ascorbic-acid and Arthritis--Rheumatoid

Potentially damaging species (reactive oxygen, nitrogen and chlorine species) arise as by-products of metabolism and as physiological mediators and signalling molecules. Levels of these species are controlled by the antioxidant defence system. Several components of this system are micronutrients (e.g. vitamins C and E) or are dependent upon dietary micronutrients (e.g. CuZn and Mn superoxide dismutase). The antioxidant defences act as a coordinated system where deficiencies in one component may affect the efficiency of the others. Oxidative stress may be an important factor in infection if micronutrients are deficient.

Topics: Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Cardiovascular Diseases; Copper; Deficiency Diseases; Developing Countries; Disease Susceptibility; HIV Infections; Humans; Iron; Magnesium; Manganese; Micronutrients; Nutritional Status; Oxidative Stress; Virus Diseases; Vitamin E; Zinc

Despite 50 years of intensive research in the field of RFs, autoimmunity and chronic inflammation, some of the serological tests used for measuring autoantibodies remain an anachronism. Clinical chemistry has the potential technology to provide the rheumatologist with automated quantitative antibody/antigen measurements. It can also widen the range of tests available for disease monitoring, which would be helpful in the management of the chronic rheumatic diseases. Traditional laboratory tests must be superseded by new developments, derived from fundamental research, if we are to improve the diagnosis and management of the rheumatic diseases.

Topics: Acute-Phase Proteins; Antibodies, Antinuclear; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Biochemistry; Humans; Iron; Liver Function Tests; Rheumatoid Factor; Rheumatology; Trace Elements

Reactive oxygen metabolic products derived from an activated NADPH oxidase present in the cell membrane of PMNs and mononuclear phagocytic cells play a critical role in the host's defense against bacterial infection. Recent studies have also demonstrated the ability of these toxic products to initiate eukaryotic cell injury and promote the development of the acute inflammatory responses. Experimental studies suggest that neutrophil-derived oxygen metabolites contribute to the development of the tissue injury associated with a variety of disease states, including emphysema, myocardial infarction, adult respiratory distress syndrome, immune complex-mediated vasculitis, and rheumatoid arthritis. Future studies to define further the mechanisms by which reactive oxygen-derived metabolic products mediate tissue injury will provide insight into the development of new therapeutic strategies for the modulation of disease states that are mediated by the recruitment and activation of PMNs.

Topics: Animals; Arthritis, Rheumatoid; Ascorbic Acid; Autoimmune Diseases; Ceruloplasmin; Chemotactic Factors; Cricetinae; Cricetulus; Free Radicals; Humans; Immune Complex Diseases; Inflammation; Lipid Peroxides; Myocardial Infarction; NADH, NADPH Oxidoreductases; NADPH Oxidases; Neutrophils; Oxidation-Reduction; Oxygen; Pancreatic Elastase; Peroxidase; Peroxidases; Peroxides; Phagocytosis; Pulmonary Emphysema; Respiratory Distress Syndrome; Superoxide Dismutase; Superoxides; Vasculitis; Vitamin E

Excess generation of reactive oxygen species in damaged joints accelerates inflammatory responses in RA (rheumatoid arthritis) patients. The complementary effects of dietary antioxidant supplementation on the blood level of inflammatory mediators and the severity of the disease in RA patients were evaluated.. The study was conducted as a randomized, placebo-controlled, double-blind, three-treatment cross-over design trial. The participants visited the hospital as outpatients.. Twenty patients meeting the 1987 criteria for the classification of rheumatoid arthritis completed the study.. The subjects were randomized in three groups to receive one of following supplementation; quercetin+vitamin C (166 mg+133 mg/capsule), alpha-lipoic acid (300 mg/capsule) or placebo for 4 weeks (3 capsules/day). Each treatment period consisted of 4 weeks with 2 weeks of wash-out period before the subject starts next supplementation.. Serum levels of tumor necrosis factor-alpha(TNF-alpha), interleukin-1beta(IL-1beta), interleukin -6(IL-6), and C-reactive protein (CRP) were measured. The severity of disease was evaluated using Korean Health Assessment Questionnaire(KHAQ) and Visual Analogue Scale(VAS). Nutrient intake was measured at baseline and at the end of each intervention period.. The mean energy and nutrient intakes remained constant during study period. No significant differences were found in the serum concentrations of pro-inflammatory cytokines and CRP between treatments. The scores of disease severity measurements were not significantly different between treatments, although quercetin supplementation had a tendency to reduce VAS.. Dietary supplementation of antioxidants at 900 mg/day for 4 weeks did not change the blood biomarkers of inflammation and disease severity of RA patients under conventional medical treatments. Further considerations for dose-response relationships, duration of supplementation, and susceptible biomarkers are required.

Topics: Adult; Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Biomarkers; C-Reactive Protein; Cross-Over Studies; Cytokines; Dietary Supplements; Double-Blind Method; Drug Administration Schedule; Drug Therapy, Combination; Energy Intake; Female; Humans; Male; Middle Aged; Quercetin; Severity of Illness Index; Thioctic Acid; Vitamins

To investigate in a double-blind placebo-controlled, parallel group study, the effects of a nutrient supplement, containing, among other ingredients, the omega-3 fatty acids eicosapentaenoic acid (1.4 g EPA), docosahexaenoic acid (0.211 g DHA), omega-6 fatty acid gamma-linolenic acid (0.5 g GLA) and micronutrients in patients with active rheumatoid arthritis (RA).. RA patients were randomized to receive either daily liquid nutrient supplementation or placebo for 4 months. The primary end point was the change in tender joint count at 2 and 4 months. Other clinical variables included swollen joint count, visual analogue scales for pain and disease activity, grip strength, functionality score and morning stiffness. Biochemical parameters included plasma concentrations of PUFA and vitamins C and E.. Outpatient university clinic.. In all, 66 patients enrolled, 55 completed the study. No significant change from baseline in tender joint count or any of the other clinical parameters was detected in either group. Patients receiving nutrient supplementation, but not those receiving placebo, had significant increases in plasma concentrations of vitamin E (P=0.015), and EPA, DHA and docosapentaenoic acid concomitant with decreases of arachidonic acid (P=0.01). Intergroup differences for PUFA and vitamin E were significantly different (P=0.01 and 0.03, respectively).. This double-blind, placebo-controlled study in RA patients did not show superior clinical benefit of daily nutrient supplementation with EPA, GLA and micronutrients at the doses tested as compared to placebo. The study adds information regarding doses of omega-3 fatty acids, below which anti-inflammatory effects in RA are not seen.

