Clinical Rheumatology最新文献

{"title":"Behçet's disease-like mucocutaneous eruption.","authors":"Masumi Bamba, Yusuke Ogata, Koichi Bamba, Ryo Hisada, Hiroyuki Nakamura","doi":"10.1007/s10067-026-08112-z","DOIUrl":"https://doi.org/10.1007/s10067-026-08112-z","url":null,"abstract":"","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147653857","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":"Evaluating the value of superoxide dismutase in anti-synthetase syndrome associated with interstitial lung disease.","authors":"Lei Luo, Wenhan Huang, Feifeng Ren, Jun Zhou, Zhihuan Zhang, Hui Ke, Lin Tang","doi":"10.1007/s10067-026-07973-8","DOIUrl":"https://doi.org/10.1007/s10067-026-07973-8","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the clinical value of serum superoxide dismutase (SOD) in anti-synthetase syndrome-related interstitial lung disease (ASyS-ILD).</p><p><strong>Methods: </strong>We conducted a retrospective study of 153 patients with anti-synthetase syndrome-associated interstitial lung disease (ASyS-ILD) at the Second Affiliated Hospital of Chongqing Medical University. Data collected included demographics, laboratory parameters [hemoglobin, absolute neutrophil count, absolute lymphocyte count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), creatine kinase (CK), lactate dehydrogenase (LDH), serum ferritin, serum superoxide dismutase (SOD), and myositis-specific antibodies], lung high-resolution computed tomography (HRCT) findings, treatment regimens, and recurrence. For comparison, serum SOD levels were also measured in 153 healthy individuals who served as the control group.</p><p><strong>Results: </strong>Compared with the healthy control group, the serum SOD level in the ASyS-ILD group was significantly decreased (P < 0.001). The serum SOD level after treatment was higher than that before treatment (P < 0.001). In ASyS-ILD patients, the serum SOD level was significantly negatively correlated with ESR (r =  - 0.281, P < 0.001); CRP (r =  - 0.262, P < 0.001); CK (r =  - 0.3678, P < 0.001); LDH (r =  - 0.446, P < 0.001); and ferritin (r =  - 0.508, P < 0.001). The serum SOD level in patients with anti-PL-7 antibodies was significantly lower than that in the anti-EJ group (P = 0.039). The serum SOD level in the ASyS-ILD recurrence group was significantly lower than that in the stable group (P = 0.001). The serum SOD level was an independent risk factor for disease recurrence in ASyS-ILD patients (P = 0.037).</p><p><strong>Conclusion: </strong>In patients with ASyS-ILD, low serum SOD levels indicate the presence of oxidative stress. Serum SOD levels decrease in response to increasing inflammation in ASyS-ILD, suggesting that SOD can be used as a valid indicator of disease activity. The serum SOD levels in patients with ASyS-ILD are closely related to recurrence and deserve attention from rheumatologists. Key Points • Our study is the first to explore the relationship between SOD and ASyS-ILD. • This study demonstrates that SOD can serve as a simple and effective biomarker for evaluating the disease activity and recurrence of ASyS-ILD, which provides relevant information for clinical practice and a reliable basis for follow-up studies.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638174","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":"Sex-specific traditional and disease-related risk factors for incident heart failure in patients with rheumatoid arthritis: a registry-based cohort study.","authors":"Vera Zietemann, Tatjana Rudi, Daniel Bestler, Peter Herzer, Uta Kiltz, Christian Kneitz, Yvette Meissner, Anja Strangfeld","doi":"10.1007/s10067-026-08078-y","DOIUrl":"https://doi.org/10.1007/s10067-026-08078-y","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate associations with incident heart failure (HF) in patients with rheumatoid arthritis (RA) in relation to sex, traditional risk factors, and RA-specific factors, with analyses stratified by sex.