RESUMO
Paciente femenina que presentó durante sus dos embarazos eritema nodoso, úlceras nasales y artritis. Debido a la persistencia del eritema nodoso después del segundo parto, se practicó determinación de ANA y anti-DNA IF, resultando este último positivo, por lo que se plantea el diagnóstico de lupus eritematoso y es referida al Centro Nacional de Enfermedades Reumáticas, (CNER) donde se le practicó biopsia de piel que resultó compatible con lepra: borderline o dimorfa (BB-BL) en estado reaccional tipo II (eritema nodoso leproso: ENL). Se discuten algunos de aspectos de la lepra haciendo especial énfasis en síntomas que presentó la paciente y la exacerbación de los mismos durante los embarazos, posiblemente en relación con algunos cambios inmunológicos adaptativos que son generados para mantener la tolerancia materno fetal(AU)
Female young patient with erythema nodosum, nasal ulcers and arthritis during her two pregnancies. Due to the persistence of the erythema nodosum after the second delivery, ANA and anti-DNA - IF determination were done, the latter being positive, and she was diagnosed with lupus erythematosus and was referred to the National Center for Rheumatic Diseases, where skin biopsy showed to be compatible with leprosy: borderline or dimorphic (BB-BL) in type II reactional state (leprous erythema nodosum: LEN). Some aspects of leprosy are discussed with special emphasis on symptoms that the patient presented and their exacerbation during pregnancies, possibly in relation to some adaptive immunological changes that was generated to maintain maternal fetal tolerance(AU)
Assuntos
Humanos , Feminino , Adulto , Artrite/fisiopatologia , Dermatite/fisiopatologia , Hanseníase , Lúpus Vulgar , Biópsia , Doenças Reumáticas , Infecções por PapillomavirusRESUMO
BACKGROUND: Arthritis is a syndrome associated with exacerbated inflammation, joint destruction and chronic pain and disability. Chronic treatment of arthritis is associated with several side effects and high abandonment. Therefore, there has been an ongoing search for alternative treatments to overcome these problems. PURPOSE: Natural products, which are already widely used for their biological, cosmetic and pharmacotechnic properties, are a possible source for new drugs. Terpenes, a large class of organic compounds produced mainly by plants and trees, are a promising natural product and have already been shown to be effective in treating chronic pain, particularly of an inflammatory origin. STUDY DESIGN AND METHODS: This review identifies the main terpenes with anti-arthritic activity reported in the last 10 years. A survey was conducted between December 2017 and June 2018 in the PUBMED, SCOPUS and Science Direct databases using combinations of the descriptors terpenes, arthritis and inflammation. RESULTS: The results showed that terpenes have promising biological effects in relation to the treatment of arthritis, with the 24 terpenes identified in our survey being effective in the modulation of inflammatory mediators important to the physiopathology of arthritis, such as IL-6, IL-17, TNF-α, NFκB, and COX-2, among others. It is important to note that most of the studies used animal models, which limits, at least in part, the direct translation to humans of the experimental evidence produced by the studies. CONCLUSION: Together, our finds suggest that terpenes can modulate the immuno-regulatory and destructive tissue events that underlie the clinical presentation and the progression of arthritis and are worthy of further clinical investigation.
