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Analysis of the therapy in patients with juvenile idiopathic arthritis
Procházková, Martina ; Malý, Josef (advisor) ; Rozsívalová, Petra (referee)
Abstarct Analysis of the Therapy in Patients with Juvenile Idiopathic Arthritis Author: Martina Procházková Tutor: PharmDr. Josef Malý, Ph.D. Department of Social and Clinical Pharmacy, Faculty of Pharmacy in Hradec Králové, Charles University Introduction and aims: Methotrexate (MTX) is an effective and safe drug used for the treatment of juvenile idiopathic arthritis (JIA) and is well-known like a golden standart in the treatment of this serious illness. The aim of this study was analysis of therapy in patients with JIA focusing on MTX and faktors affecting its intolerance. Methods: The study was undertaken from January 2017 to February 2018 at the Department of Paediatrics and Adolescent Medicine, 1st Faculty of Medicine, Charles University in Prague. Patients younger than 18 years old, who have become ill with JIA for the first time or repeatedly between years 2015-2017 and were treated by MTX were included in this study. The prevalence of MTX intolerance was measured by "Methotrexate Intolerance Severity Score" questionaire every 3 months during regular rheumatological examinations. Simultaneously, medical records were reviewed. Data analysis was performed by means of descriptive statistics, correlation dependence and statistical signifikance of dependence was assessed with statistical two-choice...
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Prevalence of myofascial trigger points in patients with rheumatoid arthritis
Vítek, Jiří ; Čech, Zdeněk (advisor) ; Procházka, Michal (referee)
Bibliography VÍTEK, Jiří. Prevalence of myofascial trigger points in patients with rheumatoid arthritis. Prague: Charles University, 2nd Faculty of Medicine, Department of Rehabilitation and Sports Medicine, 2014. 98 p. Supervisor Zdeněk Čech DPT Abstract Objectives The main objective of this bachelor thesis is a pilot study to analyse the prevalence of myofascial trigger point ( MTrPs ) in patients with rheumatoid arthritis (RA). Methods The total number of 37 patients was examined. The patients were divided in three groups: 1) patients with rheumatoid arthritis, 2) patients with any other rheumatoid disease and 3) hospitalised patients without any rheumatoid disease. We monitored the frequency of typical clinical signs of MTrPs - taut band, spot of tenderness and a local twitch response in 18 selected muscles. Results It was confirmed that in patients with rheumatoid arthritis, age does not correspond with the number of myofascial trigger points. These assumptions were not confirmed: different prevalence of MTrPs in patients with RA compared to both control groups, the decreasing prevalence of MTrPs corelating with progression of RA, the effect of biological treatment on the prevalence of MTrPs, presence of acute inflammatory joints on the prevalence of MTrPs, the impact of sleep disorders on the...
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Study of interleukin 37 and its role in rheumatoid arthritis
Jandová, Romana ; Šenolt, Ladislav (advisor) ; Krulová, Magdaléna (referee)
Dysregulation between pro- and anti-inflammatory cytokines activity in rheumatoid arthritis (RA) contributes to immune dysregulation, chronic inflammation and subsequent joint destruction. Interleukin-37 (IL-37) has been described as an anti-inflammatory cytokine in several autoimmune diseases. The main aim of this work was to determine the levels of IL-37 in serum and synovial fluid (SF) of RA patients and to compare them with the levels in patients with osteoarthritis (OA) and further explore the association of IL-37 with disease activity and other clinical parameters. Subsequent goal was to study its anti-inflammatory function on RA synovial fibroblasts and describe other cells types of synovial tissue contributing to its production. IL-37 levels were detected using enzyme-linked immunosorbent assay (ELISA). Synovial fibroblasts were stimulated by lipopolysaccharide (LPS) and recombinant IL-37 (rIL-37). The levels of studied genes were detected by PCR. Synovial tissues and immune cells were visualized by immunohistochemical and by immunofluorescence staining. We found increased levels of IL-37 in SF of patients with RA in comparison to OA patients. There was a significant correlation between serum and SF levels of IL-37. RA as well as OA patients showed increased levels of IL-37 in serum than in...