</p><p><strong>Method: </strong>Patients without prevalent HF enrolled between January 2007 and June 2022 in the biologics register RABBIT were included and followed up to 10 years until December 2022. Patients were observed from the time of enrollment until the diagnosis of HF (outcome of interest), death, dropout, or end of study, whichever occurred first. The association of sex with HF and the association of traditional and RA-specific variables with HF, stratified by sex, were analyzed using multiple logistic regression.</p><p><strong>Results: </strong>The study sample consisted of 4022 men (3.9% HF) and 11,785 women (2.6% HF). For men compared to women, adjusted odds ratio for HF [95% CI] was 1.48 [1.20-1.83] overall, 2.42 [1.60-3.66] in patients with coronary heart disease (CHD), and 1.40 [1.10-1.78] for patients without CHD. Age, CHD, and high disease activity (DAS28-ESR) were the main risk factors for both sexes. The effect estimate of hypertension and particularly diabetes was higher in women than in men. Our results suggest a possible underdiagnosis of HF in women, especially of higher age.</p><p><strong>Conclusions: </strong>Our exploratory study suggests a higher chance for HF, particularly in men with CHD compared to women, among patients with RA. Age, CHD, and high disease activity may be important risk factors for HF for both sexes, whereas diabetes, hypertension, and longer RA duration seem to be more deleterious in women than men. Key Points •Male RA patients with coronary heart disease (CHD) may have a higher chance for HF compared to females. •Effect estimates for diabetes and hypertension were higher in women than in men. •Age, CHD, and high RA disease activity were associated with HF in both sexes.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638119","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":"Cross-cultural adaptation, reliability and construct validity of the Arabic Scleroderma Assessment Questionnaire in Egyptian patients with systemic sclerosis.","authors":"Omima Ahmed El-Farra, Manal Hassanien, Amira M Ibrahim, Wedad Mahmoud Ghazy, Enas Abolkheir Abdelaleem, Nesrin Ahmed Aboeladl, Nevine Mohannad, Khaled A A Abdelgalil, Gehad Gamal Maghraby, Asmaa Khalifa Ahmed, Hanan Elsaadany, Salma A Khalil, Samah Ismail Nasef, Samar Tharwat, Osman Hammam, Shaimaa Moustafa Hafez, Nevin Hammam, Tamer A Gheita","doi":"10.1007/s10067-026-08055-5","DOIUrl":"https://doi.org/10.1007/s10067-026-08055-5","url":null,"abstract":"<p><strong>Background: </strong>Systemic sclerosis (SSc) is a multisystem autoimmune disease characterized by fibrosis, vasculopathy, and internal organ involvement, resulting in substantial symptom burden and impaired quality of life. Reliable patient-reported outcome measures adapted to Arabic-speaking populations are lacking.</p><p><strong>Objective: </strong>To develop a cross-cultural adaptation of the English version of the Scleroderma Assessment Questionnaire to the Arabic language (Ar-SAQ) and to assess its reliability and construct validity in SSc patients.</p><p><strong>Patients and methods: </strong>Translation and cultural adaptation process followed internationally accepted guidelines for patient-reported outcomes. After expert evaluation and pretesting for semantic clarity, the final version was administered to 193 SSc patients. Test-retest reliability was assessed over four weeks using intraclass correlation coefficients (ICC). Construct validity was analysed through correlation between total and domain scores of the Arabic questionnaire and the European Scleroderma Trial and Research Group activity index.</p><p><strong>Results: </strong>Patients included 171 females (88.6%) with a mean age of 44.6 ± 10.6 years. The Ar-SAQ demonstrated satisfactory reproducibility, with ICC results ranging from moderate to excellent (0.50-0.95). The musculoskeletal, respiratory, gastrointestinal, and total index of disease status indices showed good to excellent reliability (ICC = 0.90-0.95). The vascular index showed moderate reproducibility (0.50), consistent with naturally fluctuating vascular symptoms in SSc. Construct validity was confirmed by a significant positive correlation with the European Scleroderma Trial and Research Group activity index.