Clinical Rheumatology最新文献

{"title":"Clinical, radiologic, and serologic predictors of rheumatic disease in interstitial lung disease patients.","authors":"Tugce Bozkurt, Elif Dincses-Nas, Sevilay Batibay, Zeynep Nilufer Tekin, Esen Kasapoglu","doi":"10.1007/s10067-025-07505-w","DOIUrl":"https://doi.org/10.1007/s10067-025-07505-w","url":null,"abstract":"<p><strong>Objective: </strong>Interstitial lung disease (ILD) can be the first manifestation of underlying rheumatic diseases. Identifying autoimmune features in ILD patients is crucial for early diagnosis and management. This study aims to evaluate the prevalence of rheumatic diseases in patients initially referred for ILD and to analyze their clinical, radiological, and serological characteristics.</p><p><strong>Methods: </strong>A total of 181 patients referred to the rheumatology outpatient clinic with suspected ILD, who had no known history of a rheumatologic disease, were retrospectively analyzed. Patients without chest CT/HRCT scans (n = 38) and those without a confirmed ILD diagnosis after radiological re-evaluation (n = 44) were excluded. Demographics, clinical symptoms, serology, and imaging findings were compared between groups.</p><p><strong>Results: </strong>Among the 99 ILD patients, 22 (22.2%) were diagnosed with a rheumatic disease following their ILD diagnosis. The most common rheumatic conditions were primary Sjögren's syndrome (n = 7), systemic sclerosis (n = 5), and rheumatoid arthritis (n = 5). The rheumatic disease-related ILD (RD-ILD) group had a significantly higher female predominance (77.3% vs. 34.7%, p < 0.001) and lower smoking prevalence (p = 0.006) compared to the non-RD-ILD group. Usual interstitial pneumonia was the most frequently observed chest CT/HRCT pattern in both groups. ANA, RF, and ACPA positivity was significantly higher in RD-ILD patients (p = 0.029, p = 0.003, and p = 0.001, respectively). Two patients met the IPAF classification criteria, both exhibiting NSIP patterns on chest CT/HRCT.</p><p><strong>Conclusion: </strong>A substantial proportion of ILD patients were subsequently diagnosed with a rheumatic disease, highlighting the importance of routine autoimmune screening in ILD patients. Female predominance, lower smoking rates, and higher serological positivity in RD-ILD patients suggest that early rheumatologic evaluation could facilitate timely diagnosis and management.</p><p><strong>Key points: </strong>• Interstitial lung disease may be the initial clinical sign of connective tissue diseases, highlighting the essential role of rheumatology in diagnosis and disease management.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274326","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":"Luminex-based pilot study identifies novel serum autoantibodies associated with disease activity in patients with lupus nephritis.","authors":"Huan Zhang, Jiayi Deng, Yang Liu, Wen Xia, Lulu Zhuang, Houan Zhou, Zhengzhao Liu, Haitao Zhang, Weixin Hu","doi":"10.1007/s10067-025-07528-3","DOIUrl":"https://doi.org/10.1007/s10067-025-07528-3","url":null,"abstract":"<p><strong>Objective: </strong>To explore the associations of novel serum autoantibodies with disease activity and organ injuries in patients with lupus nephritis (LN).</p><p><strong>Method: </strong>This study included 75 patients with active LN (5 class II, 37 class IV, and 33 class V). Indirect immunofluorescence was used to measure serum anti-dsDNA; ELISA was used to measure serum anti-PLA2R and anti-C1q, and the Luminex method was used to measure 58 novel serum autoantibodies, with a median fluorescence intensity (MFI)/threshold ≥ 1.5 as the antibody positivity cutoff.</p><p><strong>Results: </strong>The positivity rates for 11 novel antibodies (anti-PLA2R, anti-P2RY11, anti-DEXI, anti-HARS, anti-TUBA1B, anti-KRT8, anti-TUBB, anti-NCL, anti-HSPB1, anti-AGRN, and anti-LGALS8) were highly associated with SLE activity and were inconsistent with those for anti-dsDNA and anti-C1q. Anti-TUBA1B and anti-AGRN positivity may independently influence LN with extrarenal organ involvement (OR = 6.73, 95% CI = 1.19 ~ 38.09; OR = 6.11, 95% CI = 1.32 ~ 28.25, respectively). The positivity rate for anti-PLA2R as detected by the Luminex platform was 40%, whereas the rate among those detected by ELISA was 12.7%. Twenty-one patients who achieved renal remission were retested, and the positivity rates of anti-PLA2R (42.9% vs. 9.5%, P = 0.014), anti-KRT8 (47.6% vs. 4.8%, P = 0.001), and anti-AGRN (38.1% vs. 4.8%, P = 0.008) also significantly decreased from baseline.