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OPEN ACCESS PLUS
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Contents
5(4): Pp. 252 - 258
Junya Yoneda, Ayatoshi Andou and Kenji Takehana
[Open Access Plus] |
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Amino acids are not only the building blocks of proteins but are also key regulators of various pathological and physiological processes, including immune responses, in living cells. However, the mechanisms responsible for these effects of amino acids are largely unknown. The regulatory roles of amino acids in the immune system can be considered from two perspectives, namely, the enhancement of the immune response that protects individuals from infections and malignant neoplasms, and the reduction of over-responses such as inflammation and autoimmunity. In this review, we focus on the regulatory roles of amino acids in the immune response, showing how several amino acids (e.g., glutamine, arginine, tryptophan, cystine/cysteine, glutamate, and branched-chain amino acids) enhance immunity. Additionally, we describe how one amino acid, histidine, functions as an anti-inflammatory agent in colitis.
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5(4): Pp. 241 - 245
Shoichiro Ikuyama and Emiko Imamura
[Open Access Plus] |
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Dietary supplements are the most popular class of complementary and alternative medicine (CAM) in Japan. In the present review, we describe several characteristics of dietary supplement users in patients with RA in Japan, based on our recent survey. Sixty percent of RA patients used supplements. Prevalence was higher in female than in male patients, and users were younger than non-users, particularly among females. These features were those found in CAM users in general. In comparison with CAM users with cancer, several specific characteristics of RA users emerged. First, the proportion of current users was significantly higher among those who had been diagnosed within the last 5 years compared with those who had been diagnosed more than 5 years ago, indicating that patients in the early years of disease were likely to use supplements. Second, RA patients preferred products made from herbs, algae or components of cartilage. This preference was different from that of cancer patients, who predominantly used mushroom-based products. Third, users expected CAM to produce ‘alleviation of symptoms’ and ‘health promotion’, indicating that the users expectations were essentially ‘complementary’. In contrast, cancer patients expected more positive and direct disease outcomes. Finally, we propose some ideas regarding the clinical significance of future dietary supplement use in RA, as orthodox therapeutic modalities greatly expand.
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4(4): Pp. 259 - 265
Sarah Ringold and Nora G. Singer
[Open Access Plus] |
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Developments in the treatment of rheumatoid arthritis (RA) have highlighted the need for objective disease activity indices applicable to both research and clinical settings and this area has become an important area of research. Previously, the American College of Rheumatology (ACR) response criteria were the most commonly used measures of response in clinical trials, but because they were not developed to measure individual responses to therapy in a clinical setting, the recent focus has been on the, development of indices that provide continuous, rather than relative, measures of improvement. Although the Disease Activity Score (DAS) and DAS28 have been the most commonly used of these continuous measures, these indices are perceived by some to be difficult to perform in busy outpatient settings. Therefore, indices based on simpler equations and/or fewer elements, and indices based entirely on patient-reported data have been proposed as alternatives. This review discusses each of these major disease indices and focuses on the most recent developments in their validation and application to clinical care.
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