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Oral Microbiome Analysis Reveals Potential for Streamlining Diagnosis of Rheumatoid Arthritis

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Rheumatoid Arthritis (RA) is an autoimmune disorder where the body mistakenly attacks healthy joints. This in turn causes inflammation resulting in pain and swelling. It is very important to get

Rheumatoid Arthritis (RA) is an autoimmune disorder where the body mistakenly attacks healthy joints. This in turn causes inflammation resulting in pain and swelling. It is very important to get RA accurately diagnosed and treated as early as possible. Similarly, with any disease: the longer it is left untreated, the more damage it can cause. RA can cause irreversible joint damage leading to disability. The purpose of this study is to determine if oral microbiome can be used as an additional criterion to aid in diagnosing RA. Several oral microbes have already been identified as biomarkers for RA in saliva. In this study, 10 participants were recruited: 6 diagnosed with RA and 4 Healthy as a control. Two subgroups of RA were done within this study; those diagnose with a positive Rheumatoid Factor (RF) and those diagnose with a negative RF. These subgroups were then compared in order to determine the validity of using certain microbes as biomarkers for RA even when different diagnostic criteria were met. The microbe Parahaemolyticus had the largest measure of effect, showing the greatest potential for statistically significant results with a larger sample size. If we can work narrow to down specific microbes to be undoubtedly higher in abundance with already diagnosed RA patients when comparing to healthy participants, this will be a gamechanger. Not only could we give a higher sense of confidence with the diagnosis of RA, but this could streamline RA diagnosis.

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  • 2020-12

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The effect of vitamin D supplementation on brachial artery flow mediated dilation in older adults with and without rheumatoid arthritis

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ABSTRACT Despite significant advancements in drug therapy, cardiovascular disease (CVD) is still the leading cause of death in the United States. Given this, research has begun to seek out alternative

ABSTRACT Despite significant advancements in drug therapy, cardiovascular disease (CVD) is still the leading cause of death in the United States. Given this, research has begun to seek out alternative approaches to reduce CVD risk. One of these alternative approaches is Vitamin D supplementation. Current research has shown a link between Vitamin D status and CVD risk in both healthy and diseased populations. Among the possible mechanisms is a positive effect of Vitamin D on vascular endothelial function, which can be measured with noninvasive techniques such as flow-mediated dilation (FMD) of conduit vessels using high-resolution ultrasound. This dissertation is comprised of two studies. The first examines whether Vitamin D supplementation can improve FMD in older adults within a time period (two weeks) associated with peak increases in plasma Vitamin D concentrations after a single-dose supplementation. The second examines the effect of Vitamin D supplementation in people with Rheumatoid Arthritis (RA). The reason for looking at an RA population is that CVD is the leading cause of early mortality in people with RA. In the first study 29 Post-Menopausal Women received either 100,000 IU of Vitamin D3 or a Placebo. Their FMD was measured at baseline and 2 weeks after supplementation. After 2 weeks there was a significant increase in FMD in the Vitamin D group (6.19 + 4.87 % to 10.69 + 5.18 %) as compared to the Placebo group (p=.03). In the second study, 11 older adults with RA were given 100,000 IU of Vitamin D or a Placebo. At baseline and one month later their FMD was examined as well as plasma concentrations of Vitamin D and tumor necrosis factor-alpha; (TNF-alpha;). They also filled out a Quality of Life Questionnaire and underwent a submaximal exercise test on the treadmill for estimation of maximum oxygen uptake (VO2max). There was no significant change in FMD in Vitamin D group as compared to the Placebo group (p=.721). Additionally, there was no significant improvement in either plasma Vitamin D or TNF-alpha; in the Vitamin D group. There was however a significant improvement in predicted VO2max from the submaximal exercise test in the group receiving Vitamin D (p=.003). The results of these studies suggest that a single 100,000 IU dose of Vitamin D can enhance FMD within two week in older adults, but that a similar dose may not be sufficient to increase FMD or plasma Vitamin D levels in older adults with RA. A more aggressive supplementation regimen may be required in this patient population.

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Date Created
  • 2012

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Affective responses to laboratory stressors in rheumatoid arthritis patients: a comparison of mindfulness-based emotion regulation and cognitive behavioral interventions

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This study examined whether cognitive behavioral therapy and mindfulness interventions affect positive (PA) and negative affect (NA) reports for patients with rheumatoid arthritis (RA) before, during, and after stress induction.

This study examined whether cognitive behavioral therapy and mindfulness interventions affect positive (PA) and negative affect (NA) reports for patients with rheumatoid arthritis (RA) before, during, and after stress induction. The study also investigated the effects of a history of recurrent depression on intervention effects and testing effects due to the Solomon-6 study design utilized. The 144 RA patients were assessed for a history of major depressive episodes by diagnostic interview and half of the participants completed a laboratory study before the intervention began. The RA patients were randomly assigned to 1 of 3 treatments: cognitive behavioral therapy for pain (P), mindfulness meditation and emotion regulation therapy (M), or education only attention control group (E). Upon completion of the intervention, 128 of the RA patients participated in a laboratory session designed to induce stress in which they were asked to report on their PA and NA throughout the laboratory study. Patients in the M group exhibited dampened negative and positive affective reactivity to stress, and sustained PA at recovery, compared to the P and E groups. PA increased in response to induced stress for all groups, suggesting an "emotional immune response." History of recurrent depression increased negative affective reactivity, but did not predict reports of PA. RA patients who underwent a pre-intervention laboratory study showed less reactivity to stressors for both NA and PA during the post-intervention laboratory study. The M intervention demonstrated dampened emotional reactions to stress and lessened loss of PA after stress induction, displaying active emotion regulation in comparison to the other groups. These findings provide additional information about the effects of mindfulness on the dynamics of affect and adaptation to stress in chronic pain patients.

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  • 2012