</p><p><strong>Conclusion: </strong>On the basis of Luminex technology, the present study revealed multiple novel autoantibodies related to SLE activity and organ injury, especially anti-PLA2R, anti-KRT8, and anti-AGRN, thereby providing novel serological markers for the assessment of activity in patients with LN. Anti-TUBA1B and anti-AGRN are strongly associated with extrarenal involvement. Key Points • The Luminex method is highly sensitive and high-throughput for detecting serum autoantibodies. • LN patients with anti-TUBA1B and anti-AGRN positivity are more likely to be complicated by extrarenal organ involvement. • Serum anti-PLA2R, anti-KRT8, and anti-AGRN reflect the activity of SLE and provide novel serological markers for the evaluation of LN patients negative for anti-dsDNA and anti-C1q.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274336","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":"Machine learning and bioinformatics analysis to identify and validate diagnostic model associated with immune infiltration in rheumatoid arthritis.","authors":"Jiayang Jin, Xiaohong Xiang, Xuanlin Cai, Yuke Hou, Zhaoqi Zhang, Jing Li","doi":"10.1007/s10067-025-07514-9","DOIUrl":"https://doi.org/10.1007/s10067-025-07514-9","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is a chronic autoinflammatory condition that can result in significant disability. This study focuses on identifying immune infiltration-related diagnostic biomarkers of RA patients.</p><p><strong>Method: </strong>Publicly available datasets from the Gene Expression Omnibus (GEO) were analyzed using ssGSEA and CIBERSORT algorithms to measure immune cell subset infiltration. Functional enrichment analyses, including Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG), were performed. Additionally, least absolute shrinkage and selection operator (LASSO) regression and machine learning methods, such as random forest, were employed to identify key immune infiltration-related genes. Differential expression of these hub genes between subgroups was compared, and their diagnostic potential was evaluated through receiver operating characteristic (ROC) analysis, validated using GSE93777 and GSE205962 datasets.</p><p><strong>Results: </strong>Analysis of mRNA expression from GSE93272 revealed two distinct clusters: immunity_low (38 samples) and immunity_high (194 samples). A total of 320 differentially expressed genes (DEGs) were identified by intersecting DEGs from these clusters with those from RA and healthy controls (HC). Five hub genes (BMX, BTLA, CENPK, CMPK2, GBP3) were selected using LASSO and machine learning approaches, forming the basis of a diagnostic risk model. This five-gene model demonstrated strong diagnostic performance for distinguishing immune infiltration statuses (AUC = 0.977) and identifying RA patients (AUC = 0.942). External validation with GSE93777 (AUC = 0.807) and GSE205962 (AUC = 0.938) datasets confirmed its reliability.</p><p><strong>Conclusion: </strong>Five key genes associated with immune infiltration were identified, enabling the construction of a diagnostic model for RA. This model shows potential to improve RA diagnosis and facilitate the development of personalized therapeutic strategies. Key Points •RA patients were stratified into two distinct immune subtypes (Immunity_H and Immunity_L) based on ssGSEA analysis of 29 immune gene sets, revealing marked differences in immune activity and HLA gene expression. •Five hub genes including BMX, BTLA, CENPK, CMPK2, and GBP3, were identified through LASSO and Random Forest algorithms, forming a robust risk model that accurately distinguishes RA patients and their immune subtypes. •The predictive model was validated in two independent external cohorts, confirming its diagnostic reliability and generalizability across RA datasets.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274337","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":"Causal effects of lipidomics and osteoporosis-related traits: a Mendelian randomization study.","authors":"Ping Zhu, Ju Li, Deqian Meng, Xinhua Wu, Zhongyuan Zhang, Jiajia Wang, Kai Wang, Shaohua Gu","doi":"10.1007/s10067-025-07532-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07532-7","url":null,"abstract":"<p><strong>Background: </strong>Current studies have demonstrated an association between osteoporosis (OP) and lipidome traits, yet the causal relationship between OP and lipidome remains controversial. Therefore, our aim is to explore the relationship between the lipidome and OP by calculation of genetic susceptibility.