Current Rheumatology Reports最新文献

{"title":"Fast, Present and Future of the Concept of Spondyloarthritis.","authors":"J Braun","doi":"10.1007/s11926-024-01179-0","DOIUrl":"https://doi.org/10.1007/s11926-024-01179-0","url":null,"abstract":"<p><strong>Purpose of review: </strong>Axial spondyloarthritis (axSpA) is a rather prevalent chronic inflammatory rheumatic disease that affects already relatively young patients. It has been known better since the end of the nineteenth century but quite a lot has been learned since the early 60ies when the first classification (diagnostic) criteria for ankylosing spondylitis (AS) were agreed on. I have been part of many developments in the last 30 years, and I'm happy to have been able to contribute to the scientific progress in terms of diagnosis, imaging, pathophysiology and therapy. When I was asked to write a manuscript about the SpA concept I felt honored. Thus, the purpose of this extensive review was, on the one hand, to describe the history of AS and axSpA, and on the other hand, to reason about the concept and the gestalt of axSpA, and finally to deliver some ideas what future researchers could possibly do to further study the disease.</p><p><strong>Recent findings: </strong>The last 3 decades were full of innovations for both, classification and treatment of axSpA which also helped us to learn about the pathophysiology. Thus, TNFa, IL-17, IL-23 and Janus kinase are established targets to reduce inflammation. IL-17 and IL-23 are very special in that regard because they both work for psoriasis but only anti-IL-17 agents which don't work in IBD are approved for axSpA, while IL 23 inhibitors are approved for both, psoriasis and IBD, but they don't work in axSpA. New imaging techniques such as low dose CT and synthetic MRI are likely to improve the detection of both active and structural lesions of axSpA. This manuscript tries to describe the most important findings about axSpA. The main aim of research remains to discover the pathophysiology and to further improve treatment options in order to reduce and abolish inflammation and prevent new bone formation to increase the quality of life of our patients. The differences between male and female disease and the role of the immune system in axSpA are now the main challenges, and the role of special T-cell receptors seem to deserve special interest.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"15"},"PeriodicalIF":5.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T Cell Dysregulation in Rheumatoid Arthritis: from Genetic Susceptibility to Established Disease.","authors":"Athena Chin, Annabelle Small, Soon Wei Wong, Mihir D Wechalekar","doi":"10.1007/s11926-025-01180-1","DOIUrl":"10.1007/s11926-025-01180-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>Rheumatoid arthritis (RA) is a complex autoimmune disease characterized by chronic inflammation of the synovial tissue, where T cells play a central role in pathogenesis. Recent research has identified T peripheral helper (Tph) cells as critical mediators of local B cell activation in inflamed tissues. This review synthesizes the latest advancements in our understanding the of the role of T cells in RA, from initiation to established disease.</p><p><strong>Recent findings: </strong>We explore recent advances regarding the genetic and epigenetic factors that predispose individuals to RA, the mechanisms of T cell activation and differentiation, and the interactions between T cells and other immune and stromal cells within the synovial microenvironment. The emergence of Tph cells as key drivers of RA pathobiology is highlighted, along with their potential as therapeutic targets. We also discuss the heterogeneity of T cell responses and their interplay with synovial cells, while addressing critical research gaps such as the drivers of T cell recruitment and the plasticity of synovial phenotypes. A deeper understanding of T cell dynamics in RA will provide valuable insights for developing targeted therapies to modulate T cell-mediated inflammation and improve patient outcomes.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"14"},"PeriodicalIF":5.7,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11762599/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143037085","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unconventional Imaging Methods in Psoriatic Arthritis.","authors":"Ioanna Minopoulou, Filippo Fagni, Armin Atzinger, Fredrik Albach, Georg Schett, Gerhard Krönke, Arnd Kleyer, David Simon","doi":"10.1007/s11926-024-01174-5","DOIUrl":"10.1007/s11926-024-01174-5","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriatic arthritis (PsA) is a complex heterogeneous inflammatory disease that affects about one-third of patients with psoriasis. PsA leads to significant physical impairment and reduced quality of life. Therefore, early diagnosis and intervention are critical for improving long-term outcomes. The purpose of this review is to highlight the advantages of unconventional imaging methods in the diagnosis and management of PsA and to discuss recent advancements in imaging technology.