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Inchingolo F, Inchingolo AM, Fatone MC, Avantario P, Del Vecchio G, Pezzolla C, Mancini A, Galante F, Palermo A, Inchingolo AD, Dipalma G. Management of Rheumatoid Arthritis in Primary Care: A Scoping Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:662. [PMID: 38928909 PMCID: PMC11203333 DOI: 10.3390/ijerph21060662] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/13/2024] [Accepted: 05/16/2024] [Indexed: 06/28/2024]
Abstract
Rheumatoid arthritis (RA) can lead to severe joint impairment and chronic disability. Primary care (PC), provided by general practitioners (GPs), is the first level of contact for the population with the healthcare system. The aim of this scoping review was to analyze the approach to RA in the PC setting. PubMed, Scopus, and Web of Science were searched using the MESH terms "rheumatoid arthritis" and "primary care" from 2013 to 2023. The search strategy followed the PRISMA-ScR guidelines. The 61 articles selected were analyzed qualitatively in a table and discussed in two sections, namely criticisms and strategies for the management of RA in PC. The main critical issues in the management of RA in PC are the following: difficulty and delay in diagnosis, in accessing rheumatological care, and in using DMARDs by GPs; ineffective communication between GPs and specialists; poor patient education; lack of cardiovascular prevention; and increase in healthcare costs. To overcome these criticisms, several management strategies have been identified, namely early diagnosis of RA, quick access to rheumatology care, effective communication between GPs and specialists, active patient involvement, screening for risk factors and comorbidities, clinical audit, interdisciplinary patient management, digital health, and cost analysis. PC appears to be the ideal healthcare setting to reduce the morbidity and mortality of chronic disease, including RA, if a widespread change in GPs' approach to the disease and patients is mandatory.
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Affiliation(s)
- Francesco Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Angelo Michele Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | | | - Pasquale Avantario
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Gaetano Del Vecchio
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Carmela Pezzolla
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Antonio Mancini
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | | | - Andrea Palermo
- College of Medicine and Dentistry, Birmingham B4 6BN, UK
| | - Alessio Danilo Inchingolo
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
| | - Gianna Dipalma
- Department of Interdisciplinary Medicine, University of Bari “Aldo Moro”, 70124 Bari, Italy; (A.M.I.); (P.A.); (G.D.V.); (C.P.); (A.M.); (A.D.I.); (G.D.)
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Olsen MN, Halse AK, Skeie E, Lein RK, Nilsen RM, Tangvik RJ. Effect of dietary interventions on nutritional status in patients with rheumatoid arthritis and spondyloarthritis - A systematic review and meta-analysis. Clin Nutr 2024; 43:926-935. [PMID: 38401228 DOI: 10.1016/j.clnu.2024.02.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 01/22/2024] [Accepted: 02/18/2024] [Indexed: 02/26/2024]
Abstract
BACKGROUND & AIM Patients with rheumatoid arthritis (RA) and spondyloarthritis (SpA) have an increased risk of developing altered body composition, such as low muscle mass, and an increased risk of developing cardiovascular diseases (CVD). Thus, investigating how to improve body composition and CVD risk factors is a relevant topic to improve management of RA and SpA. The aim of this study was to identify dietary interventions that can improve body composition, as well as reduce CVD risk factors in RA and SpA. METHODS We searched the databases Medline, Embase and Cochrane. Duplicates were removed using Endnote and records were screened through Rayyan. The primary outcomes were muscle mass (kg) and fat mass (kg). Secondary outcomes were body weight (kg), body mass index (BMI: kg/m2), waist circumference (cm) and lipid profile (total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), triglycerides, mmol/L). RESULTS A total of 4965 articles were identified, and 17 articles were included in this review, of which 15 were suitable for meta-analysis. We found a reduction in TC and LDL-C, (Mean difference, [95%CI]: -0.36, [-0.63, -0.10], I2 = 43%, and -0.20, [-0.35, -0.05], I2 = 0% respectively). Otherwise, no other significant effect was seen in either primary or secondary outcomes. The evidence was graded as moderate for TC and low for LDL-C. CONCLUSION Dietary interventions might reduce the levels of blood lipids, and consequently, the risk of cardiovascular diseases. However, body composition did not change significantly after a 2-4 month dietary intervention. Both short intervention period and lack of reliable methods to assess body composition are possible explanations for this finding. Further studies of longer duration are needed.
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Affiliation(s)
- Marie Njerve Olsen
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway; Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway; Mohn Nutrition Research Laboratory, Department of Clinical Medicine, University of Bergen, Bergen, Norway.
| | - Anne-Kristine Halse
- Department of Rheumatology, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Elisabeth Skeie
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | | | - Roy M Nilsen
- Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Randi J Tangvik
- Centre for Nutrition, Department of Clinical Medicine, University of Bergen, Bergen, Norway; Mohn Nutrition Research Laboratory, Department of Clinical Medicine, University of Bergen, Bergen, Norway
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Sun R, Wu L, Sun Y. Immunological studies on acupuncture and moxibustion treatment of rheumatoid arthritis: A review. Medicine (Baltimore) 2024; 103:e36875. [PMID: 38215134 PMCID: PMC10783328 DOI: 10.1097/md.0000000000036875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 12/15/2023] [Indexed: 01/14/2024] Open
Abstract
From the 4 perspectives of T lymphocytes, various cytokines, adenosine and "neuro-endocrine-immune" network, the researches related to the immune mechanism of acupuncture and moxibustion in the treatment of rheumatoid arthritis (RA) in recent years were summarized, and different acupuncture and moxibustion treatments were analyzed. The method has a regulatory effect on the mechanism of RA, in order to provide a reference and basis for acupuncture research on the immune mechanism of RA, and promote the further development of research in this field.
