Clinical Rheumatology最新文献

{"title":"CD3 + CD4 + T cells counts reflect the severity and prognosis of invasive pulmonary aspergillosis in patients with connective tissue disease-associated interstitial lung disease.","authors":"Shenyun Shi, Ruyi Zou, Rui Li, Tingting Zhao, Chao Wu, Yonglong Xiao, Xuebing Feng, Lulu Chen","doi":"10.1007/s10067-025-07425-9","DOIUrl":"https://doi.org/10.1007/s10067-025-07425-9","url":null,"abstract":"<p><strong>Objectives: </strong>Invasive pulmonary aspergillosis (IPA) is a potentially fatal complication in patients with connective tissue disease-associated interstitial lung disease (CTD-ILD). The aim of this study is to investigate the clinical significance of CD3 + CD4 + T cells counts in CTD-ILD with IPA patients.</p><p><strong>Methods: </strong>This retrospective study included 152 CTD-ILD patients admitted to a single center in China between January 2018 and June 2020. A total of 54 CTD-ILD patients with IPA were assigned to the CTD-ILD with IPA group, while 98 uninfected CTD-ILD patients were assigned to the control group. Serum CD3 + CD4 + T cells counts were compared between the above-mentioned two groups, and the correlations between CD3 + CD4 + T cells counts and the clinical features, mortality of CTD-ILD with IPA were also evaluated.</p><p><strong>Results: </strong>CTD-ILD patients with IPA had significantly lower CD3 + CD4 + T cells counts than those with CTD-ILD without IPA (P < 0.001). The area under the receiver operating characteristic curve (AUROC) of discriminating CTD-ILD with IPA from CTD-ILD without IPA was 0.800 (95% CI, 0.722-0.878, P < 0.001). Correlation analyses showed that serum CD3 + CD4 + T cells counts were positively correlated with PaO2/FiO2 ratio(r = 0.317, P = 0.034) and negatively correlated with C reactive protein (CRP) (r = - 0.358, P = 0.009), erythrocyte sedimentation rate (ESR) (r = - 0.346, P = 0.014), and lactate dehydrogenase (LDH) (r = - 0.306, P = 0.026). In addition, 30 decedents with CTD-ILD infected IPA exhibited lower values of CD3 + CD4 + T cells compared with 24 survivors (P = 0.041). Furthermore, CD3 + CD4 + T cells counts were a prognostic factor and also associated with a higher mortality rate (log-rank test, P = 0.003).</p><p><strong>Conclusion: </strong>CD3 + CD4 + T cells counts could be a useful serum indicator associated with occurrence of IPA in CTD-ILD. Moreover, decreased CD3 + CD4 + T cells counts were associated with a poor survival of IPA in CTD-ILD patients. Key Points • CTD-ILD patients with IPA had significantly lower CD3+CD4+T cells counts than those with CTD-ILD without IPA. • Correlation analyses showed that serum CD3+CD4+T cells counts were positively correlated with PaO2/FiO2 ratio and negatively correlated with C reactive protein (CRP), erythrocyte sedimentation rate (ESR) and lactate dehydrogenase (LDH). • Decreased CD3+CD4+T cells counts were associated with a poor survival of IPA in CTD-ILD patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810661","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical and mental disability is evident 8 years after diagnosis in early rheumatoid arthritis despite contemporary medication and non-pharmacological interventions.","authors":"Ingrid Thyberg, Magnus Husberg, Alf Kastbom","doi":"10.1007/s10067-025-07399-8","DOIUrl":"https://doi.org/10.1007/s10067-025-07399-8","url":null,"abstract":"<p><strong>Introduction: </strong>Early interventions are known to reduce disease activity and physical disability in rheumatoid arthritis (RA), but less is known about mental health, especially in the era of early active pharmacotherapy. Consequently, we compared long-term physical and mental disability in an early RA cohort (1996-1998) with a later cohort (2006-2008).</p><p><strong>Methods: </strong>We compared 320 patients from our project Early Intervention in RA (1996-1998) (TIRA-1) with 463 patients from TIRA-2 (2006-2008). During the 8-year follow-up, pharmacotherapy and multi-professional interventions were offered according to guidelines. Disease Activity Score (DAS28), prescribed disease-modifying antirheumatic drugs (DMARDs), Health Assessment Questionnaire (HAQ), and Short Form Health Survey (SF-36) were registered yearly.