Combination chemotherapy in rheumatoid arthritis

Article Abstract:

While the precise cause of rheumatoid arthritis remains unknown, research has shown that the disease develops through a process that activates immune cells and produces inflammatory mediators, resulting in cartilage destruction. Early treatment with suppressive agents is important to prevent irreversible cartilage damage. However, studies suggest that significant illness and death result in spite of the use of slow-acting antirheumatic drugs (SAARDs). Severe disabilities or death occurred in half of the patients in a 20-year study, despite treatment with gold, steroids, or other medications. The goals and outcome of treatment to suppress rheumatoid inflammation now need to be questioned. These poor outcomes may be attributed to using inappropriate or ineffective drugs to halt synovitis (inflammation of joint lining); delayed use of medications; inability to use drugs due to side effects; or a complex disease process that is insensitive to any single drug. The possibility of combination drug therapy needs to be considered. Hopefully, additive effects would be achieved, while minimizing side effects. The search for successful combinations has been slowed by side effects such as toxicity, especially to the bone marrow where blood cells are produced. Combination treatments have mostly been tried in patients with severe disease, who might be unresponsive to any drug, rather than in patients in the early stages of rheumatoid arthritis. Several short studies have provided preliminary evidence that certain combinations may be beneficial. Combinations of gold with drugs such as penicillamine, hydroxychloroquine, and sulphasalazine appear more effective than when each is used alone. Longer, carefully conducted studies are needed. Some drugs that have protected cartilage from damage in patients with osteoarthritis should be considered for patients with rheumatoid arthritis. Alternative ways of using drugs that are already available should also be considered to minimized the debilitating effects of this disease. (Consumer Summary produced by Reliance Medical Information, Inc.)

Chemotherapy, Combination, Combination chemotherapy

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Effects of capsaicin on the metabolism of rheumatoid arthritis synoviocytes in vitro

Article Abstract:

Capsaicin is substance found in hot (chili) peppers and it has been applied topically (directly to the skin) to patients as an experimental treatment for a variety of diseases. Experiments in animals demonstrated that capsaicin moderates the inflammation of the synovial membrane of joints. Tachykinins, also known as substance P, are polypeptides present in the synovial fluid that can be released by administration of capsaicin. Synovial tissue samples were obtained from patients with rheumatoid arthritis who were undergoing joint surgery. The cultures of these synovial cells (synoviocytes) were studied to determine if capsaicin administration would have direct beneficial effects for the treatment of patients with arthritis. Capsaicin had a direct effect on the metabolism of the synovial cells, it induced cell proliferation at low concentrations, and it increased the synthesis of collagenases and prostaglandins. The investigators believe that the modifications induced by capsaicin in rheumatoid arthritis synoviocytes were not mediated by tachykinins. Capsaicin was believed to act directly on synovial cells; however, the exact mechanisms still need to be determined. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Synovial fluid, Capsaicin, Hot peppers

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Increased circulating nerve growth factor is directly correlated with disease activity in juvenile chronic arthritis

Article Abstract:

A protein called nerve growth factor (NGF) may play a role in the joint inflammation process. NGF levels were measured in 39 children with polyarticular arthritis, 24 with pauciarticular juvenile arthritis, 17 with systemic arthritis, and 40 matched volunteers (control group). NGF levels were higher in all the patient groups when compared with the control group and higher in patients with active than inactive disease. Increases in the erythrocyte sedimentation rate, an inflammation indicator, directly corresponded with NGF levels.

Joints, Joints (Anatomy), Rheumatoid arthritis in children, Juvenile rheumatoid arthritis, Inflammation, Nerve growth factor

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