Clinical Rheumatology最新文献

{"title":"Clinical Characteristics, Imaging Patterns and Management in Male and Female Patients with Primary Sjögren's Syndrome-associated Interstitial Lung Disease.","authors":"Guanning Zhong, Congcong Zhang, Weiwei Xie, Xiaorui Ding, Naihui Wan, Tong Ji, Suwan Chen, An Yuan, Xiaoyan Xin, Jinghong Dai","doi":"10.1007/s10067-025-07578-7","DOIUrl":"10.1007/s10067-025-07578-7","url":null,"abstract":"<p><strong>Introduction: </strong>The influence of sex on primary Sjögren's disease-associated interstitial lung disease (pSjD-ILD) remains poorly understood. Therefore, we aimed to investigate the sex-related differences in the clinical characteristics and outcomes of pSjD-ILD.</p><p><strong>Methods: </strong>Consecutive patients with pSjD-ILD in Nanjing University Affiliated Drum Tower Hospital from November 2007 to November 2022 were enrolled. Demographics, comorbidities, laboratory parameters, imaging patterns, pulmonary function tests, and treatments were compared between male and female patients. Kaplan-Meier method was used to assess survival. Cox proportional hazards model was employed to identify prognostic factors.</p><p><strong>Results: </strong>A total of 125 male and 433 female patients were enrolled. Male patients had a higher prevalence of pulmonary hypertension (33.0% vs 20.6%, p = 0.014), overall cancer (14.4% vs 6.7%, p = 0.006), and radiological usual interstitial pneumonia (UIP, 28.0% vs 16.2%, p = 0.003). They also had higher usage of antifibrotic drugs (24.8% vs 16.2%, p = 0.027). In contrast, female patients had higher positive rates for antinuclear antibody (83.6% vs 73.6%, p = 0.011) and anti-Ro52 antibody (59.8% vs 44.8%, p = 0.003). No differences existed in the total ESSDAI score between male and female patients. Follow-up data showed that male patients had higher 3-year (32.3% vs 18.0%, p = 0.003) and 5-year mortality (52.4% vs 35.0%, p = 0.006) compared to female patients. Multivariate Cox model indicated that age (HR 1.058, p < 0.001) and UIP (HR 1.874, p = 0.009) were significant prognostic factors.</p><p><strong>Conclusions: </strong>In pSjD-ILD, male patients tend to have more severe pulmonary manifestations, higher frequencies of pulmonary hypertension and cancer, and poorer outcomes compared to female patients. Key points • Male pSjD-ILD patients were more likely to suffer from pulmonary hypertension and cancer than their female counterparts. • Radiological UIP pattern was more frequently observed in male patients with pSjD-ILD than in female patients. • Male patients with pSjD-ILD had higher 3-year and 5-year mortality than female patients.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4071-4080"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144803797","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":"Lupus hepatitis as the primary cause: a retrospective analysis of liver biopsy in systemic lupus erythematosus with unexplained liver function abnormalities from two centers in Southern China.","authors":"Xuan Yin, Zhendong He, Hanyou Mo, Xiaohong Luo, Yuanyuan Xiao","doi":"10.1007/s10067-025-07613-7","DOIUrl":"10.1007/s10067-025-07613-7","url":null,"abstract":"<p><strong>Objective: </strong>To assess the clinical utility and safety of liver biopsy in diagnosing systemic lupus erythematosus (SLE) patients with unexplained liver function abnormalities. Additionally, this study aims to deeply explore the etiological spectrum of such SLE cases.</p><p><strong>Methods: </strong>A retrospective analysis was conducted on the pathological results and clinical characteristics of SLE patients who underwent liver biopsy due to liver function abnormalities in the First Affiliated Hospital of Guangxi Medical University and the Affiliated Hospital of Guilin Medical College from June 2017 to December 2023.</p><p><strong>Results: </strong>A total of 73 SLE patients who underwent liver biopsy were included in the study. Among 73 patients, 71 (97.3%) achieved definitive diagnoses. Etiological distribution included: lupus hepatitis (50 cases, 68.5%), drug-induced liver injury (6 cases, 8.2%), autoimmune hepatitis (AIH, 5 cases, 6.8%), viral hepatitis (4 cases, 5.5%), fatty liver (3 cases, 4.1%), and 1 case each (1.4%) of primary biliary cirrhosis (PBC), AIH-PBC overlap syndrome, and glycogen storage disease. Two cases (2.7%) remained undetermined.</p><p><strong>Conclusion: </strong>Based on the histological analysis, lupus liver damage emerged as the most prevalent cause of unexplained abnormal liver function test results in SLE patients. Both autoimmune hepatitis and lupus hepatitis have the potential to progress with fibrotic hyperplasia, ultimately leading to cirrhosis. Liver biopsy demonstrated its safety and significant value in the etiological diagnosis of SLE patients with unexplained abnormal liver function. Clinical characteristics can offer valuable clues for etiological speculation, and pathological examination remains indispensable for accurate disease diagnosis and progression assessment.