</p><p><strong>Results: </strong>Significantly more patients were prescribed DMARDs in TIRA-2 than in TIRA-1, and initial improvements were seen for DAS28 and disability in both cohorts. At follow-up, TIRA-2 patients reported less physical disability (HAQ) and less mental disability (SF-36) than TIRA-1 patients. Despite improvements, 32% of the women and 21% of the men in the TIRA-2 cohort reported considerable disability (HAQ ≥ 1) at the 8-year follow-up.</p><p><strong>Conclusions: </strong>Despite improvements in our contemporarily treated TIRA-2 cohort, physical and mental disability was evident 8 years after diagnosis, especially among women. These results suggest a forthcoming need for person-centered non-pharmacological rehabilitation programs to optimize physical and mental function and to improve participation in daily life in RA. Also, the results highlight the need for developing new interventions directed at reducing disability. Key Points • Physical and mental disability is still considerable in contemporarily treated RA. • Interventions specifically aimed to reduce these disabilities need to be further developed. • Patients with severe disability need to be identified in clinical settings and offered person-centered rehabilitation.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"MTX-induced gastrointestinal reactions in RA: Prevotella enrichment, gut dysbiosis, and PI3K/Akt/Ras/AMPK pathways.","authors":"Ruixue Duo, Yining Wang, Quanzhi Ma, Xiaoyuan Wang, Yan Zhang, Haili Shen","doi":"10.1007/s10067-025-07406-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07406-y","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the role of gut microbiota in methotrexate (MTX)-induced gastrointestinal reactions (MRGR) in patients with rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>As a prospective, single-center, convenience sampling study, stool samples were obtained from 28 RA patients (male: female = 10:18) at Lanzhou University Second Hospital who were undergoing MTX treatment for analysis of their gut microbiota using 16S rRNA gene sequencing. Clinical disease activity (CDAI) and MRGR were assessed after two months of MTX therapy. All data collection periods exceeded one year. Intestinal germ-free mice, generated through antibiotic treatment, received fecal microbiota transplantation (FMT) from the patients, followed by varying doses of MTX to observe MRGR. Intestinal transcriptomics and markers related to intestinal barrier function were subsequently examined.</p><p><strong>Results: </strong>Females (84.6%) and high disease activity (CDAI scores, 39.6 ± 11.2 vs 26.3 ± 9.2) were prone to have MRGR in RA patients. Patients with MRGR (PT-GR) showed lower gut microbial diversity versus non-MRGR (PT-noGR). Prevotella abundance, positively correlated with CDAI and MRGR (p < 0.05), was elevated in PT-GR. Administering 10 mg/kg MTX to mice caused intestinal damage. FMT-GR-MTX mice exhibited weight loss (95.2%), morphological deterioration (86.4%), and reduced tight junction proteins (Claudin-1:72.4%; ZO-1:81.2%). Transcriptomics linked upregulated Gβγ/CREB/Atp4b to PI3K/Akt/Ras pathways and downregulated PFK2/PP2 to AMPK signaling in MRGR.</p><p><strong>Conclusion: </strong>Our study identified notable gut microbiota alterations in RA patients prone to MRGR, with changes in intestinal gene expression and reduced intestinal barrier function potentially contributing to MRGR. These findings suggest potential strategies to mitigate MRGR in RA patients undergoing MTX treatment. Key Points • The RA-related MRGR is correlated with the intestinal microbiota. • Females, low gut diversity, and Prevotella enrichment are MRGR risks in RA. • Upregulated DEGs in MRGR linked to PI3K/Akt, Ras pathways. • Downregulated DEGs in MRGR focus on the AMPK pathway.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143810663","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperuricemia in psoriatic arthritis: clinical correlations and implications.","authors":"Samar AbdAlhamed Tabra, Hany M Aly, Saad Ghanem, Mohammed Hassan Abu-Zaid","doi":"10.1007/s10067-025-07400-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07400-4","url":null,"abstract":"<p><strong>Background: </strong>Psoriatic arthritis (PsA) patients may have elevated serum uric acid levels, and hyperuricemia may impact the degree of inflammation and clinical disease severity.