Clinical Rheumatology最新文献

{"title":"Association between rheumatoid arthritis and thyroid cancer risk: a real-world cohort study using TriNetX.","authors":"Shih-Wei Lai, Yu-Hung Kuo, Kuan-Fu Liao","doi":"10.1007/s10067-025-07668-6","DOIUrl":"https://doi.org/10.1007/s10067-025-07668-6","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the association between rheumatoid arthritis (RA) and the risk of developing thyroid cancer using real-world data.</p><p><strong>Methods: </strong>This retrospective cohort study was conducted in June 2025 using data from the TriNetX Research Network, a global federated health platform aggregating anonymized electronic medical records from 28 healthcare organizations. Patients aged 20-84 years with RA were identified and matched 1:1 to controls without RA using propensity score matching. Two time-windows were used for cancer outcome assessment: primary analysis with 1-year lag and sensitivity analysis with 180-day lag. Additionally, a Cox proportional hazards regression model was applied to estimate adjusted hazard ratio (HR), controlling for age, sex, and comorbidities.</p><p><strong>Results: </strong>In the primary analysis (1-year lag), 77 of 42,068 patients with RA and 14 of 42,121 controls developed thyroid cancer (cumulative incidence: 0.18% vs. 0.03%; risk ratio: 5.51, 95% CI: 3.12-9.73). In the sensitivity analysis (180-day lag), the association between RA and thyroid cancer remained significant (cumulative incidence: 0.21% vs. 0.05%; risk ratio: 4.36, 95% CI: 2.68-7.08). The Cox model yielded an adjusted HR of 1.40 (95% CI: 1.18-1.67, P < 0.001), further supporting the association between RA and increased thyroid cancer risk.</p><p><strong>Conclusion: </strong>Rheumatoid arthritis is associated with a significantly elevated risk of thyroid cancer. Further studies are needed to explore underlying mechanisms and guide cancer surveillance strategies in care of patients with rheumatoid arthritis. Key Points • Patients with rheumatoid arthritis experience a significantly increased burden of cancers. • The Cox model yielded an adjusted hazard ratio of 1.40 (95% CI: 1.18-1.67), further supporting the association between rheumatoid arthritis and increased thyroid cancer risk. • Further studies are warranted to explore underlying mechanisms and guide cancer surveillance strategies in care of patients with rheumatoid arthritis.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145184769","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":"Molecular analysis of TNFAIP3, PTPN22, IRF5, and IL-10 gene polymorphisms in palindromic rheumatism.","authors":"Aynaz Asgharvand-Hajeb, Sima Shahmohammadi-Farid, Maryam Saberivand, Azam Safary, Kamran Javidi-Aghdam, Raha Khabbazi, Alireza Khabbazi","doi":"10.1007/s10067-025-07652-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07652-0","url":null,"abstract":"<p><strong>Objective: </strong>Palindromic rheumatism (PR) is characterized by frequent and irregular attacks of pain and swelling in the joints and peri-articular structures. In this study, we investigated TNFAIP3, PTPN22, IRF5, and IL-10 genes' single-nucleotide polymorphisms (SNPs) in patients with PR.</p><p><strong>Methods: </strong>In a cross-sectional study, patients with a diagnosis of PR and two control groups, including rheumatoid arthritis (RA) patients and healthy controls (HCs), were recruited. All participants were Azeri. The TNFAIP3 (rs2230926, rs5029937), PTPN22 (rs1217407, rs1217413), IRF5 (rs10954213, rs2004640), and IL-10 (rs1800872, rs1800896) gene SNPs were genotyped.</p><p><strong>Results: </strong>Eight SNPs were genotyped in 25 PR patients, 41 RA patients, and 40 HCs. The TT genotype of TNFAIP3 rs2230926 and GG genotype of IL10 rs1800872 polymorphisms were less common in the PR group compared to the RA and HC groups. The C allele of TNFAIP3 rs2230926 polymorphism was more common in the PR group compared to the RA and HC groups. The TC genotype and C allele of IL10 rs1800896 and AG genotype of IRF5 rs10954213 polymorphisms were more common in the PR group compared to the HCs; however, there were no significant differences between the PR and RA groups. No significant difference was observed in the distribution of TNFAIP3 rs5025937, IRF5 rs2004640, PTPN22 rs1217413, and PTPN22 rs1217407 genotypes and alleles between the studied groups.