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Affiliation(s)
- Ran Sun
- Chengdu University of Traditional Chinese Medicine, Chengdu, Sichuan, China
| | - Linna Wu
- The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin, China
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Yiming Sun
- National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, Sichuan, China
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Aharrane FZ, Taik FZ, Takhrifa N, Bensaid R, Soba N, Fourtassi M, Abourazzak FE. Is there an Association between Complementary and Alternative Medicine use and Trust in Physicians in Patients with Rheumatic Diseases? Curr Rheumatol Rev 2024; 20:444-450. [PMID: 38213157 DOI: 10.2174/0115733971271511231220101117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2023] [Revised: 11/18/2023] [Accepted: 11/27/2023] [Indexed: 01/13/2024]
Abstract
INTRODUCTION Generally, patients with chronic rheumatic diseases use complementary and alternative medicine (CAM) in addition to their conventional treatments to manage their health. Discussing these treatments with their physician is still rare, which might be directly related to patients' trust toward them. AIM The primary objective of this study was to assess the association between patients' trust in their physician and the use of complementary and alternative medicine among patients with chronic inflammatory rheumatic diseases. As secondary objectives, to estimate the prevalence of CAM use, and to identify the associated factors with their use and with trust in physicians. METHODS This is a cross-sectional study, which included patients with established chronic inflammatory rheumatic diseases, at the University Hospital Center in Tangier. The questionnaire included demographic and clinical information, use of conventional therapy, complementary and alternative therapy, as well as interpersonal trust in patient-physician relationships using the Trust in Physician Scale (TPS). A regression analysis was conducted to identify factors associated with CAM use and with trust in physicians. RESULTS The study included 189 patients. 57.14% of patients reported using complementary medicine at least once, most patients were women (77.78%), mean age was 46.67 ± 13.25 years with an average course of the disease of 11.11 ± 9.23 years. The most frequently used CAM treatments were cupping therapy, massage and the ingestion of a mixture of plants. Mean ± SD Trust in Physician Scale was 47.64 ± 7.2. There was no significant difference between CAM users vs. non-users (48.08 ± 6.9 vs 47.04 ± 7.4; p = 0.35). In uni and multivariate analysis, a low level of education was significantly associated with the use of CAM. However, no statistically significant difference was found with trust in physicians (OR = 1.020, 95% CI (0.978-1.063), p = 0.354). CONCLUSION CAM therapy is common in patients with chronic inflammatory rheumatic diseases. No statistically significant association was found with trust in physicians, it was rather observed with level of education.
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Affiliation(s)
- Fatima Zahra Aharrane
- Department of Rheumatology, Mohamed VI University Hospital Center, Tangier, Morocco
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tétouan, Morocco
| | - Fatima Zahrae Taik
- Department of Rheumatology, Mohamed VI University Hospital Center, Tangier, Morocco
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tétouan, Morocco
| | - Nihad Takhrifa
- Department of Rheumatology, Mohamed VI University Hospital Center, Tangier, Morocco
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tétouan, Morocco
| | - Rajaa Bensaid
- Department of Rheumatology, Mohamed VI University Hospital Center, Tangier, Morocco
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tétouan, Morocco
| | - Nabil Soba
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tétouan, Morocco
- Department of physical Medicine and Rehabilitation, Mohamed VI University Hospital Center, Tangier, Morocco
| | - Maryam Fourtassi
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tétouan, Morocco
- Department of physical Medicine and Rehabilitation, Mohamed VI University Hospital Center, Tangier, Morocco
| | - Fatima Ezzahra Abourazzak
- Department of Rheumatology, Mohamed VI University Hospital Center, Tangier, Morocco
- Life and Health Sciences Laboratory, Faculty of Medicine and Pharmacy of Tangier, Abdelmalek Essaadi University, Tétouan, Morocco
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Nkiruka Essien E, Revi N, Khatri V, Liu S, Van Thiel G, Bijukumar D. Methotrexate and Sulforaphane loaded PBA-G5-PAMAM dendrimers as a combination therapy for anti-inflammatory response in an intra-articular joint arthritic animal model. Int J Pharm 2023:123150. [PMID: 37336302 DOI: 10.1016/j.ijpharm.2023.123150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 06/13/2023] [Accepted: 06/14/2023] [Indexed: 06/21/2023]
Abstract
L-sulforaphane (LSF), a natural product developed from cruciferous vegetables, have shown potent anti-inflammatory effect in cancer as well as arthritis. However, the stable delivery of LSF remains a major challenge. Methotrexate (MTX) is currently the first line treatment for managing RA and is most effective in patients when used in combination with other anti-inflammatory or anti-rheumatic drugs. Here we developed phenylboronic acid-PAMAM dendrimer (PBA-G5D) nanoparticles conjugated MTX (MTX-PBA-G5D), and L-sulforaphane (LSF/PBA-G5D) loaded dendrimers. The MTX and LSF drug loading and release kinetics was analyzed using HPLC. The lipopolysaccharide (LPS) stimulated macrophages were treated with the formulations to study the inflammatory response in vitro. For in vivo studies, arthritis was induced in five-week-old female Wistar rats, and the MTX- and LSF/PBA-G5-D were injected via intra-articular injection for treatment and the arthritis reduction was scored by weight, knee diameter, and serum cytokine level measurement. The average size of the drug-nanoparticle conjugates ranged from 135-250 nm, with mostly cationic surface charges. The encapsulation efficiency of the drugs to the modified dendrimer was more than 60% with a slow release of drugs from the nanoparticles within 24 h at pH 7.4. Drugs in the nanoparticle formulation were biocompatible, with promising anti-inflammatory effects in vitro against LPS-activated murine macrophages. Further in vivo studies on arthritis induced female Wistar rats, revealed significant anti-arthritic effects based on the arthritic scoring from the knee diameter reading, and anti-inflammatory effects based on the serum cytokine levels. This study provides a promising strategy for utilizing PAMAM dendrimers as a nanocarrier for LSF delivery for RA therapy.
