Clinical Rheumatology最新文献

{"title":"Clinical characteristics of adult patients with autoimmune rheumatic diseases coexisting with persistent isolated low IgM: a retrospective study in China.","authors":"Nuerjiamali Aisha, Yingying Shi, Jingxiu Xuan, Yan He, Yangchun Chen, Hongyan Qian, Yun Peng, Guixiu Shi, Yuan Liu, Shiju Chen","doi":"10.1007/s10067-026-08484-2","DOIUrl":"https://doi.org/10.1007/s10067-026-08484-2","url":null,"abstract":"<p><strong>Objective: </strong>Selective IgM deficiency (sIgMD) is an uncommon immunological phenotype characterized by persistently reduced serum IgM, but its characteristics within autoimmune rheumatic diseases (ARDs) remain poorly defined, particularly in Chinese populations. This study aimed to characterize a persistent isolated low IgM phenotype compatible with sIgMD from an ARD-centered perspective, focusing on its clinical features, and infection spectrum in a cohort of 257 patients.</p><p><strong>Methods: </strong>A retrospective study of adult inpatients diagnosed with both ARDs and persistent isolated low IgM was conducted. Data on demographics, ARD types, infections, treatments, and laboratory parameters were collected and analyzed.</p><p><strong>Results: </strong>A total of 257 adult patients with ARDs and coexisting persistent isolated low IgM were included. The median age was 48 (35-60) years, with a female predominance (203/257, 79.0%). Systemic lupus erythematosus was the most common underlying ARD (138/257, 53.7%), followed by primary Sjögren's syndrome (51/257, 19.8%) and rheumatoid arthritis (16/257, 6.2%). Pneumonia was the most frequently observed infection type (125/257, 48.6%). Among the 257 patients, 39 (15.2%) had persistent isolated low IgM identified before exposure to immunosuppressive therapy (treatment-naïve patients), whereas 218 (84.8%) had received immunosuppressive treatment before low IgM was first documented. Overall, 40 of the 257 patients (15.6%) had documented use of intravenous immunoglobulin. Compared with treated patients, treatment-naïve patients had shorter disease duration (72 months vs. 108 months, P = 0.006) and higher IgG (15.0 vs. 12.0 g/L) and IgA (3.0 g/L vs. 2.1 g/L) levels (both P < 0.001). Multivariate analysis demonstrated that older age was associated with a higher likelihood of documented infection (OR = 1.049, P = 0.002).</p><p><strong>Conclusion: </strong>This study provided a comprehensive characterization of persistent isolated low IgM in Chinese adults with ARDs. Our findings suggest that this phenotype may not be solely attributable to immunosuppressive treatment and highlight the need for further studies to clarify its underlying mechanisms and clinical significance, particularly in relation to infection. Key Points • This is the first ARD-centered study to systematically characterize persistent isolated low IgM and represents the largest clinical cohort reported to date. • Persistent isolated low IgM was observed across multiple autoimmune rheumatic diseases and was identified before immunosuppressive therapy in a subset of patients. • Older age was independently associated with documented infection in patients with ARDs and persistent isolated low IgM.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149227554","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":"Increased risk of cancer in patients with mixed connective tissue disease: a population-based cohort study in Korea.","authors":"Su Jin Choi, Sojeong Park, Minae Park, Seung Won Choi, Doo-Ho Lim","doi":"10.1007/s10067-026-08483-3","DOIUrl":"https://doi.org/10.1007/s10067-026-08483-3","url":null,"abstract":"<p><strong>Introduction: </strong>We conducted a nationwide, population-based cohort study to evaluate the risk of cancer in Korean patients with mixed connective tissue disease (MCTD) compared with the corresponding risk in the general population.</p><p><strong>Methods: </strong>Using the Korean National Health Insurance Service data, we identified 2,094 patients with newly diagnosed MCTD between 2004 and 2020 (16,409 person-years). Standardized incidence ratios (SIRs) were calculated to compare the overall and site-specific cancer risks between patients with MCTD and the age- and sex-matched general population.