</p><p><strong>Conclusions: </strong>Carrying C allele of TNFAIP3 rs2230926, CC and TC genotypes and C allele of IL10 rs1800896, and AG genotype of IRF5 rs10954213 polymorphisms are associated with PR in the Azeri population. Key Points • The TT genotype of the TNFAIP3 rs2230926 polymorphism is less common in patients with palindromic rheumatism than in patients with rheumatoid arthritis and healthy individuals. • The GG genotype of the IL10 rs1800872 polymorphism is less common in patients with palindromic rheumatism than in patients with rheumatoid arthritis and healthy individuals. • The CC and TC genotypes, C allele of IL10 rs1800896, and AG genotype of IRF5 rs10954213 polymorphism are more common in patients with palindromic rheumatism than in healthy individuals, but there is no difference between patients with palindromic rheumatism and rheumatoid arthritis.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191040","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":"Glucagon-like peptide-1 receptor analog use is associated with reduced thromboembolic events compared with dipeptidyl peptidase-4 inhibitors in rheumatoid arthritis patients: A global retrospective cohort study.","authors":"Qi Wang, Donald D Anthony","doi":"10.1007/s10067-025-07709-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07709-0","url":null,"abstract":"<p><strong>Objective: </strong>Rheumatoid arthritis (RA) is an inflammatory disease associated with thromboembolic events. Glucagon-like peptide-1 (GLP-1) analogs, which are used in type 2 diabetes mellitus (T2DM), have shown potential anti-inflammatory effects, but their role in thrombotic events in RA is less clear. This study compares GLP-1 analogs to dipeptidyl peptidase 4 inhibitors (DPP4i) regarding thromboembolic events in RA.</p><p><strong>Methods: </strong>We performed a retrospective cohort study using TriNetX database to evaluate adult patients who carried the diagnosis of RA from January 1, 2006 to December 1, 2024 with co-existing T2DM and who initiated GLP-1 analogs or DPP4i after diagnosis of RA and T2DM. Patients were divided into two cohorts (GLP-1 vs. DPP4i), and the primary outcome was all thromboembolic events (cerebral infarction, myocardial infarction [MI], deep vein thrombosis [DVT], pulmonary embolism [PE]) within 5 years after GLP-1 analog or DPP4i start. Secondary outcomes included individual events, arterial and venous thrombosis, and all-cause mortality. Propensity score matching adjusted for demographic, clinical, and treatment variables.</p><p><strong>Results: </strong>We analyzed 41,153 patients, including 25,425 GLP-1 analog and 15,728 DPP4i users, and compared 8,697 matched patients in each group. The median age at medication start was 65 years old, with 70% females. GLP-1 analog users had a 24% lower risk of all thrombotic events (hazard ratio [HR], 0.76 [95% CI: 0.70, 0.83]; p < 0.0001), as well as reduced risks of individual events and an overall lower mortality.</p><p><strong>Conclusion: </strong>Compared to DPP4i, GLP-1 analogs may lower the risk of thromboembolic events and reduce all-cause mortality in RA patients with T2DM. Key Points • The study identified significantly reduced risks in both arterial and venous thrombosis in RA patients receiving GLP-1 analogs compared with DPP4i. • RA patients who received GLP-1 analogs had lower all-cause mortality compared to those receiving DPP4i. • These findings support potential dual benefit of GLP-1 analogs in reducing inflammation and thrombosis in RA patients with diabetes.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145181815","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":"Immature granulocyte percentage: a practical marker of acute ınflammation in pediatric familial mediterranean fever: A retrospective observational case-control study.","authors":"Pelin Özcan, Arif İsmet Çatak","doi":"10.1007/s10067-025-07698-0","DOIUrl":"https://doi.org/10.1007/s10067-025-07698-0","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;Familial Mediterranean Fever (FMF) is a monogenic autoinflammatory disease characterized by recurrent febrile attacks and serositis. Despite its clinical severity, especially in pediatric patients, there is no specific biomarker to objectively differentiate between attack and remission periods. This study aimed to evaluate the clinical utility of immature granulocyte percentage (IG%) in predicting FMF attacks and compare it with traditional inflammatory markers.