What is the true remission in rheumatoid arthritis?

• Project/Area Number: 22790937
• Research Category: Grant-in-Aid for Young Scientists (B)
• Allocation Type: Single-year Grants
• Research Field: 膠原病・アレルギー・感染症内科学
• Research Institution: Nagasaki University
• Principal Investigator: TAMAI Mami 長崎大学, 保健・医療推進センター, 助教 (60380862)
• Co-Investigator(Renkei-kenkyūsha): KAWAKAMI Atsushi 長崎大学, 大学院・医歯薬学総合研究科, 教授 (90325639) ; UETANI Masataka 長崎大学, 大学院・医歯薬学総合研究科, 教授 (40176582) ; AOYAGI Kiyoshi 長崎大学, 大学院・医歯薬学総合研究科, 教授 (80295071) ; ARIMA Kazuhiko 長崎大学, 大学院・医歯薬学総合研究科, 助教 (30423635) ; YAMASAKI Satoshi 広島大学, 病院・リウマチ・膠原病科, 助教 (30367388) ; KAWASHIRI Shin-ya 長崎大学, 医歯薬学総合研究科, 助教 (20457576)
• Project Period (FY): 2010 – 2011
• Project Status: Completed (Fiscal Year 2011)
• Budget Amount: ¥4,030,000 (Direct Cost: ¥3,100,000、Indirect Cost: ¥930,000); Fiscal Year 2011: ¥1,560,000 (Direct Cost: ¥1,200,000、Indirect Cost: ¥360,000); Fiscal Year 2010: ¥2,470,000 (Direct Cost: ¥1,900,000、Indirect Cost: ¥570,000)
• Keywords: リウマチ学 / 関節リウマチ / 真の寛解 / 疾患活動性 / 関節MRI骨髄浮腫

Research Abstract

To investigate the true remission in rheumatoid arthritis(RA), we studied very early RA with poor prognosis factors. Treatment with synthetic disease-modifying anti-rheumatic drugs reduced RA progression from undifferentiated arthritis. Significant improvement in MRI-proven bone edema may be associated with protection against structural damage(rs=0. 65, p<0. 05) and persistent remission during 12 months in very early RA patients managed using the tight control approach. The frequency of peripheral blood regulatory T cells in patients with RA negatively correlated with disease activity score, CRP and ESR. The regulatory T cell frequency of patients with RA in remission was similar to that of healthy controls.

Research Products

• [Journal Article] Magnetic resonance imaging(MRI) detection of synovitis and bone lesions of the wrists and finger joints in early-stage rheumatoid arthritis : comparison of the accuracy of plain MRI-based findings and gadolinium-diethylenetriamine pentaacetic acid(Gd-DTPA) (2011)
  • Author(s): Tamai M, Kawakami A, Uetani M, Fukushima A, Arima K, Fujikawa K, Iwamoto N, Aramaki T, Kamachi M, Nakamura H, Ida H, Origuchi T, Aoyagi K, Eguchi K.
  • Journal Title: Mod Rheumatol
  • Peer Reviewed
• [Journal Article] Magnetic resonance imaging of wrist and finger joints distinguishes secondary Sjogren' s syndrome with rheumatoid arthritis from primary Sjogren' s syndrome with articular manifestations (2011)
  • Author(s): Iwamoto N, Kawakami A, Tamai M, Arima K, Nakamura H, Kawashiri SY, Kita J, Okada A, Koga T, Kamachi M, Yamasaki S, Ichinose K, Ida H, Origuchi T, Uetani M, Eguchi K.
  • Journal Title: Clin Exp Rheumatol
  • Peer Reviewed
• [Journal Article] Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration (2011)
  • Author(s): Kita J, Tamai M(筆頭共著者), Arima K, Nakashima Y, Suzuki T, Kawashiri SY, Iwamoto N, Okada A, Koga T, Yamasaki S, Nakamura H, Origuchi T, Ida H, Aoyagi K, Uetani M, Eguchi K, Kawakami A.
  • Journal Title: Mod Rheumatol
  • NAID: 10030782090
  • Peer Reviewed
• [Journal Article] Delayed treatment with tumor necrosis factor inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drugs shows an excellent effect in patients with very early rheumatoid arthritis with poor prognosis factors (2011)
  • Author(s): Kita J, Tamai M(筆頭共著者), Arima K, Nakashima Y, Suzuki T, Kawashiri SY, Okada A, Koga T, Yamasaki S, Nakamura H, Origuchi T, Aramaki T, Nakashima M, Fujikawa K, Tsukada T, Ida H, Aoyagi K, Uetani M, Eguchi K, Kawakami A.