Assuntos
Artrite/tratamento farmacológico , Inflamação/tratamento farmacológico , Terpenos/farmacologia , Animais , Anti-Inflamatórios não Esteroides/farmacologia , Artrite/metabolismo , Artrite/fisiopatologia , Produtos Biológicos/farmacologia , Produtos Biológicos/uso terapêutico , Ciclo-Oxigenase 2/metabolismo , Modelos Animais de Doenças , Humanos , Inflamação/metabolismo , Mediadores da Inflamação/metabolismo , Terapia de Alvo Molecular/métodos , NF-kappa B/metabolismo , Fator de Necrose Tumoral alfa/metabolismoRESUMO
Temporomandibular joint (TMJ) disorders are a group of conditions that result in TMJ pain, which frequently limits basic daily activities. Experimental models that allow the study of the mechanisms underlying these inflammatory and pain conditions are of great clinical relevance. The aim of this study was to evaluate nociception, inflammation and participation of the macrophage/microglia cells in the arthritis of the TMJ induced by two phlogistic agents. 84 rats were divided into 2 groups: Zy, which received zymosan intra-articularly, or Cg, which received carrageenan intra-articularly. Mechanical nociception, total leukocyte influx to the synovial fluid and histopathological analyses were evaluated in the TMJ. The participation of macrophage/microglia located in trigeminal ganglia (TG) and in the subnucleus caudalis (V-SnC) was assessed immunohistochemically. Both agents induced mechanical hyperalgesia 6h after the induction, but a more persistent algesic state was perceived in the Cg group, which lasted for 120h. Even though both groups presented increased leukocyte influx, the Zy-group presented a more intense influx. Zymosan recruited resident macrophage in the trigeminal ganglia 24h after the injection. In the V-SnC, the group Cg presented a more prolonged immunolabeling pattern in comparison with the group Zy. It can be concluded that zymosan induced a more intense infiltrate and peripheral nervous changes, while Cg lead to a moderate TMJ inflammation with prominent changes in the V-SnC.
Assuntos
Artrite/fisiopatologia , Hiperalgesia/fisiopatologia , Medição da Dor/métodos , Dor/fisiopatologia , Transtornos da Articulação Temporomandibular/fisiopatologia , Animais , Artrite/induzido quimicamente , Artrite/diagnóstico , Artrite/patologia , Carragenina/farmacologia , Modelos Animais de Doenças , Hiperalgesia/induzido quimicamente , Hiperalgesia/patologia , Injeções Intra-Articulares , Macrófagos/efeitos dos fármacos , Macrófagos/patologia , Masculino , Microglia/efeitos dos fármacos , Microglia/patologia , Nociceptividade/efeitos dos fármacos , Nociceptividade/fisiologia , Dor/induzido quimicamente , Dor/patologia , Ratos , Ratos Sprague-Dawley , Ratos Wistar , Transtornos da Articulação Temporomandibular/induzido quimicamente , Transtornos da Articulação Temporomandibular/patologia , Gânglio Trigeminal/citologia , Gânglio Trigeminal/efeitos dos fármacos , Zimosan/farmacologiaRESUMO
Scapholunate advance collapse (SLAC) and Scaphoid nonunion advance collapse (SNAC), are the two most common patterns of postraumatic wrist arthritis. SLAC wrist develops after attenuation, either traumatically or atraumatically, of the scapholunate ligament. Atraumatic causes of SLAC wrist include calcium pyrophosphate dehydrate deposition disease, reumathoid arthritis, neuropathic diseases, and b2-microglobulin asociated amyloid deposition diseases. On the other hand, SNAC wrist develops following a scahpoid fracture that has progressed to a nonunion. Both of these processes lead to abnormal joint kinematics, since the lunate is unrestrained by the distal scaphoid and, therefore, assumes an extended posture. Over time, this may result in Dorsal intercalated segment instability (DISI) deformity, which invariably progresses to degenerative arthritis of the radioescaphoid articulation, followed by carpal collapse and midcarpal arthritis. The purpose of this retrospective study is to evaluate the functional outcome and pain relief in SLAC/SNAC wrist, after four corner fusion. This study was made in 52 patients of the Hospital de Traumatología y Ortopedia Lomas Verdes, these patients undergone four corner fusion surgery, in a period january 2007 to december 2014. We used Quick Dash Questionary to evaluate functional outcome and pain relief in these patients.