</p><p><strong>Results: </strong>The overall risk of cancer was significantly higher in patients with MCTD than in the general population (SIR 2.61, 95% confidence interval [CI] 2.27-2.99). For site-specific cancers, both the risks of solid (SIR 2.46, 95% CI 2.12-2.84) and haematologic (SIR 6.81, 95% CI 4.36-10.13) cancers were elevated in patients with MCTD compared with the general population. Among solid cancers, increased risks were observed for several sites, including the lung, ovary, liver, pancreas, cervix, gallbladder/biliary tract, prostate, bladder, and oesophagus. Regarding haematologic cancers, multiple myeloma, myelodysplastic syndrome, and non-Hodgkin lymphoma showed increased risks. The relative cancer risk was highest in patients aged 20-39 years (SIR 4.04, 95% CI 2.90-5.48) and during the first year after MCTD diagnosis (SIR 3.77, 95% CI 2.70-5.11).</p><p><strong>Conclusions: </strong>Patients with MCTD have an increased cancer risk, particularly haematologic cancer, compared with the general population. The cancer risk was particularly elevated in younger patients and during the first year after MCTD diagnosis. Key Points • Patients with MCTD have a higher overall risk of cancer, particularly haematologic cancer. • Cancer risk is particularly elevated during the first year after MCTD diagnosis, and clinicians should not overlook the possibility of cancer in younger patients with suggestive clinical features.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223518","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":"Single-cell eQTL Mendelian randomization reveals the monocyte-associated PRKCB-CTSL axis as a candidate regulatory pathway and potential therapeutic target in rheumatoid arthritis.","authors":"Pengli Wang, Guohang Shen, Wenhua Liao, Ruoyan Wang, Li Zhang, Mingjia Zhao, Dong Zhang, Nanxiang Huang, Yupei Dai","doi":"10.1007/s10067-026-08482-4","DOIUrl":"https://doi.org/10.1007/s10067-026-08482-4","url":null,"abstract":"<p><strong>Objectives: </strong>Rheumatoid arthritis (RA) involves persistent immune dysregulation, but cell-specific genetically regulated pathways remain unclear. We integrated cell-specific genetic and multi-omics evidence to prioritize candidate regulatory pathways.</p><p><strong>Methods: </strong>cis-eQTLs from 17 immune-cell populations were integrated with RA GWAS data by two-sample Mendelian randomization. Transcriptomics, WGCNA, and machine-learning feature selection identified convergent candidates. Single-cell and virtual perturbation analyses assessed cellular localization and downstream changes. Molecular docking and dynamics computationally prioritized compounds, and knockdown/rescue experiments evaluated the PRKCB-CTSL relationship.</p><p><strong>Results: </strong>Eleven candidates had convergent genetic and transcriptomic support. PRKCB was retained by LASSO, SVM, and random forest and preferentially expressed in monocytes. Virtual perturbation implicated CTSL and antigen-processing/presentation pathways. PRKCB knockdown reduced CTSL expression and NF-κB phosphorylation, whereas CTSL restoration partially rescued NF-κB phosphorylation. Separately, structure-based analyses computationally prioritized ursodiol for the most favorable predicted PRKCB interaction among evaluated compounds.</p><p><strong>Conclusions: </strong>Genetic, transcriptomic, single-cell, computational, and in vitro evidence supports monocyte-associated PRKCB-CTSL as a candidate regulatory pathway in RA. Further mechanistic and in vivo studies are required to establish its causal and pharmacological relevance. Key Points • Multi-omics analysis identified 11 key RA-associated targets. • RA was classified into two molecular subtypes with distinct immune features. • PRKCB was identified as the core target enriched in monocytes. • The PRKCB-CTSL axis may drive RA inflammation, and ursodiol showed therapeutic potential.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149223538","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":"Hepatic steatosis and liver stiffness in patients with gout: a controlled cross-sectional elastography study.","authors":"Osman Cure, Ugur Avci, Emre Emir Kilic, Ertugrul Yigit","doi":"10.1007/s10067-026-08463-7","DOIUrl":"https://doi.org/10.1007/s10067-026-08463-7","url":null,"abstract":"<p><strong>Background/objective: </strong>Gout shares cardiometabolic risk factors with metabolic dysfunction-associated steatotic liver disease (MASLD). We aimed to compare elastography-defined hepatic steatosis and liver stiffness between patients with gout and metabolically stringent controls, and to identify independent determinants of controlled attenuation parameter (CAP) and liver stiffness measurement (LSM).