</p><p><strong>Objectives: </strong>comparison between PsA patients with and without hyperuricemia and assessment of the effect of hyperuricemia on clinical presentation, disease activity, disease severity, and associated comorbidities in PsA patients.</p><p><strong>Methods: </strong>76 PsA patients with hyperuricemia and 74 PsA patients with normal uric acid as control were included. Demographic, clinical, comorbidities, and laboratory data were collected. Hyperuricemia threshold ≥ 60 mg/L.</p><p><strong>Results: </strong>There were no significant differences between patients with and without hyperuricemia regarding gender, PsA articular subtype, PASI score, and treatment received, while patients with hyperuricemia were older (40.47 ± 8.53 vs 34.59 ± 7.29, p = 0.0001), had more comorbidity, higher body mass index (BMI) (28.49 ± 2.07 vs 26.91 ± 1.63kg/m2, p = 0.0001), DAPSA score (16.75 ± 7.04 vs 9.32 ± 6.35, p = 0.0001), ESR (34.78 ± 7.12 vs 28.55 ± 8.97, p = 0.0001), CRP (11.42 ± 3.23 vs 8.68 ± 4.04, p = 0.0001), serum cholesterol (220.42 ± 46.83 vs 169.82 ± 37.82, p = 0.0001), and triglycerides (136.47 ± 36.4 vs 104.89 ± 22.15, p = 0.0001), and longer duration of Psoriasis and PsA. The serum uric acid levels were significantly positively correlated with age, duration of Psoriasis, duration of PsA, BMI, CRP, ESR, DAPSA, and PASI score. Multivariate analysis showed that male sex, BMI, and increased disease activity were independent predictors of hyperuricemia in PsA patients.</p><p><strong>Conclusion: </strong>Psoriatic arthritis patients with hyperuricemia have higher age, BMI, disease activity, and more associated comorbidities. In PsA patients, hyperuricemia was associated with male sex, BMI, and increased disease activity, but not associated with PASI score. Key Points • Psoriasis, PsA, and hyperurice s is a bi-centric case-control retrospective of cardiovascular disease. • Male gender, BMI, and increased disease activity were independent predictors of hyperuricemia in PsA patients. • Psoriatic arthritis patients with hyperuricemia have been more associated with comorbidities.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relevance of complement levels in assessing the activity of lupus nephritis of different pathological types.","authors":"Weiji Xie, Yixin Zhang, Shiting He, Xuewan Lin, Shuping Zhao, Zeen Xiao, Yimin Zhang","doi":"10.1007/s10067-025-07429-5","DOIUrl":"https://doi.org/10.1007/s10067-025-07429-5","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease that predominantly affects women of childbearing age. Lupus nephritis (LN) is a relatively common and serious complication in clinical patients. The aim of this study was to evaluate the correlation of complement levels and SLEDAI- 2000 (SLEDAI- 2 K) with renal activity in different pathological types of LN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A total of 220 patients with SLE and LN were included. Renal active inflammation was calculated using the National Institutes of Health (NIH) Activity Index (AI) . Patients were classified into two groups based on the AI at the time of kidney biopsy: low-to-moderate-activity group with an AI &lt; 10 and high-active group with an AI ≥ 10. Laboratory indicators, including complement levels and the SLEDAI- 2 K, were collected to assess their correlation with renal activity in LN.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The average complement levels in class V LN were higher than that in class III/IV and III/IV + V LN. Serum creatinine and 24-h urine protein were lower than those in class III/IV and III/IV + V LN. Laboratory indicators, including complement levels and SLEDAI- 2 K, shown no correlation with AI in class V LN. Appropriate clinical indicators of AI in patients with class III/IV and III/IV + V LN were further assessed by ROC curves, SLEDAI- 2 K exhibiting the highest performance (AUC 0.757, 95% CI 0.687-0.817), 24-h urine protein (AUC 0.736, 95% CI 0.665-0.798), hemoglobin (AUC 0.726, 95% CI 0.655-0.789), C3 (AUC 0.676, 95% CI 0.603-0.744), serum creatinine (AUC 0.664, 95% CI 0.591-0.733), and C4 (AUC 0.660, 95% CI 0.586-0.729).