El colapso avanzado de la muñeca secundario a pseudoartrosis del escafoides (scaphoid nonunion advanced collapse, SNAC) y el colapso avanzado escafosemilunar (scapholunate advanced collapse, SLAC) son dos de los patrones comunes de muñecas artrósicas postraumáticas. La muñeca SLAC se desarrolla después de una alteración, traumática o atraumática, del ligamento escafosemilunar. Entre las causas atraumáticas de muñeca SLAC se incluyen: enfermedad por depósito de pirofosfato de calcio, artritis reumatoide y enfermedad neuropática. Por otra parte, la muñeca SNAC se desarrolla por fractura del escafoides que ha progresado a no unión. Ambos procesos conllevan cinemática anormal de la articulación, desde que el semilunar no es contenido por el escafoides y, por lo tanto, asume una posición en extensión. Además, esto resulta en deformidad por inestabilidad dorsal del carpo (DISI), la cual invariablemente progresará a artritis degenerativa de la articulación radioescafoidal, seguida de colapso del carpo y artritis del medio-carpo. Este es un estudio retrospectivo, longitudinal, observacional realizado en 52 pacientes derechohabientes del IMSS, operados de artrodesis de cuatro esquinas del carpo en el Hospital de Traumatología y Ortopedia Lomas Verdes, de enero 2007 a diciembre 2014, evaluando resultados funcionales mediante cuestionario Quick Dash en los pacientes operados de artrodesis de cuatro esquinas en padecimientos de muñeca SLAC/SNAC.
Assuntos
Artrite/cirurgia , Artrodese/métodos , Articulação do Punho/cirurgia , Adolescente , Adulto , Idoso , Artrite/etiologia , Artrite/fisiopatologia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Medição da Dor , Estudos Retrospectivos , Resultado do Tratamento , Adulto JovemRESUMO
OBJECTIVE: To describe chronic chikungunya manifestations seen during the outbreak in the Caribbean from December 2013 to January 2015. METHODS: Patients were seen at our center, the only rheumatology department in Martinique Island, and were examined by a senior rheumatologist using a standard care report form. Chikungunya was diagnosed collectively based on consensus among all clinicians. The median time from onset of acute chikungunya to the first rheumatology consultation was calculated, severity was evaluated based on clinical scales and the degree of joint destruction, and each patient's treatment was recorded. RESULTS: For the 147 patients analyzed, the median time between onset of acute chikungunya and the first rheumatology consultation was 8 months. After review of each patient's medical record, 19 (12.9%) were diagnosed as having epidemic-influenced chikungunya. Four distinct rheumatologic patterns were observed in the remaining patients (those with compatible history and positive serologic findings): 47 patients (32%) had reactivation of painful chronic mechanical manifestations, 9 patients (6.1%) had fibromyalgia, 45 patients (30.6%) met criteria for spondyloarthritis (as evaluated before the chikungunya virus infection in all patients) and experienced a flare, and 27 patients (18.4%), with no history of joint disease, developed de novo bilateral symmetric chronic inflammatory joint disease in response to chikungunya virus infection. For inflammatory arthritis, most patients were treated with methotrexate (up to 25 mg/week), with good response and tolerance. Thirteen patients were treated with conventional doses of anti-tumor necrosis factor agents, with good tolerance and efficacy as expected. CONCLUSION: The term "chronic chikungunya syndrome" covers multiple etiologies. Compliance with the French Society of Rheumatology recommendations, careful recording of patient histories, and serologic verification help prevent errors inherent to the epidemic context and ensure early therapeutic intervention for these patients. To avoid late initiation of treatment, patients should receive rheumatologic consultation as early as possible.
