Clinical and experimental rheumatology最新文献

{"title":"Comment on: Clinical impact of anti-SSA antigenic specificity on disease activity and patient-reported outcomes in primary Sjögren's disease: a real-life cohort study.","authors":"Ting Fang, Xinzhu Hou","doi":"10.55563/clinexprheumatol/crqlc3","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/crqlc3","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179628","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Multifactorial explanatory model of self-reported sleep disturbance in people with rheumatoid arthritis: a structural equation approach.","authors":"Maria J Cadório, Eduardo J F Santos, João Oliveira, Ricardo J O Ferreira, José A P Da Silva, Cátia Duarte","doi":"10.55563/clinexprheumatol/emapt2","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/emapt2","url":null,"abstract":"<p><strong>Objectives: </strong>Sleep disturbance is a common and disabling symptom among patients with rheumatoid arthritis (RA). This study aimed to test a multifactorial explanatory model of cross-sectional associations among factors related to self-reported sleep disturbance in RA.</p><p><strong>Methods: </strong>This was an ancillary analysis of an observational, cross-sectional, single-centre study including patients with RA. Sleep disturbance, disease activity, perceived disease impact, depressive and anxiety symptoms, and personality traits were assessed using validated questionnaires. Structural equation modelling (SEM) was used to examine the associations between sleep disturbance and the remaining variables.</p><p><strong>Results: </strong>A total of 313 patients (82% female; mean age 60±12 years; disease duration 12±9 years) were included. The final model showed an acceptable fit to the data [χ2(71)=178.04, χ2/df=2.50, p<0.005; CFI=0.95; GFI=0.92; TLI=0.94; RMSEA=0.07, p=0.004, 95% CI=0.06 to 0.08] and explained 57% of the variance of self-reported sleep disturbance (R2=0.57). Disease activity was positively associated with disease impact (β=0.23; p<0.001), which was significantly associated with sleep disturbance (β=0.65; p=0.001). 'Positive' personality traits were inversely associated with self-reported sleep disturbance (β= -0.51; p=0.001), with direct (β= -0.16; p=0.006) and indirect associations (β= -0.35; p=0.001) through perceived disease impact. They were also inversely associated with depression (β= -0.77; p=0.001) and anxiety (β= -0.80; p<0.001). Depression and anxiety were positively associated with perceived disease impact (β=0.38; p=0.001 and β=0.30; p<0.001, respectively).</p><p><strong>Conclusions: </strong>'Positive' personality traits and perceived disease impact appear to be significantly associated with self-reported sleep disturbance in RA patients, while disease activity, depression, and anxiety showed comparatively smaller associations within the model. These findings support the need for a holistic, multidisciplinary approach to RA management.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179639","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply to the comment on: Clinical impact of anti-SSA antigenic specificity on disease activity and patient-reported outcomes in primary Sjögren's disease: a real-life cohort study.","authors":"Chiara Baldini","doi":"10.55563/clinexprheumatol/8aq1u5","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/8aq1u5","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Behçet's syndrome: one year in review 2026.","authors":"Gülen Hatemi, Emire Seyahi, Izzet Fresko, Rosaria Talarico, Didar Uçar, Vedat Hamuryudan","doi":"10.55563/clinexprheumatol/jlx260","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/jlx260","url":null,"abstract":"<p><p>This critical review aims to highlight the publications on Behçet's syndrome (BS) during 2025. Recent studies have further elucidated the immunopathogenesis of BS, highlighting the interplay between innate and adaptive immune responses. Neutrophil hyperactivation, macrophage heterogeneity, and T cell imbalance emerge as central mechanisms, with growing evidence supporting the role of intercellular crosstalk and epigenetic regulation. Monocytes and non-coding RNAs emerge as areas of interest, while confirming the already established role of Th1/Th17 immune activation. These findings contribute to a more integrated understanding