</p><p><strong>Methods: </strong>In this single-center cross-sectional study (April 2024-January 2026), 201 adults with gout and 80 controls free of hypertension, diabetes mellitus, chronic kidney disease, and coronary artery disease underwent vibration-controlled transient elastography (FibroScan®). Multivariable linear and logistic regression models identified independent predictors of CAP, LSM, and binary elastographic outcomes.</p><p><strong>Results: </strong>Patients with gout had significantly higher CAP (279 vs. 251.5 dB/m; p < 0.001) and LSM (6.1 vs. 5.1 kPa; p < 0.001). In unadjusted analyses, the odds of hepatic steatosis (CAP ≥ 238 dB/m; OR 2.42, 95% CI 1.40-4.20; p = 0.001) and of increased liver stiffness (LSM ≥ 7.0 kPa; OR 2.46, 95% CI 1.27-4.78; p = 0.007) were higher in the gout group, and LSM ≥ 9.6 kPa was more frequent (12.9% vs. 1.3%; p = 0.001). On multivariable analysis, BMI and ALT were the principal determinants of CAP, whereas BMI and age independently predicted continuous LSM. Gout status was not independently associated with CAP, continuous LSM, hepatic steatosis, or increased liver stiffness (adjusted OR 1.83, 95% CI 0.84-4.01; p = 0.131). Serum uric acid and disease activity measures were not associated with any elastographic outcome.</p><p><strong>Conclusion: </strong>Patients with gout exhibit a substantially higher burden of elastography-defined hepatic steatosis and increased liver stiffness than metabolically stringent controls. This excess was accounted for by adiposity and age rather than by gout status or urate levels, suggesting that non-invasive liver assessment in gout should be guided by cardiometabolic risk profile rather than by the diagnosis of gout itself. Key Points • In unadjusted analyses, patients with gout had more than twofold higher odds of both hepatic steatosis and increased liver stiffness on transient elastography compared with metabolically stringent controls. • BMI and ALT were the strongest independent determinants of CAP; BMI and age were the strongest determinants of continuous LSM. • After adjustment for age, BMI and cardiometabolic covariates, gout status was not independently associated with any elastographic outcome, including increased liver stiffness (LSM ≥ 7.0 kPa). • Serum uric acid, disease activity scores, and urate-lowering or anti-inflammatory therapies were not associated with elastographic liver measures, indicating that hepatic involvement in gout reflects adiposity-driven metabolic burden rather than urate-specific mechanisms.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149219631","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":"Association between post-intravenous immunoglobulin hypothermia and lower receipt of second-line therapy in Kawasaki disease: a single-center retrospective cohort study.","authors":"Masayuki Arimatsu, Yuki Naruse, Masato Mori, Shintaro Iwamoto, Kyongsun Pak","doi":"10.1007/s10067-026-08475-3","DOIUrl":"https://doi.org/10.1007/s10067-026-08475-3","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Post-IVIG temperature patterns may be associated with the subsequent treatment course in Kawasaki disease (KD), but evidence regarding outcomes among patients who develop hypothermia after treatment remains limited. We evaluated the association between hypothermia following IVIG therapy and the receipt of second-line treatment.</p><p><strong>Methods: </strong>We retrospectively reviewed patients with KD admitted to Matsudo City General Hospital between January 2018 and December 2023. Patients who achieved defervescence (body temperature < 37.5 °C) within 48 h after IVIG administration were included. Hypothermia was defined as body temperature < 36.0 °C within 48 h after IVIG administration. The primary outcome was the receipt of second-line therapy. Sensitivity analyses were conducted using alternative hypothermia thresholds of 35.5 °C and 35.0 °C. At the 35.5 °C threshold, both univariable and multivariable logistic regression analyses were performed; at the 35.0 °C threshold, results were presented descriptively because regression estimates were not estimable owing to zero-event cells.