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3899-3908"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144815997","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":"Evaluation of Endocan, endothelial nitric oxide synthase, and solubleCD89 in children with IgA vasculitis.","authors":"Fehim Akgüngör, Fatih Temiz, Yaşar Kandur","doi":"10.1007/s10067-025-07659-7","DOIUrl":"10.1007/s10067-025-07659-7","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;IgA vasculitis (IGAV) is the most frequently encountered form of vasculitis in the pediatric population and typically follows a self-limiting course. In addition to well known inflammatory markers, several other inflammatory mediators, including Endocan, endothelial nitric oxide synthase (eNOS), and soluble CD89 (sCD89), have not been extensively investigated in the context of IGAV. The aim of this study was to evaluate the association between Endocan, endothelial nitric oxide synthase (eNOS), and soluble CD89 (sCD89) and established inflammatory markers (CRP, erythrocyte sedimentation rate), as well as their relationship with clinical manifestations and laboratory findings in pediatric patients diagnosed with IGAV.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;Patients diagnosed with IGAV during the study period (December 2019 to May 2021) were included in the study. These patients were invited for a follow-up visit 3 months after diagnosis. Additionally, 35 healthy children, matched for age and gender and with no known diseases, were included as a control group. At both the time of diagnosis and the 3-month follow-up, blood samples were collected in EDTA tubes in addition to routine hematological and biochemical tests. The samples were centrifuged at 4000 rpm for 10 min and stored at -80 °C. Endocan, sCD89, and eNOS levels were measured using ELISA kits.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The mean sCD89 level in the patient group, both during the acute and remission phases, was significantly lower than in the control group (1.42 ± 0.53 ng/mL and 1.46 ± 0.80 ng/mL vs. 1.83 ± 0.73 ng/mL; p = 0.010 and p = 0.004, respectively). However, there was no statistically significant difference in sCD89 levels between the acute and remission phases within the patient group (p = 0.376). The Endocan level during the remission phase was significantly lower in patients compared to the control group (378.4 ± 238.1 ng/mL vs. 478.9 ± 240.9 ng/mL; p = 0.014). However, no significant difference was found between the control group and the acute phase (p = 0.911). A statistically significant difference in Endocan levels was observed between the acute and remission phases in patients (p = 0.004) (Table 1). The mean eNOS level in the patient group, both during the acute and remission phases, was significantly lower than in the control group (25.29 ± 14.07 U/mL and 30.12 ± 18.10 U/mL vs. 37.71 ± 19.48 U/mL; p = 0.004 and p = 0.031, respectively). However, there was no statistically significant difference in eNOS levels between the acute and remission phases (p = 0.334).&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;The unexpectedly low levels of these vascular mediators may be due to the fact that endothelial damage in IGAV is triggered by immune complex-mediated mechanisms rather than a proinflammatory cytokine-driven process, which may result in reduced or suppressed endocan release. Secondly IGAV is primarily caused by the deposition of IgA1 immune complexes in t","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4187-4191"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945392","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":"A systematic review and network meta-analysis comparing the efficacy and safety of deucravacitinib versus selected treatments for moderate to severe plaque psoriasis.","authors":"Jiaqi Chen, Xinbo Yin, Xuewei Kan, Pingping Yao, Jun Tang","doi":"10.1007/s10067-025-07597-4","DOIUrl":"10.1007/s10067-025-07597-4","url":null,"abstract":"<p><strong>Objective: </strong>To assess deucravacitinib's efficacy and safety against selected treatments for moderate-to-severe plaque psoriasis via network meta-analysis.