</p><p><strong>Recent findings: </strong>Conventional imaging methods, such as radiography, musculoskeletal ultrasound, and magnetic resonance imaging, have been instrumental in detecting structural joint damage and inflammation. However, these imaging modalities have several limitations, resulting in their inability to detect early disease changes. Recent advancements in imaging technology have led to the development of novel imaging modalities capable of characterizing not only early structural but also molecular aspects of disease activity. These cutting-edge approaches have been lately applied to both psoriasis and PsA patients, offering new insights into disease progression, the transition from psoriasis to PsA, and treatment responses. By providing more detailed and individualized assessments, unconventional imaging modalities may bring us closer to realizing the potential of personalized medicine in the management of PsA.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"13"},"PeriodicalIF":5.7,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11723843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Review on Imaging in Axial Spondyloarthritis: SPARTAN 2024 Annual Meeting Proceedings.","authors":"Mohamad Bittar, Walter P Maksymowych","doi":"10.1007/s11926-024-01177-2","DOIUrl":"10.1007/s11926-024-01177-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this publication is to review the role of imaging in axial spondyloarthritis. These findings were presented at the SPARTAN annual meeting in May 2024.</p><p><strong>Recent findings: </strong>Imaging plays a major role in the diagnosis and monitoring of axial spondyloarthritis. Magnetic resonance imaging (MRI) findings of active inflammatory lesions (bone marrow edema, capsulitis, inflammation in an erosion cavity, enthesitis, fluid in the joint) and structural lesions (erosions, fat lesions, fat metaplasia in an erosion cavity, bone bud, ankylosis) aid in the early diagnosis of axial spondyloarthritis. Recent data strongly suggests that positive imaging of the sacroiliac joint, especially MRI signs of inflammation, can predict axial spondyloarthritis progression and prognosis. Emerging data supports that MRI findings at baseline might play a role in predicting treatment response. This review covered different imaging concepts, including the role of imaging in early diagnosis as well as prediction of progression, prognosis, and treatment response.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"12"},"PeriodicalIF":5.7,"publicationDate":"2025-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946009","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Axial Spondyloarthritis Clinical Research Year in Review: SPARTAN 2024 Annual Meeting Proceedings.","authors":"Mohamad Bittar","doi":"10.1007/s11926-024-01178-1","DOIUrl":"https://doi.org/10.1007/s11926-024-01178-1","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review is to highlight high impact clinical research in axial spondyloarthritis that was published between May 2023 and April 2024. These publications were presented at the SPARTAN annual meeting in May 2024.</p><p><strong>Recent findings: </strong>Three publications addressed the rate and predictors of radiographic progression in axial spondyloarthritis. MRI-based synthetic CT was introduced as a new modality to assess spinal structural damage. One of the first definitions of difficult to treat axial spondyloarthritis was published. Biologic taper, flare rates, and predictors of flares were discussed. Minimally invasive one-level osteotomy can be an option to correct kyphosis with less risk compared to standard approach. Different therapeutic classes seem to be protective against anterior uveitis in axial spondyloarthritis. Patients who receive biologic or targeted synthetic disease modifying antirheumatic drugs are at increased risk of non-serious infections, but not serious infections that are associated with hospitalization or mortality. This year-in-review session covered different concepts, including imaging and radiographic progression, difficult to treat axial spondyloarthritis, biologic taper, surgery, anterior uveitis, and risk of infections.