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Affiliation(s)
- Edidiong Nkiruka Essien
- Nanomedicine Lab Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL
| | - Neeraja Revi
- Nanomedicine Lab Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL
| | - Vishal Khatri
- Nanomedicine Lab Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL
| | - Songyun Liu
- Rush University Medical Center, Chicago, Illinois, USA
| | | | - Divya Bijukumar
- Nanomedicine Lab Department of Biomedical Sciences, University of Illinois College of Medicine, Rockford, IL.
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Kou H, Qing Z, Guo H, Zhang R, Ma J. Effect of vitamin E supplementation in rheumatoid arthritis: a systematic review and meta-analysis. Eur J Clin Nutr 2023; 77:166-172. [PMID: 35468933 DOI: 10.1038/s41430-022-01148-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2022] [Revised: 04/04/2022] [Accepted: 04/08/2022] [Indexed: 11/09/2022]
Abstract
OBJECTIVE The purpose of this study was to evaluate the safety and effectiveness of vitamin E in rheumatoid arthritis patients. METHODS A computerized search of PubMed, Embase, The Cochrane Library, and Web of Science databases was conducted to find published randomized controlled trials of vitamin E in rheumatoid arthritis; the experimental group was treated with vitamin E, while the control group was treated with placebo, other drugs, or external therapy; the search period was from the time each database was established to December 31, 2021, and a meta-analysis was conducted using Rev Man 5.4 software. RESULTS This research eventually comprised nine publications with a total of 39,845 patients. Vitamin E supplementation was shown to be more effective in individuals with RA for sensitive joints (MD = -1.66, 95% CI - -6.32-2.99; I2 = 93%; P < 0.00001) and swollen joints (MD = -0.46, 95% CI - -1.98-1.07; I2 = 56%; P = 0.08). CONCLUSIONS Vitamin E's ability to restore the intestinal barrier and improve the gastrointestinal tract may be linked to the prevention and treatment of rheumatoid arthritis. Vitamin E supplements used on a regular basis can help individuals with RA reduce joint discomfort, edema, and stiffness, as well as enhance their overall quality of life.
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Affiliation(s)
- Haiyang Kou
- The First Clinical Medical College, Shaanxi University of Chinese Medicine, Xianyang, 712046, Shaanxi, China.,Translational Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Zhong Qing
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Hao Guo
- Yanliang Campus, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China
| | - Rui Zhang
- Translational Medicine Center, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China.
| | - Jianbing Ma
- Department of Joint Surgery, Honghui Hospital, Xi'an Jiaotong University, Xi'an, 710000, Shaanxi, China.
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Choi SK, Moon JH, Kim JH, Kim EJ, Seo BK, Sung WS. A survey on the clinical practice of rheumatoid arthritis management by Korean medicine doctors. Eur J Integr Med 2023. [DOI: 10.1016/j.eujim.2023.102227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
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Pereira L, Monteiro R. Tailoring gut microbiota with a combination of Vitamin K and probiotics as a possible adjuvant in the treatment of rheumatic arthritis: a systematic review. Clin Nutr ESPEN 2022; 51:37-49. [DOI: 10.1016/j.clnesp.2022.08.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2022] [Revised: 06/14/2022] [Accepted: 08/01/2022] [Indexed: 10/15/2022]
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Wang J, Zhu F, Huang W, Chen Z, Zhao P, Lei Y, Liu Y, Liu X, Sun B, Li H. Therapeutic Effect and Mechanism of Acupuncture in Autoimmune Diseases. THE AMERICAN JOURNAL OF CHINESE MEDICINE 2022; 50:639-652. [PMID: 35282807 DOI: 10.1142/s0192415x22500252] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Autoimmune diseases (AIDs) are conditions arising from abnormal immune reactions to autoantigens, which can be defined as the loss of immune tolerance to autoantigens, causing the production of autoantibodies and subsequent inflammation and tissue injury. The etiology of AIDs remains elusive, which may involve both genetic and environmental factors, such as diet, drugs, and infections. Despite rapid progress in the treatment of autoimmune diseases over the past few decades, there is still no approach that can cure AIDs. As an alternative approach, traditional Chinese medicine (TCM) such as acupuncture has been used in an attempt to treat AIDs including multiple sclerosis (MS), rheumatoid arthritis (RA), and inflammatory bowel disease (IBD), and the results have proven to be quite promising, despite the fact that its mechanism is still not fully understood. In this review, the present knowledge regarding mechanisms of acupuncture in the treatment of AIDs has been summarized, and deeper insights will be provided in order to better understand how acupuncture may regulate immune responses during AIDs.