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Ninety-six pediatric FMF patients diagnosed according to Tel-Hashomer criteria and 68 age- and sex-matched healthy controls were included. IG%, neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), systemic immune-inflammation index (SII), and conventional acute phase reactants (CRP, SAA, fibrinogen) were assessed during both attack and attack-free periods. ROC analysis was performed to determine the diagnostic performance of IG%.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;IG%, NLR, PLR, and SII were significantly elevated during attacks compared to both attack-free patients and controls (p &lt; 0.001 for all). IG% showed no significant difference between attack-free patients and controls (p = 0.581), indicating its specificity for acute inflammation. IG% correlated with SAA (r = 0.250, p = 0.014) and platelet count (r = 0.222, p = 0.030). ROC analysis identified an IG% cut-off value of 0.3 with 81.3% sensitivity and 85.4% specificity (AUC = 0.891). For comparison, CRP exhibited the highest diagnostic accuracy (AUC = 0.981), followed by SAA (AUC = 0.963). Although slightly less powerful than these conventional markers, IG% offers unique clinical value due to its rapid availability and cost-effectiveness. IG% levels were unaffected by MEFV mutation subtype.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;IG% is a reliable, rapid, and cost-effective biomarker for distinguishing acute attacks in pediatric FMF. While CRP and SAA demonstrated higher overall diagnostic accuracy, IG% provided greater specificity by normalizing during remission, highlighting its role as a complementary marker. Its independence from genetic variations and availability via routine CBC supports its practical use in clinical monitoring. Key Points • Immature granulocyte percentage (IG%) is a simple biomarker that can be automatically obtained from routine complete blood counts without additional cost or laboratory procedures. • In pediatric Familial Mediterranean Fever (FMF), IG% was significantly elevated during acute attacks but not in attack-free periods, suggesting its specificity for acute inflammation. • ROC analysis demonstrated good diagnostic performance of IG% (AUC = 0.889), while CRP and SAA showed higher AUCs but remained mildly elevated during remission, reducing their specificity. • Compared to conventional markers, IG% provides a rapid, cost-effective, and practical advantage for clinicians, especially in pediatric settings. • IG% may serve as a c","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145148096","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":"Effects of 36.5 Hz pulsed LASER acupuncture on pain and disease impact in fibromyalgia patients: A pilot randomized clinical trial.","authors":"Rosana Aparecida De Lima, Érika Almeida Boggiss, Rhaynara Coelho Rosário, Paula Aparecida Silva, Rosa Maria Moreira, Karol Priscila Da Silva, Caroline Lima De Farias, Vanessa de Queiroz Dos Santos, Adriana Teresa Silva Santos, Andréia Maria Silva Vilela Terra","doi":"10.1007/s10067-025-07691-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07691-7","url":null,"abstract":"<p><strong>Background: </strong>Continuous laser acupuncture is widely used to treat chronic pain, particularly fibromyalgia. This condition causes both physical and psychological disability, leading to reduced quality of life. However, little is known about the therapeutic effects of laser acupuncture delivered at pulsed frequency. This study aimed to evaluate the effect of laser acupuncture at 36.5 Hz pulsed frequency, applied to Ryodoraku electrodiagnostic points, on pain intensity and the impact of fibromyalgia.</p><p><strong>Methods: </strong>DESIGN: Pilot randomized controlled clinical trial.</p><p><strong>Setting: </strong>Human Performance Research Laboratory at the university's physical therapy clinic.</p><p><strong>Participants: </strong>Twenty volunteers (aged 40-78 years) with a clinical diagnosis of fibromyalgia syndrome.</p><p><strong>Interventions: </strong>Participants were randomly allocated into two groups. The Control Group (n = 10) received a 30-min educational lecture on fibromyalgia, while the Experimental Group (n = 10) underwent laser acupuncture treatment twice a week for three weeks.</p><p><strong>Main outcome measures: </strong>Pain Numeric Rating Scale, Generalized Pain Index, Symptom Severity Scale, and Fibromyalgia Impact Questionnaire.