  • Journal Title: Mod Rheumatol
  • NAID: 10030614950
  • Peer Reviewed
• [Journal Article] CD4+ CD25(high) CD127(low/-) Treg cell frequency from peripheral blood correlates with disease activity in patients with rheumatoid arthritis (2011)
  • Author(s): Kawashiri SY, Kawakami A, Okada A, Koga T, Tamai M, Yamasaki S, Nakamura H, Origuchi T, Ida H, Eguchi K.
  • Journal Title: J Rheumatol Volume: 38(12) Pages: 2517-21
  • NAID: 120006985184
  • Peer Reviewed
• [Journal Article] The power Doppler ultrasonography score from 24 synovial sites or 6 simplified synovial sites, including the metacarpophalangeal joints, reflects the clinical disease activity and level of serum biomarkers in patients with rheumatoid arthritis (2011)
  • Author(s): Kawashiri SY, Kawakami A, Iwamoto N, Fujikawa K, Satoh K, Tamai M, Nakamura H, Okada A, Koga T, Yamasaki S, Ida H, Origuchi T, Eguchi K.
  • Journal Title: Rheumatology(Oxford) Volume: 50(5) Pages: 962-5
  • Peer Reviewed
• [Journal Article] Contribution of an adenine to guanine single nucleotide polymorphism of the matrix metalloproteinase-13(MMP-13)-77promoter region to the production of anticyclic citrullinated peptide antibodies in patients with HLA-DRB1* shared epitope-negative rheumatoi (2011)
  • Author(s): Iwamoto N, Kawakami A, Arima K, Tamai M, Nakamura H, Kawashiri SY, Kita J, Okada A, Koga T, Kamachi M, Yamasaki S, Ichinose K, Ida H, Origuchi T, Eguchi K.
  • Journal Title: Mod Rheumatol Volume: 21(3) Pages: 240-3
  • Peer Reviewed
• [Journal Article] Magnetic resonance imaging (MRI) detection of synovitis and bone lesions of the wrists and finger joints in early-stage rheumatoid arthritis : comparison of the accuracy of plain MRI-based findings and gadolinium-diethylenetriamine pentaaceticacid (Gd-DTPA)-enhanced MRI-based findings (2011)
  • Author(s): Tamai M, Kawakami A, Uetani M, Fukushima A, Arima K, Fujikawa K, Iwamoto N, Aramaki T, Kamachi M, Nakamura H, Ida H, Origuchi T, Aoyagi K, Eguchi K
  • Journal Title: Mod Rheumatol Volume: (E-pub) Issue: 5 Pages: 654-658
  • DOI: 10.1007/s10165-011-0575-8
  • Peer Reviewed
• [Journal Article] Treatment discontinuation in patients with very early rheumatoid arthritis in sustained simplified disease activity index remission after synthetic disease-modifying anti-rheumatic drug administration (2011)
  • Author(s): Kita J, Tamai M(筆頭共著者), ArimaK, Nakashima Y, Suzuki T, Kawashiri SY, Iwamoto N, Okada A, Koga T, Yamasaki S, Nakamura H, Origuchi T, Ida H, Aoyagi K, Uetani M, Eguchi K, Kawakami A
  • Journal Title: Mod Rheumatol Volume: (E-pub) Issue: 3 Pages: 346-352
  • DOI: 10.1007/s10165-011-0522-8
  • NAID: 10030782090
  • Peer Reviewed
• [Journal Article] Delayed treatment with tumor necrosis factor inhibitors in incomplete responders to synthetic disease-modifying anti-rheumatic drags shows an excellent effect in patients with very early rheumatoid arthritis with poor prognosis factors (2011)
  • Author(s): Kita J, Tamai M(筆頭共著者), ArimaK, Nakashima Y, Suzuki T, Kawashiri SY, Okada A, Koga T, Yamasaki S, Nakamura H, Origuchi T, Aramaki T, Nakashima M, Fujikawa K, Tsukada T, Ida H, Aoyagi K, Uetani M, Eguchi K, Kawakami A
  • Journal Title: Mod Rheumatol Volume: (E-pub) Issue: 2 Pages: 195-201
  • DOI: 10.1007/s10165-011-0511-y
  • Peer Reviewed
• [Journal Article] Comparative study of the detection of joint injury in early-stage rheumatoid arthritis by MRI of wrist and finger joints and physical examination. 2010 Nov 15. (2011)
  • Author(s): Tamai M, Kawakami A, Iwamoto N, Kawashiri S, Fujikawa K, Aramaki T, Kita J, Okada A, Koga T, Kamachi M, Yamasaki S, Ichinose K, Ida H, Origuchi T, Eguchi K.