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Affiliation(s)
- Jing Wang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Fangyi Zhu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Wei Huang
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Zhengyi Chen
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Ping Zhao
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Yanting Lei
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Yumei Liu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Xijun Liu
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Bo Sun
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
| | - Hulun Li
- Department of Neurobiology, School of Basic Medical Sciences, Harbin Medical University Harbin, Heilongjiang 150081, P. R. China
- The Key Laboratory of Myocardial Ischemia, Harbin Medical University, Ministry of Education Harbin, Heilongjiang 150081, P. R. China
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Caballero-Hernández CI, González-Chávez SA, Urenda-Quezada A, Reyes-Cordero GC, Peláez-Ballestas I, Álvarez-Hernández E, Pacheco-Tena C. Prevalence of complementary and alternative medicine despite limited perceived efficacy in patients with rheumatic diseases in Mexico: Cross-sectional study. PLoS One 2021; 16:e0257319. [PMID: 34582473 PMCID: PMC8478211 DOI: 10.1371/journal.pone.0257319] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2021] [Accepted: 08/28/2021] [Indexed: 12/21/2022] Open
Abstract
INTRODUCTION Complementary and alternative medicine (CAM) is frequently used by patients with rheumatic diseases (RD) to improve their symptoms; however, its diversity and availability have increased notably while scientific support for its effectiveness and adverse effects is still scarce. OBJECTIVE To describe the prevalence and diversity of CAM in patients with RD in Chihuahua, Mexico. METHODS A cross-sectional study was conducted in 500 patients with RD who were interviewed about the use of CAM to treat their disease. The interview included sociodemographic aspects, characteristics of the disease, as well as a description of CAM use, including type, frequency of use, perception of the benefit, communication with the rheumatologist, among others. RESULTS The prevalence of CAM use was reported by 59.2% of patients, which informed a total of 155 different therapies. The herbal CAM group was the most used (31.4%) and included more than 50 different therapies. The use of menthol-based and arnica ointments was highly prevalent (35%). Most patients (62.3%) reported very little or no improvement in their symptoms. Only a fourth of the patients informed the rheumatologist of the use of CAM. The use of CAM was influenced by female sex, university degree, diagnosis delay, lack adherence to the rheumatologist's treatment, family history of RD, and orthopedic devices. CONCLUSION The use of CAM in our population is highly prevalent and similar to reports in different populations suggesting a widespread use in many different societies. We found high use of herbal remedies; however, there were many different types suggesting a lack of significant effect. Patients continue using CAM despite a perception of no-effectiveness. Recurrent use of CAM is explained by factors other than its efficacy.
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Affiliation(s)
| | - Susana Aideé González-Chávez
- Facultad de Medicina y Ciencias Biomédicas, Laboratorio PABIOM, Universidad Autónoma de Chihuahua, Chihuahua, México
| | - Adelfia Urenda-Quezada
- Facultad de Medicina y Ciencias Biomédicas, Universidad Autónoma de Chihuahua, Chihuahua, México
| | | | - Ingris Peláez-Ballestas
- Servicio de Reumatología, Hospital General de México “Dr. Eduardo Liceaga”, México City, México
| | | | - César Pacheco-Tena
- Facultad de Medicina y Ciencias Biomédicas, Laboratorio PABIOM, Universidad Autónoma de Chihuahua, Chihuahua, México
- * E-mail:
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Shang J, Xu J, Zhang Z, Tian L, He Y. The efficacy and safety of acupuncture-related therapy in the treatment of rheumatoid arthritis: A protocol for systematic review and network meta-analysis. Medicine (Baltimore) 2021; 100:e26859. [PMID: 34397895 PMCID: PMC8360448 DOI: 10.1097/md.0000000000026859] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Accepted: 07/21/2021] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Rheumatoid arthritis (RA) has seriously affected the quality of life of patients with its refractory, recurrent, and disabled characteristics, and has become a major public health problem. Previous studies have confirmed that acupuncture and moxibustion have a reliable effect on RA, but there are many forms of acupuncture and moxibustion, and the efficacy of each form is different. This study is to evaluate the clinical efficacy of different acupuncture-related therapies in the treatment of RA by means of network meta-analysis. METHODS According to the retrieval strategy, we retrieved the randomized controlled studies on acupuncture-related therapy for RA from China National Knowledge Infrastructure, Wanfang, VIP, China Biomedicine, PubMed, Embase, Web of Science, and The Cochrane Library databases from the establishment of the database to July 2021. We assessed the quality of the studies using the Cochrane Risk Bias Assessment Tool and assessed the strength of the evidence using the Grading of Recommendation Assessment, Development, and Evaluation methodology. All data analyses were performed by Revman5.3, Gemtc 0.14.3, and Stata 14.0. RESULTS This study is to evaluate the efficacy of different acupuncture-related therapies in the treatment of RA by evaluating the total effective rate, pain scores, joint function scores, quality of life scores, laboratory indicators, adverse reactions, etc. CONCLUSION This study will provide a reliable evidence-based basis for the selection of the best acupuncture form for the treatment of RA. ETHICS AND DISSEMINATION Private information from individuals will not be published. This systematic review also does not involve endangering participant rights. Ethical approval will not be required. The results may be published in a peer-reviewed journal or disseminated at relevant conferences.