</p><p><strong>Results: </strong>Compared with the Control Group, the Experimental Group showed significantly lower scores on the Pain Numeric Rating Scale (p < 0.05; effect size = 2.07; power = 0.99), Generalized Pain Index (p < 0.05; effect size = 1.88; power = 0.97), Symptom Severity Scale (p < 0.05; effect size = 2.55; power = 0.99), and Fibromyalgia Impact Questionnaire (p < 0.05; effect size = 2.76; power = 0.99).</p><p><strong>Conclusions: </strong>Laser acupuncture at 36.5 Hz pulsed frequency, applied to Ryodoraku electrodiagnostic points, demonstrated beneficial effects on pain intensity and functional impact in individuals with fibromyalgia syndrome. Key Points • LASER acupuncture has a positive effect on pain intensity.. • LASER acupuncture has an impact on fibromyalgia syndrome.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136665","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 serum uric acid as an independent risk factor for multiple stent placement in non-hypertensive, non-diabetic patients with coronary artery disease: a retrospective cohort analysis.","authors":"Qingyan Li, Jianguo Li, Mengwen Niu, Tianshu Chu, Lemei An","doi":"10.1007/s10067-025-07602-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07602-w","url":null,"abstract":"<p><strong>Background: </strong>While the relationship between serum uric acid (SUA) and coronary artery disease (CAD) remains controversial, emerging evidence suggests a particularly significant association in patients lacking traditional cardiovascular risk factors. The specific role of hyperuricemia in determining CAD severity in non-hypertensive, non-diabetic populations warrants further investigation.</p><p><strong>Methods: </strong>In this retrospective cohort study, we analyzed 716 consecutive CAD patients undergoing percutaneous coronary intervention (PCI), with a focus on 279 individuals without hypertension or diabetes. We employed multivariable logistic regression and stratified analyses to assess the independent association between SUA levels and multiple stent implantation (≥ 2 stents), a robust indicator of CAD complexity, and prognosis. Hyperuricemia was defined using gender-specific thresholds (> 420 μmol/L for males and postmenopausal females; > 360 μmol/L for premenopausal females).</p><p><strong>Results: </strong>In the overall cohort, multivessel disease (OR = 2.27, 95% CI 1.94-3.96, p < 0.001) and diabetes (OR = 1.47, 95% CI 1.05-2.07, p = 0.027) independently predicted multiple stent placement. Notably, in the non-hypertensive, non-diabetic subgroup, hyperuricemia emerged as a strong independent predictor (OR = 4.62, 95% CI 1.93-11.07, p = 0.001), exceeding the predictive value of multivessel disease (OR = 3.16, 95% CI 1.78-5.55, p < 0.001). No significant association was observed between SUA levels and stent number in the broader cohort.</p><p><strong>Conclusions: </strong>Elevated serum uric acid independently predicts complex coronary lesions requiring multiple stent placements in non-hypertensive, non-diabetic CAD patients. These findings suggest that uric acid assessment may enhance risk stratification in this specific patient population, warranting further investigation into its clinical implications. Key Points • Elevated serum uric acid is an independent predictor of complex coronary lesions requiring multiple stent placements in non-hypertensive, non-diabetic patients with coronary artery disease, highlighting its potential role in risk stratification for this specific population.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136678","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":"Serological distribution of anti-endothelial cell antibodies and their association with laboratory indicators in autoimmune and immune-mediated diseases.","authors":"Renren Ouyang, Xu Yuan, Rujia Chen, Wei Wei, Yun Wang, Ting Wang, Lin Zhu, Shiji Wu, Feng Wang, Hongyan Hou","doi":"10.1007/s10067-025-07692-6","DOIUrl":"https://doi.org/10.1007/s10067-025-07692-6","url":null,"abstract":"<p><strong>Background: </strong>Anti-endothelial cell antibodies (AECA) are implicated in vascular injury associated with autoimmune and inflammatory diseases. However, their distribution and clinical significance across diverse conditions remain inadequately characterized.</p><p><strong>Methods: </strong>We analyzed 1,334 serum samples from patients with vasculitis, systemic autoimmune diseases, kidney diseases, arthritis, and other immune-mediated disorders. AECA titers were measured using indirect immunofluorescence assays and categorized as low (1:100), moderate (1:320) or high (1:1000). Laboratory parameters, including hematological, renal, hepatic, and coagulation indicators, were compared among different AECA titer groups within each disease category.