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Arthritis Watch

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New Breakthrough in Identifying Genes Associated with Arthritis
Scientists have recently identified 6 genetic regions linked with a common form of arthritis, ankylosing spondylitis. An international consortium made up of researchers from Oxford University, the University of Queensland, and the University of Texas has recently discovered 2 genes in particular, ERAP1 and IL23R, that have a strong tie to this chronic, inflammatory arthritis.

These 2 genes are involved in the inflammatory processes in the body and can now be targeted for developing better treatments for ankylosing spondylitis. ERAP1 is involved in key pathways that are said to play a role in controlling inflammation. IL23R has been linked to psoriasis and inflammatory bowel diseases.

This new breakthrough may allow for patients to be diagnosed earlier and could lead to new treatments of this autoimmune disease. Ankylosing spondylitis primarily affects joints in the spine and the sacroilium in the pelvis and may result in the spine becoming permanently bent. “We knew there was a strong genetic component to this disease, and we now have the foundation we need for future research to pin down the genetic causes of this condition,” said professor and lead researcher Paul Wordsworth of Oxford University’s Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences (as published recently in Nature Genetics).


Clinical Study Shows Outcomes for Joint Injections Not Improved with Ultrasound Guidance
The authors of a recent study in Arthritis & Rheumatism (online March 10, 2010) found that, although ultrasound guidance improves the accuracy of steroid joint injections for inflammatory arthritis, it does not improve clinical outcomes. At the onset of the study, the researchers intended to determine whether ultrasound guidance improves the accuracy of needle placement and if clinical outcomes were enhanced.

For the randomized study, researchers studied 184 patients with inflammatory arthritis in the shoulder, elbow, wrist, knee, or ankle who received 40-mg injections of triamcinolone into the affected joint, guided either by ultrasonography or clinical examination. The researchers evaluated pain, function, and stiffness at the targeted joint before, 2 weeks after, and 6 weeks after injection using visual analog scales.

Accuracy rates were 83% with ultrasound guidance and 66% when injections were guided by clinical examination (P=.01). Although the ultrasound guidance provided for “direct visualization of the injection needle within the joint in real time,” and some improvement in accuracy of needle placement and joint aspiration has been found, the vast majority of clinical outcomes were comparable in each group. The authors did find that joint function at 6 weeks was improved when an injection was accurate.


Strong Collagen May Help Treat Arthritis and Other Collagen Defects
Researchers from the University of Wisconsin-Madison, led by Ronald T. Raines, PhD, a professor of chemistry and biochemistry, have formulated the strongest form of collagen yet—a stable substitute for human collagen that could perhaps be used to treat arthritis and other collagen-defective conditions.

Collagen is the main protein of connective tissue and is the most abundant protein in the human body. It is one of the long, fibrous structural proteins that supports the structure of the skin, internal organs, cartilage, and bones. Arthritis is caused by the body’s breakdown of natural collagen. Raines’ team began their quest to develop human collagen in the lab in 2006 and created collagen molecules longer than any found in nature. With the aid of new funding from the National Institutes of Health, the researchers were able to create a form of super-strong collagen that may eventually help millions of patients with arthritis and other conditions resulting from collagen defects. “This hyper-stable collagen is really a testament to the power of modern protein chemistry,” said Raines. The findings of the study were published in the January 12, 2010, issue of the Proceedings of the National Academy of Sciences. ■


FAST FACT: Total annual medical care expenses for osteoarthritis patients in the United States are generally higher for women ($118 billion), compared with men ($67.5 billion).
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For pharmacist-recommended products for arthritis, go to www.OTCGuide.net