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Affiliation(s)
- Jingwen Shang
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, Sichuan Province, China
| | - Jia Xu
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, Sichuan Province, China
| | - Zilong Zhang
- Second Provincial People's Hospital of Gansu, Gansu Province, China
| | | | - Yongyang He
- Chengdu Eighth People's Hospital (Geriatric Hospital of Chengdu Medical College), Chengdu, Sichuan Province, China
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Horta-Baas G, Sandoval-Cabrera A, Romero-Figueroa MDS. Modification of Gut Microbiota in Inflammatory Arthritis: Highlights and Future Challenges. Curr Rheumatol Rep 2021; 23:67. [PMID: 34218340 DOI: 10.1007/s11926-021-01031-9] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/22/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE OF REVIEW This Review evaluates the available information on the modification of the microbiota by diet, prebiotics, probiotics, or drugs and its association with the severity of arthritis in animals and humans and highlights how this modulation could have therapeutic applications in RA. RECENT FINDINGS The gut microbiota and microbiota-derived metabolites play a role in developing rheumatoid arthritis (RA) in animals and humans, making the intestinal microbiota an exciting novel approach to suppress autoimmunity. Studies in animal models of RA show that it is possible to modify the intestinal microbiota with drugs, natural products, diet, probiotics, and prebiotics. Furthermore, these changes showed beneficial effects on symptom relief in animal models of RA and that these effects were associated with modulation of the immune response. Therapies that modify the gut microbiota would significantly impact the preclinical stage of arthritis, based on the fact that dysbiosis occurs before clinical arthritis. The effects of interventions to modulate the microbiota could not reverse arthritis. Furthermore, the therapies modulating therapies in controlling symptoms were limited once arthritis developed. The results obtained in the study of acarbose, probiotics, and prebiotics suggest that these interventions may decrease the disease's incidence rather than treat or cure it.
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Affiliation(s)
- Gabriel Horta-Baas
- Servicio de Reumatología, Hospital General Regional número 1, Delegación Yucatán, Instituto Mexicano del Seguro Social, Calle 41 No. 439 x 34. Colonia Industrial, 97150, Mérida, Yucatán, Mexico.
| | - Antonio Sandoval-Cabrera
- Laboratorio de alta especialidad en Hemato-Oncología, Hospital para el Niño, IMIEM, Toluca, Mexico.,Facultad de Medicina, Campus Universitario Siglo XXl, Zinacantepec, State of Mexico, Mexico
| | - María Del Socorro Romero-Figueroa
- Facultad de Medicina, Campus Universitario Siglo XXl, Zinacantepec, State of Mexico, Mexico.,Centro de Investigación en Ciencias de la Salud, Campus Norte Huixquilucan, Universidad Anáhuac México, Mexico City, Mexico
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13
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Deligiannidou GE, Gougoula V, Bezirtzoglou E, Kontogiorgis C, Constantinides TK. The Role of Natural Products in Rheumatoid Arthritis: Current Knowledge of Basic In Vitro and In Vivo Research. Antioxidants (Basel) 2021; 10:antiox10040599. [PMID: 33924632 PMCID: PMC8070014 DOI: 10.3390/antiox10040599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/14/2022] Open
Abstract
Rheumatoid arthritis (RA) is an autoimmune disorder affecting a vast variety of the population. The onset of RA as well as the development of systematic immunization is affected by both genetic and environmental risk factors. This review aims to point out the role of natural products in the management of RA, focusing on the reports of basic research (in vitro and animal studies) emphasizing the antioxidant and anti-inflammatory properties considered in the field of RA. A systematic screening of the relevant literature was carried out on PubMed, Google Scholar, and Scopus with the following criteria: publication date, 2015-2020; language, English; study design, in vitro or animal models; and the investigation of one or several natural products in the context of RA, including, when available, the molecular mechanisms implicated. A total of 211 papers were initially obtained and screened. In vitro and animal studies referring to 20 natural products and 15 pure compounds were ultimately included in this review. The outcomes of this work provide an overview of the methods employed in basic research over the past five years, with emphasis on the limitations presented, while demonstrating the potential benefits of utilizing natural products in the management of RA as supported by in vitro and animal studies.
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Affiliation(s)
- Georgia-Eirini Deligiannidou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, GR-68100 Alexandroupolis, Greece; (G.-E.D.); (V.G.); (E.B.); (T.K.C.)
| | - Vasiliki Gougoula
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, GR-68100 Alexandroupolis, Greece; (G.-E.D.); (V.G.); (E.B.); (T.K.C.)
| | - Eugenia Bezirtzoglou
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, GR-68100 Alexandroupolis, Greece; (G.-E.D.); (V.G.); (E.B.); (T.K.C.)
| | - Christos Kontogiorgis
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, GR-68100 Alexandroupolis, Greece; (G.-E.D.); (V.G.); (E.B.); (T.K.C.)
- Institute of Agri-Food and Life Sciences, Hellenic Mediterranean University Research Centre, GR-71410 Heraklion, Greece
- Correspondence:
| | - Theodoros K. Constantinides
- Laboratory of Hygiene and Environmental Protection, Department of Medicine, Democritus University of Thrace, GR-68100 Alexandroupolis, Greece; (G.-E.D.); (V.G.); (E.B.); (T.K.C.)