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"11"},"PeriodicalIF":5.7,"publicationDate":"2025-01-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142926848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Podocytes in Lupus Pathology.","authors":"Kayaho Maeda, Reza Abdi, George C Tsokos","doi":"10.1007/s11926-024-01175-4","DOIUrl":"https://doi.org/10.1007/s11926-024-01175-4","url":null,"abstract":"<p><strong>Purpose of review: </strong>Kidney injury due to lupus nephritis (LN) is a severe and sometimes life-threatening sequela of systemic lupus erythematosus. Autoimmune injury to podocytes has been increasingly demonstrated to be a key driver of LN-related kidney injury because these cells play key roles in glomerular filtration barrier homeostasis. Irreparable podocyte injury impairs these processes and can lead to proteinuria, which is an indicator of poor prognosis in LN. This review highlights recent advances in our understanding of the involvement of podocytes in the pathogenesis of LN and discusses new podocyte-targeted therapeutic strategies.</p><p><strong>Recent findings: </strong>Podocytes play a key role in glomerular filtration barrier homeostasis, both by helping to secrete and organize the glomerular basement membrane and by the formation of a glomerular slit diaphragm between adjacent cells. Recent studies revealed the involvement of abnormal calcium signaling, dysregulation of actin-related proteins, and mitotic catastrophe in LN progression. In addition, podocytes express many molecules related to the innate and adaptive immune responses. IgG from patients with LN induces direct injury of podocytes, inflammasome, and interactions with immune cells which have been shown to promote the development of LN. Our understanding of the role of podocytes in the pathogenesis of LN has been improved. Recent studies have shed light on potential therapeutic strategies targeting podocytes to control kidney injury.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"10"},"PeriodicalIF":5.7,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892749","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Year in Review: Novel Insights in the Pathogenesis of Spondyloarthritis - SPARTAN 2024 Annual Meeting Proceedings.","authors":"Patricia Remalante-Rayco, Akihiro Nakamura","doi":"10.1007/s11926-024-01176-3","DOIUrl":"https://doi.org/10.1007/s11926-024-01176-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The canonical pathogenesis of spondyloarthritis (SpA) involves inflammation driven by HLA-B27, type 3 immunity, and gut microbial dysregulation. This review based on information presented at the SPARTAN meeting highlights studies on the pathogenesis of SpA from the past year, focusing on emerging mechanisms such as the roles of microbe-derived metabolites, microRNAs (miRNAs) and cytokines in plasma exosomes, specific T cell subsets, and neutrophils.</p><p><strong>Recent findings: </strong>The induction of arthritis in a preclinical model through microbiota-driven alterations in tryptophan catabolism provides new insights as to how intestinal dysbiosis may activate disease via the gut-joint axis. Immune activation may likewise be modulated by dysregulated miRNAs and cytokines contained in plasma exosomes, which appear to influence the homeostasis of both effector T cells and regulatory T cells (Tregs). Closer examination of T cells in animal models has uncovered distinct transcriptional and functional profiles between gut and joint Tregs, as well as highly specific T cell subsets that can be targeted to induce disease modification. Newer studies including both SpA patients and preclinical models have focused on the key role of neutrophils as drivers of inflammation and new bone formation in hypoxic, inflammation-driven tissue environments, potentially through interactions with adipocytes and mesenchymal stem cells. Functional studies and high-throughput techniques using samples from SpA patients and preclinical models have significantly enhanced our understanding of SpA pathogenesis, offering new insights into the specific mechanisms of immune regulation and identifying promising therapeutic targets.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"9"},"PeriodicalIF":5.7,"publicationDate":"2024-12-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142892765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updating the 2019 ACR/SAA/SPARTAN Recommendations for the Treatment of Ankylosing Spondylitis and Nonradiographic Axial Spondyloarthritis (SPARTAN 2024 Annual Meeting Proceedings).","authors":"Mathieu Choufani, Joerg Ermann","doi":"10.1007/s11926-024-01170-9","DOIUrl":"10.1007/s11926-024-01170-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Since the publication of the 2019 American College of Rheumatology/Spondylitis Association of America/Spondyloarthritis Research and Treatment Network (ACR/SAA/SPARTAN) treatment recommendations for ankylosing spondylitis (AS) and nonradiographic axial spondyloarthritis (axSpA), new evidence has emerged that necessitates a revision of the ACR/SAA/SPARTAN clinical practice guideline (CPG).