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골관절염 연골세포에서 진행성당화종말생성물에 의한 기질단백분해효소 발현의 증가
나성수 ( Seong Su Nah ),최인영 ( In Young Choi ),문세환 ( Se Hwan Mun ),김용길 ( Yong Gil Kim ),문희범 ( Hee Bom Moon ),유빈 ( Bin Yoo ),이창근 ( Chang Keun Lee ) 대한류마티스학회 2007 대한류마티스학회지 Vol.14 No.1
Objective: Although increased expression of receptor for advanced glycation end products (AGE) in osteoarthritis (OA) has been reported, little is known concerning the role of AGEs in the pathogenesis of OA. This study was undertaken to determine the effect of AGEs on the regulation of matrix metalloproteinase (MMP) expressions and activities in human OA chondrocytes Methods: OA chondrocytes were treated with increasing doses of AGE-bovine serum albumin (AGE-BSA). The expressions of MMPs were determined by both enzyme-linked immunosorbent assay (ELISA) and immunoblot analysis. The activities of MMPs were evaluated by both gelatin and casein zymography assays. In addition, electrophoretic mobility shift assay (EMSA) was employed to investigate the DNA binding activity of nuclear factor-kappa B (NF-κB) by AGE-BSA treatment. Results: The productions of MMP-1, -3, and -13 were significantly elevated by AGE-BSA in a dose dependent manner. The elevated activities of MMP-1, -3, and -13, and TNF-α by AGE-BSA were also observed. DNA binding activity of NF-κB was markedly increased by AGE-BSA treatment implicating possible involvement of NF-κB mediated pathway in the AGE-BSA induced MMP-1, -3, and -13, and TNF-α productions in OA chondrocytes. Taken together, this study demonstrates the stimulatory effect of AGE-BSA on the productions of MMPs and TNF-α and suggests the possible involvement of NF-κB mediated pathway in OA chondrocytes. Conclusion: These results suggest that AGE may play a role in pathogenesis of OA.
김기원 ( Ki Won Kim ),정혜경 ( Hye Kyoung Chung ),이한민 ( Han Min Lee ),조아라 ( A Ra Cho ),이세환 ( Se Whan Lee ),나성수 ( Seong Su Nah ),모상일 ( Sang Il Mo ),이혁규 ( Hyeok Gyu Lee ),고규봉 ( Gyu Bong Ko ),강병일 ( Byong Il Ka 대한류마티스학회 2011 대한류마티스학회지 Vol.18 No.1
Klinefelter`s syndrome (KFS) is a gonosomal aberration disease that occurs in males, and is characterized by 47, XXY karyotype, hypogonadism and a lack of secondary sexual characteristics. A potential link between this hormonally deficient syndrome and autoimmune disease, particularly systemic lupus erythematosus (SLE), has been reported. On the other hand, KFS is rarely reported to be accompanied by rheumatoid arthritis (RA), and there are no Korean cases reported. We report the first Korean case of a KFS patient with sero-positive RA and discuss the role of the pathogenesis of RA with KFS.
류마티스관절염에서 DAS28에 근거한 보험급여기준 적용시 항 TNF제제 대상 환자 예측
원소영 ( Soyoung Won ),성윤경 ( Yoon-Kyoung Sung ),조수경 ( Soo-Kyung Cho ),최찬범 ( Chan-Bum Choi ),고은미 ( Eun-Mi Koh ),김성규 ( Seong-Kyu Kim ),김진석 ( Jinseok Kim ),김태환 ( Tae-Hwan Kim ),김현아 ( Hyoun Ah Kim ),나성수 ( Se 대한류마티스학회 2014 대한류마티스학회지 Vol.21 No.2
Objective. The purpose of this study is to examine the difference between the numbers of patients in rheumatoid arthritis (RA) who are eligible to TNF inhibitors by the past Korean National Health Insurance reimbursement guideline and by the disease activity score with 28-joint assessment (DAS28) based criteria. Methods. Data were obtained from a multi-center registry for biologics users in Korean RA patients, BIOlogics Pharmacoepidemiologic StudY (BIOPSY). DAS28 was calculated based on either ESR or CRP, and DAS28 of more than 5.1 or between 3.2 and 5.1 with radiographic changes was defined as a cut-off point for the initiation of TNF inhibitors. For the maintenance criteria, we used both of improving in DAS28 score (>1.2) and low disease activity (DAS 28<3.2). Differences between the numbers in each step by two criteria were described with Chi-square test and Kappa agreement. Results. Of the 489 patients in BIOPSY, 299 were included in this study. Among them, 278 patients (93.0%) were eligible of TNF inhibitors when we applied the new initiation criteria with DAS28-ESR, and 244 patients (81.6%) were indicated for TNF inhibitors with DAS28-CRP. For the maintenance criteria, a low disease activity (DAS28<3.2) in 3 months after starting TNF inhibitors is too strict for achieving (33.6% with DAS28-ESR and 50.0% with DAS28-CRP). Instead, decreasing DAS28 by more than 1.2 is more reasonable as a tool for deciding early responsiveness of TNF inhibitors in RA patients (81.2% both with DAS28-ESR and DAS28-CRP). Conclusion. Our results show that the candidates for TNF inhibitors will be enormously changed according to a change in the reimbursement criteria. To define appropriate patients to receive TNF inhibitors, a further study with regard to the impact of changes in the reimbursement criteria on the outcomes of RA patients will be required.