Assuntos
Febre de Chikungunya/fisiopatologia , Doenças Reumáticas/fisiopatologia , Doença Aguda , Adulto , Idoso , Idoso de 80 Anos ou mais , Antirreumáticos/uso terapêutico , Artrite/tratamento farmacológico , Artrite/etiologia , Artrite/fisiopatologia , Bursite/etiologia , Bursite/fisiopatologia , Síndrome do Túnel Carpal/etiologia , Síndrome do Túnel Carpal/fisiopatologia , Febre de Chikungunya/complicações , Febre de Chikungunya/tratamento farmacológico , Febre de Chikungunya/epidemiologia , Doença Crônica , Epidemias , Feminino , Fibromialgia/etiologia , Fibromialgia/fisiopatologia , Humanos , Dor Lombar/etiologia , Dor Lombar/fisiopatologia , Masculino , Martinica/epidemiologia , Metotrexato/uso terapêutico , Pessoa de Meia-Idade , Osteoartrite/etiologia , Osteoartrite/fisiopatologia , Doenças Reumáticas/tratamento farmacológico , Doenças Reumáticas/etiologia , Espondilartrite/tratamento farmacológico , Espondilartrite/etiologia , Espondilartrite/fisiopatologia , Tendinopatia/etiologia , Tendinopatia/fisiopatologia , Fator de Necrose Tumoral alfa/antagonistas & inibidoresRESUMO
The baroreflex is a critical physiological mechanism controlling cardiovascular function by modulating both the sympathetic and parasympathetic activities. Here, we report that electrical activation of the baroreflex attenuates joint inflammation in experimental arthritis induced by the administration of zymosan into the femorotibial cavity. Baroreflex activation combined with lumbar sympathectomy, adrenalectomy, celiac subdiaphragmatic vagotomy or splenectomy dissected the mechanisms involved in the inflammatory modulation, highlighting the role played by sympathetic inhibition in the attenuation of joint inflammation. From the immunological standpoint, baroreflex activation attenuates neutrophil migration and the synovial levels of inflammatory cytokines including TNF, IL-1ß and IL-6, but does not affect the levels of the anti-inflammatory cytokine IL-10. The anti-inflammatory effects of the baroreflex system are not mediated by IL-10, the vagus nerve, adrenal glands or the spleen, but by the inhibition of the sympathetic drive to the knee. These results reveal a novel physiological neuronal network controlling peripheral local inflammation.
Assuntos
Artrite/fisiopatologia , Barorreflexo , Inflamação/fisiopatologia , Articulação do Joelho/fisiopatologia , Sistema Nervoso Simpático/fisiopatologia , Adrenalectomia , Animais , Artrite/induzido quimicamente , Artrite/metabolismo , Modelos Animais de Doenças , Estimulação Elétrica , Inflamação/metabolismo , Mediadores da Inflamação/metabolismo , Articulação do Joelho/patologia , Masculino , Neutrófilos/metabolismo , Ratos , Ratos Wistar , Esplenectomia , Vagotomia , ZimosanRESUMO
Recent literature has revealed that centrally generated prostaglandins participate in the febrile response in zymosan-induced arthritis in rats. However, it is not clear whether other centrally acting pyrogenic mediators such as cytokines, endothelins (ETs), and the corticotropin-releasing factor (CRF) contribute to the febrile response in this model. In the present study, rats were pretreated with intracerebroventricular (i.c.v.) injections of soluble TNF receptor I (sTNFRI), recombinant IL-1 receptor antagonist (IL-1ra), anti-rat IL-6 monoclonal antibody (AbIL-6), α-helical CRF9-41 (a nonselective CRF1/CRF2 receptor antagonist), BQ-123 (an ETA receptor antagonist), BQ-788 (an ETB receptor antagonist), and artificial cerebrospinal fluid (aCSF, control) prior to an intra-articular zymosan (4 mg) injection. Rectal temperatures were measured with a telethermometer. The administration of IL-1ra (200 µg), sTNFRI (500 ng), and AbIL-6 (5 µg) attenuated body temperature elevations after a zymosan injection. The administration of BQ-788 (3 pmol), BQ-123 (3 pmol), and α-helical CRF9-41 (25 µg) did not affect the zymosan-induced febrile response. All the compounds used to pretreat the animals did not significantly alter their basal body temperatures. Together, the results here demonstrate that the febrile response in zymosan-induced arthritis in rats depends on the centrally acting pyrogenic cytokines TNF-α, IL-1ß, and IL-6, but does not depend on either CRF or ET-1.