</p><p><strong>Results: </strong>Of 1063 patients screened, 557 met the inclusion criteria. Hypothermia occurred in 324 (58.2%) patients. Second-line therapy was required less frequently in the hypothermia group than in the non-hypothermia group (14.2% vs. 28.3%; adjusted odds ratio, 0.39; 95% confidence interval, 0.25-0.62). Findings were consistent using the 35.5 °C threshold. At the 35.0 °C threshold, none of the 7 patients with hypothermia received second-line therapy, precluding estimation of the odds ratio.</p><p><strong>Conclusion: </strong>Among patients with KD who achieved defervescence within 48 h after IVIG administration, second-line therapy was less frequently administered to those who developed post-IVIG hypothermia. Prospective studies are needed to clarify the clinical significance of this finding. Key Points • Among patients with Kawasaki disease who achieved defervescence within 48 h after IVIG administration, second-line therapy was less frequently administered to those who developed post-IVIG hypothermia (< 36.0 °C). • This association remained significant after adjustment for age, sex, Gunma score, and concomitant medications. • The clinical significance of post-IVIG temperature patterns requires further evaluation in prospective studies.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149215137","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":"Clinical and sonographic enthesitis in psoriatic arthritis patients and its relation to serum calprotectin level.","authors":"Abdel Latif Gaballah, Yousra Hisham Abdel-Fattah, Zeinab Tharwat, Nermeen Eldabah, Marwa A Amer","doi":"10.1007/s10067-026-08450-y","DOIUrl":"https://doi.org/10.1007/s10067-026-08450-y","url":null,"abstract":"<p><strong>Objective: </strong>Investigate the clinical and sonographic characteristics of enthesitis in psoriatic arthritis (PsA) patients and its relation to psoriatic disease activity and serum calprotectin (CLP).</p><p><strong>Methods: </strong>This cross-sectional study enrolled PsA patients, diagnosed according to the classification criteria for psoriatic arthritis and an equal number of age and sex matched healthy controls. In PsA patients, enthesitis was assessed clinically using Spondylarthritis Research Consortium of Canada (SPARCC) and sonographically using the Madrid Sonographic Enthesitis Index (MASEI). Serum CLP was measured in both groups.</p><p><strong>Results: </strong>Most of the enrolled 45 PsA patient, were diagnosed with clinical enthesitis at least at one entheseal site (n = 43, 95.6%). However, on sonographic assessment, only 51.1% (n = 23) of the patients studied were classified with entheseal disease, MASEI ≥ 18. Achilles tendon was the most frequently involved entheseal site on clinical and ultrasonographic assessment. Total MASEI positively correlated with Disease Activity in Psoriatic Arthritis (DAPSA) (p = 0.047). Serum CLP was significantly higher in PsA patients (38.76 ng/mL) compared to healthy controls (31.07 ng/mL, p = 0.01). Serum CLP positively correlated with SPARCC, total MASEI and DAPSA (p = 0.002, 0.001 and 0.003, respectively). Serum CLP and MASEI were significantly lower in PsA patients on biological treatment compared to those on conventional treatment (p < 0.001).</p><p><strong>Conclusions: </strong>PsA patients with entheseal disease might have higher disease activity. Serum CLP showed potential association with disease activity and entheseal involvement in PsA patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179857","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":"Osteoporosis and fracture severity as independent risk factors for osteonecrosis of the jaw in rheumatoid arthritis: a TriNetX cohort study.","authors":"Hiroko Nagafuchi, Takayasu Ando, Kimito Kawahata","doi":"10.1007/s10067-026-08462-8","DOIUrl":"https://doi.org/10.1007/s10067-026-08462-8","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the independent impact of osteoporosis and its severity, characterised by bone fractures, on osteonecrosis of the jaw (ONJ) risk in patients with rheumatoid arthritis (RA) using a global real-world database. We hypothesised that osteoporosis independently increases ONJ risk in patients with RA, irrespective of medication exposure.