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Decreased levels of complement C3 and C4 have limited predictive value as a clinical tool for assessing disease activity in patients with LN, especially in class V LN. SLEDAI- 2 K, a widely used clinical scale, correlates with disease activity in patients with class III/IV, III/IV + V LN. Serum creatinine is a clinical indicator of chronic kidney damage in patients with class III/IV, III/IV + V, and V LN. Key Points Complement levels: can they accurately assess disease activity in lupus nephritis? • Studies investigating the correlation between complement levels and disease activity in patients with SLE and LN yield inconsistent results, and the ambiguity of these findings may stem from factors such as the pathological staging of LN and individual variations in complement levels. Fewer studies in the current research on disease activity in patients with LN will be based on different pathological types of LN, which leads to limitations in the final findings. • This study aimed to analyze the feasibility of complement levels and SLEDAI- 2 K in assessing renal activity in patients with different pathological types of LN. • We assessed disease activity by obtaining AI from renal biopsies in 220 patients with LN and examined their correlation with dise","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged glucocorticoid use and rheumatoid arthritis-associated cervical spine deformity.","authors":"Anna B Lebouille-Veldman, Tom W J Huizinga, Rania A Mekary, Carmen L A Vleggeert-Lankamp","doi":"10.1007/s10067-025-07408-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07408-w","url":null,"abstract":"<p><strong>Objectives: </strong>RA patients are often prescribed glucocorticoids, although it is known that their long-term use increases the risk of osteoporosis and fractures. The association between glucocorticoid use and RA-associated cervical spine deformity is yet to be determined.</p><p><strong>Method: </strong>Duration and dose of glucocorticoid use were evaluated in patients with new onset RA (BeSt Trial). Missing values on the exposure were imputed using the last observation carried forward. Lateral X-rays at 5- and 10-year follow-ups were assessed for atlantoaxial subluxation (AAS) and subaxial subluxation (SAS). To estimate the association between glucocorticoids and cervical spine deformity, multiple logistic regression models adjusted for age, gender, baseline Disease Activity Score (DAS), ACPA positivity, and RF positivity were used to estimate odds ratios (ORs) and their 95% confidence intervals (CIs). Mediation analysis was performed to evaluate whether such potential association was mediated via mean DAS.</p><p><strong>Results: </strong>Cervical deformity (AAS and/or SAS > 2 mm) was observed in 108 (40%) out of 272 patients. For a 1-year increase in total duration of glucocorticoid use, the adjusted OR for RA-associated cervical spine deformity was 1.19 (95% CI, 1.03-1.38; p = 0.02), and for an increase of 1 g of glucocorticoid in total cumulative dose, the OR was 1.06 (95% CI, 1.01-1.12; p = 0.02). Mediation analysis could not reveal an influence of mean DAS on these associations.</p><p><strong>Conclusions: </strong>There was evidence of a direct association between long-term use of glucocorticoids in newly diagnosed RA patients and RA-associated cervical spine deformity after 10 years. Other effective therapies to suppress disease activity may be preferred over glucocorticoids. Key Points • For a 1-year increase in total duration of prednisone use in RA patients, the adjusted OR for RA-associated cervical spine deformity was 1.17 (95% CI, 1.01-1.36; p = 0.04). • For an increase in total cumulative dose of 1 g of prednisone in RA patients, the adjusted OR for RA-associated cervical spine deformity was 1.06 (95% CI, 1.00-1.11; p = 0.04). • The use of glucocorticoids in RA patients was associated with an increased odds of RA-associated cervical spine deformity after 10 years, which may suggest that other effective therapies to suppress disease activity should be preferred over glucocorticoids.