</p><p><strong>Results: </strong>AECA positivity was most frequently observed in vasculitis (40.6%), arthritis (44.4%), and autoimmune kidney diseases (25.5%). Higher titers were especially common in Behet's disease, ANCA-associated vasculitis, and ankylosing spondylitis. In autoimmune nephropathy, patients with moderate to high AECA titers (≥ 1:320) exhibited significantly elevated serum creatinine and urea levels compared to both AECA-negative and low-titer groups, suggesting impaired renal function. In the kidney disease subgroup, higher AECA titers indicated lower red blood cell counts and decreased estimated glomerular filtration rate (eGFR). Among systemic autoimmune diseases, moderate to high AECA titers were linked to significantly reduced white blood cell counts.</p><p><strong>Conclusion: </strong>AECAs show heterogeneous distribution across immune-mediated diseases and are linked to laboratory abnormalities inidicative of endothelial injury and organ dysfunction. These findings support the potential role of AECA titier as biomarkers for systemic involvement, warranting validation in prospective studies. Key Points • Anti-endothelial cell antibodies (AECAs) are heterogeneously distributed across a broad spectrum of immune-mediated diseases. • AECA positivity is associated with disease-specific patterns, particularly in Behçet's disease and ANCA-associated vasculitis. • AECA may serve as potential serological biomarkers for disease severity and immune-mediated endothelial injury.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124054","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 tooth loss and clinical complications in rheumatoid arthritis: a pilot study.","authors":"Laura Silva Siano Rodrigues, Victoria Boëchat Feyo, Lydia Silva Provinciali, José Jonas Pereira, Cristhiane Almeida Leite da Silva, Viviane Angelina de Souza, Cynthia Savioli, Gisele Maria Campos Fabri","doi":"10.1007/s10067-025-07647-x","DOIUrl":"https://doi.org/10.1007/s10067-025-07647-x","url":null,"abstract":"<p><strong>Introduction: </strong>Rheumatoid Arthritis (RA) is a chronic autoimmune disease that affects the oral cavity, contributing to the development of periodontal disease (PD), an inflammatory condition that has a bidirectional relationship with various systemic conditions and can lead to tooth loss (TL).This study aimed to evaluate whether the number of missing teeth could serve as an additional indicator for the medical team in assessing the association with systemic disease exacerbations.</p><p><strong>Methods: </strong>This pilot study assessed patients with rheumatoid arthritis (RA) using specific protocols, including medical record analysis and a systematic orofacial examination to calculate the Decayed, Missing, and Filled Teeth (DMFT) index. Validated questionnaires were applied, and the disease activity (DAS-28) and functional capacity (HAQ) indices were collected.</p><p><strong>Results: </strong>The study included 21 patients with a mean DAS28 of 3.12 and a mean HAQ of 1.077. Of these, 7 (33.4%) were in remission, while 14 (66.6%) had some level of disease activity. 10 (47%) had moderate to severe disability due to RA. Statistical analysis identified polypharmacy as a clinically relevant factor associated with tooth loss (p = 0.029; r = 0.48). Additionally, patients with disease activity had higher DMF-T scores. Correspondence analysis indicated that polypharmacy was associated with a higher prevalence of moderate to severe disability (HAQ) and higher DMF-T scores.</p><p><strong>Conclusion: </strong>It is concluded that there is a relationship between the DMF-T index, RA activity, the number of missing teeth, and the need for polypharmacy, making these data important to be assessed in the clinical routine of RA patients. Additional studies are necessary to explore this association in greater depth and strengthen the evidence base.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124620","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":"Investigating the causal role of the gut microbiome in Kawasaki disease: mediating effects of immune cells.","authors":"Youfei Fan, Shuo Zhang, Feng Guo","doi":"10.1007/s10067-025-07687-3","DOIUrl":"https://doi.org/10.1007/s10067-025-07687-3","url":null,"abstract":"<p><strong>Introduction: </strong>The etiology of Kawasaki disease (KD), a leading cause of acquired heart disease in children, is unknown, though a link to the gut microbiome is suspected. This study aimed to move beyond association by establishing a causal relationship between gut microbiota and KD, and to explore the immune pathways involved.