  • Journal Title: Arthritis Care Res (Hoboken) Volume: 63(Epub ahead of print) Pages: 436-9
  • Peer Reviewed
• [Journal Article] Comparative study of the detection of joint injury in early-stage rheumatoid arthritis by MRI of wrist and finger joints and physical examination (2010)
  • Author(s): Tamai M, Kawakami A, Iwamoto N, Kawashiri SY, Fujikawa K, Aramaki T, Kita J, Okada A, Koga T, Arima K, Kamachi M, Yamasaki S, Nakamura H, Ida H, Origuchi T, Takao S, Aoyagi K, Uetani M, Eguchi K.
  • Journal Title: Arthritis Care Res(Hoboken) Volume: 63 Pages: 436-9
  • Peer Reviewed
• [Journal Article] Contribution of anti-CCP antibodies, proximal interphalangeal joint involvement, HLA-DRB1 shared epitope, and PADI4 as risk factors for the development of rheumatoid arthritis in palindromic rheumatism. (2010)
  • Author(s): Tamai M, Kawakami A, Iwamoto N, Arima K, Aoyagi K, Eguchi K.
  • Journal Title: Scand J Rheumatol Volume: 39 Pages: 287-91
  • NAID: 120006984220
  • Peer Reviewed
• [Journal Article] 関節リウマチ:治癒を目指す最新治療コンセンサス (2010)
  • Author(s): 玉井慎美、川上純
  • Journal Title: 医学のあゆみ(医歯薬出版) Volume: 234 Pages: 9-13
• [Journal Article] 関節リウマチの予後不良因子とその対策 (2010)
  • Author(s): 玉井慎美、川上純
  • Journal Title: Medical Practice(文光堂) Volume: 27 Pages: 2045-8
• [Journal Article] 抗CCP抗体測定キット(ARCHITECT Anti-CCP)の臨床的評価 (2010)
  • Author(s): 玉井慎美、川上純、江口勝美
  • Journal Title: 医学と薬学 Volume: 64 Pages: 779-83
• [Presentation] Evaluation of the patients with early arthritis by 2010 RA criteria in conjunction with MRI of wrists and finger joints (2011)
  • Author(s): Tamai M, Arima K, Uetani M, Iwamoto N, Kita J, Okada A, Koga T, Kawashiri SY, Ichinose K, Yamasaki S, Nakamura H, Ida H, Origuchi T, Aoyagi K, Eguchi K, Kawakami A
  • Organizer: アメリカリウマチ学会2011
  • Place of Presentation: McCormick Place Convention Center(シカゴ、イリノイ州、アメリカ合衆国)(ポスター)
  • Year and Date: 2011-11-06
• [Presentation] 抗CCP抗体価とMRI骨髄浮腫:RAにおける関節破壊 (2011)
  • Author(s): 玉井慎美、有馬和彦、上谷雅孝、岩本直樹、岡田覚丈、喜多潤子、古賀智裕、川尻真也、一瀬邦弘、山崎聡士、中村英樹、折口智樹、井田弘明、青柳潔、江口勝美、川上純
  • Organizer: 第39回日本臨床免疫学会
  • Place of Presentation: 京王プラザホテル(東京)
  • Year and Date: 2011-09-15
• [Presentation] Evaluation of the patients with early arthritis by 2010 ACR/EULAR criteria in conjunction with MRI of wrists and finger joints (2011)
  • Author(s): Tamai M, Arima K, Iwamoto N, Okada A, Kita J, Koga T, Kawashiri SY, Yamasaki S, Nakamura H, Origuchi T, Uetani M, Aoyagi K, Eguchi K, Kawakami A
  • Organizer: ヨーロッパリウマチ学会2011
  • Place of Presentation: ExCeL London(ロンドン、イギリス)(口演)
  • Year and Date: 2011-05-25
• [Presentation] Evaluation of the patients with early arthritis by 2010 RA criteria in conjunction with MRI of wrists and finger joints (2011)
  • Author(s): Tamai M, Arima K, Uetani M, Iwamoto N, Kita J, Okada A, Koga T, Kawashiri SY, Ichinose K, Yamasaki S, Nakamura H, Ida H, Origuchi T, Aoyagi K, Eguchi K, Kawakami A.