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143779339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Inflammatory bowel disease in paediatric rheumatological diseases.","authors":"Özen Taş, Fatma Aydın, Zarife Kuloğlu, Ceyda Tuna Kırsaçlıoğlu, Onur Bahçeci, Betül Öksüz Aydın, Doğacan Sarısoy, Zeynep Birsin Özçakar","doi":"10.1007/s10067-025-07424-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07424-w","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatological diseases (RD) in childhood are systemic diseases that occur on the basis of auto-immunity or inflammation, and they can be accompanied by inflammatory bowel disease (IBD). When there is no knowledge of this association, the treatments applied may not be sufficient and/or treatments given for RD may even lead to aggrevation of IBD findings. Thus, early identification of an association is crucial for the correct management of the diseases.</p><p><strong>Objectives: </strong>The aim of this study is to show the frequency of IBD in patients with RDs. We also aimed to investigate in which cases IBD should be suspected in children with RDs.</p><p><strong>Methods: </strong>Electronic medical records of the patients who were followed up between 2012 and 2024 with a diagnosis of RD in our Paediatric Rheumatology Unit and diagnosed with IBD were reviewed retrospectively.</p><p><strong>Results: </strong>Between 2012 and 2024, 20 (3%) of 650 familial Mediterranean fever (FMF) patients, 3 (7.5%) of 40 chronic nonbacterial osteomyelitis (CNO) patients (one of them also had FMF) and 2 (1.2%) of 170 juvenile idiopathic arthritis (JIA) patients were diagnosed with IBD. While 15 (62.5%) of the patients received a RD as the initial diagnosis, 9 (37.5%) of them were initially diagnosed with IBD and then referred to rheumatology for their symptoms. The median age at the diagnosis of RD was 9 years (inter quartile range (IQR), 14.5). The median age at the diagnosis of IBD was 12 years (IQR, 13), and 12 patients (50%) had Crohn's disease (CD), 10 patients (41.6%) ulcerative colitis (UC) and 2 patients (8.4%) undeterminated disease. Although majority of the patients had classical findings of IBD, 4 patients presented with more vague symptoms including treatment-resistant iron deficiency anaemia, perianal abscess, weight loss and growth retardation.</p><p><strong>Conclusions: </strong>RD and IBD share similar pathological pathways and clinical findings, and IBD can accompany to various RD. The diagnosis of IBD should be considered in the presence of rare and atypical symptoms. Furthermore, RD should also be considered in children with IBD who have complex extraintestinal symptoms. Key Points • RD, especially FMF, JIA and CNO, may be associated with IBD. • Paediatric rheumatologists should consider IBD as a potential diagnosis in the presence of atypical findings that may develop during the course of RD. • The co-existence of RD and IBD is important both in terms of disease progression and treatment decisions.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143788122","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prospective Sham-Controlled trial: acupuncture for symptom-relieving in patients with Sjögren's disease.","authors":"Jaciara M Gomes-Silva, Carolina P Torres, Lucas R Teixeira, Maria da Conceição P Saraiva, Fabiola R Oliveira, Eduardo M Rocha, Maria Cristina Borsatto, Ana Carolina F Motta","doi":"10.1007/s10067-025-07410-2","DOIUrl":"https://doi.org/10.1007/s10067-025-07410-2","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to assess the clinical efficacy of acupuncture in relieving sicca symptoms of SjD.</p><p><strong>Methods: </strong>A prospective, single-center, randomized, double-blind, controlled trial was conducted on SjD patients experiencing dry eyes and dry mouth. Forty-six patients were randomized and 27 completed the study (acupuncture, n = 15; sham, n = 12). Patients received either acupuncture or sham acupuncture (control) weekly for 8 weeks. Key outcomes, including Schirmer test (ST), corneal fluorescein staining score, tear film break-up time, Ocular Surface Disease Index, unstimulated whole salivary flow (UWSF), EULAR Sjögren's Syndrome Patient Reported Index (ESSPRI), Xerostomia Inventory (XI) score, Oral Health Impact Profile (OHIP-14) score, and Challacombe scale, were measured at baseline, immediately after treatment, and 4 weeks later. Statistical analysis consisted of comparing outcomes between groups over time.