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14
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Kaihara K, Nakagawa S, Arai Y, Inoue H, Tsuchida S, Fujii Y, Kamada Y, Kishida T, Mazda O, Takahashi K. Sustained Hypoxia Suppresses Joint Destruction in a Rat Model of Rheumatoid Arthritis via Negative Feedback of Hypoxia Inducible Factor-1α. Int J Mol Sci 2021; 22:ijms22083898. [PMID: 33918929 PMCID: PMC8068944 DOI: 10.3390/ijms22083898] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Revised: 04/05/2021] [Accepted: 04/07/2021] [Indexed: 12/29/2022] Open
Abstract
Hypoxia inducible factor (HIF)-1α has been implicated in the pathogenesis of rheumatoid arthritis (RA). HIF-1α, which is expressed in hypoxia, is reversely suppressed in sustained hypoxia. Here, we investigated the inhibitory effect of hypoxia on arthritis by controlling HIF-1α. Rheumatoid fibroblast-like synoviocyte MH7A cells were cultured in a hypoxic incubator for up to 72 h to evaluate the expression of HIF-1. Furthermore, collagen-induced arthritis (CIA) model rats were maintained under 12% hypoxia in a hypoxic chamber for 28 days to evaluate the effect on arthritis. In MH7A cells, HIF-1α protein level increased at 3 h, peaked at 6 h, and subsequently decreased in a time-dependent manner. The transcription of pro-inflammatory cytokines increased at 1 h; however, they decreased after 3 h (p < 0.05). Deferoxamine-mediated activation of HIF-1α abolished the inhibitory effect of sustained hypoxia on pro-inflammatory cytokines. In the rat CIA model, the onset of joint swelling was delayed and arthritis was suppressed in the hypoxia group compared with the normoxia group (p < 0.05). Histologically, joint destruction was suppressed primarily in the cartilage. Thus, sustained hypoxia may represent a new safe, and potent therapeutic approach for high-risk patients with RA by suppressing HIF-1α expression.
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Affiliation(s)
- Kenta Kaihara
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (K.K.); (H.I.); (S.T.); (Y.F.); (Y.K.); (K.T.)
| | - Shuji Nakagawa
- Department of Sports and Para-Sports Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan;
| | - Yuji Arai
- Department of Sports and Para-Sports Medicine, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan;
- Correspondence: ; Tel.: +81-75-251-5139; Fax: +81-75-261-5433
| | - Hiroaki Inoue
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (K.K.); (H.I.); (S.T.); (Y.F.); (Y.K.); (K.T.)
| | - Shinji Tsuchida
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (K.K.); (H.I.); (S.T.); (Y.F.); (Y.K.); (K.T.)
| | - Yuta Fujii
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (K.K.); (H.I.); (S.T.); (Y.F.); (Y.K.); (K.T.)
| | - Yoichiro Kamada
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (K.K.); (H.I.); (S.T.); (Y.F.); (Y.K.); (K.T.)
| | - Tsunao Kishida
- Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (T.K.); (O.M.)
| | - Osam Mazda
- Department of Immunology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (T.K.); (O.M.)
| | - Kenji Takahashi
- Department of Orthopaedics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kamigyo-ku, Kyoto 602-8566, Japan; (K.K.); (H.I.); (S.T.); (Y.F.); (Y.K.); (K.T.)
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Pascoalino SD, Lüdtke DD, Heymanns AC, Salm D, Costa DM, Martins DF, Horewicz VV, Bobinski F, Piovezan AP. Antihyperalgesic effect of exercise is augmented by the oral pretreatment with extract of Casearia sylvestris in an animal model of osteoarthritis. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2020. [DOI: 10.1177/2210491720935614] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
Background/Purpose: Osteoarthritis (OA) is the main orthopedic disease to cause pain and edema in humans. This study evaluated the influence of complementary medicine on the hyperalgesia and edema induced by exercise in an animal model of OA as well as possible role for interleukin (IL)-1β to these outcomes. Methods: Mice (25–35 g) were subjected to intraplantar injection of Freund’s complete adjuvant and were subjected to exercise and oral treatment with ethanolic crude extract of Casearia sylvestris (ECE-CS) or vehicle (alone or in combination) and evaluated through behavioral and biochemical tests. Results: At day 5, exercise and ECE-CS alone did not reduce hyperalgesia, while the combination of both enhanced this effect. In muscle and skin tissues from the treated paw of mice, both treatments alone or in combination reduced in similar extent the levels of IL-1β in relation to the control group. Conclusion: Association of both complementary therapies may bring benefits on pain associated with OA in humans.