  • Organizer: (ポスター)アメリカリウマチ学会
  • Place of Presentation: Chicago, USA
• [Presentation] Evaluation of the patients with early arthritis by 2010 ACR/ EULAR criteria in conjunction with MRI of wrists and finger joints (2011)
  • Author(s): Tamai M, Arima K, Iwamoto N, Okada A, Kita J, Koga T, Kawashiri SY, Yamasaki S, Nakamura H, Origuchi T, Uetani M, Aoyagi K, Eguchi K, Kawakami A.
  • Organizer: ヨーロッパリウマチ学会
  • Place of Presentation: London, UK
• [Presentation] 長崎大学早期関節炎コホートによる2010年ACR/ EULAR RA分類基準の検証 (2011)
  • Author(s): 玉井慎美、喜多潤子、上谷雅孝、有馬和彦、中島好一、鈴木貴久、岡田覚丈、川尻真也、一瀬邦弘、山崎聡士、中村英樹、折口智樹、青柳潔、江口勝美、川上純
  • Organizer: 第26回日本臨床リウマチ学会
  • Place of Presentation: 横浜市
• [Presentation] 抗CCP抗体価とMRI骨髄浮腫: RAにおける関節破壊(ワークショップ) (2011)
  • Author(s): 玉井慎美、有馬和彦、上谷雅孝、岩本直樹、岡田覚丈、喜多潤子、古賀智裕、川尻真也、一瀬邦弘、山崎聡士、中村英樹、折口智樹、井田弘明、青柳潔、江口勝美、川上純
  • Organizer: 第39回日本臨床免疫学会
  • Place of Presentation: 東京都
• [Presentation] 2010RA分類基準とNagasaki scoreを用いた早期関節炎の評価(ワークショップ) (2011)
  • Author(s): 玉井慎美、川尻真也、岩本直樹、有馬和彦、喜多潤子、岡田覚丈、古賀智裕、中島好一、鈴木貴久、山崎聡士、中村英樹、折口智樹、青柳潔、上谷雅孝、江口勝美、川上純
  • Organizer: 第55回日本リウマチ学会総会・学術集会
  • Place of Presentation: 神戸市
• [Presentation] 早期関節リウマチの経過における手指関節MRI骨髄浮腫と抗CCP抗体価変動の検討(一般口演) (2010)
  • Author(s): 玉井慎美
  • Organizer: 第25回日本臨床リウマチ学会
  • Place of Presentation: 東京ステーションコンファレンス
  • Year and Date: 2010-11-27
• [Presentation] 2009年ACR/EULAR criteria : UA 129症例を用いた検証(ポスター) (2010)
  • Author(s): 玉井慎美
  • Organizer: 第107回日本内科学会総会
  • Place of Presentation: 東京国際フォーラム
  • Year and Date: 2010-04-10
• [Presentation] 早期関節リウマチの経過における手指関節MRI骨髄浮腫と抗CCP抗体価変動の検討 (2010)
  • Author(s): 玉井慎美、川上純、上谷雅孝、有馬和彦、岩本直樹、藤川敬太、中村英樹、井田弘明、折口智樹、青柳潔、江口勝美
  • Organizer: 第25回日本臨床リウマチ学会
  • Place of Presentation: 東京都
• [Presentation] 自己抗体と手指関節非造影MRIを用いるNagasaki scoreの評価(ポスター) (2010)
  • Author(s): 玉井慎美、川上純、上谷雅孝、有馬和彦、岩本直樹、藤川敬太、中村英樹、井田弘明、折口智樹、青柳潔、江口勝美
  • Organizer: 第54回日本リウマチ学会総会・学術集会
  • Place of Presentation: 東京都
• [Presentation] RA診断・新診断基準診断未確定関節炎コホートを用いたACR2009新基準の評価(ポスター) (2010)
  • Author(s): 玉井慎美、川上純、岩本直樹、藤川敬太, 有馬和彦、中村英樹、折口智樹、井田弘明、青柳潔、上谷雅孝、江口勝美
  • Organizer: 第54回日本リウマチ学会総会・学術集会
  • Place of Presentation: 東京都
• [Presentation] 関節リウマチの早期診断ACR2009新基準、Nagasaki score、Leiden scoreの比較(ポスター) (2010)
  • Author(s): 玉井慎美、川上純、喜多潤子、岩本直樹、川尻真也, 有馬和彦、藤川敬太、上谷雅孝、青柳潔、江口勝美
  • Organizer: 第107回日本内科学会
  • Place of Presentation: 東京都