from 1.5 to 12 g/day for 6 to 58 days. Seventy-three of the 77 patients responded satisfactorily, and 63 (of 70 from whom material for culture was obtainable) patients had a bacteriologic cure. Forty-one of 81 isolates were identified as Staphylococcus aureus. Other pathogens included Streptococcus epidermidis, Haemophilus influenzae, Enterobacter sp., Escherichia coli, aerobic and anaerobic cocci, as well as Bacteroides fragilis. The drug was well tolerated. Pharmacological studies indicated that cefamandole penetrated the bones and joints. Cefamandole would seem to be a safe and efficacious drug, for the treatment of serious bone and joint infections due to a wide variety of gram-positive and gram-negative microorganisms.
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