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Arthritis Care & Research Jun 2022Emerging research supports the role of chronic stress in chronic disease development. The objective was to perform a scoping review mapping the field of research...
OBJECTIVE
Emerging research supports the role of chronic stress in chronic disease development. The objective was to perform a scoping review mapping the field of research exploring relationships between chronic stress and the development of arthritis in adult populations.
METHODS
Five electronic databases were systematically searched without publication limits based on 3 key concepts: stress, arthritis, and adults. Eligible qualitative studies investigated individuals' perceived causes of arthritis; quantitative studies investigated relationships between exposure to a chronic stressor and an arthritis presence outcome. Articles were screened by 2 independent reviewers, and data were narratively synthesized.
RESULTS
Of 1,819 unique records, 54 studies met inclusion criteria. Nine studies used qualitative methods, and 45 used quantitative methods. The frequency of studies increased chronologically, with half (n = 27) published since 2010. Chronic stress exposures were heterogenous; most were categorized as adverse life events (n = 22) or adverse childhood experiences (n = 17). Self-reported arthritis was the most frequent measure of arthritis outcome (n = 26) in quantitative studies. A majority of studies (n = 41) suggested a relationship between exposure to chronic stressors and arthritis development.
CONCLUSION
Increasing study numbers in the past decade may reflect increasing awareness of the potential impact of chronic stress in arthritis development, consistent with a biopsychosocial approach to chronic disease etiology and management. Further research, using precise arthritis definitions, conducted within a clearly articulated pathophysiologic framework, is required to establish a causal relationship between exposure to chronic stressors and the development of specific arthritis conditions.
Topics: Adult; Arthritis; Chronic Disease; Humans; Qualitative Research
PubMed: 33278062
DOI: 10.1002/acr.24528 -
Arthritis & Rheumatology (Hoboken, N.J.) Jan 2018Current classification of primary inflammatory arthritis begins from the assumption that adults and children are different. No form of juvenile idiopathic arthritis... (Review)
Review
Current classification of primary inflammatory arthritis begins from the assumption that adults and children are different. No form of juvenile idiopathic arthritis bears the same name as an adult arthritis, a nomenclature gap with implications for both clinical care and research. Recent genetic data have raised questions regarding this adult/pediatric divide, revealing instead broad patterns that span the age spectrum. Combining these genetic patterns with demographic and clinical data, we propose that inflammatory arthritis can be segregated into 4 main clusters, largely irrespective of pediatric or adult onset: seropositive, seronegative (likely including a distinct group that usually begins in early childhood), spondyloarthritis, and systemic. Each of these broad clusters is internally heterogeneous, highlighting the need for further study to resolve etiologically discrete entities. Eliminating divisions based on arbitrary age cutoffs will enhance opportunities for collaboration between adult and pediatric rheumatologists, thereby helping to promote the understanding and treatment of arthritis.
Topics: Adult; Arthritis; Child; Child, Preschool; Diagnosis, Differential; Female; Genetic Predisposition to Disease; Humans; Male
PubMed: 29024575
DOI: 10.1002/art.40350 -
Seminars in Musculoskeletal Radiology Apr 2016The foot and ankle are commonly involved in a range of arthritides that affect the joints, bones, and soft tissues. Accurate plain film interpretation can often aid the... (Review)
Review
The foot and ankle are commonly involved in a range of arthritides that affect the joints, bones, and soft tissues. Accurate plain film interpretation can often aid the diagnosis and monitor disease progression and treatment response. Ultrasound and MRI afford superior depiction of the soft tissues, and advances over recent years have centered on early detection of synovitis, enabling earlier diagnosis and treatment. Advantages and disadvantages of the imaging techniques of radiography, multidetector computed tomography, ultrasound, and MRI are discussed, as is optimization of these modalities for the assessment of the anatomically complex joints of the foot and ankle. Diagnostic features enabling differentiation between rheumatoid arthritis, seronegative spondyloarthropathies, osteoarthritis, gout, crystal deposition disease, pigmented villonodular synovitis, Charcot arthropathy, septic arthritis, synovial osteochondromatosis, hemophilia, and reflex sympathetic dystrophy are also reviewed.
