INSIGHTS AND PERSPECTIVES IN RHEUMATOLOGY docx

INSIGHTS AND PERSPECTIVES IN RHEUMATOLOGY Edited by Andrew Harrsion Insights and Perspectives in Rheumatology Edited by Andrew Harrsion Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2011 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Ivana Zec Technical Editor Teodora Smiljanic Cover Designer InTech Design Team Image Copyright Eraxion, 2011. DepositPhotos Used under license from Shutterstock.com First published December, 2011 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Insights and Perspectives in Rheumatology, Edited by Andrew Harrsion p. cm. ISBN 978-953-307-846-5 free online editions of InTech Books and Journals can be found at www.intechopen.com Contents Preface IX Part 1 Pathogenic Mechanisms in Rheumatic Disease 1 Chapter 1 Natural and Pathologic Autoantibodies 3 Péter Németh and Diána Simon Chapter 2 Adipokines and Systemic Rheumatic Diseases: Linking Inflammation, Immunity and Metabolism 21 Morena Scotece, Javier Conde, Veronica Lopez, Rodolfo Gómez, Francisca Lago, Juan J Gómez Reino and Oreste Gualillo Chapter 3 Gene Expression Profiling in Rheumatoid Arthritis 39 Cornelis L. Verweij and Saskia Vosslamber Chapter 4 Vitamin D and Autoimmune Disease 63 Ayah M. Boudal and Suzan M. Attar Chapter 5 Osteoporosis in Rheumatoid Arthritis 75 Alessandro Geraci Chapter 6 Infectious Complications of Anti-Tumour Necrosis Factor-α Therapy in Rheumatoid Arthritis 93 Ioannis D. Xynos and Nikolaos V. Sipsas Chapter 7 Pamidronate Treatment in Charcot Neuro-Osteoarthropathy: Change in Biochemical Markers of Bone Turnover and Radiographic Outcome After Treatment 109 Ivonne Vázquez, Mireia Moreno and Marta Larrosa Part 2 Sjögren's Syndrome: Clinical and Immunological Aspects 121 Chapter 8 Diagnostic and Prognostic Features of Sjögren’s Syndrome 123 Muhammad S. Soyfoo and Elie Cogan VI Contents Chapter 9 Oral Aspects of Sjögren’s Syndrome 149 Sertan Ergun Chapter 10 Mechanisms of Salivary Gland Secretory Dysfunction in Sjögren’s Syndrome 171 Kaleb M. Pauley, Byung Ha Lee, Adrienne E. Gauna and Seunghee Cha Chapter 11 Sjögren’s Syndrome: The Proteomic Approaches 193 Laura Giusti, Chiara Baldini, Laura Bazzichi, Stefano Bombardieri and Antonio Lucacchini Part 3 Psychosocial Considerations in Rheumatic Disease 213 Chapter 12 The Pathogenetic Link Between Stress and Rheumatic Diseases 215 O. Malysheva and C.G.O. Baerwald Chapter 13 Pain in Rheumatic Diseases 241 Susette Unger and Christoph Baerwald Chapter 14 Transition of Care in Rheumatology: Managing the Rheumatic Patient from Childhood to Adulthood 255 Philomine van Pelt and Nico Wulffraat Preface Over the past two decades, there has been remarkable progress in the understanding of pathogenesis of rheumatic disease, which has in turn led to dramatic improvements in the ability to control inflammation. In documenting some of the advances that have taken place, this book demonstrates the therapeutic possibilities that fields such as pharmacogenomics might bring, while highlighting the current challenges in rheumatology, such as prevention of treatment-related opportunistic infection and the control of chronic pain. The first section is concerned with the pathogenesis mechanisms that underlie rheumatic diseases, beginning with a review of autoantibodies and their role in disease pathogenesis. There is a chapter on adipokines; the inflammatory mediators produced by adipose tissue, and the relationship between metabolism and inflammation. The results of microarray studies are outlined within a review on gene expression profiling in rheumatoid arthritis. The role of vitamin D in autoimmune disease is deliberated and there is a chapter that examines the effects of rheumatoid arthritis on bone metabolism. The first section concludes with a review of great clinical relevance – the contribution of TNF inhibitors to the risk of infection in rheumatoid arthritis. The second section narrows the focus to discuss various aspects of one particular rheumatic disease; Sjögren’s syndrome. This section is not intended to be a monograph on this disease, but more of a collection of reviews that put the spotlight on specific interesting facet of Sjögren’s syndrome: diagnosis and prognosis, mechanisms of decreased glandular secretion, oral manifestations and salivary proteomics. The final section of the book moves away from somatic physiology and pathology and examines the impact of the rheumatic diseases on higher functions. The role of psychological stress in the presentation of rheumatic disease is reviewed, and there is a chapter on assessment and management of pain. The transition of JIA patients, from childhood to adulthood, is reviewed in the final chapter of this section. The hope is, that this book will serve as a resource for those seeking comprehensive reviews of these topics. In its entirety, this book demonstrates the breadth and depth X Preface of knowledge that has been accumulated in rheumatology from the molecular level to the highest level of human function. Dr. Andrew Harrsion University of Otago, New Zealand [...]