of disease mechanisms and may inform future targeted therapeutic strategies. While most studies are limited by small patient numbers and lack of validation in independent cohorts, the overall direction of research is encouraging. BS remains a diagnostically challenging systemic vasculitis. A meaningful proportion of patients develop significant organ damage without satisfying formal classification criteria. There is growing interest in the diagnostic utility of multimodal imaging for Behçet's uveitis. Phenotypic clustering offers a promising modality for understanding disease mechanisms, but there are substantial methodological inconsistencies across cohorts. Roflumilast and dusquetide might be promising agents for severe oral ulcers.Vascular involvement appears to be the most frequent de novo manifestation during treatment with monoclonal TNF inhibitors. High CRP level and large aneurysm diameter are associated with the need of surgery in patients with arterial involvement.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179651","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incorporation of patient-reported outcomes in the clinical risk score to improve relapse prediction in ANCA-associated vasculitis.","authors":"Oh Chan Kwon, Jang Woo Ha, Yong-Beom Park, Sang-Won Lee","doi":"10.55563/clinexprheumatol/l2mg3x","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/l2mg3x","url":null,"abstract":"<p><strong>Objectives: </strong>To evaluate whether integration of patient-reported outcomes (PROs), particularly the 36-item short form health survey (SF-36), with the French Vasculitis Study Group relapse score (FRS) improves relapse prediction in patients with microscopic polyangiitis (MPA) or granulomatosis with polyangiitis (GPA).</p><p><strong>Methods: </strong>This retrospective cohort study included 98 patients with MPA or GPA whose baseline and first-year follow-up SF-36 data were available. The predictive accuracy of the FRS, baseline SF-36 physical component summary (PCS) and mental component summary (MCS), and first-year cumulative SF-36 PCS and MCS for relapse was evaluated using receiver operating characteristic curve analysis. The area under the curve (AUC) with 95% confidence interval (CI) was estimated for each variable. A combination of FRS and PRO with higher accuracy was developed using multivariable Cox regression incorporating variables significantly associated with relapse.</p><p><strong>Results: </strong>During a median follow-up of 50.9 months, 28 patients (28.6%) experienced relapse. The FRS (AUC=0.666, 95% CI=0.552-0.780, p=0.010) and first-year cumulative SF-36 PCS (AUC=0.629, 95% CI=0.503-0.755, p=0.047) significantly predicted relapse, whereas baseline SF-36 PCS and MCS and first-year cumulative SF-36 MCS did not. A combination of the FRS and first-year cumulative SF-36 PCS demonstrated improved predictive performance (AUC=0.727, 95% CI=0.623-0.830, p<0.001).</p><p><strong>Conclusions: </strong>The first-year cumulative SF-36 PCS was independently associated with relapse in patients with MPA or GPA, and its integration with the FRS improved relapse risk prediction. These findings support a multidimensional approach incorporating both clinical and patient-reported data to better stratify relapse risk and inform treatment planning in MPA or GPA.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179705","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Utility of follow-up cardiac magnetic resonance imaging in patients with eosinophilic granulomatosis with polyangiitis.","authors":"Chelsea J Cheng, Justine Lafleur-Careau, Navneet Kang, Medha L Soowamber, Krishnakumar Nair, Christian Pagnoux","doi":"10.55563/clinexprheumatol/hlgq7q","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/hlgq7q","url":null,"abstract":"<p><strong>Objectives: </strong>Cardiac involvement in eosinophilic granulomatosis with polyangiitis (EGPA) occurs in approximately 20-40% of patients and has been shown to be a major predictor of mortality. Cardiac magnetic resonance imaging (CMRI) can detect late gadolinium enhancement (LGE), which can indicate myocardial inflammation and/or fibrosis. However, the role of CMRI at diagnosis and to monitor evolution of cardiac manifestations in EGPA remains unclear. Our aim was to describe the CMRI findings in our EGPA patient cohort, including the presence and persistence of LGE, and to report on the clinical outcomes observed during follow-up.