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The role of S100 proteins in the pathogenesis of rheumatic diseases
Andrés Cerezo, Lucie ; Šenolt, Ladislav (advisor) ; Hrnčíř, Zbyněk (referee) ; Horák, Pavel (referee)
Introduction: Recent findings and better understanding to the pathogenesis of rheumatic diseases contributed to the development of biological therapies targeting cytokines and immune cells. Several S100 proteins exert cytokine-like effects and participate in the regulation of the inflammatory process. The aim of this work was to study the role of selected S100 proteins in the activity and in the pathogenesis of the rheumatic diseases. Results: Our data show for the first time an association of S100A4 proteinwith RA disease activity and decrease of the bioactive form, but not the total amount of S100A4, after aplication of tumour necrosis factor (TNF) blocking biologic therapy in patients with RA. We demonstrated that in vitro S100A4 acts as a potent pro-inflammatory mediator inducing production of TNFα, interleukin (IL)-1β and IL-6 in PBMCs via Toll-like receptor 4 (TLR-4), transcription factor NFκB and tyrosine kinases erk1/2 and p38. Moreover, S100A4 can play an important role in the pathogenesis of inflammatory myopathies. S100A4 is present in the inflammatory infiltrate of the affected muscles and in the regenerating muscles and may act as a cytokine-like factor indirectly promoting muscle fiber damage by stimulating mononuclear cells to increase the synthesis of pro-inflammatory cytokines. We...
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Case of physiotherapy care for patient with rheumatoid arthritis diagnosed
Koukalová, Martina ; Neuwirthová, Svatava (advisor) ; Jarošová, Hana (referee)
Title of bachelor's thesis: Case of physiotherapy care for patient with rheumatoid arthritis diagnosed Objectives: The aim of this thesis is to show using of physiotherapeutistic methods on patient with rheumatoid arthritis. One part of this thesis is casuistry of patient with rheumatoid arthritis. The summary: The thesis is divided into two parts, the theoretical part and the special part. The theoretical part is focused on issue of rheumatoid arthritis, its characteristic, division, diagnostics and following therapy. In the special part is closely processed casuistry of patient with rheumatoid arthritis, this part includes entry kinesiological assesment, process of following therapies, output kinesiological assesment and evaluation of therapy efect. This casuistry was processed at the Institue of Rheumatology in Prague in period from 6th of January to 31st of Janury 2014. Key words: Physiotherapeutic methods, case of physiotherapy, rheumatoid arthritis
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Selected aspects of methotrexate treatment in patients with rheumatoid arthritis
Hloch, Karel ; Pávek, Petr (advisor) ; Souček, Miroslav (referee) ; Tomčík, Michal (referee)
Charles University, Faculty of Pharmacy in Hradec Králové Training Workplace Department of Social and Clinical Pharmacy Doctoral Degree Program Clinical and Social Pharmacy Candidate MSc. Karel Hloch Supervisor prof. PharmD. Petr Pávek, Ph.D. Advisor assoc. prof. MUDr. Tomáš Soukup, Ph.D.; PharmD. Martin Doseděl, Ph.D. Title of Doctoral Thesis: Selected aspects of methotrexate treatment in patients with rheumatoid arthritis Introduction and objectives Rheumatoid arthritis (RA) is an autoimmune disease typically connected with chronic inflammation of the joints, causing their swelling and pain. The prevalence of RA is about 1% in the general population. A crucial role in higher morbidity and mortality in RA patients has been associated with increased inflammatory activity. Methotrexate (MTX), a drug with immunosuppressive activity, is the most frequent drug of choice used in RA therapy. It seems that main anti-inflammatory effect is mediated via release of purine nucleoside adenosine. The status of patients with inflammatory diseases is influenced by activation of A2a and A3 adenosine receptors. High caffeine (adenosine receptor antagonist) consumption may therefore lead to alteration of MTX treatment efficacy. 1) The aim of first study was to determine whether RA patients who had discontinued...
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Characterization of biological and functional features of a new type of CD27- memory B lymphocytes.
Bajzíková, Martina ; Růžičková, Šárka (advisor) ; Šinkora, Marek (referee)
The increased frequencies of two novel B cell populations defined as IgM+ CD19+ CD27- CD21low CD38low CD24+ and IgM+ CD19+ CD27- CD21low CD38low CD24- in peripheral blood of patients with common variable immunodeficiency (CVID) compared to healthy donors were found. The aim was to search for such B cells in patients with rheumatoid arthritis (RA) and their further characterization. The production of immunoglobulin (Ig) mRNA in single B cells was analyzed using flow cytometry, single cell sorting and RT-PCR, IgVH-specific PCR, cycle sequencing and statistical analysis. The study was focused on analysis of variable regions of the heavy chains of Igs and significant differences in the usage of VH, DH and JH gene segments, mutational frequencies, distribution of silent and replacement mutations, length and composition of CDR3 regions, clonal relation and RAG gene expression in above mentioned B cell populations were found. Because of lack of the surface CD27 molecule being regarded as marker of B cells that have undergone antigen-driven germinal reactions, analyzed populations were considered as naive. However, the pattern and type of mutations suggested that these cells could represent a new type of differentiated memory/antigen- experienced B lymphocytes (in CVID less maturated) with the likely role in...