</p><p><strong>Conclusion: </strong>The Ar-SAQ is a reliable and valid instrument for assessing patient-reported disease status in Egyptian SSc patients and may serve as a foundation for further validation in other Arabic-speaking populations. Key Points • A culturally adapted Arabic version of the Scleroderma Assessment Questionnaire was developed following standardized cross-cultural adaptation guidelines. • The Arabic Scleroderma Assessment Questionnaire demonstrated good to excellent reliability and acceptable construct validity in Egyptian patients with systemic sclerosis. • This instrument provides a feasible patient-reported measure of disease status that may support clinical assessment and research in Arabic-speaking populations.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638084","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":"Subchondral bone density and trabecular morphometry mediate the association between knee malalignment and osteophyte progression in osteoarthritis: data from the osteoarthritis initiative.","authors":"Shiwen Yuan, Guangfeng Ruan, Xiaodong Wang, Grace H Lo, Cuicui Wang, Zhaohua Zhu, Siqi Xu, Weinian Li, Xiaoyan Cai, David J Hunter","doi":"10.1007/s10067-026-08067-1","DOIUrl":"https://doi.org/10.1007/s10067-026-08067-1","url":null,"abstract":"<p><strong>Objective: </strong>To investigate whether subchondral bone mediates the relationship between knee malalignment and osteophyte progression.</p><p><strong>Design: </strong>Data were obtained from the Osteoarthritis Initiative (OAI) and two ancillary imaging studies. Two analytic cohorts were defined by mediator type: a DXA cohort (periarticular bone mineral density [paBMD]) and an MRI cohort (trabecular morphometry: aBVF, aTb.N, aTb.Sp, aTb.Th). Alignment (hip-knee-ankle [HKA] angle) was assessed at either 12 or 24 months under the Lower Limb Alignment study; bone measures were obtained at either 30 or 36 months through the Bone Ancillary Study; and radiographic osteophyte scores were evaluated at baseline and 48 months. Knees were categorized into five alignment groups (neutral, mild/severe varus, mild/severe valgus). Analyses used generalized estimating equations and multivariable linear regression with non-parametric bootstrapping.</p><p><strong>Results: </strong>A total of 826 knees (DXA cohort) [ (mean age 61.9 years (SD 9.1), BMI 29.8 kg/m² (SD 4.5); 60.5% female; 79.8% KL grade ≥ 2)] and 401 knees (MRI cohort) were analyzed. Only severe varus and valgus were associated with osteophyte progression. For severe varus, medial progression was mediated by higher medial paBMD and a higher medial-to-lateral (M:L) paBMD ratio, accounting for 20.3% and 70.7% of the total effect for the femur, and 23.2% and 65.4% for the tibia. Medial trabecular morphometry contributed to medial tibial progression, with indirect effects via higher aBVF (27.2%) and aTb.N (35.4%), and via lower aTb.Sp (12.2%). For severe valgus, lateral progression was mediated by higher lateral paBMD and a lower M:L paBMD ratio, accounting for 14.2% and 67.9% for the femur, and 9.3% and 40.7% for the tibia.</p><p><strong>Conclusions: </strong>Compartment-specific bone measures partly mediate the association between static malalignment and osteophyte progression, suggesting that targeting bone may modify this longitudinal relationship. Key Points • Compartment-specific paBMD mediates the relationship between malalignment and osteophyte progression, with the M:L BMD ratio strengthening this effect more than either medial or lateral paBMD alone. • Medial trabecular morphometry partially mediates the varus alignment-osteophyte progression relationship. • Subchondral bone remodeling is locally driven by mechanical stress, as systemic measures like femoral neck BMD do not mediate the malalignment-osteophyte link.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638088","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":"Elevated proportion of BST2 + CD4 + T cells: a potential biomarker for diagnosis and disease activity in Sjögren's disease.","authors":"Tian Ren, Xin Zhou, Erye Zhou, Cuiping Liu, Jian Wu, Xin Chang, Weichang Chen","doi":"10.1007/s10067-026-07988-1","DOIUrl":"https://doi.org/10.1007/s10067-026-07988-1","url":null,"abstract":"<p><strong>Objective: </strong>We constructed a gene coexpression network to uncover central key genes related to Sjögren's disease (SjD), and investigated the clinical significance of bone marrow stromal antigen 2 (BST2) in SjD.