</p><p><strong>Method: </strong>We conducted a two-step, two-sample MR study using GWAS summary data from European-ancestry cohorts. Genetic variants for 471 gut microbiota were used as instruments. The primary causal estimate was derived using the inverse-variance weighted (IVW) method, validated with nine sensitivity analyses. A subsequent two-step MR analysis assessed mediation by 731 immune cell phenotypes.</p><p><strong>Results: </strong>We identified 17 gut microbiota taxa causally associated with KD. Robust analyses consistently supported a protective association for Ensifer (beta = -3.33, P = 0.01) and a risk-increasing association for Lawsonibacter sp900066645 (beta = 3.05, P = 0.02). The protective effect of Ensifer was partially mediated by its influence on CD8dim Natural Killer T %lymphocyte (10.71% mediation). The risk-increasing effect of Coprobacter secundus was mediated through CD27 on CD20- B cells (9.41% mediation).</p><p><strong>Conclusion: </strong>This study provides the first genetic evidence for a causal link between specific gut microbiota and KD, with effects partially mediated by the immune system. These findings highlight the gut-immune axis in KD pathogenesis and offer genetically validated targets for novel therapeutic strategies. Key Points • This study is the first to use Mendelian Randomization to establish a causal link between specific gut microbiota and Kawasaki disease. • It identifies 17 specific microbial taxa that causally increase or decrease the risk of developing the disease. • The research elucidates the mechanistic pathway, showing that the effects of the gut microbiota on Kawasaki disease are partially mediated by specific immune cell populations. • The findings provide genetically validated targets (specific microbes and immune cells) for developing novel therapies and preventative strategies for Kawasaki disease.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124568","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":"Seasonal variation influences fibromyalgia severity in terms of widespread pain among female patients: data from a large national registry.","authors":"Marco Di Carlo, Sonia Farah, Manuela Di Franco, Cristina Iannuccelli, Annunziata Capacci, Serena Guiducci, Giovanni Biasi, Roberto Giacomelli, Laura Bazzichi, Fabiola Atzeni, Piercarlo Sarzi-Puttini, Fausto Salaffi","doi":"10.1007/s10067-025-07697-1","DOIUrl":"https://doi.org/10.1007/s10067-025-07697-1","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Seasonal variation may influence musculoskeletal pain, and fibromyalgia is primarily characterized by widespread chronic pain. This study aimed to assess whether symptom severity in fibromyalgia varies by season.</p><p><strong>Methods: </strong>A retrospective, cross-sectional analysis was conducted on patients from the Italian Fibromyalgia Registry. Patients were grouped based on the season of their clinical evaluation. Disease severity was measured using disease-specific clinimetric tools: the Polysymptomatic Distress Scale (PSD), including the Widespread Pain Index (WPI) and Symptom Severity Scale (SSS), as well as the revised Fibromyalgia Impact Questionnaire (FIQR) and the modified Fibromyalgia Assessment Status (FASmod). Statistical analyses included the Kruskal-Wallis test and pairwise comparisons using the Dwass-Steel-Critchlow-Fligner test.</p><p><strong>Results: </strong>A total of 2614 patients were evaluated. Significant seasonal differences were found for both WPI (p = 0.042) and FASmod (p = 0.037). In female patients, these differences were more pronounced (WPI, p = 0.016; FASmod, p = 0.018), while no significant variation was observed in males. Pairwise analysis showed higher symptom severity in autumn compared to summer for both WPI (W = -4.009; p = 0.024) and FASmod (W = -3.800; p = 0.037).</p><p><strong>Conclusion: </strong>In fibromyalgia, widespread pain appears more severe in autumn than in summer, particularly among female patients. These findings highlight the potential role of seasonality in symptom modulation and underscore the importance of incorporating seasonal factors into patient management and education.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124578","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}