... dysregulation of osteoblast function (Mutabaruka et al., 2010) Leptin’s and leptin receptor (Ob-Rb) expression levels were significantly increased in advanced OA cartilage and in SF The induction by leptin of IL-1β production y MMP-9 and 24 Insights and Perspectives in Rheumatology MMP-13 protein expression in chondrocytes indicates a pro-inflammatory and catabolic role of this hormone on cartilage metabolism... secreted proteins including mannose binding lectin, C1q, pulmonary surfactant proteins A and D, C-reactive protein and lipopolysaccharide binding proteins, respectively These molecules facilitate opsonisation for phagocytosis and aid the complement system in destroying pathogens that have been bound by these secreted proteins (Medzhitov 2001) The third functional group is constituted by signalling receptors... osteoarthritis (OA) A prevailing hypothesis is that obesity increases mechanical loading on the articular cartilage that finally leads to its degeneration However, obesity is also associated with OA in non-weight bearing joints such as hand joints, which suggest that metabolic factors, as adipokines, contribute to the high prevalence of OA in obese subjects 22 Insights and Perspectives in Rheumatology (Felson,... demonstrated that leptin is able to induce also the expression of MMPs involved in OA cartilage damage, such as MMP-9 and MMP-13 (Toussirot et al., 2007) Leptin alone and in combination with IL-1β up-regulates MMP-1 and MMP-3 production in human OA cartilage through the transcription factor NF-κB, protein kinase C and MAP kinase pathways This hormone is also correlated positively to MMP-1 and MMP-3 in synovial... physiological antigen conformation and does not require prior epitope prediction The technology is based on the expression of recombinant peptides or proteins fused to a phage coat protein Its key advantage is in the physical coupling of the displayed protein to 10 Insights and Perspectives in Rheumatology the nucleic acid coding for it, making the repeated affinity selection and amplification possible The... ISSN 1286-4579 2 Adipokines and Systemic Rheumatic Diseases: Linking Inflammation, Immunity and Metabolism Morena Scotece1, Javier Conde1, Veronica Lopez1, Rodolfo Gómez1, Francisca Lago2, Juan J Gómez Reino1 and Oreste Gualillo1 1SERGAS, Santiago University Clinical Hospital, Research laboratory 9 (NEIRID LAB: Neuroendocrine Interactions in Rheumatology and Inflammatory Diseases), Institute of Medical... selected, expand, and acquire their innate-like phenotype and functions in the thymus They accumulate in the liver and the spleen, independently of the presence of any exogenous stimuli such as the normal bacterial flora INKT cells play an important role in both protective and regulatory responses The nature of the response is determined by the initial cytokine environment: interaction with IL-10-producing... capable of transducing the leptin signal Leptin is a hormone with pleiotropic actions In fact, in addition to regulation of food intake, it also affects a variety of other physiological functions, including fertility, bone metabolism, inflammation, infection, immune responses and others Recent evidence demonstrates an involvement of leptin in promoting the pathogenesis of different autoimmune and rheumatic... expansion of Treg cells leading to a down-regulation of Th1 immunity and cell- Adipokines and Systemic Rheumatic Diseases: Linking Inflammation, Immunity and Metabolism 23 mediated autoimmune diseases associated with increased susceptibility to infections On the other hand, an increase in adipocyte mass leads to high leptin secretion, which results in expansion of effector T cells and reduction of T-Reg... plus interferon-γ, and NOS2 activation by IL-1β is increased by leptin via a mechanism involving JAK2, PI3K, and mitogen activated kinases (MEK1 and p38) (Otero M et al., 2003, 2005) Nitric oxide (NO), which is induced by a wide range of pro-inflammatory cytokines, is a well-known pro-inflammatory mediator on joint cartilage, where it triggers chondrocyte phenotype loss, apoptosis, and metalloproteinases . INSIGHTS AND PERSPECTIVES IN RHEUMATOLOGY Edited by Andrew Harrsion Insights and Perspectives in Rheumatology Edited by Andrew Harrsion Published by InTech. of PRRs are secreted proteins including mannose binding lectin, C1q, pulmonary surfactant proteins A and D, C-reactive protein and lipopolysaccharide binding proteins, respectively. These molecules. Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from orders@intechweb.org Insights and Perspectives in Rheumatology,