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Case of physiotherapy care for patient diagnosed with rheumatoid arthritis
Šedková, Štěpánka ; Hnátová, Iva (advisor) ; Jarošová, Hana (referee)
Title of bachelor's thesis: Case of physiotherapy care for patient diagnosed with rheumatoid arthritis Objectives: The aim is to emphasize the use of physiotherapy as a part of comprehensive treatment of a patient with rheumatoid arthritis. The thesis includes a detailed casuistry of a patient with rheumatoid arthritis. Methods: The thesis is divided into a general part and a special part. The general part is focused on description of rheumatoid arthritis. It discusses characteristics of the disease and its division, clinical symptoms, pathogenesis, prognosis, psychological aspect, examination and treatment procedures. The Special part of the thesis presents a casuistry of a patient with rheumatoid arthritis. It includes entry kinesiological analysis of a patient with rheumatoid arthritis, subsequent therapy and output kinesiological analysis. This casuistry was prepared at the Institute of Rheumatology in Prague during the bachelor praxis in the period from 14th of January 2013 to 8th of February 2013 under the professional guidance of Eva Ištvánková. Keywords: physiotherapy, case report, rheumatoid arthritis
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Case study of physiotherapy treatment of a patient with rheumatoid arthritis
Dostálová, Barbora ; Kozáková, Alena (advisor) ; Jarošová, Hana (referee)
Title: Case study of physiotherapy treatment of a patient with rheumatoid arthritis Aims: The main goal of my thesis was to use knowledge gained during studies of physiotherapy in a practical case of a patient treatment and to get feedback of the therapy that was used. The therapy included: an investigation, a proposal of the therapy, a procedure for the therapy and an evaluation of the effect of the therapy. Methods: The first part of my thesis is focused on the theoretical issue of rheumatoid arthritis. The main topic of this part is a clinical picture through which rheumatoid arthritis can come out. I also focused on arthral and non-arthral, neurological, symptoms. At the end of the thesis the physical therapy is discussed. The second part includes the actual diagnosis elaboration of a case study of physiotherapy treatment of a patient with rheumatoid arthritis. It was created during my practice in the Institute of Rheumatology in Prague, from 11th January until 21st January. The part includes an entry investigation, a short-term and a long-term therapy schedule, therapeutic units, an output investigation and an efficiency of the used therapy. The main aim of the therapy was to reduce pain and to restore the strength of muscles and the latitude of joints Results: With a high support of a medical...
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Circulating miRNAs as biomarkers in the diagnosis and treatment of rheumatic diseases
Prajzlerová, Klára ; Filková, Mária (advisor) ; Hrnčíř, Zbyněk (referee) ; Procházková, Leona (referee)
Background: MicroRNAs (miRNAs) are small non-coding single-stranded RNAs involved in the posttranscriptional inhibition of gene expression and thereby regulating all cellular functions. Their dysregulation contributes to the pathophysiology of many diseases, including rheumatic diseases. MiRNAs can also be found extracellularly in body fluids and represent promising diagnostic and prognostic biomarkers. Our study aimed to investigate miRNAs as biomarkers of stage and activity and predictors of therapeutic response of two most common inflammatory rheumatic diseases: spondyloarthritis (SpA) and rheumatic arthritis (RA). Results: We found several circulating miRNAs differentially expressed in SpA patients reflecting the severity of axial involvement and/or disease activity. The decrease in circulating miR-145 in plasma of patients with ankylosing spondylitis 3 months of anti-TNF therapy predicted a good therapeutic response and low disease activity after a year of therapy. Circulating and intracellular expression of miR-125b in peripheral blood mononuclear cells (PBMC) was lower in treatment-naïve patients with early RA than in healthy controls. Baseline expression of miR-125 in PBMC predicted a (non)adequate therapeutic response. We also found the increased expression of miR-451 in PBMC in...
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