This is a study in pre- and peri-menopausal women with onset of rheumatoid arthritis (RA) of less than 3 years duration, to be conducted at the NIH Clinical Center and The General Clinical Research Center of the Johns Hopkins Bayview Medical Center, Baltimore, MD. In this investigation, we hypothesize that the excess of systemically released inflammatory cytokines in RA patients suppresses activity of the GH/IGF-1 axis, and that the combined effects of disordered endocrine-immune function contribute to changes in body composition, endocrine-metabolic and vascular functions thought predisposing to RA-related sarcopenia, osteopenia and increased cardiovascular risk. In phase I of the study, we shall admit RA patients and control subjects to the Clinical Center for a 36 hour period for assessments of the GH/IGF-I axis, cytokines, body composition, endocrine- metabolic and cardiovascular functions, and quality of life. We have initiated Phase I of the study to compare baseline endocrine and inflammatory parameters in RA patients with those in healthy, BMI-matched women. Should the hypotheses in Phase I be satisfied, we plan to conduct a 2nd Phase of the study, in which we shall enroll a new group of RA patients to evaluate the above outcome measures at baseline and after six months of treatment with standard therapy, using one of the available TNF-alpha receptor antagonists that has been approved by the FDA for the treatment of patients with early RA. At present we are enrolling patients and healthy control subjects for entry into Phase I of the study. To date, 1 RA patient and 1 matched control subject have been evaluated. These studies are intended as platform investigations prior to assess the possible impact of various CAM biological agenst, such as DHEA, in RA patients.

National Institute of Health (NIH)
National Center for Complementary & Alternative Medicine (NCCAM)
Intramural Research (Z01)
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Complementary & Alternative Medicine
United States
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Blackman, Marc R; Muniyappa, Ranganath; Wilson, Mildred et al. (2007) Diurnal secretion of growth hormone, cortisol, and dehydroepiandrosterone in pre- and perimenopausal women with active rheumatoid arthritis: a pilot case-control study. Arthritis Res Ther 9:R73
Muniyappa, Ranganath; Wong, Kelli A; Baldwin, Howard L et al. (2006) Dehydroepiandrosterone secretion in healthy older men and women: effects of testosterone and growth hormone administration in older men. J Clin Endocrinol Metab 91:4445-52
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Hougaku, Hidetaka; Fleg, Jerome L; Najjar, Samer S et al. (2006) Relationship between androgenic hormones and arterial stiffness, based on longitudinal hormone measurements. Am J Physiol Endocrinol Metab 290:E234-42
Huang, Xin; Blackman, Marc R; Herreman, Karen et al. (2005) Effects of growth hormone and/or sex steroid administration on whole-body protein turnover in healthy aged women and men. Metabolism 54:1162-7
Roy, Tracey Ann; Blackman, Marc R; Harman, S Mitchell et al. (2002) Interrelationships of serum testosterone and free testosterone index with FFM and strength in aging men. Am J Physiol Endocrinol Metab 283:E284-94