</p><p><strong>Methods: </strong>Relevant studies were selected via a systematic literature search in PubMed, EMBASE, Web of Science, and Cochrane Library databases. To assess the ORs with corresponding 95% CIs for outcomes including PASI 75, PASI 90, sPGA 0/1, and treatment discontinuation due to adverse events over the 10-16-week timeframe, a network meta-analysis was performed utilizing R software. Treatment efficacy and safety were comparatively ranked by calculating the surface under the cumulative ranking curve (SUCRA).</p><p><strong>Results: </strong>This study included 66 trials of 27,074 patients. All interventions outperformed placebo in short-term outcomes. Infliximab ranked the highest for achieving PASI 75 (OR, 0.01; 95% CI, 0.00 to 0.01, moderate-to-high-quality evidence). Bimekizumab ranked the highest for achieving PASI 90 (OR, 0.00; 95% CI, 0.00 to 0.01, moderate-to-high-quality evidence). Tildrakizumab ranked the highest for achieving sPGA 0/1 (OR, 0.01; 95% CI, 0.00 to 0.05, low-to-high-quality evidence). Brodalumab had the highest risk of discontinuation due to adverse events (OR, 1.28; 95% CI, 0.36 to 5.04, moderate-to-high-quality evidence).</p><p><strong>Conclusions: </strong>Accumulating research, albeit of differing robustness, suggests that bimekizumab could potentially offer superior efficacy compared to other therapies in attaining both the PASI 75 and PASI 90 response thresholds in psoriasis treatment. Tildrakizumab appears to have achieved the highest proportion of participants reaching a static Physician's Global Assessment (sPGA) score of clear or almost clear (sPGA 0/1). Deucravacitinib has demonstrated moderate efficacy and tolerability; however, additional head-to-head comparative trials are warranted to substantiate its effects due to the paucity of existing studies. Key Points • The NMA of 66 RCTs reveals that infliximab, bimekizumab, and tildrakizumab are superior in achieving PASI 75, PASI 90, and sPGA 0/1, respectively, in moderate-to-severe plaque psoriasis, underscoring their therapeutic significance. • Deucravacitinib, an oral TYK2 inhibitor, outperforms placebo and apremilast in efficacy for moderate-to-severe plaque psoriasis. Its once-daily dosing may enhance adherence, presenting a promising oral therapy. • The study's strengths are its assessment of deucravacitinib's short-term effects, use of high-quality RCTs, and analytical rigor. Limitations involve varying trial durations and reporting biases. Sensitivity analyses were conducted to ensure robust findings.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4025-4032"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945404","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of the ABCG2 Q141K variant with gout in Kinh Vietnamese: a cross-sectional study.","authors":"Khanh Phu Nguyen, Linh Hoang Gia Le, Minh Duc Do, Khoa Dinh Nguyen, Thao Phuong Mai","doi":"10.1007/s10067-025-07656-w","DOIUrl":"10.1007/s10067-025-07656-w","url":null,"abstract":"<p><strong>Background: </strong>Gout is a form of microcrystalline arthritis caused by chronic hyperuricemia, leading to monosodium urate crystal deposition. The ABCG2 gene, particularly the Q141K polymorphism, is a significant genetic factor influencing gout susceptibility and the therapeutic response to allopurinol. However, the association of Q141K with gout in the Vietnamese population remains undefined. This study investigates the relationship between the ABCG2 Q141K polymorphism and gout susceptibility among Kinh Vietnamese individuals.</p><p><strong>Materials and methods: </strong>This cross-sectional study includes 468 participants, comprising 234 gout patients and 234 controls. The basic clinical and paraclinical characteristics of all the participants were collected. Genomic DNA was extracted from peripheral blood samples and genotyped for the ABCG2 Q141K polymorphism using real-time PCR. The association of ABCG2 Q141K with gout and clinical characteristics was analyzed.</p><p><strong>Results: </strong>The ABCG2 Q141K polymorphism is significantly associated with gout in dominant, recessive, and additive genetic models. Specifically, the A allele was identified as a risk factor, observed in 46.8% of gout patients compared to 25% of healthy controls.</p><p><strong>Conclusion: </strong>The ABCG2 Q141K polymorphism significantly increases gout susceptibility among the Kinh Vietnamese population. The high frequency of the A allele in Vietnamese gout patients highlights the potential utility of genetic screening for appropriate preventive strategies. Key Points • The data regarding the contributions of genetic factors in gout of Vietnamese population remain insufficient. • This study showed that the ABCG2 Q141K polymorphism significantly increases gout susceptibility among the Kinh Vietnamese population.