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Affiliation(s)
- Shayany Dalbem Pascoalino
- Physical Education Undergraduate Course, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Daniela Dero Lüdtke
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Ana Caroline Heymanns
- Physical Education Undergraduate Course, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Daiana Salm
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Déborah M Costa
- Medicine Undergraduate Course, University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Daniel Fernandes Martins
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Verônica V Horewicz
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Franciane Bobinski
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
| | - Anna Paula Piovezan
- Postgraduate Program in Health Sciences (PPGCS), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
- Laboratory of Experimental Neuroscience (LANEX), University of Southern Santa Catarina (UNISUL), Palhoça, Santa Catarina, Brazil
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Parenti G, Tomaino SCM, Cipolletta S. The experience of living with rheumatoid arthritis: A qualitative metasynthesis. J Clin Nurs 2020; 29:3922-3936. [PMID: 32702139 DOI: 10.1111/jocn.15428] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/30/2020] [Accepted: 07/10/2020] [Indexed: 12/12/2022]
Abstract
AIMS AND OBJECTIVES To develop a model of understanding of how rheumatoid arthritis (RA) affects daily life based on a third-order interpretation of qualitative findings. BACKGROUND Rheumatoid arthritis is a chronic condition subject to a progressive deterioration of joints, limiting the ability to move and causing severe impairment in patients' lives. DESIGN A qualitative metasynthesis. METHODS CINHAL, ProQuest, PsycINFO, PubMed, SCOPUS and Web of Science databases were searched for relevant studies applying appropriate criteria. Screening and selection of studies were performed following the PRISMA guidelines and the PRISMA checklist was completed. Thirty-eight qualitative articles were retrieved: in total, 17 were excluded for failing to meet inclusion criteria, and 21 were considered for synthesis. Data analysis followed a third-order interpretation of data for synthesising qualitative research. RESULTS Findings led to the creation of a model consisting of two overarching categories: "rheumatoid arthritis impact on life domains" and "Confronting the illness," and two cross-sectional codes: "Health" and "Independence and normality." CONCLUSION This meta-study provides a model that is both inclusive of participants' own viewpoint and solidly grounded in a health psychology model. RELEVANCE TO CLINICAL PRACTICE The model can be highly informative for both practitioners and researchers in developing tailored interventions of support and prevention.
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Affiliation(s)
- Giulia Parenti
- Department of General Psychology, University of Padua, Padova, Italy
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Seca S, Patrício M, Kirch S, Franconi G, Cabrita AS, Greten HJ. Effectiveness of Acupuncture on Pain, Functional Disability, and Quality of Life in Rheumatoid Arthritis of the Hand: Results of a Double-Blind Randomized Clinical Trial. J Altern Complement Med 2019; 25:86-97. [DOI: 10.1089/acm.2018.0297] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Susana Seca
- Heidelberg School of Chinese Medicine, Heidelberg, Germany
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Miguel Patrício
- Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Sebastian Kirch
- Heidelberg School of Chinese Medicine, Heidelberg, Germany
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
| | - Giovanna Franconi
- Department of Systems Medicine, University of Rome Tor Vergata, Rome, Italy
| | | | - Henry J. Greten
- Heidelberg School of Chinese Medicine, Heidelberg, Germany
- Institute of Biomedical Sciences Abel Salazar, University of Porto, Porto, Portugal
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Chabanov D, Tsintzas D, Vithoulkas G. Levels of Health Theory With the Example of a Case of Juvenile Rheumatoid Arthritis. J Evid Based Integr Med 2018; 23:2515690X18777995. [PMID: 29896977 PMCID: PMC6024340 DOI: 10.1177/2515690x18777995] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Contemporary medicine is in great need of a new patient health group classification that could be the basis for in-depth pathology assessments, disease development and prognosis, and the possibility of healing, as well as for possible complications of organism reactions to treatment processes. This classification is possible if founded on holistic approaches at the level of health assessment from the point of view of organism reactivity and resistance. Such a classification, assigning 12 levels and 4 health groups, exists in classical homeopathy. METHODS A new method for determining the group and level of health is shown in a case of juvenile rheumatoid arthritis of a generalized form in an 11-year-old girl, treated with classical homeopathy. The follow-up of the case is 18 years. CONCLUSION The method allows the physician to assess the organism dynamics as a whole during the pathology development.
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Affiliation(s)
- Dmitri Chabanov
- 1 Novosibirsk Centre of Classical Homeopathy, Novosibirsk, Russia
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19
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Chou PC, Chu HY. Clinical Efficacy of Acupuncture on Rheumatoid Arthritis and Associated Mechanisms: A Systemic Review. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE : ECAM 2018; 2018:8596918. [PMID: 29849731 PMCID: PMC5925010 DOI: 10.1155/2018/8596918] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 03/07/2018] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The objective of this review is to investigate the detailed existing scientific information about the clinical efficacy of acupuncture on rheumatoid arthritis (RA) conditions and to reveal the proposed mechanisms. METHODS We searched the PubMed, EMBASE, Cochrane, AMED (Allied and Complementary Medicine), NCCAM (The National Center for Complementary and Alternative Medicine), and CNKI (China National Knowledge Infrastructure) databases to identify relevant monographs and related references from 1974 to 2018. Chinese journals and theses/dissertations were hand searched. RESULTS 43 studies were recruited. Each research was analyzed for study design, subject characteristics, intervention, selected acupoints, assessment parameters, proposed mechanisms, and results/conclusions. CONCLUSIONS In our review, we concluded that acupuncture alone or combined with other treatment modalities is beneficial to the clinical conditions of RA without adverse effects reported and can improve function and quality of life and is worth trying. Several important possible mechanisms were summarized including anti-inflammatory effect, antioxidative effect, and regulation of immune system function. However, there is still inconsistency regarding the clinical efficacy and lack of well-designed human/animal double-blinded RCTs. Future discussion for further agreement on taking traditional Chinese medicine (TCM) theory into consideration as much as possible is a top priority.