Topics: Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Dietary Supplements; Docosahexaenoic Acids; Double-Blind Method; Eicosapentaenoic Acid; Fatty Acids, Omega-3; Fatty Acids, Omega-6; Fatty Acids, Unsaturated; Female; gamma-Linolenic Acid; Hand Strength; Humans; Male; Micronutrients; Middle Aged; Pain; Treatment Outcome; Vitamin E

Oxygen free radicals have been implicated as mediators of tissue damage in patients of rheumatoid arthritis (RA). This study was designed to elucidate plasma oxidant/antioxidant status in rheumatoid arthritis, with the aim of evaluating the importance of antioxidant therapy in the management of this disease.. The study included 40 patients of rheumatoid arthritis who were randomly divided into two subgroups of 20 each. One group received conventional treatment for 12 weeks and in the other group conventional treatment was supplemented with antioxidants for the same duration. Twenty age- and sex-matched normal individuals constituted the control group. Blood samples of controls and patients were collected at the time of presentation and analyzed for total thiols, glutathione, vitamin C and malondialdehyde (MDA-marker of oxidative stress). The investigations were repeated in the patients after 12 weeks.. The blood concentrations of total thiols, glutathione and vitamin C were found to be significantly lower in rheumatoid arthritis patients as compared to healthy controls, while the concentrations of MDA were much higher. There was a statistically significant increase in the posttreatment concentrations of these antioxidants, along with a decrease in the concentrations of MDA.. The antioxidant defense system is compromised in rheumatoid arthritis patients. There is a shift in the oxidant/antioxidant balance in favor of lipid peroxidation, which could lead to the tissue damage observed in the disease. The results suggest the necessity for therapeutic co-administration of antioxidants along with conventional drugs to such patients. However, due to the limited number of cases included in this study, more studies may be required to substantiate the results and arrive at a definite conclusion, in terms of safety and efficacy of adding on antioxidant therapy for the treatment of RA.

Topics: Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Female; Glutathione; Humans; Male; Malondialdehyde; Sulfhydryl Compounds

In a prospective double-blind controlled trial the effect of large doses of ascorbic acid on the healing of pressure-sores has been assessed. 20 surgical patients were studied, the pressure areas being assessed by serial photography and ulcer tracings. The mean ascorbic-acid levels in treated and non-treated groups one month after the start of treatment were 65.6 and 25.8 mug per 10-8 white blood-cells. In the group treated with ascorbic acid there was a mean reduction in pressure-sore area of 84% after one month compared with 42.7% in the placebo group. These findings are statistically significant (P less than 0.005) and suggest that ascorbic acid may accelerate the healing of pressure-sores.

Topics: Aged; Arthritis, Rheumatoid; Ascorbic Acid; Ascorbic Acid Deficiency; Cerebrovascular Disorders; Clinical Trials as Topic; Female; Fractures, Bone; Humans; Leukocytes; Male; Middle Aged; Paraplegia; Postoperative Complications; Pressure Ulcer; Prospective Studies; Vascular Diseases; Wound Healing

Topics: Adolescent; Adrenocorticotropic Hormone; Adult; Arthritis, Rheumatoid; Ascorbic Acid; Female; Fructose; Humans; Methods; Middle Aged; Phenylbutazone; Physical Therapy Modalities; Prednisone

Symptomatic vitamin C deficiency, scurvy, is a relatively rare disease in developed countries, but it has been reported in patients with autism spectrum disorder or developmental delay who tend to have selective diets. Patients with scurvy often demonstrate musculoskeletal manifestations with unknown pathophysiology. Herein, we report a case of scurvy in an 11-year-old boy who presented with iron-deficiency anaemia, systemic osteomyelitis, myositis predominantly in the lower extremities, and right ventricular volume overload with mild pulmonary hypertension and was diagnosed with scurvy. He had a mild developmental disorder and a selective diet, which resulted in severe vitamin C deficiency. He received intravenous and oral vitamin C supplementation, which relieved his arthralgia and muscle pain in a week. Following 4 months of vitamin C supplementation, he demonstrated no abnormal manifestations on laboratory or imaging examination and recovered without sequelae. Inflammatory cytokine and chemokine evaluations demonstrated elevated levels of interleukin (IL)-6, IL-17A, and IL-23, which are associated with T-helper (Th) 17 cell activation. This study is the first to suggest the association between the inflammation seen in scurvy, rheumatic manifestations in the patient, and Th17 cell activation. Further analysis of the association between the inflammation and vitamin C supplementation may contribute to new insights for the comprehension and treatment of other inflammatory diseases, such as rheumatic diseases.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Ascorbic Acid Deficiency; Autism Spectrum Disorder; Child; Humans; Inflammation; Interleukin-17; Interleukin-23; Interleukin-6; Male; Scurvy