</p><p><strong>Methods: </strong>Two microarray datasets (GSE84844 and GSE66795) were analyzed to construct a gene coexpression network and identify hub genes, using the GSE51092 dataset for validation. The expression of the hub gene BST2 in peripheral blood mononuclear cells (PBMCs) was quantified using reverse transcription quantitative polymerase chain reaction (RT-qPCR), and BST2 expression on T cells subsets was measured using flow cytometry in 35 SjD and 20 healthy controls (HC). Furthermore, we analyzed the correlations between the proportion of BST2 + CD4 + T cells and various clinical and laboratory features.</p><p><strong>Results: </strong>Sixteen hub genes (BST2, IFI27, IFI6, PARP12, HERC6, PLSCR1, LY6E, EIF2AK2, GBP1, IFI44L, RTP4, IFIT2, MX1, OASL, GBP5, and XAF1) were identified through WGCNA. BST2 mRNA expression showed significantly elevated in SjD than HC (p < 0.05). Compared to HC, the proportions of BST2 + cells were markedly higher among the CD3 + , CD4 + , and CD8 + T cell subsets in SjD (p < 0.05). The proportion of BST2 + CD4 + T cells was positively associated with serum IgG and ESR and negatively associated with serum C3 (all p < 0.05). BST2 + CD4 + T cells proportions were more greater in patients with ≥ 2 involved organ systems, fatigue, anemia, interstitial lung disease, high IgG levels, or rheumatoid factor positivity than in those without these manifestations (p < 0.05). Receiver operating characteristic (ROC) curve analysis revealed that the proportion of BST2 + CD4 + T cells was good for the diagnosis and disease activity of SjD.</p><p><strong>Conclusions: </strong>These findings suggest that BST2 may serve as a potential biomarker for identifying and evaluating disease activity of SjD, but further investigattion of this biomarker in SjD is needed. Key Points • Compared with that in HC, the mRNA expression of BST2 in SjD significantly increased. • The proportion of BST2+CD4+ T cells was elevated in SjD, especially among those with active disease and multi-system involvement. • The proportion of BST2+CD4+ T cells was good for diagnosing and evaluating the disease activity of SjD.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638096","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":"Cumulative adverse social determinants of health and the odds of self-reported rheumatoid arthritis: a national study.","authors":"Hanfei Ma, Yawen Xu, Yong Fang, Yunyun Pan","doi":"10.1007/s10067-026-08104-z","DOIUrl":"https://doi.org/10.1007/s10067-026-08104-z","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Rheumatoid arthritis (RA) is a chronic autoimmune disease influenced by not only biological but also social and environmental factors. However, the cumulative associations of multiple social determinants of health (SDoHs) with prevalent RA remain underexplored.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2005-2018, including 32,758 adults aged ≥ 20 years after exclusions. Rheumatoid arthritis (RA) cases (n = 1,832) were identified based on participants' self-reported physician diagnosis using the NHANES arthritis questionnaire. Survey-weighted logistic regression models were applied to examine associations between cumulative social determinants of health (SDoHs) and prevalent RA. Eight SDoH indicators were evaluated: employment status, family income-to-poverty ratio, food security, educational attainment, health insurance coverage, type of health insurance, home ownership, and marital status. Each variable was dichotomized as favorable or unfavorable. A cumulative SDoH score was calculated by summing the number of unfavorable conditions. Survey-weighted logistic regression models were used to assess associations between SDoHs and RA, with stratified analyses by sex and race or ethnicity.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Five SDoHs including unemployment, low income-to-poverty ratio, food insecurity, low educational attainment, and non-private health insurance were independently associated with higher odds of prevalent self-reported RA. A significant graded association was observed between the number of unfavorable SDoHs and the odds of prevalent rheumatoid arthritis. Participants with five unfavorable conditions had 4.69 times higher odds of prevalent RA compared with those with none (95 percent confidence interval 3.42 to 6.44, P for trend &lt; 0.0001). The association was stronger among women and in the White subgroup.