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4275-4281"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945435","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":"Coronary periarteritis in IgG4-RD: A case series.","authors":"Georges El Hasbani, Daniel Larson, Matthew J Koster, Kenneth J Warrington","doi":"10.1007/s10067-025-07684-6","DOIUrl":"10.1007/s10067-025-07684-6","url":null,"abstract":"<p><strong>Objectives: </strong>IgG4-related disease (IgG4-RD) can affect multiple organ systems, with coronary artery involvement being rare. Coronary periarteritis may lead to complications such as myocardial infarction and ischemic cardiomyopathy. This case series characterizes the clinical and radiological features, complications, and treatment strategies in patients with IgG4-RD-associated coronary periarteritis.</p><p><strong>Methods: </strong>A retrospective review of the Mayo Clinic electronic health record identified 146 patients, of whom 9 met the inclusion criteria for IgG4-RD with coronary periarteritis. Clinical, laboratory, imaging, treatment, and outcome data were analyzed.</p><p><strong>Results: </strong>The cohort included 9 male patients (mean age: 55.5 ± 5.7 years). The median serum IgG-4 level was 282 mg/dL (interquartile range [IQR], 148-393), while the median C-reactive protein value was 10.8 mg/dL (IQR 7.5-53.6). The mean time from IgG4-RD diagnosis to coronary involvement was 2.5 years. CT angiography detected vessel wall thickening, affecting the right coronary artery (RCA) in five cases, the left anterior descending artery (LAD) in four, and the left main coronary artery in one. Aneurysm formation occurred in two cases. All patients received glucocorticoids, and seven were treated with rituximab. Over a mean follow-up of 7.5 years, one patient developed ischemic heart disease, and another progressed to heart failure. Repeat imaging showed partial or complete resolution of coronary thickening in seven patients.</p><p><strong>Conclusion: </strong>Coronary artery involvement in IgG4-RD is rare but may lead to aneurysm formation and ischemic complications. CT and MRI are valuable diagnostic tools, and rituximab with glucocorticoids appears effective, though further studies are needed. Key Points • IgG4-related disease can involve the coronary arteries, leading to periarteritis and potential complications such as myocardial infarction and aneurysm formation, highlighting the need for early recognition. • Glucocorticoids and rituximab appear to be effective in managing IgG4-RD-associated coronary periarteritis, but further studies are needed to evaluate long-term outcomes.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4133-4136"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145033000","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":"Risk factors for relapse of IgG4-related disease: a systematic review and meta‑analysis.","authors":"Fan Yang, Tianqi Wang, Yanying Liu","doi":"10.1007/s10067-025-07641-3","DOIUrl":"10.1007/s10067-025-07641-3","url":null,"abstract":"<p><strong>Objectives: </strong>Patients with IgG4-related disease (IgG4-RD) suffer high relapse during long-term treatment, but risk factors associated with relapse are not well established. This study aims to review the potential risk factors and integrate relapse rates of observational studies for IgG4-RD.</p><p><strong>Method: </strong>Relevant articles published up to January 28, 2025, were comprehensively and systematically identified from PubMed, EMBASE, and Web of Science databases. A systematic review and meta-analysis was performed to estimate pooled odds ratios (ORs), hazard ratios (HRs), and 95% confidence interval (CI).</p><p><strong>Results: </strong>Twenty-four studies comprising 3797 patients were included. Our findings reveal that a history of allergies (OR: 2.97, 95%CI: 2.07-4.25, P < 0.001), multi-organ involvement (HR: 1.60, 95% CI: 1.23-2.09, P = 0.0005), and decreased complement levels (HR: 2.27, 95% CI: 1.04-4.93, P = 0.04) are significantly associated with relapse. Furthermore, the combination of corticosteroids and immunosuppressants significantly reduces relapse rates (HR: 0.25, 95% CI: 0.10-0.62, P = 0.003). The pooled 12-, 24-, and 36-month relapse rates were 17% (95% CI: 0.10-0.24), 26% (95% CI: 0.22-0.31) and 33% (95% CI: 0.26-0.39), respectively.</p><p><strong>Conclusions: </strong>This meta-analysis indicated that a history of allergy, multi-organ involvement, and decreased complement levels were risk factors for IgG4-RD relapse. Besides, corticosteroid combined with immunosuppressant therapy could decrease relapse rates. Key Points • A history of allergy, multi-organ involvement, and decreased complement levels were risk factors for IgG4-RD relapse. • The combination of corticosteroids and immunosuppressants could reduces relapse rates of IgG4-RD. • The 12-, 24- and 36-month relapse rates of IgG4-RD were 17%, 26% and 33%, respectively.