</p><p><strong>Methods: </strong>This monocentric retrospective descriptive cohort study included 75 patients diagnosed with EGPA, who were seen at least twice between 2015 and January 2023.</p><p><strong>Results: </strong>Among these 75 patients (male 56%, mean age at diagnosis 45 years), 30 patients underwent CMRI at diagnosis, 9 (30%) of whom had cardiac symptoms. All 30 patients (100%) were treated with glucocorticoids, with 13 (43%) also receiving cyclophosphamide. 16/30 (53%) had LGE on first CMRI; 10/11 had persistent LGE on second CMRI, 4/4 had LGE on third CMRI, and 2/2 had LGE on fourth CMRI. Of these 30 patients, 3 (10%) had cardiovascular events at follow-up, 2 of whom had atrial fibrillation (neither had LGE on their CMRIs), and 1 of whom had coronary artery disease requiring stenting (with LGE on his 4 CMRIs).</p><p><strong>Conclusions: </strong>The role of CMRIs to study and monitor cardiac involvement in EGPA remains unclear. LGE most often persists despite treatment, with no apparent association with adverse cardiac outcomes in this cohort.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum zonulin levels and intestinal permeability in Behçet's syndrome: a cross-sectional study.","authors":"Mustafa Erdogan, Fatma Ozbakir, Berna Yurttas, Ibrahim Hatemi, Enes Ali Kurt, Dilsen Cevirgen, Hasan Yazici, Gülen Hatemi","doi":"10.55563/clinexprheumatol/q1pab3","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/q1pab3","url":null,"abstract":"<p><strong>Objectives: </strong>Increased intestinal permeability has been implicated in the pathogenesis of autoimmune and inflammatory conditions, including Behçet syndrome (BS). Zonulin, an endogenous regulator of intestinal tight junctions, serves as a biomarker for assessing intestinal barrier integrity. We aimed to evaluate intestinal permeability in patients with BS using serum zonulin levels, a novel and validated biomarker for intestinal barrier dysfunction.</p><p><strong>Methods: </strong>A total of 173 participants were enrolled: 87 patients with BS, 20 patients with Crohn's disease (CD), and 66 healthy controls. Patients with active gastrointestinal symptoms, risk factors or using medications known to affect intestinal permeability, were excluded. Serum zonulin levels were measured using ELISA. High levels indicate increased intestinal permeability. Behçet Disease Current Activity Form and Crohn's Disease Activity Index were used to assess disease activities.</p><p><strong>Results: </strong>Median serum zonulin level was significantly lower in BS patients (24 ng/mL, IQR: 18-43) compared to CD patients (112 ng/mL, IQR: 22-204) and healthy controls (109 ng/mL, IQR: 36-226) (p<0.01). Multivariate logistic regression analysis identified female sex as the only independent predictor of elevated zonulin levels (OR=13.5, 95% CI: 2.5-72). Immunosuppressives, disease duration, age, and major organ involvement were not significantly associated with serum zonulin levels.</p><p><strong>Conclusions: </strong>In this cross-sectional study, patients with BS did not exhibit increased intestinal permeability. Longitudinal studies, including treatment-naive patients, are required to better understand the role of intestinal permeability and gut microbiota alterations in the pathogenesis and disease activity of BS.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149178804","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on:18F-fluorodeoxyglucose PET/CT uptake characteristics in ICI-induced polymyalgia rheumatica compared to idiopathic polymyalgia rheumatica.","authors":"Suhail Aamar","doi":"10.55563/clinexprheumatol/if4bpe","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/if4bpe","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179684","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"FMO2+ fibroblasts as a potential disease-associated subset in the submandibular gland of IgG4-related disease: insights from single-cell RNA sequencing comparative analysis with the labial gland in primary Sjögren's syndrome.","authors":"Hui Lu, Yanmei Li, Hongyan Liu, Haiyun Li, Juan Meng","doi":"10.55563/clinexprheumatol/kft03v","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/kft03v","url":null,"abstract":"<p><strong>Objectives: </strong>To perform a comprehensive analysis of the immune landscapes in submandibular glands of IgG4-related disease (IgG4-RD) and labial salivary glands of primary Sjögren's syndrome (pSS).