Rheumatoid Arthritis: Vojinović J

Damjanov N, Vojinović J. · No affiliation provided · Srp Arh Celok Lek. · Pubmed #19459571 No free full text.

Abstract: Rheumatoid arthritis (RA) and juvenile idiopathic/rheumatoid arthritis (JIA) are chronic, inflammatory, systemic, autoimmune diseases characterized by chronic arthritis leading to progressive joint erosions. The individual functional and social impact of rheumatoid arthritis is of great importance. Disability and joint damage occur rapidly and early in the course of the disease. The remarkably improved outcomes have been achieved initiating biologic therapy with close monitoring of disease progression. Biologic agents are drugs, usually proteins, which can influence chronic immune dysregulation resulting in chronic arthritis. According to the mechanism of action these drugs include: 1) anti-TNF drugs (etanercept, infiximab, adalimumab); 2) IL-1 blocking drugs (anakinra); 3) IL-6 blocking drugs (tocilizumab); 4) agents blocking selective co-stimulation modulation (abatacept); 5) CD 20 blocking drugs (rituximab). Biologics targeting TNF-alpha with methotrexate have revolutionized the treatment of RA, producing significant improvement in clinical, radiographic, and functional outcomes not seen previously. The new concept of rheumatoid arthritis treatment defines early diagnosis, early aggressive therapy with optimal doses of disease modifying antirheumatic drugs (DMARDs) and, if no improvement has been achieved during six months, early introduction of biologic drugs. The three-year experience of biologic therapy in Serbia has shown a positive effect on disease outcome.

Pejcić T, Stanković I, Rancić M, Djordjević I, Ristić L, Vojinović J. · No affiliation provided · Srp Arh Celok Lek. · Pubmed #16535997 No free full text.

Abstract: Fibrous alveolitis (FA), or diffuse interstitial fibrosis, is used as a term for diseases in patients suffering from some kind of systemic connective tissue (SCT) disorder and lung fibrosis. FA is not unusual in clinical practice in patients with SS and rheumatoid arthritis (RA) and can be found in the definitive fibrosis phase of the disease; the early detection of FA is of great importance. The aim of this study was to determine whether there was a correlation between certain lung function parameters and cellular components of BAL in patients with SS and RA. Lung function (LF) and BAL examination was carried out in all 20 SS patients and 38 RA patients. LF was evaluated via spirometry, flow volume curves, the lung transfer factor for carbon monoxide (DLco), and the coefficient of transfer factor (K/DLco), as well as body plethysmography and blood gas analysis. A differential number of cells were taken in all BAL samples. Normal cellular components of lavage were found in 19 patients (50%). Ly-alveolitis was found in 10 patients (4 with SS and 6 with RA) (26%), and N-alveolitis in 9 patients (8 with SS and 1 with RA) (23.7%). An increased percentage of CD8+T lymphocytes in relation to CD4+T lymphocytes, and a decreased level of CD4+/CD8+ was found through BAL. Restrictive ventilation disorder was discovered in 6 patients (15.7%), TLC values were reduced in 6 patients (15.7%), and K/DLco was decreased in 5 patients. DLco was normal in 20 patients (53%) and reduced in 18 patients (47%). We discovered a significant correlation between DLco and cellular components (neutrophile or lymphocyte) present in BAL, but there was no significant correlation between other lung function parameters. Analysis of BAL and DLco examination can be considered to be suitable parameters of interstitial lung changes in SS and RA patients.