Triptolide (TP) has its unique curative effect in the treatment of rheumatoid arthritis (RA), but its application is limited by the poor water solubility and multi-organ toxicity. We herein developed a novel nanoparticle platform composed of L-ascorbate palmitate (VP, vitamin C derivative) that can deliver TP to synergistically treat arthritis and inhibit the occurrence of oxidative stress. The TP-loaded nanoparticles (termed TP-VP NPs) showed the suitable particle size (about 145 nm) and good physical stability. TP-VP NPs effectively down-regulated IL-1β, IL-6 and TNF-α levels to inhibit the erosion of synovitis and bone tissue, and alleviate the swelling and deformation of CIA mice's feet. Compared to the TP, TP-VP NPs could inhibit effectively the oxidative stress in liver, and alleviate significantly the triptolide-induced toxicity injury in liver, kidney and testicle. The results demonstrated that TP-VP NPs is a promising triptolide delivery system for the treatment of RA, which enhances the water solubility of TP and reduces the toxicity of TP

Topics: Animals; Arthritis, Rheumatoid; Ascorbic Acid; Diterpenes; Epoxy Compounds; Mice; Micelles; Palmitates; Phenanthrenes; Water

Rheumatoid arthritis (RA) is an autoimmune disorder that is a painful health crisis. This study aimed to assess the serum C-reactive protein (CRP), malondialdehyde (MDA), non-enzymatic antioxidant (vitamin C), and trace elements (Zn, Cu, Mn, and Fe) in RA patients, and thereby correlate these parameters with the association of RA. This study included 20 Bangladeshi RA patients and 20 normal healthy volunteers as control subjects. CRP level was determined using a laboratory-based latex agglutination-enhanced immunoassay. The lipid peroxidation level was determined by measurement of the serum level of MDA. Non-enzymatic antioxidant vitamin C was assessed by UV spectrophotometric method. Trace elements were determined by atomic absorption spectroscopy (AAS). Our study observed significantly higher concentrations of CRP (p < 0.001) and MDA (p < 0.001), and significantly lower concentrations of vitamin C (p < 0.001) in the RA patient. The mean values of Zn, Cu, Mn, and Fe were 6.62 ± 0.34, 1.42 ± 0.17, 7.51 ± 0.23, and 29.25 ± 0.41 ppm for the RA patients respectively and 13.57 ± 9.13, 1.15 ± 0.17, 1.59 ± 0.18, and 62.47 ± 5.25 ppm for the control subjects, consequently. There was a significant difference (p < 0.05) in the trace element levels between the RA patients and control subjects. Our study suggests that a higher concentration of CRP and MDA, lower levels of vitamin C, and altered trace elements may be linked to RA.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; C-Reactive Protein; Humans; Malondialdehyde; Receptors, Immunologic; Trace Elements

Topics: Aged; Antirheumatic Agents; Arthritis, Rheumatoid; Ascorbic Acid; Dermatitis, Allergic Contact; Erythema; Etanercept; Facial Dermatoses; Female; Humans; Immunosuppressive Agents; Methotrexate; Patch Tests; Skin Cream

Gingival disase and rheumatoid arthritis (RA) are linked at both the epidemiologic and pathogenesis levels. In this study, we aimed to identify environmental factors associated with RA and gingival disease and to investigate factors that protect the gingival tissue in RA patients. This retrospective study analyzed 754 RA patients with gingival disease selected from the NHANES database who completed the mobile examination center interview/examination between 1999 and 2004. Data collected included demographics, lifestyle, dietary intake, and biomarkers. The study included 173 RA patients with gingival disease. Multivariate logistic regression analysis showed that the odds of gingival disease were significantly increased with male gender. However, the odds of gingival disease was significantly decreased with increased vitamin C intake (OR = 0.996, p = 0.041), and higher serum vitamin D levels (OR = 0.979, p = 0.011). Given the significant association between the prevalence of gingival disease and RA, identification of risk factors of gingival disease will be useful as a screening tool in national health surveys to improve the management of periodontal disease in patients with RA.

Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Ascorbic Acid; Biomarkers; Female; Gingival Diseases; Humans; Life Style; Logistic Models; Male; Middle Aged; Nutrition Surveys; Odds Ratio; Prevalence; Retrospective Studies; Risk Factors; Sex Factors; Vitamin D

To assess the dietary quality of older women with and without rheumatoid arthritis (RA) using the Healthy Eating Index-2005 (HEI-2005) to identify potential strategies to improve the nutritional status.. Cross-sectional. Diet was assessed using 7 d food records and analysed for nutrient composition (Food Processor v. 7.11). Diet quality was determined using the HEI-2005, a measure of compliance with 2005 US Dietary Guidelines. Individuals with RA completed a self-reported evaluation of arthritis (pain scale and disability index). Independent two-tailed t tests or Mann-Whitney tests compared the differences between groups and correlations were computed between HEI-2005 and measures of disease reactivity.. Arizona, USA.. Older (> or = 55 years) women (n 108) with RA (n 52) and healthy controls (HC; n 56).. There were no differences between groups in age, weight, or BMI (kg/m2). HC participants had higher mean HEI-2005 scores for whole fruit (cups; P = 0.02), total fruit (cups; P = 0.05), whole grains (oz; P = 0.004), oil (g; P = 0.05) and total HEI score (P = 0.04) than the RA group. In the RA group, these same HEI components were inversely correlated with disability index (r = -0.20, P = 0.04). Participants with RA reported lower mean intakes of carbohydrate (g; P = 0.02), fibre (g; P = 0.01) and vitamin C (mg; P = 0.04).. This is the first study examining the dietary quality in older women with and without RA using the HEI-2005. Living with RA was associated with significantly lower dietary quality. Since even small changes in dietary quality can translate into better nutritional status, future interventions should focus on increasing dietary quality in this high-risk group.

