ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The etiology of systemic lupus erythematosus (SLE) and the many lupuslike syndromes continues to challenge investigators. Focus is now on the role of heat-shock proteins, apoptosis, the possible role of diet factors, and in particular, the role of lipids. The role of various infections as either triggering mechanisms or in contributing to morbidity is receiving close attention. In particular, retroviruses are being carefully studied with all the molecular tools available. This area has real promise and carries with it the possibility of anti-infection treatments. Considerably more attention is being paid to the hormonal aspects of SLE and their modulation of the immune system. Environmental associations continue to intrigue investigators and clinicians, and both drugs and other environmental factors provide excellent investigational models. We continue to need good prevalence and incidence studies. Genetically, there is an increasing sophistication in the type of studies, and the ensuing data may well provide real insights into various subsets of SLE.

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Studies that were published over the past year have added new knowledge to our understanding of cellular abnormalities in systemic lupus erythematosus (SLE). Antigen-specific and “pathogenic” T cells can be identified and characterized in SLE. Interleukin-10 has been added to the factors that may promote B cell overactivity and autoantibody production. Protein kinase isozyme I was shown to be deficient in patients with SLE, indicating defects in cell signaling events. Aberrant expression of adhesion molecules on the surface membrane of leukocytes and endothelial cells was shown, with important mechanistic and therapeutic implications. Disruption of the lymphokine network (anti-interleukin-10 antibody) and the function of adhesion-costimulatory molecules (CTLA-4-immunoglobulin) were shown to be therapeutically significant in murine SLE.

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Autoantibodies in systemic lupus erythematosus (SLE) are targeted predominantly to intracellular nucleoprotein particles. Following analysis of the quantitative and qualitative properties of the humoral immune response as well as identification of the major particles recognized as antigens, current studies are addressing the following questions: How is tolerance lost? What accounts for the selection of the antigens? What perpetuates the autoimmune response in SLE?

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

More than a decade has gone by since the detailed clinical description of antiphospholipid syndrome (APS). Thrombosis, the main complication of the syndrome, can affect vessels of all sizes; the consistent histopathologic lesion is a bland thrombus without inflammation. Animal models are providing important new data on clinical and pathogenic aspects of APS. New data on the biology of the so-called cofactor ß2-glycoprotein I is now available. Clearly, the mode of presentation of the phospholipid antigen appears significant, and ß2-glycoprotein I may play an important part. Regarding treatment, there is further confirmation that long-term anticoagulation therapy with maintenance of a high international normalized ratio is needed in patients with antiphospholipid antibody-associated thrombosis to prevent recurrences.

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Major findings in the understanding of the epidemiology of systemic lupus erythematosus and in the description and understanding of its presentation and course in individual organ systems are reviewed. The role of serologic tests as correlates of disease activity remains controversial. No consensus has been reached on the association of either corticosteroid dose or of antiphospholipid antibodies with avascular necrosis of bone. Multiple rare presentations of cutaneous lupus have been reviewed during the past year. The role of hormones in the activity of lupus and the use of hormonal agents in the treatment of lupus are rapidly expanding and contentious areas of research. Cognitive function deficit continues to be an area of great interest, with studies differing on whether psychiatric disorders or organic lupus (or both) are responsible. Finally, fatigue and the potential role of fibromyalgia as an explanation for “lupus fatigue,” are of major interest.

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

This article summarizes the evidence for improved prognosis in patients with systemic lupus erythematosus (SLE), including reasons for improved survival, as well as the risk for mortality, which remains high for patients with this disease. Causes of death are reviewed, and prognostic factors are examined. Other outcome measures for prognosis in SLE, including specific organ damage, accumulated damage index, health status, and quality of life are considered. The continuing controversy regarding the use of cyclophosphamide is reviewed, together with new therapeutic approaches.

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

The literature published over the past year on Sjögren's syndrome is reviewed, including epidemiology, genetic, environmental, and clinical features. The criteria for the classification of Sjögren's syndrome remain controversial, potentially leading to confusion in clinical practice and in research publications. Dryness of the eyes and mouth can result from either interruption of the neurovascular innervation of the glands or from any infiltrative process that affects the ability of the glands to secrete. Recent studies have demonstrated that sicca symptoms also can result from autonomie neuropathy in patients with diabetes, multiple sclerosis, or systemic lupus erythematosus. It is suggested that the termSjögren's syndromebe used to describe one subset of patients with sicca symptoms who exhibit particular major histocompatibility complex antigens, the presence of T cell lymphoid infiltrates on glandular biopsy, and specific autoantibodies in their sera. Even using these restrictive criteria for classification, no single environmental factor has been shown as necessary or sufficient for pathogenesis. Recent studies on Epstein-Barr virus have indicated a novel deleted virus in some Chinese Sjögren's syndrome patients. Other patients with sicca symptoms and autoimmune features may have infections with HIV or hepatitis C virus.

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID

摘要:

Often, a child is referred for evaluation to a pediatrie rheumatologist and found to have a nonrheumatologic disorder. Infections constitute an important group of disorders with potential musculoskeletal system involvement. Reactive arthritis subsequent to infection withYersiniais discussed, as well as reactive arthritis seen in the course of cystic fibrosis. Musculoskeletal manifestations of tuberculosis and brucellosis are reviewed. The continued presence of acute rheumatic fever in the United States has been documented, but the clinical spectrum of the disease appears to be changing over time. A variety of inherited syndromes may involve the musculoskeletal system, either primarily or as a minor manifestation. The bony dysplasias, another group of disorders, result from abnormal collagen structure and affect musculoskeletal development; clinical findings and new genetic information is reviewed. Descriptions of several rare syndromes (eg, hyaline fibromatosis and hypertrophie osteoarthropathy) also are reviewed here.

ISSN:1040-8711    

出版商:OVID    

年代:1995

数据来源: OVID