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Cumulative exposure to adverse social determinants was cross-sectionally associated with higher odds of self-reported RA. These findings may help inform equity-oriented care and future research; longitudinal studies are needed to clarify temporality and causality. Key Points • Cumulative Association of Social Determinants: The study demonstrates that cumulative exposure to multiple adverse social determinants of health, including unemployment, low income, food insecurity, low education, and non-private health insurance, is significantly associated with higher odds of prevalent self-reported rheumatoid arthritis. • Graded Association: A graded association was observed between the number of unfavorable social determinants and the odds of prevalent rheumatoid arthritis, with a higher number of unfavorable conditions correlating with higher odds of disease. • Sex and Racial/Ethnic Variations: The study found that the associations between social determinants and the odds of prevalen","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147632787","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":"Macrophage 2 plays an important role in axonal lesions and vasculitis in Sjogren's syndrome complicated with peripheral neuropathy.","authors":"Jiaman Zheng, Liying Xu, Jiayu Zhang, Jiying Wei, Ziqi Li, Huihao Ye, Xinhao Chen, Haishan Jiang, Min Yang, Hui Zheng, Chao Yuan","doi":"10.1007/s10067-026-08099-7","DOIUrl":"https://doi.org/10.1007/s10067-026-08099-7","url":null,"abstract":"<p><strong>Objective: </strong>To explore the pathological changes of peripheral neuropathy in Sjogren's syndrome and the role of macrophages in it.</p><p><strong>Methods and results: </strong>Methods: Sural nerve biopsy was performed in 12 patients diagnosed with primary Sjogren's syndrome associated peripheral nervous system involvement (pSS-PN) and 3 traumatic amputees. First, we collected clinical data and electromyography (EMG) findings from 12 pSS-PN patients. Histological assessment of sural nerve specimens was subsequently performed using hematoxylin-eosin (HE) and neurofilament protein (NF) staining under light microscopy. The ultrastructural changes of peripheral nerves were observed by transmission electron microscopy (TEM). Macrophage types were labeled with CD206 and iNOS antibodies by immunohistochemistry and immunofluorescence. The 3 control cases underwent HE staining, CD68 IHC, and TEM.</p><p><strong>Results: </strong>Patients with pSS-PN typically present with symptoms such as neuropathic pain, limb weakness, and sensory disturbances. HE and NF staining revealed mild-to-severe damage to both myelinated and unmyelinated fibers in peripheral nerves, with some cases showing predominant small‑vessel inflammation. Immunohistochemistry and immunofluorescence demonstrated infiltration of CD68⁺ macrophages-predominantly of the M2 phenotype-around small vessels and within nerve bundles. Electron microscopy further illustrated that macrophages progressively strip and engulf myelin sheaths, leaving bare axons. In addition, inflammatory cell infiltration within vasa nervorum led to blood‑cell stasis, endothelial damage, platelet aggregation, and eventual vascular obstruction and collapse.</p><p><strong>Conclusion: </strong>These clinicopathological observations establish vasculitic peripheral neuropathy as the predominant form of pSS‑PN. This prominent infiltration of M2 macrophages in the affected nerves suggests that they play a pivotal role in the pathogenesis of pSS‑PN, potentially offering a novel therapeutic direction for this condition. Key Points • Vasculitic peripheral neuropathy is the main pattern of pSS‑PN, with M2 macrophages heavily infiltrating affected nerves. • Ultrastructural evidence shows macrophages actively stripping myelin sheaths, leading to axonal exposure. • These findings highlight M2 macrophages as a potential new therapeutic direction for pSS-PN.