Topics: Aged; Arizona; Arthritis, Rheumatoid; Ascorbic Acid; Cross-Sectional Studies; Diet; Diet Records; Disabled Persons; Female; Humans; Middle Aged; Reference Values; Statistics, Nonparametric; Vitamins

Pro- and anti-oxidative effects of an anti-rheumatoid drug, D-penicillamine (D-PN), on the kinetics of high-molar-mass hyaluronan (HA) degradation were monitored using the method of rotational viscometry. The degradation of the dissolved HA macromolecules was attained by applying the Weissberger's system comprising ascorbic acid plus cupric ions. Electron paramagnetic resonance (EPR) spectroscopy was used to identify the generated free radicals. The results obtained indicate that the initial anti-oxidative action of D-PN is followed by induction of pro-oxidative conditions due to the generation of reactive free radicals. It is speculated, however, that the latter situation may be considered as an advantageous property of D-PN. Hydroxyl radicals formed in this way may participate in decomposition of proteinases, which are believed to be responsible for the destruction of joint cartilage under rheumatoid arthritic conditions.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Cyclic N-Oxides; Electron Spin Resonance Spectroscopy; Humans; Hyaluronic Acid; Hydroxyl Radical; Penicillamine

To examine the oxidation or reduction products in patients with rheumatism arthritis (RA), and investigate the relationship between oxidation or reduction products and occurrence and development of RA.. The serum levels of total ascorbic acid (TAA), dehydroascorbic acid (DHAA)/TAA, vitamin E, advanced oxidation protein products (AOPP) and malondialdehyde (MDA) were detected by high-performance liquid chromatography with electrochemical detection in 83 RA patients and 30 healthy adults. Correlation analysis of AOPP, MDA and hs-CRP was performed.. Compared with normal control group, significantly higher serum MDA, DHAA/TAA, and AOPP levels were detected in RA patients (P<0.05), but vitamin E showed no significant difference (P<0.05). Linear regression analysis showed that MDA (P<0.01) was positively but AOPP (P>0.05) negatively correlated to hs-CRP.. Oxidation or reduction products in serum of RA patients increases significantly, which may be an important mechanism for the occurrence and development of RA. Serum AOPP and MDA levels can reflect the oxidation status in RA patients.

Topics: Adult; Arthritis, Rheumatoid; Ascorbic Acid; Chromatography, High Pressure Liquid; Dehydroascorbic Acid; Female; Humans; Male; Malondialdehyde; Middle Aged; Oxidation-Reduction; Vitamin E

To evaluate the dehydroascorbate (DHA) transport mechanisms in human chondrocytes.. The transport of L-(14)C-DHA in human chondrocytes was analyzed under various conditions, including the use of RNA interference (RNAi), to determine the role of glucose transporter 1 (GLUT-1) and GLUT-3 in L-14C-DHA transport and to evaluate the effects of physiologically relevant oxygen tensions on L-14C-DHA transport. In order to estimate the contributions of reduced ascorbic acid (AA) and DHA to intracellular ascorbic acid (Asc), the quantities of AA and DHA were measured in synovial fluid samples from osteoarthritis (OA) patients and compared with the reported levels in rheumatoid arthritis (RA) patients.. DHA transport in human chondrocytes was glucose-sensitive, temperature-dependent, cytochalasin B-inhibitable, modestly stereoselective for L-DHA, and up-regulated by low oxygen tension. Based on the RNAi results, GLUT-1 mediated, at least in part, the uptake of DHA, whereas GLUT-3 had a minimal effect on DHA transport. DHA constituted a mean 8% of the total Asc in the synovial fluid of OA joints, in contrast to 80% of the reported total Asc in RA joints.. We provide the first evidence that chondrocytes transport DHA via the GLUTs and that this transport mechanism is modestly selective for L-DHA. In the setting of up-regulated DHA transport at low oxygen tensions, DHA would contribute 26% of the total intracellular Asc in OA chondrocytes and 94% of that in RA chondrocytes. These results demonstrate that DHA is a physiologically relevant source of Asc for chondrocytes, particularly in the setting of an inflammatory arthritis, such as RA.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Biological Transport; Cartilage, Articular; Cell Hypoxia; Cells, Cultured; Chondrocytes; Chromatography, High Pressure Liquid; Dehydroascorbic Acid; Gene Expression; Knee Joint; Monosaccharide Transport Proteins; Osteoarthritis, Knee; Reverse Transcriptase Polymerase Chain Reaction; RNA Interference; RNA, Messenger; RNA, Small Interfering; Up-Regulation

Topics: Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Cardiovascular Diseases; Chronic Disease; Comorbidity; Diabetes Mellitus; Free Radicals; Gastritis; Inflammation; Oxidation-Reduction; Oxidative Stress; Pancreatitis

The therapeutic effect of a nutritional supplement consisting of a combination of glucosamine hydrochloride (FCHG49), purified sodium chondroitin sulfate (TRH122), and manganese ascorbate (GCM)3 was investigated in the rat model of collagen-induced autoimmune arthritis (CIA). The GCM compound was mixed with a palatable nutritional paste (Nutri-cal [NC]). Oral administration of the NC/GCM compound was initiated in 26 rats 10 days before immunization and continued until the day of sacrifice. One group of 12 control rats was given no oral agents; a second group of 12 control rats received NC only. Evaluations included arthritis index (AI) scoring by three independent evaluators, histologic index (HI) scoring of lesions, T-cell proliferation, and serological studies for antibody classes and subclasses. Both the AI and HI criteria showed a statistically significant reduction in the prevalence of CIA in rats pretreated with the NC/GCM (54%) compared to the combined control groups (96%, chi2 analysis P = 0.001). Rats fed the NC/GCM also exhibited a significant decrease in the severity of autoimmune arthritis in both the AI and HI compared to control Group 2 (immunized-NC) (chi2 analysis P < 0.05). Histological studies verified the decreased incidence of arthritis in the NC/GCM group compared to control Group 2. GCM treatment failed to alter T-cell proliferation and antibody production to bovine type-II collagen, indicating that its effects are not due to alteration of the antigen-specific immune response.

