Clinical and experimental rheumatology最新文献

{"title":"Stem cell-derived extracellular vesicles: a functional immunomodulator for cell-free therapy of autoimmune diseases.","authors":"Haoxi Ni, Haoting Zhan, Rongrong Wang, Jingdi Zhang, Ye Guo, Yongzhe Li","doi":"10.55563/clinexprheumatol/exbsv0","DOIUrl":"10.55563/clinexprheumatol/exbsv0","url":null,"abstract":"<p><p>Patients with autoimmune diseases (AIDs) seldom receive efficient clinical management and timely therapy.Although certain immunomodulatory drugs or biologics currently in use have been shown to decelerate AID progression, potential complications and the extended treatment duration affect the prognosis and living quality of patients.Extracellular vesicles (EVs) have attracted significant interest as a cell-free therapeutic approach with reduced side effects. Research has indicated that stem cell-derived EVs (SC-EVs) can modulate the immune response by suppressing hyper-immunity and inflammation. Of note, SC-EVs are anticipated to serve as a potential alternative to traditional cell therapy. The present review explores the effects of different isolation methods on the quality and quantity of EVs derived from various sample sources. It also discusses the mechanisms through which SC-EVs can be used for AID treatment. In addition, the paper summarises the classic preclinical findings of SC-EVs in AID in recent years.Finally, the potential challenges of SC-EVs before receiving approval for clinical application have been elucidated, thereby offering novel insights for future studies on SC-EVs in AIDs.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1678-1690"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975609","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":"ChatGPT's response regarding ankylosing spondylitis-related questions.","authors":"Shuang Li, Chunyan Huang, Xiaoqing Chen","doi":"10.55563/clinexprheumatol/ig7k68","DOIUrl":"10.55563/clinexprheumatol/ig7k68","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1691"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143647408","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":"Application of vascular index based on superb microvascular imaging technique for assessing disease activity in rheumatoid arthritis patients with signal-positive joints.","authors":"Yan Song, Jingyi Ma, Tianshu Chu, Ming Wu, Xijun Zhang, Haohui Zhu","doi":"10.55563/clinexprheumatol/8x1nhn","DOIUrl":"10.55563/clinexprheumatol/8x1nhn","url":null,"abstract":"<p><strong>Objectives: </strong>To explore the value of the vascular index (VI) based on superb microvascular imaging (SMI) technique in assessing rheumatoid arthritis (RA) disease activity.</p><p><strong>Methods: </strong>The study involved 119 RA patients who underwent SMI examinations of 28 joints. Observers obtained the VI values by manually drawing the area of interest and calculating the sum of the VI values for each patient to obtain the VIsum, and then dividing the VIsum by the number of signal-positive joints to obtain the VIstand. Data of patients' 28-joint Disease Activity Score (DAS28) and laboratory tests were also collected. The relationship between VI parameters and clinical indexes as well as the differences of VI parameters among groups with different disease activity were investigated. Moreover, the cut-off values of VI parameters to identify RA patients with DAS28 <2.6/DAS28 ≤3.2 were calculated using the receiver operating characteristic (ROC) curves.</p><p><strong>Results: </strong>VIsum, VIstand correlated with clinical and laboratory indicators, especially with DAS28 (r=0.740, 0.659, respectively, p<0.05). The differences of VIsum and VIstand among the 4 groups of patients were statistically significant (p<0.05). VIsum had higher diagnostic efficacy than VIstand for identifying patients in remission or in low and below activity. With a VIsum cut-off value of 35.5/47.8, the area under the ROC curve for identifying DAS28 <2.6/DAS28 ≤3.2 was 0.872/0.846.</p><p><strong>Conclusions: </strong>As a quantitative indicator to assess synovitis activity of RA patients, SMI-based VI was helpful in assessing RA disease activity.