</p><p><strong>Methods: </strong>Five single-cell transcriptomics datasets of submandibular glands (SG) harvested from IgG4-RD patients and seven single-cell transcriptomics datasets of labial glands (LG) derived from pSS patients were processed and integrated by Seurat and Harmony R packages. After identifying cell types by classic marker genes, differential abundance analysis, functional enrichment and cell-cell communication were performed.</p><p><strong>Results: </strong>After integrating single-cell RNA sequencing datasets, thirteen distinct subsets were identified. Differential abundance analysis revealed significant enrichment of LZ_GC B cells, DZ_GC B cells, Naive B cells, IgG4+plasma cells, CD4+DUSP4+MAF+T, CD4+TCM, CD8+TEM, Tfh, Treg, FMO2+ monocytes, M2 macrophages and FMO2+ fibroblasts in SG from patients with IgG4-RD compared to those in LG tissues in patients with pSS. FMO2+ fibroblasts were heterogeneous from other subpopulations with high expression of SELENOP, SEPTIN7, SELENOW, CCN1, LHFPL6, BEX3, CCN2, REX1BD, TMEM35B, TLE5. Gene Ontology (GO) analysis of the differentially expressed genes implicated this population in critical processes, including the humoral immune response, oxidative phosphorylation, and fibroblast proliferation. Moreover, we found the chemerin signalling pathway was the primary ligand-receptor interaction between fibroblasts and macrophages in SG from IgG4-RD. Specifically, Chemerin (encoded by RARRES2), the ligand in the CHEMERIN signalling pathway, was mainly expressed in fibroblasts and its receptors CMKLR1 and CCRL2 were primarily expressed on both macrophages and fibroblasts.</p><p><strong>Conclusions: </strong>FMO2+ fibroblasts emerged as a candidate cell subset potentially associated with the submandibular gland micro-environment in IgG4-RD. These findings provided a foundation for future functional studies to elucidate the potential roles of fibroblast-immune cell interactions in the pathogenesis of IgG4-RD.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy of calcineurin inhibitors in interstitial lung disease of patients with antisynthetase syndrome: a systematic literature review and single-arm prevalence meta-analysis.","authors":"Ege Sinan Torun, Elif Ertaş","doi":"10.55563/clinexprheumatol/9qsgmn","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/9qsgmn","url":null,"abstract":"<p><strong>Objectives: </strong>Interstitial lung disease (ILD) of antisynthetase syndrome (ASyS) is one of the most common and significant clinical features of this disease, and it is associated with a worse prognosis. An increasing number of studies on the efficacy of calcineurin inhibitors (CNI) in this field have been published. This study aimed to assemble these data to better determine the efficacy of CNIs in ASyS-ILD.</p><p><strong>Methods: </strong>Cochrane Reviews, MEDLINE, Ovid, Scopus, and Web of Science were searched for studies that used CNIs (cyclosporine A or tacrolimus) in combination with steroids to treat ILD associated with ASyS. Meta-analyses of the efficacy of CNIs were performed, with proportions used as effect sizes for overall efficacy, efficacy in acute/subacute ILD, efficacy in chronic ILD, and ILD relapses under treatment.</p><p><strong>Results: </strong>A total of twelve studies were eligible. Meta-analyses demonstrated that CNIs use resulted in improvement and stable disease in 88.4 % (95 % Confidence Interval-CI: 78.2-95.7) of patients with ASyS-ILD (overall), in 91.5 % (95 % CI: 65.5-99.9) of patients with acute/subacute ASyS-ILD, and in 84.9 % (95% CI: 64.0-97.6) of patients with chronic ASyS-ILD. However, 56.4 % (95% CI: 47.9-65.2) of ASyS-ILD patients relapsed under CNI treatment.</p><p><strong>Conclusions: </strong>CNIs, in combination with glucocorticoids, can be effective for treating acute/subacute and chronic ILD in patients with ASyS. However, relapses of ILD can frequently occur under this treatment modality. Future studies are needed to identify patients who have a higher risk of relapse.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149104565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}