Topics: Animals; Arthritis, Rheumatoid; Ascorbic Acid; Autoantibodies; Chondroitin Sulfates; Collagen; Deferoxamine; Dietary Supplements; Drug Therapy, Combination; Female; Glucosamine; Knee; Manganese; Organometallic Compounds; Rats; Severity of Illness Index

Oxygen free radicals have been implicated as mediators of tissue damage in patients with rheumatoid arthritis. The aim of our study was to assess the lipid peroxide products and antioxidant status in rheumatoid arthritis patients (RA). The study involved determination of two plasma lipid peroxide products, malondialdehyde (MDA) and conjugated dienes (CD), two plasma antioxidant vitamins (C and E) in 91 RA patients and 26 healthy subjects. The results showed that rheumatoid patients had increased plasma CD but not MDA and decreased plasma vitamin E, when properly expressed per unit cholesterol and triglyceride. This finding suggested that RA patients had increased oxidant stress that might play a role in the tissue damage and inflammation process of this disease.

Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Ascorbic Acid; Female; Humans; Lipid Peroxides; Malondialdehyde; Middle Aged; Vitamin E

Peroxynitrite, formed by reaction of superoxide and nitric oxide, appears to be an important tissue-damaging species generated at sites of inflammation. In this paper, we compare the abilities of several biological antioxidants to protect against peroxynitrite-dependent inactivation of alpha 1-antiproteinase, and to inhibit tyrosine nitration upon addition of peroxynitrite. GSH and ascorbate protected efficiently in both systems. Uric acid inhibited tyrosine nitration but not alpha 1-antiproteinase inactivation. The possibility that ascorbic acid is an important scavenger of reactive nitrogen species in vivo is discussed.

Topics: alpha 1-Antitrypsin; Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Humans; Lipid Peroxidation; Nitrates; Oxidation-Reduction; Oxidative Stress; Pancreatic Elastase; Synovial Fluid; Tyrosine

The percentage of oligosaccharide chains lacking galactose was measured in IgG obtained from pokeweed mitogen-activated cultures of blood lymphocytes from patients with rheumatoid arthritis and controls. Secreted IgG from rheumatoid arthritis lymphocytes was deficient in galactose compared with IgG from the lymphocytes of controls. This confirms that agalactosylation is a significant feature of the disease and demonstrates that it can occur at the B cell level and is not merely a post-secretory event.

Topics: Adult; Aged; Aged, 80 and over; Arthritis, Rheumatoid; Ascorbic Acid; B-Lymphocytes; Humans; Immunoglobulin G; In Vitro Techniques; Middle Aged; Pokeweed Mitogens

The ability of fresh sera to resist attack by peroxyl radicals (TRAP) was found to be significantly lower in 20 patients with rheumatoid arthritis (RA) than in 20 healthy controls, consistent with the existence of a redox stress in RA imposed by inflammation. TRAP values in RA varied inversely with a combination of visual analogue pain scale, duration of early morning stiffness, grip strength, and articular index (reflecting inflammatory activity) using multiple linear regression analysis. The concentration of the antioxidant vitamin ascorbic acid was lower in RA plasma and the oxidation-reduction equilibrium of ascorbic acid was disturbed, giving further support to the existence of a redox stress. The major determinant of TRAP in vitro was found to be serum uric acid in RA and serum vitamin E in controls. Serum urate concentration in RA correlated inversely with oxidative changes in serum albumin and IgG. It is suggested that serum urate might have an antioxidant role under certain conditions by limiting free radical induced oxidative changes to protein during inflammation.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Female; Free Radicals; Humans; Immunoglobulin G; Male; Middle Aged; Oxidation-Reduction; Oxygen; Peroxides; Serum Albumin; Uric Acid; Vitamin E

This work attempts to determine the influence of vitamin C on locally induced inflammation and arthritis in rat paws, as measured by rat paw swelling, polymorphonuclear leukocyte infiltration, pain, and surface skin temperature. Daily subcutaneous administration of 150 mg/kg of vitamin C over 20 days reduced arthritic swelling, increased pain tolerance, and decreased polymorphonuclear leukocyte infiltration, with no significant change in surface temperature. Vitamin C may provide podiatrists with a supplemental or alternative treatment for patients with rheumatoid arthritis.

Topics: Animals; Arthritis, Rheumatoid; Ascorbic Acid; Body Temperature; Disease Models, Animal; Edema; Male; Pain; Rats; Rats, Inbred Strains

Ascorbic acid, at physiological concentrations, can scavenge the myeloperoxidase-derived oxidant hypochlorous acid at rates sufficient to protect alpha 1-antiprotease against inactivation by this molecule. The rapid depletion of ascorbic acid at sites of inflammation, as in the inflamed rheumatoid joint, may therefore facilitate proteolytic damage.

Topics: alpha 1-Antitrypsin; Antioxidants; Arthritis, Rheumatoid; Ascorbic Acid; Chromatography, High Pressure Liquid; Hydrogen-Ion Concentration; Hydroxides; Hydroxyl Radical; Hypochlorous Acid; Oxidation-Reduction; Pancreatic Elastase; Peroxidase

A patient with quiescent rheumatoid arthritis, amyloidosis and chronic renal failure developed an inflamed knee. Intracellular bipyramidal crystals characteristic of oxalate were found and are suggested as the cause of the acute arthritis. Since the patient had been treated with vitamin C, this precursor of oxalate is proposed as a possible factor in the crystal deposition.

Topics: Amyloidosis; Arthritis, Rheumatoid; Ascorbic Acid; Humans; Kidney Failure, Chronic; Male; Middle Aged; Oxalates; Oxalic Acid; Peritoneal Dialysis; Radiography; Synovial Fluid

Neutrophil polymorphonuclear leucocytes and macrophages contain 10-40 times increased intracellular ascorbate concentrations compared to plasma. A slight decrease of ascorbate content could be observed in total white blood cells and in monocytes upon stimulation with opsonized zymosan. These decreases were more pronounced in peritoneal and alveolar macrophages from rats. In patients with rheumatoid disease whose phagocytes are exposed to a constant challenge, significantly lowered intracellular ascorbate contents were found in neutrophils and mononuclear cells. Surgical and thermal trauma in rats depressed intracellular ascorbate levels in peritoneal macrophages. These results are indicative of an essential role ascorbic acid plays in phagocytic cells.