</p><p><strong>Methods: </strong>This retrospective cohort study utilised the TriNetX database. Primary analysis estimated the association between osteoporosis and incident ONJ (primary outcome) after propensity score matching (PSM). Secondary analysis evaluated the impact of bone fractures using multivariable Cox proportional hazards models. Sensitivity analyses assessed robustness.</p><p><strong>Results: </strong>In the primary PSM analysis (160,789 pairs), osteoporosis was the strongest independent risk factor for ONJ (adjusted hazard ratio [aHR] 3.135, 95% confidence interval [CI] 2.740-3.584, P < 0.001). Among patients with osteoporosis (22,821 pairs), ONJ incidence was higher in those with bone fractures (P = 0.047). Multivariable analysis identified bone fractures (aHR 1.522, 95% CI 1.202-1.931, P < 0.001) and denosumab use (aHR 1.970, 95% CI 1.397-2.777, P < 0.001) as independent risk factors. Sensitivity analyses confirmed that the association between osteoporosis and ONJ remained robust in antiresorptive-naïve and glucocorticoid-naïve patients after excluding bone metastasis and high-dose antiresorptive therapy (aHR 3.125, 95% CI 2.564-3.817, P < 0.0001).</p><p><strong>Conclusion: </strong>Osteoporosis and fracture history are independent risk factors for ONJ in patients with RA. These findings support a disease-driven paradigm where underlying bone fragility drives ONJ development beyond antiresorptive or glucocorticoid effects, highlighting the need for comprehensive bone health management in this population. Future prospective studies are needed to evaluate targeted screening interventions. Key points • Osteoporosis is a stronger independent risk factor for ONJ than antiresorptive medication. • Prior bone fractures significantly increase ONJ risk among patients with rheumatoid arthritis and osteoporosis. • Managing underlying bone fragility is crucial for ONJ prevention, beyond monitoring osteoporosis medication use.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179836","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":"Higher APOB is associated with poor renal outcome in lupus nephritis.","authors":"Qiaoyu Wang, Weihua Wu, Zheng Jiang","doi":"10.1007/s10067-026-08479-z","DOIUrl":"https://doi.org/10.1007/s10067-026-08479-z","url":null,"abstract":"<p><strong>Aims: </strong>Lupus nephritis is a common and severe complication of SLE, significantly affecting patient morbidity and mortality. It is quite meaningful to identify some non-invasive predictors related to the progression of LN. Early intervention of these factors may delay the development to ESRD.</p><p><strong>Methods and results: </strong>This study included 462 LN patients at The Affiliated Hospital of Southwest Medical University from January 2018 to September 2023. The participants were divided into two groups: high APOB group (serum APOB > 0.8 g/L, n = 264) and the low APOB group (serum APOB ≤ 0.8 g/L, n = 198) according to the median baseline serum APOB concentration. The results demonstrated that LN patients in the high APOB group had significantly higher lipid metabolism-related indicators (P < 0.001), higher levels of urea, SUA, and SCr (P < 0.01), and a higher proportion of patients with CKD stages 3-4 (P = 0.011). The Kaplan-Meier survival curve showed that the high APOB group patients had worse renal prognosis (HR = 3.292, 95%CI: 1.835-5.907, P < 0.001). To investigate the impact of long-term APOB exposure, this study also collected various APOB exposure metrics in the cumAPOB cohort which included 286 LN patients. The statistical results showed that compared with the low cumAPOB group, the lipid metabolism-related indexes (P < 0.001) and the proportion of patients who reached endpoints (P = 0.001) in the high cumAPOB group were significantly higher. And the cumAPOB was a risk factor for poor renal prognosis in patients with LN. When the high APOB exposure time reached 3 years, the risk of endpoint events was approximately 15 times that of the control group (OR = 15.08, 95%CI 2.159-105.3, P = 0.006).