1,721,922 research outputs found
Macrophages as effectors of the immunoendocrinologic interactions in autoimmune rheumatic diseases.
No full textGlucocorticoids and chronotherapy in rheumatoid arthritis
No full textIt is evident that the morning symptoms of rheumatoid arthritis (RA) are linked to the circadian abnormal increase in night inflammation, favoured by inadequate cortisol secretion under conditions of active disease. Therefore, exogenous glucocorticoid treatment is recommended in RA at low doses since it may partially act like a ‘replacement therapy’. The prevention/treatment of the night upregulation of the immune/inflammatory reaction (and related flare of cytokine synthesis) has been shown to be more effective when exogenous glucocorticoid administration is obtained with a night-time-release formulation. Large-scale trials documented that modified-release prednisone has greater efficacy then morning prednisone for long-term low-dose glucocorticoid treatment in patients with RA, showing at least a more significant reduction in morning joint stiffness. Interestingly, despite a considerably higher cost than conventional prednisone, chronotherapy with night-time-release prednisone was recognised as a cost-effective option for patients with RA not on glucocorticoids who are eligible for therapy with biological disease-modifying antirheumatic drugs (DMARDs). Moreover, since different cell populations involved in the inflammatory process are particularly activated during the night, other therapeutical approaches used in RA, for example, conventional DMARDs and non-steroidal anti-inflammatory drugs (NSAIDs), should follow the same concepts of glucocorticoid chronotherapy. Indeed, bedtime methotrexate chronotherapy was found to improve RA symptoms compared to the current standard dosing methods, and several available NSAIDs (ie, indomethacin, aceclofenac, ketoprofen, flurbiporfen, lornoxicam) have been very recently modified in their formulation, in order to obtain chronotherapeutical effects in RA
Estrogen metabolites: increasing evidence for their role in rheumatoid arthritis and systemic lupus erythematosus.
No full textThe role of the hypothalamus-pituitary-adrenocortical and -gonadal axis in rheumatoid arthritis.
No full textFurther emergent evidence for the vitamin D endocrine system involvement in autoimmune rheumatic disease risk and prognosis.
No full textThe Second International Conference on the Neuroendocrine Immune Basis of the Rheumatic Diseases.
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