Topics: Animals; Arthritis, Rheumatoid; Ascorbic Acid; Female; Humans; Macrophages; Male; Neutrophils; Phagocytes; Phagocytosis; Pulmonary Alveoli; Rats; Rats, Inbred Strains

Using a novel high performance liquid chromatography (HPLC) determination of ascorbic acid and dehydroascorbic acid, we have measured the relative amounts of ascorbate and dehydroascorbate in 20 normal controls and in paired sera and synovial fluid from 13 patients with rheumatoid arthritis (RA). In complete contrast to previous published findings we were able to detect dehydroascorbate in normal human sera (12.0 +/- 3.7 mumol/l), while the mean and range of ascorbate measured in normals was 69.6 +/- 20.6 mumol/l. These findings were completely reversed in rheumatoid sera (21.8 +/- 8.6 mumol/l and 5.1 +/- 5.0 mumol/l for dehydroascorbate and ascorbic acid respectively). In several rheumatoid sera no ascorbate could be detected. In paired synovial fluid and serum samples, there was always more dehydroascorbate detected in synovial fluids than in the corresponding sera (p less than 0.01). The data suggests that the reduced level of ascorbate and increased level of dehydroascorbate may be a reflection of the increased antioxidant and free-radical scavenging activity of the vitamin in RA, especially within the inflamed joint.

Topics: Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Chromatography, High Pressure Liquid; Dehydroascorbic Acid; Humans; Middle Aged; Synovial Fluid

1. Superoxide and hydrogen peroxide are formed by activated phagocytes and react together in the presence of iron salts to form the hydroxyl radical, which attacks hyaluronic acid. Ascorbic acid also interacts with hydrogen peroxide and iron salts to form hydroxyl radical in a reaction independent of superoxide. Since iron salts, ascorbate and activated phagocytes are present in the rheumatoid joint, experiments were designed to see whether ascorbate-dependent or superoxide-dependent formation of hydroxyl radicals would be more important in vivo. 2. In the present study, addition of ascorbate to a superoxide-generating system at concentrations of 100 mumol/l provoked a superoxide-independent formation of hydroxyl radicals for a short period. Lower concentrations of ascorbate did not do this. It is therefore suggested that the superoxide-dependent reaction is probably more important. 3. It is further suggested that destruction of ascorbate by oxygen radicals formed by activated phagocytes accounts for the previously reported low concentrations of this compound in the serum and synovial fluid of rheumatoid patients.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Chemical Phenomena; Chemistry; Ferric Compounds; Free Radicals; Humans; Hydrogen Peroxide; Hydroxylation; Iron; Oxygen; Phagocytes; Superoxides

20 patients with active rheumatoid arthritis were treated for 12 weeks with the prostaglandin E1 precursors cis-linoleic acid and gamma-linolenic acid in the form of primrose evening oil (Efamol) and the co-factors zinc, ascorbic acid, niacin, and pyridoxin (Efavit). There was a slight fall in skin reactivity to UV light during the treatment, but no effect on plasma or urine concentrations of PGE1, cAMP or cGMP. There was no effect of the treatment on ESR, P-fibrinogen, number of tender joints, number of swollen joints, the duration of morning stiffness, or on the patient's estimation of pain.

Topics: Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Cyclic AMP; Cyclic GMP; Drug Combinations; Fatty Acids, Essential; Fatty Acids, Unsaturated; Female; gamma-Linolenic Acid; Humans; Linoleic Acids; Male; Middle Aged; Niacin; Oenothera biennis; Plant Oils; Prostaglandins E; Pyridoxine; Radioimmunoassay; Skin; Ultraviolet Rays; Zinc; Zinc Compounds

Topics: Adolescent; Adult; Aged; Amyloidosis; Arthritis, Juvenile; Arthritis, Rheumatoid; Ascorbic Acid; Child; Child, Preschool; Dimethyl Sulfoxide; Drug Evaluation; Glomerular Filtration Rate; Humans; Kidney; Middle Aged; Proteinuria; Scleroderma, Systemic; Sjogren's Syndrome; Ultrasonics

Topics: Adolescent; Adult; Arthritis, Rheumatoid; Ascorbic Acid; Capillary Permeability; Female; Humans; Iron; Male; Middle Aged

Topics: Adult; Arthritis, Rheumatoid; Ascorbic Acid; B-Lymphocytes; Chediak-Higashi Syndrome; Concanavalin A; Cyclic GMP; Humans; Hypersensitivity, Delayed; Immunity, Cellular; Immunoglobulins; In Vitro Techniques; Lymphocytes; Middle Aged; Monocytes; Pokeweed Mitogens; T-Lymphocytes, Regulatory

Purified commercial hyaluronic acid contains significant amounts of iron. Addition of Fe2+ to solutions of it causes depolymerization, which is inhibited by catalase and scavengers of the hydroxyl radical (. OH) but not by superoxide dismutase. Fe3+ is ineffective. Ascorbic acid also depolymerizes hyaluronic acid, apparently because it can reduce Fe3+ in the reaction mixtures to Fe2+. Ascorbate-induced depolymerization is inhibited by the specific iron chelator desferrioxamine, by catalase, and by scavengers of the hydroxyl radical. The relevance of these observations to rheumatoid arthritis and inflammatory joint diseases is discussed.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Chemical Phenomena; Chemistry; Free Radicals; Humans; Hyaluronic Acid; Iron; Superoxides; Synovial Fluid