</p><p><strong>Results: </strong>The acupuncture group exhibited significant improvement in total ESSPRI and ESSPRI dryness scores. The positive effects persisted for at least 4 weeks after the completion of treatment. Furthermore, the acupuncture group exhibited improvement over time in the ESSPRI fatigue domain, ESSPRI pain domain, OHIP-14, XI, UWSF, and ST. No other statistically significant differences were observed.</p><p><strong>Conclusion: </strong>Acupuncture is effective in relieving dryness in SjD patients. Larger samples and longer observation periods are necessary to better understand the effectiveness of this intervention in SjD. (NCT04056221/ 18/02/2019). Key Points • Acupuncture is a low-cost method with few side effects • Acupuncture exerts a symptom-relieving effect in primary Sjögren's disease patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143771658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Letter to \"The predictive value of anti-IFI16 antibodies for the development or persistence of digital ulcers in systemic sclerosis\".","authors":"Yan Shen, Xianxian Fu","doi":"10.1007/s10067-025-07427-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07427-7","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762716","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serum ferritin is a superior biomarker for evaluating disease activity and kidney injury compared with C-reactive protein in anti-neutrophil cytoplasmic antibody-associated vasculitis.","authors":"Li-Yuan Xie, Xian-Ying Qiu, Yu-Nan Li, Hao-Miao Zhang, Hong-Shan Chen, Qiu-Hua Gu, Tie-Kun Yan, Jun-Ya Jia, Peng-Cheng Xu","doi":"10.1007/s10067-025-07412-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07412-0","url":null,"abstract":"<p><strong>Background: </strong>Elevated C-reactive protein (CRP) is a characteristic of active anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). However, its relationship with organ involvement severity is ambiguous. Serum ferritin (SF) is a proinflammatory marker elevated in many autoimmune diseases, yet its role in AAV is poorly studied.</p><p><strong>Methods: </strong>A total of 399 AAV patients were retrospectively selected and divided into four groups based on SF and CRP levels. Clinical, laboratory, and pathological data were compared. Survival analyses were conducted to estimate end-stage renal disease (ESRD) and death.</p><p><strong>Results: </strong>In this cohort, 256 patients (64.16%) had elevated SF, and 289 (72.43%) had elevated CRP. Patients with elevated SF and normal CRP had the highest BVAS, lowest initial estimated glomerular filtration rate, highest 24-h proteinuria, and worst renal prognosis. SF showed a weak positive correlation with BVAS (R = 0.201, p < 0.001), while CRP showed a weak negative correlation with proteinuria (R = - 0.158, p = 0.002). Univariate Cox regression analysis revealed high SF level was a risk factor for ESRD and death, whereas CRP was not. Pathological tests showed that patients with elevated SF had a higher proportion of glomeruli with cellular crescents compared to those with normal SF. CRP positively correlated serum complement 3 (C3) with SF as a control variable (R = 0.434, p < 0.001), while SF negatively correlated with C3 with CRP as a control variable (R = - 0.201, p < 0.001).</p><p><strong>Conclusion: </strong>In active AAV, high SF is associated with severe injury and poor kidney prognosis, whereas CRP is not. The underlying mechanism may be related to the different impacts on the complement system. Key Points • Patients with elevated SF and normal CRP had the highest BVAS, lowest initial estimated glomerular filtration rate, highest 24-hour proteinuria, and worst renal prognosis. . • CRP positively correlated serum C3 with SF as a control variable, while SF negatively correlated with C3 with CRP as a control variable. • High SF reflects a high proportion of glomeruli with cellular crescents in renal histopathology.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143762741","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}