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1554-1560"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143975607","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":"RANTES is a possible marker of paradoxical psoriatic arthritis.","authors":"En-Chih Liao, Yi-Da Wu, Shang-Hung Lin, Kuo-Lung Lai, Wei-Ting Chao, Chung-Yang Yen","doi":"10.55563/clinexprheumatol/ktbnx4","DOIUrl":"10.55563/clinexprheumatol/ktbnx4","url":null,"abstract":"<p><strong>Objectives: </strong>Biologic therapies have revolutionised the treatment of psoriasis (PsO) and psoriatic arthritis (PsA), significantly improving patient outcomes. However, paradoxical psoriatic arthritis (PPsA), a condition where biologics exacerbate joint inflammation, has emerged as a rare but concerning adverse effect. This study aimed to investigate the immunological mechanisms underlying PPsA and identify potential biomarkers associated with its development.</p><p><strong>Methods: </strong>A cohort of 23 patients with PsO, with or without concurrent PsA, who had undergone biologic therapy, was analysed. Peripheral blood mononuclear cells (PBMCs) were isolated and stimulated with Streptococcus pyogenes to mimic inflammatory outbreaks, followed by ex vivo treatment with the biologics each patient had experienced. Cytokine and chemokine levels were quantified to assess immune responses.</p><p><strong>Results: </strong>Patients who developed PPsA exhibited a significant elevation in regulated upon activation normal T cell expressed and secreted (RANTES) levels (p = 0.001) after exposure to culprit biologics, compared to those without PPsA. Additionally, a notable decrease in interferon-gamma (IFN-γ) levels was observed, suggesting altered immune dynamics. These findings indicate that RANTES plays a central role in the pathogenesis of PPsA and may serve as a predictive biomarker.</p><p><strong>Conclusions: </strong>This study highlights the importance of screening for elevated RANTES levels before initiating biologic therapy to mitigate PPsA risk. The results underscore the need for personalised therapeutic approaches and further research into the molecular mechanisms of PPsA, paving the way for safer and more effective treatments.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1638-1649"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636282","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":"Role of ultrasound in the interception of psoriatic arthritis in patients with psoriasis.","authors":"Niccolò Possemato, Alessandra Rai, Marianna Oliva, Nicolò Girolimetto, Carlo Salvarani, Antonio Marchesoni","doi":"10.55563/clinexprheumatol/vudu1q","DOIUrl":"10.55563/clinexprheumatol/vudu1q","url":null,"abstract":"<p><p>Skin psoriasis (PsO) often precedes the development of psoriatic arthritis (PsA), with a PsO to PsA conversion rate of about 1.5-2% per year. A careful observation of the PsO patients may allow early detection, treatment, and maybe even prevention, of the rheumatic condition. In PsA patients, musculoskeletal ultrasound (MSK-US) imaging can be used to investigate the presence of enthesitis, synovitis, tenosynovitis, and paratenonitis and this imaging technique has been shown to be more sensitive than clinical examination. MSK-US may reveal the presence of synovial and entheseal inflammation even in PsO patients without musculoskeletal symptoms and these findings might be considered indicative of subclinical PsA, although a clinical evaluation is essential to prevent overdiagnosis and overtreatment. This narrative review provides an overview of the transition from PsO to PsA with a focus on the value of US examination in this context.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1667-1677"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144636284","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":"Application of the 2023 ACR/EULAR antiphospholipid syndrome classification criteria to patients fulfilling the 2006 revised Sapporo criteria.","authors":"Oh Chan Kwon, Jang Woo Ha, Min-Chan Park, Yong-Beom Park, Sang-Won Lee","doi":"10.55563/clinexprheumatol/r0irbn","DOIUrl":"10.55563/clinexprheumatol/r0irbn","url":null,"abstract":"<p><strong>Objectives: </strong>The American College of Rheumatology (ACR) and the European Alliance of Associations for Rheumatology (EULAR) developed new classification criteria for antiphospholipid syndrome (APS) in 2023. Although the new criteria yielded high specificity, further validation is needed in Asia, as the clinical characteristics of APS differ across ethnicities. We applied the 2023 ACR/EULAR criteria to Korean patients classified as having APS by the 2006 revised Sapporo criteria and assessed the concordance rate between the criteria.