1. On exposure of synovial fluid to superoxide and hydrogen peroxide, generated enzymically or by activated polymorphonuclear leucocytes, hyaluronic acid is depolymerized and the fluid loses its lubricating properties. The ability of synovial fluid from rheumatoid patients to scavenge superoxide and hydrogen peroxide was therefore examined. 2. Synovial fluid from a range of rheumatoid patients contained no superoxide dismutase activity, insufficient caeruloplasmin to scavenge any superoxide radical and little, if any, catalase activity. 3. Total ascorbate (reduced ascorbate + dehydroascorbate) concentrations in the plasma and synovial fluid of rheumatoid patients were similar in each case. The values are at the low end of the normal range. 4. These results are discussed in relation to the role of oxygen radicals in inflammatory joint disease.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Catalase; Humans; Superoxide Dismutase; Synovial Fluid

Lack of adequate synthesis of prostaglandin (PG) E1 may be the key factor in Sjogren's syndrome. PGE1 is important for lacrimal and salivary gland secretion and for T lymphocyte function: a deficiency could therefore account for the main features of Sjogren's syndrome and the sicca syndrome. PGE1 could also account for many of the other features often associated with these syndromes. These include the Raynaud's phenomenon, the abnormalities of renal function and the precipitation of the syndrome by vitamin C deficiency. Vitamin C is important in PGE1 biosynthesis. PGE1 treatment has been shown to correct the immunological abnormalities in the NZB/W mouse, the animal model of Sjogren's syndrome. An attempt to treat humans with Sjogren's syndrome by raising endogenous PGE1 production by administration of essential fatty acid PGE1 precursors, of pyridoxine and of vitamin C was successful in raising the rates of tear and saliva production.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Fatty Acids, Essential; Female; Humans; Lacrimal Apparatus Diseases; Middle Aged; Prostaglandins E; Pyridoxine; Salivary Gland Diseases; Sjogren's Syndrome; Syndrome

Synovial cells derived from patients with either rheumatoid arthritis, or simple joint-trauma were grown in tissue culture. The rheumatoid osteoarthritic and non-arthritic synovial cells in cultured all had similar levels of prolyl hydroxylase activity. Following a 3 hour incubation with ascorbate (10(-4)M), prolyl hydroxylase activity was elevated to a similar extent in all synovial cell cultures examined. The activation of prolyl hydroxylase by ascorbate (10(-4)M) was accompanied by increased radioactive hydroxyproline formation and secretion into the media. Increased amounts of collagenase degradable radioactive protein were also secreted into the media, but no changes in total collagen synthesis (media plus cell layer) were observed as a result of ascorbate supplementation using this assay system.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Cells, Cultured; Collagen; Humans; Hydroxylation; Hydroxyproline; Procollagen-Proline Dioxygenase; Proteins; Synovial Fluid

Normal and rheumatoid arthritic human synovial cells, normal rat muscle and bone cells, were cultured with combinations of aspirin (acetylsalicytic acid), vitamins C and E. Aspirin reduced percent growth of all cells by about 1/5 relative to controls. High vitamin C eradicated arthritic cells. In combinations, vitamin C was most important in eradicating arthritic cells. A low-vitamin C combination was most effective in reducing arthritic cell populations, while having little effect on normal cells. Vitamin E retarded but did not prevent the action of vitamin C.

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Bone and Bones; Cell Division; Cell Line; Cell Survival; Dose-Response Relationship, Drug; Drug Interactions; Humans; Muscles; Synovial Fluid; Vitamin E

Topics: Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Female; Humans; Leukocytes; Male; Middle Aged

Topics: Activities of Daily Living; Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Disabled Persons; Female; Foot; Gold; Hand; Humans; Interpersonal Relations; Joint Prosthesis; Knee; Middle Aged; Phenylbutazone; Prednisone; Radiography; Synovectomy

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Female; Humans; Intestinal Absorption; Male; Middle Aged; Vitamin A

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Culture Techniques; Cytoplasm; Extracellular Space; Humans; Hydrogen-Ion Concentration; Lysosomes; NADP; Oxidation-Reduction; Synovial Membrane; Vitamin K

Topics: Adolescent; Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Carotenoids; Female; Humans; Iron; Male; Middle Aged; Vitamin A; Vitamin E

Topics: Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Ascorbic Acid Deficiency; Aspirin; Blood Platelets; Humans; Middle Aged

Topics: Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Drug Synergism; Female; Humans; Male; Middle Aged; Muscular Diseases; Neuralgia; Pain; Salicylamides; Spinal Diseases; Surveys and Questionnaires; Triamcinolone

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Biopsy; Carbon Isotopes; Collagen; Humans; Iron; Ketoglutaric Acids; Mixed Function Oxygenases; Oxygen; Proline; Synovial Membrane

Topics: Adult; Alcohols; Animals; Arthritis, Rheumatoid; Ascorbic Acid; Cattle; Chemical Phenomena; Chemistry; Gold; Hexosamines; Humans; Hyaluronic Acid; Hyaluronoglucosaminidase; Iodoacetates; Male; Oligosaccharides; Penicillamine; Sulfur; Synovial Fluid; Testis; Thiomalates; Viscosity

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Humans; Iron; Rheumatic Fever; Vitamins

Topics: Animals; Arthritis, Rheumatoid; Ascorbic Acid; Dog Diseases; Dogs; Gold; Horse Diseases; Horses

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Ceruloplasmin; Chemical Phenomena; Chemistry; Hepatolenticular Degeneration; Humans; Hyaluronic Acid; Synovial Fluid; Viscosity

Topics: Adult; Aged; Arthritis, Rheumatoid; Ascorbic Acid; Female; Humans; Iron; Male; Peptic Ulcer; Romania

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Blood Sedimentation; Cervical Vertebrae; Galvanic Skin Response; Humans; Male; Physical Fitness; Prostate; Shoulder Joint; Spondylitis, Ankylosing

