Raised plasma renin and prorenin in rheumatoid vasculitis

Article Abstract:

The kidney enzyme renin transforms the liver protein angiotensinogen to angiotensin I, which is then converted by angiotensin-converting enzyme to angiotensin II. This factor, angiotensin II, constricts blood vessels and activates the production and release of the adrenal hormone aldosterone, which regulates sodium, potassium, and chloride metabolism. The levels of prorenin, the substance from which renin is formed, were shown to be increased in pregnant women and in patients with diabetes mellitus with associated blood vessel disorders. Blood vessel disorders may also contribute to the disease process of rheumatoid arthritis (RA), an inflammatory joint disease. The blood vessels within the affected joint deteriorate rapidly, leading to damage of the synovial tissue lining the joint and cartilage tissue due to lack of an oxygen supply and increased acidity. Changes in the blood vessels of the skin have also been detected in patients with RA. Vasculitis, the inflammation of the blood vessels, may develop in some patients with RA, and is characterized by the accumulation of white blood cells within the vessel wall and tissue death. Similar to diabetic patients with blood vessel disorders, RA patients with blood vessel disease may also have increased levels of prorenin. Hence, the role of renin and prorenin as markers for vasculitis in RA was assessed among 34 patients. Renin levels were 19 milliunits per liter (mU/l), compared with 9 mU/l in healthy subjects. Prorenin levels were 233 mU/l in RA patients with vasculitis, compared with 144 mU/l in normal subjects. The discontinuation of nonsteroidal anti-inflammatory drugs resulted in increased renin and prorenin levels in both patients and normal subjects. Thus, patients with RA complicated by vasculitis had slightly raised levels of renin and prorenin. This may indicate activation of the renin-angiotensin system and early complications of the heart and kidney associated with RA. (Consumer Summary produced by Reliance Medical Information, Inc.)

Evaluation, Measurement, Complications and side effects, Physiological aspects, Vasculitis, Renin-angiotensin system, Renin

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An open study of pentoxyfylline and thalidomide as adjuvant therapy in the treatment of rheumatoid arthritis

Article Abstract:

A combination of thalidomide and pentoxyfylline therapy appears to provide marginal benefit for patients with rheumatoid arthritis. Effects on tumor necrosis factor alpha (TNFa) production were evaluated after 12 weeks of thalidomide and pentoxyfylline treatment among 12 patients with rheumatoid arthritis. TNFa is a component of the immune response. TNFa production decreased by half after treatment while production of other immune response factors including interleukin (IL) 12, IL-10, and IL-6 did not change significantly. Disease activity improved by 20% in five patients but most patients experienced one of several side effects.

Health aspects, Drug therapy, Thalidomide, Pentoxifylline

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Comparison of high and low intensity training in well controlled rheumatoid arthritis. Results of a randomised clinical trial

Article Abstract:

Higher impact, organized, and varied exercise programs seem to provide short-term improvement in joint and overall physical fitness among stable patients with rheumatoid arthritis. One hundred patients with rheumatoid arthritis participated in one of four 12-week exercise programs. The programs consisted of either higher or lower impact group exercise, personalized lower impact exercise, or self-directed exercise. Participants in the higher impact group exercise program showed a greater improvement in joint mobility and physical fitness scores than the other three groups. This variation diminished 12 weeks later.

Care and treatment, Usage, Exercise therapy, Arthritics

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