</p><p><strong>Recent findings: </strong>An online survey was conducted among SPARTAN members prior to the 2024 Annual Meeting, with 81 members participating. A majority (62%) expressed a preference for treating axSpA as a single entity in the updated CPG, eliminating the distinction between AS and nonradiographic axSpA. Updating the recommendations on pharmacotherapy was considered the top priority, followed by revising recommendations on disease activity monitoring and biosimilar use. Over half of the respondents (58%) rated the 2019 CPG as no more than moderately user-friendly. Key areas for improvement include outdated content, lack of quick reference materials, complex flow charts, and inadequate visual aids. The survey results indicate strong support among SPARTAN members for treating axSpA as a single entity in the forthcoming update of the ACR/SAA/SPARTAN CPG. Additionally, there is demand for a more user-friendly guideline document.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"8"},"PeriodicalIF":5.7,"publicationDate":"2024-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142827650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advancements in Imaging Techniques for Early Diagnosis and Management of Axial Spondyloarthritis.","authors":"Howook Jeon, Hong Ki Min","doi":"10.1007/s11926-024-01172-7","DOIUrl":"10.1007/s11926-024-01172-7","url":null,"abstract":"<p><strong>Purpose of review: </strong>We aimed to introduce recent finding of imaging studies used in axial spondyloarthritis (axSpA).</p><p><strong>Recent findings: </strong>Using low-dose whole spine CT (CT syndesmophyte score [CTSS]) improved diagnostic accuracy for evaluating spinal structural progression than previous method (modified Stoke Ankylosing Spondylitis Spinal Score [mSASSS]) in axSpA. The novel definition of positive finding of sacroiliac joint (SIJ) and spine magnetic resonance imaging (MRI) enabled to diagnose axSpA earlier than plain radiography. In addition, novel MRI protocol such as volumetric interpolated breath-hold examination improved detection rate of structural change of axial joints in axSpA, Nuclear medicine imaging showed potential for diagnosis and predicting progression of axSpA. Ultrasonography guided injection is useful for controlling local joint pain of axSpA. AxSpA is characterised by pain and inflammation of axial joints such as the SIJ and spine. Detection of active inflammatory lesions using MRI has expanded the subtypes of axSpA to include non-radiographic axSpA (nr-axSpA). In addition, many other imaging techniques have improved, and can now detect structural and early inflammatory lesions of the axial joints. In addition, a method for quantitative measurement of syndesmophytes by CTSS has been developed; this method is more accurate and sensitive than the mSASSS for detecting spinal structural damage. Here, we discuss the current knowledge and clinical advances in computed tomography, MRI, nuclear medicine imaging, and ultrasonography as imaging methods for axSpA.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"7"},"PeriodicalIF":5.7,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142812644","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incremental Cardiovascular Risk of Menopause in Women with Psoriasis, Psoriatic Arthritis or Spondyloarthritis?","authors":"Donna E Vegt, Delia A Popa-Diaconu, Michelle L M Mulder, Sander I van Leuven, Irene E van der Horst-Bruinsma","doi":"10.1007/s11926-024-01169-2","DOIUrl":"10.1007/s11926-024-01169-2","url":null,"abstract":"<p><strong>Purpose of the review: </strong>This narrative review aims to discuss the most recent studies regarding the risk of cardiovascular disease (CVD) in women with psoriasis, psoriatic arthritis (PsA) and spondyloarthritis (SpA). In addition, the potential of menopause to modulate/increase CVD risk in women with these diseases will also be explored. It is of major interest to gain more understanding into this topic because it can have meaningful implications for screening and treatment of CVD risk in these women.</p><p><strong>Recent findings: </strong>Literature shows that psoriasis, PsA, SpA and menopause itself cause higher CVD risks and higher CVD prevalence. This is predominantly explained by the increase of chronic systemic inflammation. No existing literature conclusively demonstrates or studies specifically whether the menopause amplifies this effect caused by psoriasis, PsA, or SpA.</p><p><strong>Conclusion: </strong>Differences in pathophysiology of psoriasis, SpA and PsA versus the menopausal transition could suggest that menopause may increase the risk of CVD. However, the hypothesis that menopause represents an additional CV risk factor in women with psoriasis, PsA and SpA still needs to be thoroughly investigated and more clinical studies are required for further understanding and conclusions.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"27 1","pages":"6"},"PeriodicalIF":5.7,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142784370","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}