</p><p><strong>Conclusion: </strong>Serum APOB level may be positively associated with the poor renal progression of LN. Key Points • Renal biopsy plays a key role in the evaluation and management of lupus nephritis (LN). However, some patients may not accept this detection for its invasive procedure. Therefore, it is quite meaningful to identify risk factors related to the progression of LN in some non-invasive method. • With the prolonged high-exposure duration of APOB, the risk of endpoint events in LN patients within the cohort gradually increased. • The impact of APOB on the renal prognosis of LN patients was not instantaneous, but results from long-term high-level cumulative exposure - a slow process of quantitative to qualitative change. • APOB was an independent risk factor for LN patients, with a cumulative effect.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179846","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":"Challenges of experimental medicine studies.","authors":"Asma Abdul Malek, Ema-Louise Long, John D Isaacs","doi":"10.1007/s10067-026-08348-9","DOIUrl":"https://doi.org/10.1007/s10067-026-08348-9","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179859","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":"Association of ambient humidity with online search interest in musculoskeletal stiffness across the United States.","authors":"Shaya Naimi, Kimiya R Aframian, Oliver Simpson, Gordon H Bae","doi":"10.1007/s10067-026-08474-4","DOIUrl":"https://doi.org/10.1007/s10067-026-08474-4","url":null,"abstract":"<p><strong>Background: </strong>Weather-related worsening of musculoskeletal symptoms is widely reported by patients, yet prior clinical studies have shown inconsistent associations between environmental conditions and pain. Population-level online search behavior may provide an additional lens through which to study symptom concern and health information-seeking behavior.</p><p><strong>Objective: </strong>To evaluate the association between ambient humidity and online search interest related to musculoskeletal stiffness in the United States.</p><p><strong>Methods: </strong>State-level climate data was obtained from the National Oceanic and Atmospheric Administration (NOAA). Average dew point from 2021 to 2026 was used as a proxy for ambient humidity. Google Trends was queried for musculoskeletal stiffness-related terms, including \"muscle stiffness,\" \"joint stiffness,\" \"stiff,\" and \"arthritis,\" over the same period. Search interest values were aggregated by state and normalized to state population and baseline search activity using selected control terms. Linear regression was performed to assess the association between average dew point and normalized search interest.</p><p><strong>Results: </strong>Search interest demonstrated geographic variation across the United States. States with higher average dew points generally exhibited higher normalized search interest for musculoskeletal stiffness-related terms. A statistically significant positive association was observed between average dew point and normalized search interest.</p><p><strong>Conclusion: </strong>Higher ambient humidity was associated with greater population-level online search interest related to musculoskeletal stiffness. These findings suggest that interest search behavior may serve as a complementary population-level signal for studying environmental correlates of symptom concern. Key Points • Across US states from 2021 to 2026, higher average dew point was associated with greater musculoskeletal stiffness search interest (r = 0.32, p = 0.024), supporting a population-level link between ambient humidity and stiffness-related information-seeking behavior. • To our knowledge, this is among the first nationwide digital epidemiology studies to specifically examine humidity and stiffness-related search behavior, addressing a gap in literature that has largely focused on temperature and pain rather than humidity and stiffness. • Population-level online search behavior, when normalized against nonmedical control terms and population size, may serve as a complementary, continuously updated signal for studying environmental correlates of musculoskeletal symptom perception alongside traditional clinical data.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149179903","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}