CONTACT: JENNIFER CRONIN
2130 Medical Laboratories
Iowa City IA 52242
(319) 335-9917; fax (319) 335-8034
Release: Feb. 8, 2000
Researchers want more studies for juvenile rheumatoid
IOWA CITY, Iowa -- A team of University of Iowa Health
Care researchers believes the medical community should focus more on understanding
how hormones affect juvenile rheumatoid arthritis (JRA) in an effort to determine
whether hormone therapy might help alleviate the progression of the disease.
"We must conduct additional studies in the area of hormones
as they relate to juvenile rheumatoid arthritis so that the medical community
can finally come to a consensus on the issue," said Mary Hendrix, Ph.D., UI
professor and head of anatomy and cell biology. "Only then can we begin to
look at ways that hormones might be used to treat the often debilitating condition."
Zhila Ellis, Ph.D., a member of the Hendrix laboratory,
outlines the Hendrix lab's plea for more investigations in an article appearing
in the February issue of BioDrugs.
JRA is a chronic inflammatory disease in children, affecting
mostly girls. The prevalence of JRA in females suggests that sex steroids
may play a role in the condition. Like its adult counterpart, rheumatoid arthritis
(RA), JRA is a progressive disease that erodes the articular cartilage, often
leading to deformities and disabilities.
For more than 50 years, many researchers have believed
that hormones play some part in RA, and numerous studies have been conducted.
However, no one has ever really looked at hormones and their involvement in
Ellis and Hendrix suggested that previous studies in this
area have been hampered by the lack of access to sufficient numbers of matched
patient blood and tissue samples. Through valuable clinical collaboration
with Terry Moore, M.D., director of JRA and RA clinics at St. Louis University,
the UI was able to conduct a JRA/hormone investigation.
Hendrix's laboratory identified low levels of adrenal
androgens in the serum and synovial fluid of patients with JRA. Synovial fluid
is a lubricant in joints, and serum is the fluid portion of the blood.
The researchers examined the synovial fluid and serum
from 21 patients with JRA -- half were between ages 5 and 12, the other half
were between 15 and 18. Specifically, the researchers wanted to analyze the
serum and synovial fluid for levels of testosterone, as well as the hormones
dehydroepiandrosterone (DHEA) and its sulphated conjugate DHEA-S, progesterone
and 17 beta-estradiol. The investigators then compared the hormone levels
in the synovial fluid and serum to the
level found in the serum of a control group of subjects.
The researchers did not look at the synovial fluid from the control group
because it would be almost impossible to sample the small amount found in
The UI data showed reduced levels of DHEA-S and testosterone
in the synovial fluid and serum of patients with JRA. In addition, the ratio
of DHEA/DHEA-S in both synovial fluid and serum was much higher than that
of the corresponding control serum, thus indicating the potential importance
of hormonal imbalances in the JRA disease process.
Although past investigations involving hormones used to
treat RA have shown mixed results, which could be explained by variations
in laboratory techniques and/or patient populations, some recent clinical
trials of testosterone in both male and female patients with RA have proven
"Additional laboratory studies are urgently needed to
better understand the precise role of hormones in arthritis so that better
therapeutic interventions can be developed," Hendrix said.
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