Topics: Adult; Animals; Arthritis, Rheumatoid; Ascorbic Acid; Carbamates; Cell Membrane Permeability; Connective Tissue; Cysteine; Dye Dilution Technique; Ethanol; Humans; Hyaluronic Acid; Injections, Intradermal; Isotonic Solutions; Penicillamine; Prednisone; Rats; Skin; Sodium Salicylate; Thiourea

Topics: Acetylcholine; Adrenocorticotropic Hormone; Antistreptolysin; Arthritis, Rheumatoid; Ascorbic Acid; Blood Protein Electrophoresis; Blood Sedimentation; Fructose; Hemagglutination Tests; Humans; Leukocyte Count; Phenylbutazone; Pyridines; Pyridostigmine Bromide

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Humans; Middle Aged; Urine

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Blood Chemical Analysis; Humans; Knee; Plasma; Proteins; Salicylates; Serum Albumin; Synovial Fluid

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Blood Protein Electrophoresis; Hemagglutination Inhibition Tests; Humans; Hyaluronic Acid; Knee; Synovial Fluid

Topics: Anticoagulants; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Gout; Hip Joint; Humans; Joint Diseases; Rheumatology; Spondylitis; Spondylitis, Ankylosing

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid

Topics: Antimalarials; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Gout; Humans; Psoriasis; Spondylitis; Spondylitis, Ankylosing; Sunlight; Triamcinolone; Ultraviolet Rays; Vitamin A

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Blood Proteins; Blood Sedimentation; Humans; Tyrosine; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Body Fluids; Humans; Joint Diseases; Thiamine; Vitamins

Topics: 4-Aminobenzoic Acid; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Niacin; Nicotinic Acids; Vitamins

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Humans; Prednisolone; Rheumatic Diseases; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Humans; Prednisone; Salicylamides; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Mechlorethamine; Nitrogen Mustard Compounds; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Combined Modality Therapy; Gold; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Flavones; Hesperidin; Osteoarthritis; Vitamins

Topics: Antacids; Arthritis; Arthritis, Reactive; Arthritis, Rheumatoid; Ascorbic Acid; Aspirin; Prednisone; Vitamins

Topics: Anthelmintics; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Mephenesin; Salicylates; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Vitamins

Topics: Adenosine Triphosphate; Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Humans; Hypersensitivity; Rheumatic Diseases

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Carbohydrate Metabolism; Electrolytes; Humans; Leukocyte Count; Minerals; Rheumatic Diseases; Salicylates; Sodium Salicylate; Uric Acid

Topics: Administration, Intravenous; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Eosinophils; Humans; Infrared Rays; Leukocyte Count; Quartz; Ultraviolet Rays; Ultraviolet Therapy; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Oxytetracycline; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Blood Proteins; Capillary Permeability; Desoxycorticosterone; Desoxycorticosterone Acetate

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Desoxycorticosterone Acetate; Pregnenolone; Vitamins

Topics: Adrenal Cortex; Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Desoxycorticosterone Acetate; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Vitamins

Topics: Adrenal Glands; Animals; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Formaldehyde; Rats; Respiratory Hypersensitivity

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Desoxycorticosterone Acetate; Rheumatic Diseases; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Rheumatic Diseases; Steroids

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Desoxycorticosterone Acetate; Diabetes Mellitus; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Steroids; Vitamins

Topics: Animals; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Desoxycorticosterone; Formaldehyde; Rats; Vitamins

Topics: Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Desoxycorticosterone Acetate; Psoriasis; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Desoxycorticosterone Acetate; Rheumatic Fever; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Acetates; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Pregnenolone; Steroids; Testosterone Propionate

Topics: Acetates; Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Adrenal Cortex Hormones; Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Formaldehyde; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Desoxycorticosterone; Nitrogen; Pregnenolone; Sulfur

Topics: Aged; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Humans; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Gonadal Steroid Hormones

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Joint Diseases

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Corticosterone; Rheumatic Diseases

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Diabetes Mellitus; Humans; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Vitamins

Topics: Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Steroids; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Corticosterone; Desoxycorticosterone; Psychotherapy, Multiple; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Hormones; Steroids; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Formaldehyde; Potassium; Potassium Chloride; Vitamins

Topics: Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Desoxycorticosterone Acetate; Disease; Humans; Osteoarthritis; Sciatic Nerve; Sciatica; Spondylitis

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone; Desoxycorticosterone; Humans; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Desoxycorticosterone Acetate; Eosinophils; Joints; Leukocyte Count; Leukocytes

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Vitamins

Topics: Adrenal Cortex Hormones; Animals; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Leukocytes; Rats

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis, Rheumatoid; Ascorbic Acid; Rheumatic Diseases; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Muscles; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Rheumatic Diseases

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Joint Diseases; Water-Electrolyte Balance

Topics: Adrenal Cortex Hormones; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Rheumatic Diseases

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Steroids; Vitamins

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Tissue Extracts; Vitamins

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Tissue Extracts

Topics: Adrenal Cortex; Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Tissue Extracts; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Rheumatic Diseases; Vitamins

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Tissue Extracts

Topics: Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Epinephrine; Injections, Intramuscular; Vitamins

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Humans; Joint Diseases; Niacin; Niacinamide

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Tissue Extracts

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Joint Diseases; Tissue Extracts

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone Acetate; Tissue Extracts

Topics: Adrenal Cortex; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Desoxycorticosterone; Joint Diseases; Tissue Extracts

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Gold; Organogold Compounds; Vitamins

Topics: Acetates; Adrenal Glands; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Injections; Tissue Extracts; Vitamins

Topics: Acetates; Adrenal Glands; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Tissue Extracts; Vitamins

Topics: Adrenocorticotropic Hormone; Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Cortisone

Topics: Arthritis; Arthritis, Rheumatoid; Ascorbic Acid; Blood Vessels; Capillaries; Capillary Fragility; Cardiovascular System; Hesperidin; Humans