Rheumatoid Arthritis: Wakabayashi T

Suzuki Y, Wakabayashi T, Saito E, Yamada C, Suwa A. · Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine. · Clin Calcium. · Pubmed #19252251 No free full text.

Abstract: More than 50 years have passed since glucocorticoid (GC) therapy was introduced into the treatment of rheumatoid arthritis (RA) . Although the effect of GC monotherapy on RA is limited to short-term and long-term GC treatment carries the risks of adverse effects and rebound phenomenon after the discontinuation, disease-modifying action of GC have been recently reported when used in combination with DMARDs. One of the important side effects associated with GC therapy is osteoporosis, and Japanese guidelines on the management and treatment of glucocorticoid -induced osteoporosis have been published recently. Further studies are necessary to elucidate long-term benefit-risk ratio of low-dose GC therapy on RA.

Suwa A, Saito E, Wakabayashi T, Suzuki Y. · Tokai University School of Medicine, Department of Internal Medicine, Division of Rheumatology, Japan. · Clin Calcium. · Pubmed #17660625 No free full text.

Abstract: Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic synovitis which causes osteoporosis and joint destruction. Recently, it has been well understood that pro-inflammatory cytokine plays a pivotal role in disease progression. These pro-inflammatory cytokine induces activation of osteoclasts, resulting in paraarticular osteoporosis and joint destruction. While systemic osteoporosis caused by several factors is often seen in patients with RA. This article reviews the pathologic condition of osteoporosis in RA.

Suzuki Y, Wakabayashi T, Saito E, Suwa A. · Tokai University School of Medicine, Department of Internal Medicine, Division of Rheumatology. · Clin Calcium. · Pubmed #17404484 No free full text.

Abstract: From the results of recent randomized controlled clinical trials of disease modifying antirheumatic drugs (DMARDs), slowing radiographic progression has been documented with the use of methotrexate, leflunomide, salazusulfapyridine, IM gold, and cyclosporine. Although the effects of DMARDs is inferior to that of anti-tumor necrosis factor (TNF) agents, DMARDs can stop the progression of joint damage with the achievement of remission or good response.

Suzuki Y, Wakabayashi T, Jackson K. · Division of Rheumatology, Department of Internal Medicine, Tokai University School of Medicine. · Nippon Rinsho. · Pubmed #15799406 No free full text.

This publication has no abstract.

Kato H, Matsumine A, Wakabayashi T, Hasegawa M, Sudo A, Shintani K, Fukuda A, Kato K, Ide N, Orita S, Hasegawa T, Matsumura C, Furukawa M, Tasaki T, Sonoda H, Uchida A. · Department of Orthopedic Surgery, Mie University School of Medicine, Tsu-City, Mie, Japan. · Biomarkers. · Pubmed #17564844 No free full text.

Abstract: Osteoarthritis (OA) is one of the most common age-related chronic disorders of articular cartilage, joints and bone tissue. Diagnosis of OA commonly depends on clinical and radiographic findings. However, changes in cartilage associated with the early stage of OA cannot be detected using radiographs, because significant cartilage degeneration must occur before radiographic findings show alterations of the appearance of cartilage. To identify new biomarkers of OA, we analysed gene expression profiles of synovium from 43 patients with OA, ten patients with rheumatoid arthritis (RA), and eight non-OA/non-RA patients using a novel cDNA microarray chip. We identified 21 genes with simultaneous significant differences in expression between OA and non-OA/non-RA groups and between OA and RA groups. Linear discriminant analysis showed that the three groups could be well separated using those 21 genes. Statistical analysis also revealed that several of the 21 genes were associated with disease progression and clinical presentation. The graphical modelling method indicated that some of the 21 genes are significantly associated with a particular clinical presentation, suggesting biological relationships among those genes. This is the first report of the use of cDNA microarray technology to create large-scale gene expression profiles differentially expressed in situ in OA synovium of the knee joint.

Kato T, Fujii K, Wakabayashi T, Tanaka A, Hidaka Y. · Department of Rheumatology, Kameda Medical Center, 929 Higashi-cho, Chiba, Kamogawa City 296-8602, Japan. · Clin Rheumatol. · Pubmed #16234994 No free full text.

Abstract: A 24-year-old Japanese woman was admitted for investigation of recurrent spiking high fever associated with a macular eruption of the upper extremities associated with fever and polyarthralgia. These symptoms were self-limiting but recurrent and seemed to be consistent with a diagnosis of adult-onset Still's disease (AOSD). However, livedo reticularis was detected on the lower extremities, suggesting the presence of vasculitic disease rather than AOSD. Investigation did not reveal any evidence of visceral involvement. Skin biopsy of the affected lower extremity demonstrated a necrotizing vasculitis of small muscular artery and confirmed a diagnosis of cutaneous polyarteritis nodosa (PAN) rather than AOSD. Treatment with 30 mg of prednisolone daily improved the skin lesions and the recurrent spiking high fever and the arthralgia were resolved. PAN and AOSD are clinically similar, and discrimination may be sometimes difficult. The presence of livedo reticularis and the finding of a characteristic skin biopsy appearance may be diagnostically useful to distinguish PAN from AOSD. Indeed, the clinical features of cutaneous PAN may be more similar to AOSD than systemic PAN, and a skin biopsy may be necessary to distinguish cutaneous PAN from AOSD in some cases.

Wakabayashi T, Jackson K, Yamada C, Suzuki Y, Suzuki Y. · Division of Rheumatology, Department of Internal Medicine, Tokai University. · Clin Calcium. · Pubmed #15775150 No free full text.

Abstract: Methotrexate (MTX) plays an important role in treatment of rheumatoid arthritis (RA). It significantly reduce expected radiographic progression. Comparing with other traditional disease-modifying anti-rheumatic drugs (DMARDs), MTX slow radiographic progression during the first 2 years. Since combination with anti-tumor nectosis factor alpha (TNF-alpha) therapy has been shown to be effective for the early supression of disease activity, it could be usefull to minimize bone destruction in RA.