</p><p><strong>Methods: </strong>This study utilized a two-sample Mendelian randomization (MR) approach which the instrument variables were derived from a large genome-wide database: lipidome (7174 Finnish individuals), osteoporosis (56,637 samples), fractures (426,795 samples), heel bone density (426,824 samples), whole-body bone density (56,284 samples), femoral neck bone density (32,735 samples), lumbar spine bone density (28,498 samples), and forearm bone density (8143 samples). The primary results were based on inverse variance weighting (IVW) with random effects.</p><p><strong>Results: </strong>Based on the IVW results, we identified 138 significant associations between lipidome traits and osteoporosis and its traits (P < 0.05). Among these, 8, 24, 27, 37, 17, 8, and 17 lipid species were significantly associated with femoral neck bone density, forearm bone density, fractures, heel bone density, lumbar spine bone density, osteoporosis, and whole-body bone density, respectively. Triglycerides were found to be significant protective factors for osteoporosis, forearm BMD, and lumbar BMD, whereas phosphatidylcholine was considered a prominent risk factor for osteoporosis, fractures, heel BMD, and lumbar BMD. The results of the heterogeneity test indicated that our IVW analysis was largely free of heterogeneity (P > 0.05). However, the pleiotropy test revealed significant pleiotropy between heel bone density and the measurement of triacylglycerol (56:6) (P < 0.05).</p><p><strong>Conclusions: </strong>By applying MR methods, this study overcomes the biases inherent in traditional observational studies and provides novel mechanistic insights into lipid metabolism in op. Key Points • One hundred thirty-eight significant associations found. • Triglycerides protective for some bone densities, phosphatidylcholine a risk factor, phosphatidylethanolamine protective against fractures. • Different lipidomic traits associated with various bone measures and fracture risk.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144265516","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":"First case of lupus induced by the Shingrix vaccine: a case report and literature review.","authors":"Coral Arévalo-Cañas, Juan Arévalo-Serrano, Melchor Álvarez de Mon-Soto","doi":"10.1007/s10067-025-07529-2","DOIUrl":"https://doi.org/10.1007/s10067-025-07529-2","url":null,"abstract":"<p><p>The recombinant zoster vaccine (Shingrix) was recently approved for the prevention of herpes zoster reactivation in adults aged ≥ 50 years. While its effectiveness has been widely demonstrated, its safety profile and potential adverse effects remain uncertain. We report the first case of lupus induced by the Shingrix vaccine. An 85-year-old woman was evaluated in the hospital due to a pleuropericarditis with pleural and pericardial effusion. Test for anti-nuclear antibody was positive at a titer of 1:640 with a homogeneous pattern, as well as for IgG anti-cardiolipin antibodies. Infectious or malignant etiologies were excluded. A diagnosis of Shingrix vaccine-induced lupus was suspected, and a short course of prednisone was initiated. The patient's symptoms resolved within the first two months, and after one year of follow-up, both the antinuclear and anti-cardiolipin IgG antibodies were negative. Although many drug categories have been associated with the development of drug-induced lupus erythematosus (DILE), it remains unclear whether vaccine-induced immune system upregulation could trigger the onset of systemic lupus. However, particularly after the introduction of the SARS-CoV2 vaccine, cases of cutaneous and systemic lupus induced by vaccines have been reported, and the serological pattern appears to be different from that observed in drug-induced lupus. Our case details a critical adverse effect observed in a patient who received the zoster vaccine. This finding is particularly relevant given the ongoing widespread vaccination campaigns and the global public health implications. Vaccine-induced lupus should be suspected following vaccination in the presence of cutaneous or systemic lupus symptoms, particularly serositis or renal involvement, when no other cause can be identified. The diagnosis is supported by positive antinuclear antibodies and other laboratory abnormalities, such as decreased complement levels or positivity for other antibodies, including antiphospholipid antibodies. Key Points • The varicella-zoster vaccine will be administered to a large percentage of the population, which could lead to an increase in adverse effects that have not yet been described. This article reports the first documented case of lupus induced by the varicella-zoster vaccine. • The diagnosis of Drug-induced lupus erythematosus (DILE) requires a low threshold of suspicion. • Clinical manifestations in DILE are usually milder, and it often presents with general symptoms, arthralgia, serositis, and hematologic abnormalities. • The autoimmune profile of vaccine-induced lupus appears to differ from that of drug-induced lupus, being characterized by a higher frequency of positive antinuclear antibodies (ANA), antiphospholipid antibodies, and hypocomplementemia, with a lower prevalence of anti-histone antibodies.