Assuntos
Artrite/fisiopatologia , Hormônio Liberador da Corticotropina/metabolismo , Citocinas/metabolismo , Endotelina-1/metabolismo , Febre/fisiopatologia , Animais , Temperatura Corporal/fisiologia , Modelos Animais de Doenças , Hiperalgesia/fisiopatologia , Masculino , Ratos Wistar , ZimosanRESUMO
A artrite é uma inflamação que ocorre nos tecidos moles que compõe o espaço articular podendo evoluir para processo degenerativo como a osteoartrite, pela liberação de enzimas, mediadores inflamatório se citocinas. Um equino, fêmea, raça Quarto de Milha, pelagem castanha, de 4 anos de idade, utilizado para provas de laço em dupla, foi atendida no dia 6 de agosto de 2014 no Hospital Veterinário da UENP com o histórico de aumento da volume na região articular dos carpos do membro esquerdo. O exame do aparelho locomotor revelou claudicação de grau IV,aumento de volume de consistência flutuante, dor apalpação,aumento de temperatura local e edema na região dorsal dos carpos, aumento de temperatura local e edema na região dorsal da região cárpica. Exames radiográficos e análise do líquido sinovial foram realizados.O tratamento recomendado foi realizado no hospital, e na semana seguinte o animal apresentou melhora. (AU)
Arthritis is an inflammation that occurs in the soft tissues that make up the joint space mayprogress to degenerative process such as osteoarthritis, by releasing enzymes, inflammatory mediators and cytokines. One horse, female, Quarter Horse, brown fur, 4 years old, used for tests of double-Ioop, wasserved on August 6,2014 at the Veterinary Hospital of UENP with historical increase in volume in the regioncarpal joint of the left limb. The examination of the locomotor system revealed lameness grade IV, swellingfloating consistency, pain during palpation, increased local temperature and edema in the dorsal region ofCarpi, increased local temperature and edema in the dorsal region of the carpal region. Radiographicexaminations and synovial fluid analysis were performed. The recommended treatment was performed inthe hospital, and the following week the animal showed improvement. (AU)
La artritis es una irf!~maci~r ql!~se produce en los tejidos blandos que conforman el espaciode Ia articulación puede progresar a proceso degenerativo tales como Ia osteoartritis, mediante Ia liberación de enzimas, mediadores inflamatorios y citoquinas. Un caballo, femenino, Cuarto de milla, piei marrón, de4 anos, que se utiliza para Ias pruebas de doble circuito, se sirvió el 6 de agosto de 2014 el Hospital Veterinario de UENP con aumento histórico en volumen en Ia región carpo de Ia extremidad izquierda. EIexamen dei aparato locomotor reveló Ia cojera grado IV, hinchazón consistencia flotante, dolor durante Ia palpación, aumento de Ia temperatura local y el edema en Ia región dorsal de Carpi, aumento de Ia temperaturalocal y el edema en Ia región dorsal de Ia región carpiano. Se lIevaron a cabo exámenes radiográficos yanálisis dei líquido sinovial. EI tratamiento recomendado se lIevó a cabo en el hospital, y Ia semana siguienteel animal mostró una mejoría. (AU)
Assuntos
Animais , Feminino , Artrite/diagnóstico , Artrite/fisiopatologia , Artrite/terapia , Artrite/veterinária , Claudicação Intermitente/veterinária , Articulações/fisiopatologia , Cavalos/fisiologia , Inflamação/fisiopatologia , Inflamação/veterinária , Osteoartrite/veterinária , Enzimas , Citocinas , Atletas , Dor/veterinária , Radiografia/veterinária , Líquido SinovialRESUMO
A artrite é uma inflamação que ocorre nos tecidos moles que compõe o espaço articular podendo evoluir para processo degenerativo como a osteoartrite, pela liberação de enzimas, mediadores inflamatório se citocinas. Um equino, fêmea, raça Quarto de Milha, pelagem castanha, de 4 anos de idade, utilizado para provas de laço em dupla, foi atendida no dia 6 de agosto de 2014 no Hospital Veterinário da UENP com o histórico de aumento da volume na região articular dos carpos do membro esquerdo. O exame do aparelho locomotor revelou claudicação de grau IV,aumento de volume de consistência flutuante, dor apalpação,aumento de temperatura local e edema na região dorsal dos carpos, aumento de temperatura local e edema na região dorsal da região cárpica. Exames radiográficos e análise do líquido sinovial foram realizados.O tratamento recomendado foi realizado no hospital, e na semana seguinte o animal apresentou melhora.