</p><p><strong>Methods: </strong>For this study, 126 patients with APS were included. Clinical and laboratory data were reviewed, and the fulfilment of the 2023 ACR/EULAR criteria was assessed for each patient.</p><p><strong>Results: </strong>Of the 126 patients classified by the 2006 revised Sapporo criteria, 107 had APS according to the 2023 ACR/EULAR criteria, accounting for a concordance rate of 84.9%. The concordance rate differed according to the index event. Patients with venous thromboembolism had the highest concordance rate (100%), followed by those with arterial thrombosis (76.4%). Patients with obstetric events had the lowest concordance rate (45.5%), attributable to the stricter obstetric criterion in the 2023 ACR/EULAR criteria than in the 2006 revised Sapporo criteria.</p><p><strong>Conclusions: </strong>In Korean patients with APS, the concordance rate between the 2023 ACR/EULAR criteria and the 2006 revised Sapporo criteria was high. The concordance rate was considerably lower when confined to patients with obstetric APS. The 2023 ACR/EULAR criteria are stricter, particularly for obstetric events; its emphasis on specificity may result in the exclusion of patients with clinically significant obstetric APS.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1604-1610"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143961567","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":"A co-produced patient-reported outcomes-driven dashboard to support shared decision-making in rheumatologic diseases: a feasibility study.","authors":"Maja Kuharic, Courtney N Hurt, George J Greene, Eric Ruderman, Yvonne C Lee, Arthur M Mandelin, David Cella, John D Peipert","doi":"10.55563/clinexprheumatol/7ecam5","DOIUrl":"10.55563/clinexprheumatol/7ecam5","url":null,"abstract":"<p><strong>Objectives: </strong>This study explored the potential of a co-produced clinical dashboard on shared decision-making (SDM) and patient-reported outcomes (PROs), and its usability in rheumatology care.</p><p><strong>Methods: </strong>We conducted a prospective, single-group, pretest-posttest study involving patients with rheumatologic diseases (RD). Patients completed PROs via their patient portal which was integrated with the electronic health record (EHR), and data were displayed on a dashboard accessible to clinicians. The collaboRATE tool assessed SDM. Changes in three Patient-Reported Outcomes Measurement Information System® (PROMIS®) measures (Physical Function, Fatigue, Pain Interference) were evaluated using the Likely Change Index. Dashboard usability was assessed with the System Usability Scale (SUS), where a score above 68 indicates above-average usability, user satisfaction was assessed with the SPHERE questionnaire, and dashboard integration was assessed with the Normalization Measure Development (NOMAD) scale.</p><p><strong>Results: </strong>We enrolled 123 patients with RD between December 2021 and April 2022. The participants were predominantly female (80.3%), aged 24-82 years (mean: 54, SD: 15.0), with rheumatoid arthritis being the most common condition (37.4%). Three months after the dashboard integration, top box scores on all CollaboRATE questions increased significantly from 35% to 55% (p<0.001). The most significant PRO improvement was Pain Interference, with 35.5% of participants showing clinically significant improvement. The dashboard achieved an above-average user experience, as evidenced by its average SUS score of 75.9.</p><p><strong>Conclusions: </strong>Integrating a clinical dashboard into RD management may support SDM and pain management. This innovative approach enhances interactions between patients and clinicians, and increases patient involvement in their care.