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144274334","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hyperuricemia is a prognostic marker for antiphospholipid syndrome patients: a retrospective cohort study in China.","authors":"Liang Luo, Qingmeng Cai, Fangning You, Yixi Xing, Tianxing Yi, Yihui Deng, Zhongqiang Yao, Chun Li","doi":"10.1007/s10067-025-07480-2","DOIUrl":"https://doi.org/10.1007/s10067-025-07480-2","url":null,"abstract":"<p><strong>Objective: </strong>Hyperuricemia (HUA) is implicated in inflammation and a prothrombotic state, but its prognostic role in antiphospholipid syndrome (APS) remains uncertain. This study aims to evaluate the prognostic value of HUA in APS and identify optimal serum uric acid (SUA) thresholds for predicting adverse outcomes.</p><p><strong>Methods: </strong>All patients fulfilled the 2006 Sydney criteria for APS were followed up at Peking University People's Hospital (2009-2022). Patients with persistent HUA were included in the HUA group. Comparative analyses were conducted between APS patients with and without HUA. Subgroup and ROC analyses were performed to evaluate prognostic value and identify optimal SUA thresholds.</p><p><strong>Results: </strong>Among 240 primary APS patients, 45 (18.8%) had HUA. APS patients with HUA had a significantly higher 10-year cumulative all-cause mortality (60.8% vs. 6.6%, P = 0.002), APS-related mortality (45.2% vs. 2.0%, P = 0.004), and thrombosis recurrence rates (40.3% vs. 17.2%, P = 0.005). Multivariate Cox mortality analysis showed that HUA was significantly associated with 10-year cumulative all-cause mortality (HR = 6.408, P = 0.010), APS-related mortality (HR = 15.409, P = 0.031), and thrombosis recurrence rates (HR = 3.227, P = 0.014). SUA thresholds predicting all-cause mortality (8.7 mg/dL, OR = 44.121, P < 0.001) and thrombosis recurrence (5.6 mg/dL, OR = 4.145, P = 0.004) were identified.</p><p><strong>Conclusions: </strong>HUA is associated with a higher risk of adverse outcomes in APS patients. SUA thresholds of 8.7 mg/dL and 5.6 mg/dL may serve as predictors of mortality and thrombotic recurrence, providing potential insights for risk stratification and management in APS. Key Points • APS patients with HUA have higher 10-year cumulative mortality and thrombotic recurrence rates. • HUA may serve as a prognostic marker for APS patients. • SUA thresholds of 8.7 mg/dL and 5.6 mg/dL may serve as predictors of mortality and thrombotic recurrence. • Our observations remind clinicians to focus on APS patients with HUA, and adopt appropriate strategies to reduce the recurrence of thrombosis and mortality.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257508","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":"LncRNA PVT1 regulates CD4 + T cell dysregulation in systemic lupus erythematosus: insights from human patients and MRL/lpr mouse.","authors":"Jiali Zhang, Ying Yuan, Shuangying Ni, Siqi Mu, Wanrong Wang, Feiyang Sun, Bo Liang, Peng Lu, Yue Qiu, Wenhui Du, Chenjun Wang, Huijie Duan, Zejuan Hu, Leilei Wen, Xiaodong Zheng, Yujun Sheng, Shengquan Zhang, Shanyu Chen, Xueli Yin, Zhengwei Zhu","doi":"10.1007/s10067-025-07519-4","DOIUrl":"https://doi.org/10.1007/s10067-025-07519-4","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate the role of lncRNA PVT1 in modulating CD4⁺ T cell subsets and its contribution to systemic lupus erythematosus (SLE) pathogenesis in human patients and MRL/lpr mice.</p><p><strong>Methods: </strong>Measured PVT1 and miR-30e-5p expression in SLE patients (n = 65) and healthy controls (HCs) using qRT-PCR. Analyzed Th1/Th2/Th17/Treg cell frequencies by flow cytometry and cytokine levels (IL-2, IL-4, IL-6, IL-17, TGF-β) via ELISA. Constructed lentiviral vectors to silence (SLE + si-Pvt1) or overexpress Pvt1 (SLE + lenti-Pvt1) in MRL/lpr mice (n = 40).</p><p><strong>Results: </strong>PVT1 was upregulated (p = 0.0488) and miR-30e-5p downregulated (p = 0.0095) in SLE patients. Th2 (p = 0.0165) and Th17 (p = 0.0017) cells exhibited a significant increase, while Th1 and Treg cells decreased. Pvt1 silencing reversed SLE phenotypes, increasing Th1 and Treg cells, reducing Th2 and Th17 cells, restoring IL-2 and TGF-β levels and reducing levels of IL-6 and IL-17. Overexpression of Pvt1 exacerbated disease severity. Pvt1 acted as a ceRNA to sponge miR-30e-5p, modulating T-bet/GATA3/RORγt/Foxp3 expression.