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638101","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":"Unraveling the inflammatory bridge: genomic evidence identifies TNFRSF9 as a potential biomarker linking Sjögren's syndrome to total risk non-Hodgkin lymphoma.","authors":"Hongye Wang, Helin Yan, Mifeng Yang, Yingyi Zhang, Jia Zhang, Mengqian Zhouyang, Bo Zhao","doi":"10.1007/s10067-026-08092-0","DOIUrl":"https://doi.org/10.1007/s10067-026-08092-0","url":null,"abstract":"<p><strong>Background: </strong>Patients with Sjögren's syndrome (SS) are at significantly increased risk of developing non-Hodgkin lymphoma (NHL). However, effective biomarkers to identify the subgroup of SS patients who will progress to lymphoma are currently lacking. This study aims to elucidate the causal mechanisms linking SS to NHL and to identify circulating inflammatory protein biomarkers for risk stratification.</p><p><strong>Methods: </strong>Employing a Mendelian randomization framework and leveraging summary data from large-scale genome-wide association studies, we systematically evaluated the causal effect of SS on NHL (total effect) and the potential mediating roles of 91 circulating inflammatory proteins. The analysis comprised three core steps: total effect assessment, mediator screening, and validation.</p><p><strong>Results: </strong>Genetic evidence confirms that SS is a causal risk factor for NHL (OR = 1.400, 95% CI 1.012-1.938). Among the 91 candidate proteins, 14 showed a causal association with SS. Further validation, however, identified tumor necrosis factor receptor superfamily member 9 (TNFRSF9) as the sole protein that was both significantly upregulated by SS and independently capable of increasing NHL risk (OR = 1.797, 95% CI 1.087-2.970). Mediation analysis quantified its clinical relevance: TNFRSF9 mediates approximately 18% of the SS-associated lymphoma risk.</p><p><strong>Conclusion: </strong>This study not only establishes a causal relationship between SS and NHL but, more importantly, identifies circulating TNFRSF9 as a key functional biomarker linking autoimmunity to lymphomagenesis. This finding suggests that circulating TNFRSF9 levels emerge as a candidate biomarker worthy of further investigation. Future prospective clinical studies are needed to correlate serum TNFRSF9 levels with lymphoma development. Key Points • First genetic evidence establishing a causal link between Sjögren's syndrome and increased risk of non-Hodgkin lymphoma using Mendelian randomization. • TNFRSF9 is identified as a key inflammatory mediator, upregulated by Sjögren's syndrome and independently driving lymphoma risk. • Mediation analysis quantifies that TNFRSF9 accounts for approximately 18% of the total causal effect of Sjögren's syndrome on lymphoma. • A novel biomarker and potential therapeutic target, circulating TNFRSF9 may enable risk stratification in Sjögren's syndrome patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638128","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":"Potential of CAR-T cell immunotherapy in rheumatoid arthritis.","authors":"Ian C Chikanza, Lazaros I Sakkas","doi":"10.1007/s10067-026-08095-x","DOIUrl":"https://doi.org/10.1007/s10067-026-08095-x","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by inflammation and joint destruction. Despite the availability of various treatment options, many patients remain refractory to conventional therapies. Recent advancements in cellular immunotherapy, particularly chimeric antigen receptor T-cell (CAR-T cell) therapy, have demonstrated promising potential in targeting the underlying immunological mechanisms of RA. This paper explores the rationale for CAR-T cell therapy in RA, the mechanisms by which CAR-T cells may exert therapeutic effects, the current state of clinical research, and the challenges that need to be addressed for the successful implementation of CAR-T cell immunotherapy in RA treatment. We also discuss future directions for improving the safety and efficacy of CAR-T cell therapy in autoimmune diseases.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147638154","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}