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Affiliation(s)
- Pei-Chi Chou
- School of Chinese Medicine, College of Chinese Medicine, China Medical University, Taichung, Taiwan
| | - Heng-Yi Chu
- Department of Rehabilitation, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
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20
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Santos Radai JA, da Silva Graciani F, Berno CR, Leitão MM, Dos Santos EP, Oliveira RJ, Kassuya CAL. Genetic toxicological assessment and anti-arthritic effects of an ethanolic extract obtained from Salvia lachnostachys Benth leaves in mice. Regul Toxicol Pharmacol 2017; 92:239-244. [PMID: 29233772 DOI: 10.1016/j.yrtph.2017.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Revised: 11/20/2017] [Accepted: 12/08/2017] [Indexed: 12/18/2022]
Abstract
In the present study, mice were subjected to prolonged treatment with ethanolic extract of Salvia lachnostachys Benth leaves (SLEE), and the inflammatory and arthritic parameters were evaluated using the Complete Freund's Adjuvant (CFA) model. The genotoxicity of SLEE were also assayed using genetic toxicological tests. For the CFA model, 28 male C57BL/6 mice were distributed randomly into four groups (control, 50 mg/kg of SLEE, 100 mg/kg of SLEE and dexamethasone) for the evaluation of hyperalgesia and paw edema for 21 days after injection of CFA into the paw. To conduct the toxicogenetic assessments (comet assay and micronuclei assay), apoptosis and splenic phagocytosis were evaluated in male Swiss mice after the administration of saline (control group), cyclophosphamide (positive control group) and SLEE (10, 100 and 1000 mg/kg). SLEE significantly reduced the mechanical hyperalgesia and edema caused by CFA injection. The results of the toxicogenetic assessment revealed no toxicogenetic potential in the mice, and the evaluation of apoptosis showed an increase in apoptotic cells in the spleen after 72 h of treatment with SLEE (1000 mg/kg). SLEE exhibited anti-arthritic activity with no toxicogenetic damage. These toxicogenic results support the safety of SLEE.
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Affiliation(s)
- Joyce Alencar Santos Radai
- Federal University of Grande Dourados, College Exact Sciences and Technology, Dourados, Mato Grosso do Sul, Brazil.
| | | | - Claudia Rodrigues Berno
- Federal University of Mato Grosso Do Sul, College of Health Science, Campo Grande, MS, Brazil
| | - Maicon Matos Leitão
- Federal University of Grande Dourados, College of Health Science, Dourados, MS, Brazil
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The Role of High-Mobility Group Box-1 and Its Crosstalk with Microbiome in Rheumatoid Arthritis. Mediators Inflamm 2017; 2017:5230374. [PMID: 29200665 PMCID: PMC5672636 DOI: 10.1155/2017/5230374] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 07/16/2017] [Indexed: 02/06/2023] Open
Abstract
Rheumatoid arthritis (RA) is a chronic, definitely disabling, and potentially severe autoimmune disease. Although an increasing number of patients are affected, a key treatment for all patients has not been discovered. High-mobility group box-1 (HMGB1) is a nuclear protein passively and actively released by almost all cell types after several stimuli. HMGB1 is involved in RA pathogenesis, but a convincing explanation about its role and possible modulation in RA is still lacking. Microbiome and its homeostasis are altered in patients with RA, and the microbiota restoration has been proposed to patients with RA. The purpose of the present review is to analyze the available evidences regarding HMGB1 and microbiome roles in RA and the possible implications of the crosstalk between the nuclear protein and microbiome in understanding and possibly treating patients affected by this harmful condition.
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Schlaeger JM, Roach K, Golas M, Takayama M, Wilkie DJ. Treatment-Seeking Behaviors of Persons With Rheumatoid Arthritis. J Holist Nurs 2017; 36:179-191. [PMID: 28506103 DOI: 10.1177/0898010117693539] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE Describe perceptions of patients with rheumatoid arthritis (RA) regarding disease-related pain, tendency to tell others about their pain, and treatments used since diagnosis. DESIGN Cross sectional, exploratory. METHOD A total of 63 participants responded to telephone interview about their treatments and tendency to tell others about their RA pain. They also responded to McGill Pain Questionnaire and Health Assessment Questionnaire (HAQ) items. Participants marked pain location on mailed body outlines. FINDINGS RA diagnosis occurred an average of 11 years prior. Mean HAQ Standard Disability Index score was 1.26. Previous week symptoms were joint pain (97%), joint swelling (83%), decreased movement/function (83%), fatigue (70%), muscle weakness (65%). Mean morning stiffness duration was 120 ± 137 minutes. Mean pain intensity was 1.15 ± 0.6 at its least and 3.8 ± 1.1 at its worst. 65% were not satisfied with pain levels. 57% stated a tendency not to tell others about their pain; 43% tended to tell. 78% used medications and alternative therapies, none solely used alternative therapies, and 22% only used medications. CONCLUSIONS RA patients reported high rates of alternative therapy use. Dissatisfaction with pain levels indicates need for improved pain management. Not talking about pain lends insights into the importance of teaching patients to communicate their pain to others.
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Affiliation(s)
| | | | - Mary Golas
- University of Illinois at Chicago, Chicago.,Jesse Brown VA Medical Center Chicago, Chicago
| | - Miho Takayama
- Tokyo Ariake University of Medical and Health Sciences, Japan
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