Rheumatology Commons^™

Peripheral Blood Biomarkers For Rheumatoid Arthritis-Associated Interstitial Lung Disease, Brent A. Luedders

Theses & Dissertations

Rheumatoid arthritis-associated interstitial lung disease (RA-ILD) is a common extra-articular complication of rheumatoid arthritis (RA). Measuring peripheral blood biomarkers represents an appealing strategy to inform the screening and prediction of RA-ILD. In these studies, I aimed to further characterize the associations of peripheral blood biomarkers with prevalent and incident RA-ILD. First, I evaluated the associations of matrix metalloproteinases (MMPs) with RA-ILD among a multicenter cohort of RA U.S. Veteran patients (n = 2,312). Higher concentrations of MMP-7 and MMP-9 were independently associated with both prevalent and incident RA-ILD, including a nearly four-fold increased odds of prevalent RA-ILD (adjusted odds ratio …

Rheumatoid Arthritis Disease Activity Is Associated With Frailty In Veterans, Courtney N. Loecker

Theses & Dissertations

Frailty, a physiologic vulnerability to everyday stressors, affects approximately 30% of the 1.3 million Americans with rheumatoid arthritis (RA) and is associated with increased risk for adverse health outcomes. Active RA manifests as inflammation, pain, and joint damage leading to functional impairments and morbidity which cumulatively influences frailty. However, the relationship between RA disease activity and frailty is incompletely understood.

This study evaluated the relationship of RA disease activity and frailty at baseline and over up to five years in Veterans. A cohort study was performed using data from the Veterans Affairs Rheumatoid Arthritis registry. RA disease activity was measured …

Serum Antibodies To Periodontal Pathogens And Anti-Malondialdehyde-Acetaldehyde: Potential Role In The Interrelationship Between The Periodontium And Rheumatoid Arthritis, Joyce Lee

Theses & Dissertations

Objectives: Study 1 – To quantify associations between anti-Porphyromonas gingivalis, anti-Prevotella intermedia, and anti-Fusobacterium nucleatum serum antibody concentrations and risk of developing rheumatoid arthritis (RA). Study 2 – To test if periodontal clinical measures, alveolar bone loss (ABL), and the aforementioned serum anti-bacterial antibody concentrations are associated with anti-malondialdehyde-acetaldehyde (MAA) serum antibody concentrations.

Methods: Study 1 – Serum samples pre- and post- RA diagnosis (n=214 cases, 210 matched controls) from the U.S. Department of Defense Serum Repository were utilized to compare timing of elevations of anti-bacterial antibody concentrations relative to RA diagnosis and associations …

Citrullinated And Malondialdehyde-Acetaldehyde Modified Proteins Promote Cellular Inflammatory And Fibrotic Responses Associated With Rheumatoid Arthritis, Nozima Aripova

Theses & Dissertations

Rheumatoid arthritis (RA) is a systemic, autoimmune disease primarily characterized by perpetual synovial inflammation that results in synovial tissue proliferation and fibrosis (pannus). Although joint involvement is the predominant manifestation of RA, extra-articular features, such as interstitial lung disease (ILD), contribute significantly to the elevated mortality associated with the condition. Post-translational modifications play a significant role in RA and RA-ILD pathogenesis. Circulating anti-citrullinated protein antibodies (ACPAs) are a highly diagnostic tool implicating a potential role for citrullinated antigens in RA and RA-ILD.

Recently, antibodies to malondialdehyde acetaldehyde adducts (MAA) have been markedly elevated in patients with RA and RA-ILD. MAA …

Enhancing The Identification Of Rheumatoid Arthritis-Associated Lung Disease, Bryant England

Theses & Dissertations

Rheumatoid arthritis (RA) is a systemic autoimmune disease that predisposes afflicted individuals to reduced quality of life, physical disability, and premature mortality. While joint involvement is the primary manifestation of RA, extra-articular features including lung disease are responsible for a significant portion of the excess mortality. In this dissertation I demonstrate the contribution of chronic lung diseases to premature mortality in RA, contrasting with the more widely recognized comorbidity in RA of cardiovascular disease. Then, I establish that a novel serum biomarker, anti-malondialdehyde-acetaldehyde adduct (MAA) antibody, is associated with the presence of interstitial lung disease (ILD) in RA subjects. Further …

Modifiable Barriers To Optimal Outcomes In Gout Management, Brian W. Coburn

Theses & Dissertations

Improving patient outcomes in chronic disease is of critical importance to the future of health care. Gout, affecting 4% of the US population, is a highly treatable chronic disease from which patients experience unnecessarily suboptimal outcomes. In this dissertation, I demonstrate how interrelated patient and provider factors affect patient outcomes in gout. First, I describe how only 14% of gout patients know their serum urate (SU) goal for urate lowering therapy (ULT) despite otherwise being knowledgeable about gout and its treatment. I then demonstrate the importance of multiple patient and provider factors in achieving SU goal. Specifically, I demonstrate that …