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4137-4147"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144882350","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":"Multi-omics characterization of gut microbiota and fecal and plasma metabolites in patients with primary Sjögren's syndrome.","authors":"Yuanyuan Liu, Qi Wang, Yan Zhang, Ruixue Duo, Xueting Bian, Jingjing Tian, Jiayao Hao, Jianxiong Zheng, Haili Shen","doi":"10.1007/s10067-025-07642-2","DOIUrl":"10.1007/s10067-025-07642-2","url":null,"abstract":"<p><strong>Introduction: </strong>Accumulating evidence has implicated gut microbiota and their metabolites in primary Sjögren's syndrome (pSS) pathogenesis. However, no study simultaneously explores the gut microbiome, microbial, and plasma metabolome in pSS patients.</p><p><strong>Method: </strong>Thirty pSS patients and 60 healthy controls (HCs) were recruited. Shotgun metagenomic sequencing and untargeted metabolomics were performed on stool and plasma samples.</p><p><strong>Results: </strong>pSS patients exhibited significant reduction in microbial richness and diversity. Bacteroidetes and Firmicutes accounted for over 80% of all phyla. Four phyla, 48 genera, and 106 species with significant differences were identified (P < 0.05). Proteobacteria, Ascomycota, Fusobacteria, and 31 genera (e.g., Escherichia, Veillonella, Prevotella, Klebsiella) were enriched in pSS, while Actinobacteria, Bifidobacterium, Dorea, and Blautia were depleted. Opportunistic pathogens (e.g., Escherichia coli, Prevotella copri, Streptococcus oralis, Klebsiella pneumoniae, Enterococcus faecalis) and pathogenic Clostridium bolteae and Fusobacterium nucleatum were more abundant in pSS, whereas beneficial Bifidobacterium longum and butyrate-producing Eubacterium hallii and Anaerostipes hadrus were in HCs. Notably, Lactobacillus spp. were enriched in pSS. Of 298 differential functional pathways, 239 pSS-enriched pathways were focused on nutrient and energy metabolism, while amino acid biosynthesis in HCs. During 881 differential fecal metabolites (pSS: HCs = 631:250), fatty acyls were enriched in pSS, and glycerophospholipids in HCs. Among the 712 differential plasma metabolites (pSS: HCs = 438:274), heterocyclic compounds and benzene derivatives were more abundant in pSS, while fatty acyls and glycerophospholipids prevailed in HCs. Amino acids and organic acids were predominant in both samples.</p><p><strong>Conclusions: </strong>This study characterized gut microbiome and fecal/plasma metabolome in pSS patients, providing theoretical support for regional pSS prevention and treatment. Key Points • This is the first study to systematically characterize the gut microbiome and fecal and plasma metabolomes of primary Sjögren's syndrome (pSS) patients in Northwest China via multi-omics integration analysis. • Significant reduction in gut microbial diversity and probiotic bacteria, enrichment of opportunistic and infectious pathogens, and microbial dysfunction were observed in pSS patients. • Much more differential fecal and plasma metabolites were observed in pSS patients, with amino acids, organic acids and derivatives, nucleotides, and metabolites being the main altered metabolites in both samples.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4103-4118"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144945529","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":"Knowledge mapping of plasmacytoid dendritic cells in systemic lupus erythematosus: a bibliometric analysis (2004-2023).","authors":"Yuan Tian, Kang Tao, Hongyan Zhou, Shifei Li, Xiaoqiang Chen, Mingwang Zhang, Zhifang Zhai","doi":"10.1007/s10067-025-07674-8","DOIUrl":"10.1007/s10067-025-07674-8","url":null,"abstract":"<p><strong>Background: </strong>Plasmacytoid dendritic cells (pDCs) are a specialized subset of dendritic cells known for their ability to produce type I interferon (IFN I), contributing to antiviral defense and the pathogenesis of autoimmune diseases like systemic lupus erythematosus (SLE). In SLE patients, pDCs are excessively activated, leading to overproduction of IFN-α, which plays a critical role in disease progression. However, no bibliometric analysis has been conducted on the relationship between pDCs and SLE. This study aims to map the knowledge structure and trends in research on pDCs in SLE through bibliometric analysis.