Topics: Ankle Joint; Arthritis; Diagnostic Imaging; Foot Joints; Humans
PubMed: 27336451
DOI: 10.1055/s-0036-1581117 -
Expert Review of Clinical Immunology May 2019Most arthritides are associated with pain and psychological distress (clinically significant depression and anxiety). Pain and depression are mutually exacerbating; both... (Review)
Review
Most arthritides are associated with pain and psychological distress (clinically significant depression and anxiety). Pain and depression are mutually exacerbating; both may continue even when joint involvement appears well controlled. Area covered: There is strong evidence that arthritis-related stress impacts the central nervous system and, together with peripheral inflammatory changes, can cause central sensitization that can lead to chronic pain and worsening of affective distress. Cytokines and chemokines participate both in joint inflammation and in central sensitization. We review evidence of these relationships in five arthritides, namely rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, gout, and in osteoarthritis of the hips and knees. Central sensitization in these conditions results in long-lasting pain and psychological distress. Expert commentary: Chronic pain and depression are important but often neglected in the clinical assessment and treatment of arthritis. The potential role of biologic cytokines and Janus kinase inhibitors in dealing with these symptoms needs further study.
Topics: Animals; Arthritis; Central Nervous System; Humans; Inflammation; Pain; Psychological Distress
PubMed: 30669892
DOI: 10.1080/1744666X.2019.1573675 -
Current Opinion in Rheumatology May 2024Postinfectious inflammatory arthritis can result from various pathogens, including bacteria, viruses, fungi, and parasites. Prompt identification and treatment of acute... (Review)
Review
PURPOSE OF REVIEW
Postinfectious inflammatory arthritis can result from various pathogens, including bacteria, viruses, fungi, and parasites. Prompt identification and treatment of acute infection is vital, but some cases progress to chronic arthritis despite successful treatment of infection. Postinfectious inflammatory arthritis varies from mild, self-limited arthralgia to severe, refractory arthritis, necessitating ongoing disease-modifying treatment. This review explores the spectrum of postinfectious inflammatory arthritis to provide insights into effective management.
RECENT FINDINGS
Research continues regarding the benefit of antimicrobial therapy, beyond treatment of the acute infection, to diminish the severity of postinfectious inflammatory arthritis. Following treatment of acute infection, most cases are self-limited so treatment is symptomatic. However, a difficult-to-predict fraction of cases develop chronic postinfectious inflammatory arthritis that can be challenging to manage. Recently, as more biologic, and targeted synthetic DMARDs have become available, treatment options have expanded.
SUMMARY
In this article, we use the term 'postinfectious inflammatory arthritis' rather than 'reactive arthritis' because it describes a broader spectrum of diseases and emphasizes the common pathogenesis of a postinfectious inflammatory process. We summarize the conventional therapies and recent management developments for the most frequently encountered postinfectious inflammatory arthritides.
Topics: Humans; Arthritis; Inflammation; Antirheumatic Agents; Infections
PubMed: 38411201
DOI: 10.1097/BOR.0000000000001009 -
Nature Reviews. Rheumatology Mar 2018Proteinases are enzymes with established roles in physiological and pathological processes such as digestion and the homeostasis, destruction and repair of tissues. Over... (Review)
Review
Proteinases are enzymes with established roles in physiological and pathological processes such as digestion and the homeostasis, destruction and repair of tissues. Over the past few years, the hormone-like properties of circulating proteinases have become increasingly appreciated. Some proteolytic enzymes trigger cell signalling via proteinase-activated receptors, a family of G protein-coupled receptors that have been implicated in inflammation and pain in inflammatory arthritis. Proteinases can also regulate ion flux owing to the cross-sensitization of transient receptor potential cation channel subfamily V members 1 and 4, which are associated with mechanosensing and pain. In this Review, the idea that proteinases have the potential to orchestrate inflammatory signals by interacting with receptors on cells within the synovial microenvironment of an inflamed joint is revisited in three arthritic diseases: osteoarthritis, spondyloarthritis and rheumatoid arthritis. Unanswered questions are highlighted and the therapeutic potential of modulating this proteinase-receptor axis for the management of disease in patients with these types of arthritis is also discussed.