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":"1593-1603"},"PeriodicalIF":3.4,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144752469","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":"Discovering four sacroiliac joints in a patient with spondylarthritis.","authors":"Georgios A Drosos, Anastasia K Zikou, Paraskevi V Voulgari, Alexandros A Drosos","doi":"10.55563/clinexprheumatol/o4jl8q","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/o4jl8q","url":null,"abstract":"","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944948","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":"COVID-19 in rheumatoid arthritis: prevalence, hospital admission, and risk of all-cause mortality before and after COVID-19 pandemic.","authors":"Mohammad Movahedi, Xiuying Li, Angela Cesta, Claire Bombardier, Elliot Hepworth, Sibel Zehra Aydin","doi":"10.55563/clinexprheumatol/00jq99","DOIUrl":"https://doi.org/10.55563/clinexprheumatol/00jq99","url":null,"abstract":"<p><strong>Objectives: </strong>COVID-19 infection can trigger a cytokine storm, treatable with immunomodulating therapies similar to those used in rheumatoid arthritis (RA). This study investigated COVID-19 prevalence, hospitalisation, emergency department (ED) visits, and the impact of RA treatment and baseline characteristics on mortality in RA patients.</p><p><strong>Methods: </strong>RA patients from the Ontario Best Practices Research Initiative (OBRI) were linked to Ontario healthcare records held at the Institute for Clinical Evaluative Sciences (ICES). The study examined COVID-19 infection, ED visits, hospitalisation, and intensive care unit (ICU) admissions between January 1st 2020, and March 31st 2022, and the risk of all-cause mortality before and after the pandemic.</p><p><strong>Results: </strong>Among 2,969 RA patients, 596 (20.1%) had COVID-19. Of those with COVID-19, 108 (18.1%) were hospitalised or visited ED. Females were more likely to be infected (81.9% vs. 76.5%; adj ORs:1.30; 95% CI: 1.01-1.66). COVID-19 patients were more likely to use biologics (52.5% vs. 46.1%; adj ORs:1.28; 95% CI: 1.04-1.57) or Janus Kinase inhibitors (JAKi) (13.4% vs. 9.5%; adj ORs:1.44; 95% CI: 1.08-1.93). Older age (>80 years) (adj HR: 10.9; 95% CI:6.49-18.2), smoking (adj HR: 1.85; 95% CI:1.41-2.42), and higher disease activity score (adj HR: 1.09; 95% CI:1.00-1.18) were associated with higher all-cause mortality both before and after the COVID-19 pandemic, with stronger associations in the latter. JAKi were negatively associated with increased death before the pandemic (adj HR: 0.55; 95% CI: 0.34-0.91).</p><p><strong>Conclusions: </strong>COVID-19 was higher in females, younger patients, those with comorbidities, and those using advanced therapies. Compared to pre-pandemic, higher death rates during the pandemic were associated with older age, oral steroid use, smoking, and higher disease activity.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144944898","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":"Research progress of NLRP3 in immune cells of systemic lupus erythematosus.","authors":"Yifan Liu, Yuqun Wang, Xiaodong Wang, Yajing Liu, Yingliang Wang","doi":"10.55563/clinexprheumatol/xmghi4","DOIUrl":"10.55563/clinexprheumatol/xmghi4","url":null,"abstract":"<p><p>Systemic lupus erythematosus (SLE) represents a multifaceted autoimmune disorder characterised by widespread organ involvement and abnormal autoantibody production. Its underlying mechanisms are closely related to immune system dysfunction. Recent advancements in immunological research have highlighted the pivotal role of the NLRP3 inflammasome, which acts as a key regulator of both innate and adaptive immunity. This molecular complex has attracted significant attention in SLE studies because it can drive pathological inflammation by modulating key pro-inflammatory cytokines, including IL-1β and IL-18, thereby establishing itself as a critical focus in the investigation of SLE pathogenesis.In this review, we conducted a systematic examination of the structural and functional features of NLRP3 inflammatory vesicles, focused on the mechanism of their interaction with different immune cell populations during the development of SLE, and found that their dysfunctions in different immune cells jointly contributed to the pathological process of SLE. Moreover, potential therapeutic strategies aimed at targeting NLRP3 inflammatory vesicles are discussed to introduce novel concepts to the research and treatment of SLE.</p>","PeriodicalId":10274,"journal":{"name":"Clinical and experimental rheumatology","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945124","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}