Eckart Knipping, Peter H. Krammer, Karen B. Onel, Thomas J. A. Lehman, Eduardo Mysler, and Keith B. Elkon 1735

In this study, levels of soluble Fas/APO-1 were measured in patients with SLE and JRA. Increased soluble Fas/APO-1 levels were found infrequently in SLE patients, indicating that this protein probably has little pathogenetic significance in this disease.

Niti Goel, Dawn T. Ulrich, E. William St. Clair, Judith A. Fleming, David H. Lynch, and Michael F. Seldin 1738

Previous studies have suggested that soluble Fas/APO-1/CD95 levels are elevated in sera from patients with systemic lupus erythematosus and potentially are an important mechanism in down-regulating Fas/ APO-1-mediated apoptosis. This study examined whether elevated serum soluble Fas/APO-1 levels were associated with the diagnosis of an autoimmune inflammatory disease or correlated with clinical or laboratory evidence of disease flares. No association was found between serum soluble Fas/APO-1 levels and either autoimmune disease (including SLE) or autoimmune disease activity measurements. The results strongly suggest that levels of soluble Fas/APO-1 receptors are not a major determinant in maintaining the altered immune cell repertoire or disease activity associated with established human autoimmune disease.

Susan L. Woulfe, Christine P. Bono, Michelle L. Zacheis, Dawn A. Kirschmann, Troy A. Baudino, Craig Swearingen, Robert W. Karr, and Benjamin D. Schwartz 1744

Key amino acid interactions between peptide and p4 pocket residues of the HLA-DR molecule were identified. This has implications for the design of potential DRB1*0401-specific therapeutic agents.

Toni I. Evans, Jinfeng Han, Rovinder Singh, and George Moxley 1754

Although populations with RA include more persons with genotypes containing 1 shared-epitope DRB1 allele paired with another DRB1 allele than persons with genotypes composed of 2 shared-epitope alleles, there are still more with 2 shared-epitope alleles than would be expected. This study illustrates that double doses of shared-epitope DRB1 alleles are so frequent that the RA-associated disease-susceptibility gene must follow a recessive pattern of inheritance.

Malcolm L. Handel, Linda B. McMorrow, and Ellen M. Gravallese 1762

The presence of p50 and p60 subunits of NF-[gk]B, a transcription factor that induces the expression of cytokines, in the nuclei of CD14+ (macrophage-like) synovial lining cells and endothelial cells suggests an important role of NF-[gk]B in gene expression by these cells. Different but overlapping distributions of nuclear p50 and p65 versus Jun and Fos indicate separate or divergent mechanisms for the activation of NF-[gk]B and expression of AP-1 proteins in rheumatoid synovium.

Lisardo Perez, Javier Orte, and Jose A. Brieva 1771

The presence of rheumatoid factor is a common feature of RA, and RF is thought to contribute to RA lesions. This study demonstrates that final maturation of rheumatoid factor-secreting cells from RA patients depends on the endogenous production of interleukin-10. These results contribute to the understanding of RA pathophysiology.

Raimund W. Kinne, Carsten B. Schmidt-Weber, Ralph Hoppe, Eberhard Buchner, Ernesta Palombo-Kinne, Eberhard Nurnberg, and Frank Emmrich 1777

Selective anti-macrophage therapy exerts a true disease-controlling effect on rat adjuvant arthritis by counteracting objective clinical signs of joint destruction. Specific anti-macrophage principles, therefore, may provide a means of controlling the mutilating course of human RA.

Paul J. Christner, Josephine Peters, David Hawkins, Linda D. Siracusa, and Sergio A. Jimenez 1791

Animal models have proven to be of great value for the study of the pathogenesis of various rheumatic diseases. Animal models that exhibit all the features of systemic sclerosis have not been available. This report describes the Tsk2 mouse, a novel animal model of systemic sclerosis which displays both cutaneous fibrosis and mononuclear cell infiltration.

Robert F. Willkens, John T. Sharp, Donald Stablein, Carolly Marks, and Robert Wortmann 1799

This study of the comparison of methotrexate, azathioprine, and their combination in the treatment of RA showed that, at the dosage schedules used, the combination is not more effective than methotrexate alone. Radiologic assessment of disease progression showed a trend toward slowing of joint damage at 48 weeks with methotrexate treatment.

Jerry C. Parker, Karen L. Smarr, Susan P. Buckelew, Renee C. Stucky-Ropp, John E. Hewett, Jane C. Johnson, Gail E. Wright, William S. Irvin, and Sara E. Walker 1807

This study examined a systematic psychoeducational approach to helping RA patients cope with the stressors associated with their disease. The results indicate that significant clinical benefits can be achieved via a cognitive-behavioral stress-management program.

Carola J. E. Kaandorp, Dirkjan van Schaardenburg, Pieta Krijnen, J. Dik F. Habbema, and Mart A. F. J. van de Laar 1819

Patients with joint diseases who were treated in outpatient rheumatology clinics were prospectively monitored for the presence of potential risk factors for septic arthritis and for the occurrence of septic arthritis. The major risk factors for the development of septic arthritis were the presence of a hip and/or knee prosthesis and the presence of skin infection. Knowledge of these risk factors can help in the effort to reduce the incidence of septic arthritis.

Ronald F. van Vollenhoven, Edgar G. Engleman, and James L. McGuire 1826

The treatment of lupus has remained unsatisfactory despite improvements in mortality rates. DHEA may be a useful adjunctive treatment and have a role as a steroid-sparing agent.

Ashley J. Duits, Hendrika Bootsma, Ronald H. W. M. Derksen, Peter E. Spronk, Louis Kater, Cees G. M. Kallenberg, Peter J. A. Capel, Nomdo A. C. Westerdaal, Gerrit Th. Spierenburg, Frits H. J. Gmelig-Meyling, and Jan G. J. van de Winkel 1832

The results of this study indicate a relationship between the FcγRIIa allotype distribution among SLE patients and the occurrence of renal disease. This may be associated with an allotype-bound capacity to handle immune complexes.

Robert W. Hoffman, Gordon C. Sharp, and Susan L. Deutscher 1837

This study characterized a group of connective tissue disease patients who were positive for autoantibodies reactive with U1 RNA molecules. These patients were found to have immunogenetic and clinical features distinct from those of patients who lacked anti-U1 RNA autoantibodies.

Neil J. McHugh, Georgina R. Harvey, Jean Whyte, and J. Kevin Dorsey 1845

This report describes 3 monozygotic twin pairs discordant for systemic sclerosis (SSc) in which the proband had SSc for at least 5 years and the twin sibling had no sign of a connective tissue disease. In each case an SSc-associated autoantibody was detected only in the affected twin and the MHC class II genotype was that expected for the relevant autoantibody. The findings suggest that extrahereditary factors are important in the development of SSc and emphasize the strong links between disease phenotype and the generation of specific autoantibody.