</p><p><strong>Conclusions: </strong>PVT1 dysregulation disrupts CD4⁺ T cell homeostasis in SLE. Targeting the PVT1/miR-30e-5p axis may restore immune balance and represent a novel therapeutic strategy. Key Points • Our data confirm the imbalance of CD4+ T cell subsets in SLE patients and demonstrate specific upregulation of lncRNA PVT1 expression in female SLE patients. • Targeting lncRNA PVT1 affects Th1/Th2 and Th17/Treg homeostasis in MRL/lpr mice. • Offers fresh insight into the dysregulation of lymphocyte subsets in SLE.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257509","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 efficacy of fire-needle warming therapy in the treatment of knee osteoarthritis of cold-dampness type and its effect on serum IL-1β and MMP-3.","authors":"Tanshu Liu, Qingqing Lian, Yuan Zeng, Binfu Que, Yonglong Tang, Wenbao Wu, Rui Qiu","doi":"10.1007/s10067-025-07497-7","DOIUrl":"https://doi.org/10.1007/s10067-025-07497-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Objective: &lt;/strong&gt;This study aims to explore the clinical efficacy of fire-needle warming therapy in managing knee osteoarthritis attributed to cold-dampness patterns. Specifically, it evaluates the therapy's influence on interleukin-1β (IL-1β) serum concentrations and matrix metalloproteinase-3 (MMP-3).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 80 patients treated for knee osteoarthritis from September 2023 to February 2024. Patients were divided into two groups: 40 received electroacupuncture, and 40 received fire acupuncture combined with warming techniques. The primary outcome measures included treatment efficacy, Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) scores, compare the changes in IL-1β and MMP-3 levels in serum and synovial fluid between two groups, and compare the total knee joint X-ray scores between the two groups: pain levels and knee joint function. Adverse reactions were also recorded.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The fire acupuncture group had a significantly higher treatment efficacy rate (92.5%) compared to the electroacupuncture group (75%, P &lt; 0.05). Both groups showed significant reductions in WOMAC scores post-treatment, with a greater reduction in the fire acupuncture group (P &lt; 0.05). Serum levels of IL-1β and MMP-3 decreased significantly in both groups, with a more pronounced decrease in the fire acupuncture group (P &lt; 0.05). After 4 weeks of intervention and 8 weeks of follow-up, the levels of IL-1β and MMP-3 in the synovial fluid of the fire needle group and the electroacupuncture group were significantly reduced (P &lt; 0.05), and the fire needle group was significantly lower than the electroacupuncture group (P &lt; 0.05). Pain and knee function scores improved significantly in both groups, with the fire acupuncture group showing greater improvements (P &lt; 0.05). After 4 weeks of intervention and 8 weeks of follow-up, the total joint X-ray scores of the fire needle group and the electroacupuncture group were significantly reduced (P &lt; 0.05), and the fire needle group was significantly lower than the electroacupuncture group (P &lt; 0.05). The adverse reaction rate was lower in the fire acupuncture group (5%) compared to the electroacupuncture group (20%, P &lt; 0.05).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Fire-needle warming therapy demonstrates significant clinical efficacy in treating knee osteoarthritis of the cold-dampness type. It effectively reduces inflammation and pain and improves knee function, suggesting its potential for broader clinical application. Further research is recommended to confirm these findings. Key Points • Fire needle acupuncture for knee osteoarthritis: Fire needle acupuncture is highly effective in treating cold-dampness arthralgia-type knee osteoarthritis by promoting blood circulation, enhancing metabolism, and reducing inflammation. • Clinical and biochemical outcomes: Patients receiving fire needle acupuncture showed signi","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257507","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":"Ankle and foot complaints: musculoskeletal ultrasound evaluation compared to clinical assessment.","authors":"Ahmed M Abdalla, Yasser A Aziz, Peter Mandl, Marwa Y Mahgoub","doi":"10.1007/s10067-025-07503-y","DOIUrl":"https://doi.org/10.1007/s10067-025-07503-y","url":null,"abstract":"<p><strong>Background: </strong>The ankle and foot joints are frequently affected by rheumatic and musculoskeletal disorders (RMDs) at all ages, causing pain and limited movement. Ultrasound (US) is an effective tool for assessing soft tissue and monitoring patients with inflammatory and degenerative RMDs.