Arthritis is an inflammation that occurs in the soft tissues that make up the joint space mayprogress to degenerative process such as osteoarthritis, by releasing enzymes, inflammatory mediators and cytokines. One horse, female, Quarter Horse, brown fur, 4 years old, used for tests of double-Ioop, wasserved on August 6,2014 at the Veterinary Hospital of UENP with historical increase in volume in the regioncarpal joint of the left limb. The examination of the locomotor system revealed lameness grade IV, swellingfloating consistency, pain during palpation, increased local temperature and edema in the dorsal region ofCarpi, increased local temperature and edema in the dorsal region of the carpal region. Radiographicexaminations and synovial fluid analysis were performed. The recommended treatment was performed inthe hospital, and the following week the animal showed improvement.
La artritis es una irf!~maci~r ql!~se produce en los tejidos blandos que conforman el espaciode Ia articulación puede progresar a proceso degenerativo tales como Ia osteoartritis, mediante Ia liberación de enzimas, mediadores inflamatorios y citoquinas. Un caballo, femenino, Cuarto de milla, piei marrón, de4 anos, que se utiliza para Ias pruebas de doble circuito, se sirvió el 6 de agosto de 2014 el Hospital Veterinario de UENP con aumento histórico en volumen en Ia región carpo de Ia extremidad izquierda. EIexamen dei aparato locomotor reveló Ia cojera grado IV, hinchazón consistencia flotante, dolor durante Ia palpación, aumento de Ia temperatura local y el edema en Ia región dorsal de Carpi, aumento de Ia temperaturalocal y el edema en Ia región dorsal de Ia región carpiano. Se lIevaron a cabo exámenes radiográficos yanálisis dei líquido sinovial. EI tratamiento recomendado se lIevó a cabo en el hospital, y Ia semana siguienteel animal mostró una mejoría.
Assuntos
Feminino , Animais , Articulações/fisiopatologia , Artrite/diagnóstico , Artrite/fisiopatologia , Artrite/terapia , Artrite/veterinária , Cavalos/fisiologia , Claudicação Intermitente/veterinária , Atletas , Citocinas , Dor/veterinária , Enzimas , Inflamação/fisiopatologia , Inflamação/veterinária , Líquido Sinovial , Osteoartrite/veterinária , Radiografia/veterináriaRESUMO
The mechanisms of muscle wasting and decreased mobility have a major functional effect in rheumatoid arthritis, but they have been poorly studied. The objective of our study is to describe muscular involvement and the pathways in an experimental model of arthritis compared to the pathways in disuse atrophy. Female Wistar rats were separated into three groups: control (CO), collagen-induced arthritis (CIA), and immobilized (IM). Spontaneous locomotion and weight were evaluated weekly. The gastrocnemius muscle was evaluated by histology and immunoblotting to measure the expression of myostatin (a negative regulator), LC3 (autophagy), MuRF-1 (proteasome-mediated proteolysis), MyoD, and myogenin (satellite-cell activation). The significance level was set at P < 0.05, and histological analysis of joints confirmed the severity of the arthropathy. There was a significant difference in spontaneous locomotion in the CIA group. Animal body weight, gastrocnemius muscle weight, and relative muscle weight decreased 20%, 30%, and 20%, respectively, in the CIA rats. Inflammatory infiltration and swelling were present in the gastrocnemius muscles of the CIA rats. The mean cross-sectional area was reduced by 30% in the CIA group and by 60% in the IM group. The expressions of myostatin and LC3 between the groups were similar. There was increased expression of MuRF-1 in the IM (1.9-fold) and CIA (3.1-fold) groups and of myogenin in the muscles of the CIA animals (1.7-fold), while MyoD expression was decreased in the IM (20%) rats. This study demonstrated that the development of experimental arthritis is associated with decreased mobility, body weight, and muscle loss. Both IM and CIA animal models presented muscle atrophy, but while proteolysis and the regeneration pathways were activated in the CIA model, there was no activation of regeneration in the IM model. We can assume that muscle atrophy in experimental arthritis is associated with the disease itself and not simply with decreased mobility.