Topics: Arthritis; Arthritis, Rheumatoid; Disease Management; Humans; Osteoarthritis; Pain; Peptide Hydrolases; Receptors, Proteinase-Activated; Signal Transduction; Spondylarthritis; Synovial Fluid
PubMed: 29416136
DOI: 10.1038/nrrheum.2018.17 -
RMD Open Feb 2024It is known that metabolic shifts and tissue remodelling precede the development of visible inflammation and structural organ damage in inflammatory rheumatic diseases... (Review)
Review
It is known that metabolic shifts and tissue remodelling precede the development of visible inflammation and structural organ damage in inflammatory rheumatic diseases such as the inflammatory arthritides. As such, visualising and measuring metabolic tissue activity could be useful to identify biomarkers of disease activity already in a very early phase. Recent advances in imaging have led to the development of so-called 'metabolic imaging' tools that can detect these changes in metabolism in an increasingly accurate manner and non-invasively.Nuclear imaging techniques such as F-D-glucose and fibroblast activation protein inhibitor-labelled positron emission tomography are increasingly used and have yielded impressing results in the visualisation (including whole-body staging) of inflammatory changes in both early and established arthritis. Furthermore, optical imaging-based bedside techniques such as multispectral optoacoustic tomography and fluorescence optical imaging are advancing our understanding of arthritis by identifying intra-articular metabolic changes that correlate with the onset of inflammation with high precision and without the need of ionising radiation.Metabolic imaging holds great potential for improving the management of patients with inflammatory arthritis by contributing to early disease interception and improving diagnostic accuracy, thereby paving the way for a more personalised approach to therapy strategies including preventive strategies. In this narrative review, we discuss state-of-the-art metabolic imaging methods used in the assessment of arthritis and inflammation, and we advocate for more extensive research endeavours to elucidate their full field of application in rheumatology.
Topics: Humans; Arthritis; Inflammation; Tomography, X-Ray Computed; Positron-Emission Tomography; Molecular Imaging
PubMed: 38341194
DOI: 10.1136/rmdopen-2023-003880 -
Aging Clinical and Experimental Research Jul 2023Normal bone remodeling depends of a balance between bone forming cells, osteoblasts and bone resorbing cells, the osteoclasts. In chronic arthritides and some... (Review)
Review
Normal bone remodeling depends of a balance between bone forming cells, osteoblasts and bone resorbing cells, the osteoclasts. In chronic arthritides and some inflammatory and autoimmune diseases such as rheumatoid arthritis, there is a great constellation of cytokines produced by pannus that impair bone formation and stimulate bone resorption by inducing osteoclast differentiation and inhibiting osteoblast maturation. Patients with chronic inflammation have multiple causes that lead to low bone mineral density, osteoporosis and a high risk of fracture including circulating cytokines, impaired mobility, chronic administration of glucocorticoids, low vitamin D levels and post-menopausal status in women, among others. Biologic agents and other therapeutic measures to reach prompt remission might ameliorate these deleterious effects. In many cases, bone acting agents need to be added to conventional treatment to reduce the risk of fractures and to preserve articular integrity and independency for daily living activities. A limited number of studies related to fractures in chronic arthritides were published, and future investigation is needed to determine the risk of fractures and the protective effects of different treatments to reduce this risk.
Topics: Humans; Female; Arthritis, Rheumatoid; Osteoclasts; Bone Resorption; Bone and Bones; Osteoblasts; Cytokines; Fractures, Bone
PubMed: 37222927
DOI: 10.1007/s40520-023-02432-9 -
Casopis Lekaru Ceskych 2016Making the diagnosis of monoarthritis can be quite difficult, because in contrast with polyarthritis just a few clinical data is available and wide diagnostic spectrum... (Review)
Review
Making the diagnosis of monoarthritis can be quite difficult, because in contrast with polyarthritis just a few clinical data is available and wide diagnostic spectrum is present.The diagnosis of inflammatory rheumatic disease is usually in responsibility of a rheumatologist, but we know from experience that is necessary to carry out the basal differential diagnostic assessment as soon as possible to begin the optimal therapy. General practitioners and orthopaedists are usually first to face this problem.Monoarthritis can be divided into non-inflammatory arthritis where activated osteoarthritis and trauma belongs and inflammatory arthritis, which include gouty arthritis, chondrocalcinosis, infectious arthritis, juvenile idiopathic arthritis, spondylitis, incipient rheumatoid arthritis and many others.The article also focuses on the management of patients with monoarthritis where detailed history, careful clinical joint examination and the nature of arthritis assessment is necessary for differential diagnostic considerations. Our balance sheet further facilitate imaging, arthrocentesis with the analysis of synovial fluid and of course the laboratory examination.
Topics: Acute Disease; Arthritis; Arthritis, Infectious; Arthritis, Rheumatoid; Decision Making; Diagnosis, Differential; Humans; Medical History Taking; Osteoarthritis; Physical Examination; Synovial Fluid
PubMed: 27917633
DOI: No ID Found -
The Lancet. Rheumatology Jul 2023
Topics: Humans; Overtreatment; Arthritis
PubMed: 38251543
DOI: 10.1016/S2665-9913(23)00166-2