</p><p><strong>Objective: </strong>To examine the frequency and classifications of soft tissue lesions, including tenosynovitis, tendon injuries, and ligament damage, as well as synovitis in the ankle and foot, clinically and with ultrasound evaluation in patients presenting associated symptoms.</p><p><strong>Methods: </strong>A cross-sectional study at two centers of rheumatology, including clinical examination of patients with ankle and/or foot complaints. Ultrasound evaluation included B-mode gray scale, and power Doppler was done. Functional assessment of ankle and foot was performed by the Foot Function Index.</p><p><strong>Results: </strong>A study of 200 ankles and feet were examined in100 patients with rheumatoid arthritis (34%), spondylarthritis (23%), and undiagnosed cases (16%). Joints were more affected than tendons or ligaments, notably the metatarsophalangeal (83%), talonavicular (63%), subtalar (46%), and tibiotalar (35%) joints. The Achilles tendon was most affected in both rheumatoid arthritis and spondylarthritis patients.</p><p><strong>Conclusion: </strong>Subclinical diagnosis and differentiation using ultrasound for ankle and foot pathologies were proven and correlated significantly with patients' function and disability. Key Points • Musculoskeletal US has a beneficial effect in the evaluation of ankle and foot complaints. • The physical activity is severely impacted by the ankle-foot manifestations.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144257506","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":"Mandibular involvement in pediatric chronic nonbacterial osteomyelitis: a retrospective study of 12 patients from a single-center.","authors":"JingXuan Chang, Mu Wang, Ji Li","doi":"10.1007/s10067-025-07498-6","DOIUrl":"https://doi.org/10.1007/s10067-025-07498-6","url":null,"abstract":"<p><strong>Introduction: </strong>The quantitative imaging assessment and comparative effectiveness of second-line treatments for chronic nonbacterial osteomyelitis (CNO) remain inconclusive. Our study aimed to analyze the clinical characteristics and effectiveness of second-line medications in CNO children with mandibular involvement and to evaluate the applicability of the mRINBO (Modified Radiographic Index of Nonbacterial Osteomyelitis) scoring tool.</p><p><strong>Methods: </strong>We conducted a retrospective study of 12 CNO patients who visited Peking Union Medical College Hospital between April 2016 and August 2023. The study included demographic characteristics, clinical manifestations, inflammatory markers, imaging data, and treatment effectiveness. Imaging data were compared using the mRINBO score.</p><p><strong>Results: </strong>Seventy-five percent of the patients had unilateral mandibular involvement, and 33.33% maintained a single lesion throughout the follow-up period. Following second-line treatment, the average mRINBO score decreased from 5.36 ± 1.03 to 4.4 ± 1.43 points (P = 0.023). Clinical symptom scores decreased from a median of 1 (0.875-1) to 0.5 (0-0.5) points (P = 0.023), concurrently. At 9 months of follow-up, the clinical remission rates were 75% for the TNF inhibitors group, and 100% for the bisphosphonate group (P > 0.05).</p><p><strong>Conclusion: </strong>CNO affecting the mandible predominantly involves unilateral involvement, with some children maintaining single-site involvement throughout the course of the disease. The mRINBO scoring tool demonstrates applicability in assessing radiographic changes during follow-up of CNO patients. Second-line treatments show better effectiveness with TNF inhibitors and bisphosphonates, although a comparison of the effectiveness between them needs further investigation. Key Points • CNO affecting the mandible typically involves one side, and some children may exhibit only a single site of involvement. • The mRINBO score tool demonstrates applicability in assessing imaging changes in CNO patients, and baseline scores may be more sensitive than inflammatory markers in reflecting disease activity. • TNF inhibitors and bisphosphonates have shown better effectiveness in treatments for CNO.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246788","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}