</p><p><strong>Methods: </strong>We analyzed publications related to pDCs in SLE from 2004 to 2023 using the Web of Science Core Collection. Data were analyzed and visualized with VOSviewers, CiteSpace, and the R package bibliometrix, offering a comprehensive view of the research landscape.</p><p><strong>Results: </strong>The analysis included 1086 articles from 57 countries, with the USA leading in publication volume. Major contributing institutions include Uppsala University, University of Michigan, and Baylor Institute for Immunology Research. Among the 565 authors, Ronnblom Lars was the most prolific, while Elkon Keith B ranked highest in terms of network centrality. Key research themes focus on pDC mechanisms in SLE development and emerging therapeutic strategies. Trending topics include \"anifrolumab,\" \"mortality,\" and \"population.\"</p><p><strong>Conclusion: </strong>This bibliometric study provides a thorough overview of research trends on pDCs in SLE, identifying recent advances and key areas of interest, offering valuable insight for future research directions.</p><p><strong>Key points: </strong>• pDCs play a crucial role in systemic lupus erythematosus (SLE) through the overproduction of type I interferon (IFN-α). • This is the first bibliometric analysis mapping the research landscape of pDCs in SLE from 2004 to 2023. • Emerging research focuses on therapeutic strategies, including trending topics like \"anifrolumab\" and \"mortality\" in SLE. • This study offers valuable insights into key research themes and trends, guiding future investigations on pDCs in SLE.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"3945-3958"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014033","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":"Targeted and biologic therapies and risk of total knee or hip replacement in axial spondyloarthritis and psoriatic arthritis.","authors":"Angela Achkar, Christine Peloquin, Jean W Liew, Maureen Dubreuil","doi":"10.1007/s10067-025-07666-8","DOIUrl":"10.1007/s10067-025-07666-8","url":null,"abstract":"<p><strong>Background: </strong>Axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are chronic inflammatory diseases that often cause joint damage, potentially leading to joint replacement surgery. We assessed whether Janus kinase (JAK) inhibitors reduce the risk of total knee or hip replacement compared to nonsteroidal anti-inflammatory drugs (NSAIDs).</p><p><strong>Methods: </strong>Using the Merative™ MarketScan® Commercial Database, we conducted a nested case-control study of adults aged 18-65 years with axSpA and/or PsA from October 2015 to December 2021. Medication exposure was categorized hierarchically using pharmacy and procedure claims, including JAK inhibitors, non-tumor necrosis factor inhibitor biologics (non-TNFi biologics), TNF inhibitors (TNFi), DMARDs, NSAIDs (referent), and none. Logistic regression with confounder adjustment assessed associations between medication class and joint replacement risk.</p><p><strong>Results: </strong>Among 8855 eligible adults, 1771 cases of joint replacement were identified. JAK inhibitor use was not significantly associated with reduced odds of joint replacement compared to NSAIDs (odds ratio [OR] 0.67, 95% confidence interval [CI] 0.41-1.08). Non-TNFi biologic users (OR 0.66, 95% CI 0.53-0.82), TNFi users (OR 0.63, 95% CI 0.52-0.76), and DMARD users (OR 0.65, 95% CI 0.53-0.80) had lower odds of joint replacement than NSAID users.</p><p><strong>Conclusion: </strong>We did not find conclusive evidence that relative to NSAIDs, JAK inhibitors prevent end-stage arthritis requiring surgery in axSpA and PsA; however, risk was reduced with use of non-TNFi biologics, TNFi, or DMARDs. Longer-term data are needed to understand the optimal utilization of JAK inhibitors in preventing end-stage arthritis in these conditions. Key Points • Axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) are chronic inflammatory diseases that often cause joint damage, potentially leading to joint replacement surgery. • In our study, although there was not conclusive evidence that JAK inhibitors prevent end-stage arthritis requiring surgery in axSpA and PsA relative to NSAIDs, we did find that risk was reduced with use of non-TNFi biologics, TNFi, or DMARDs. • Understanding the impacts of different medication classes, including Janus kinase (JAK) inhibitors and tumor necrosis factor inhibitors (TNFi) relative to nonsteroidal anti-inflammatory drugs (NSAIDs) may guide treatment decisions.</p>","PeriodicalId":10482,"journal":{"name":"Clinical Rheumatology","volume":" ","pages":"4005-4013"},"PeriodicalIF":2.8,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12435908/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145039310","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}