Current Rheumatology Reports最新文献

{"title":"Adipose-Joint Crosstalk in Obesity-Induced Osteoarthritis: Mechanisms, Biomarkers, and Translational Therapeutic Opportunities.","authors":"Wei Hang, Kathy Triantafilou, You Zhou","doi":"10.1007/s11926-026-01229-9","DOIUrl":"10.1007/s11926-026-01229-9","url":null,"abstract":"<p><strong>Purpose of review: </strong>Obesity-induced osteoarthritis (OA) is emerging as a distinct metabolic phenotype fundamentally different from mechanically driven OA. Current therapies largely target downstream joint damage and fail to address underlying adipose-joint pathological interactions. This review synthesises recent advances in understanding how systemic metabolic dysfunction, adipose tissue inflammation, and cellular heterogeneity revealed by single-cell analyses drive OA pathogenesis, and highlights emerging strategies targeting metabolic dysfunction and chronic inflammation.</p><p><strong>Recent findings: </strong>We critically summarised human and experimental studies investigating the role of dysfunctional adipose depots, including visceral, subcutaneous, and infrapatellar fat, in joint degeneration. Mechanistic findings on adipokine signalling, immune activation, and metabolic stress were integrated with recent single-cell insights and therapeutic interventions addressing systemic metabolism and inflammation. Obesity promotes adipose tissue hypertrophy, hypoxia, and inflammatory adipokine secretion, which remodel systemic metabolism and alter the function of joint-resident cells. Crosstalk between adipocytes, macrophages, fibroblasts, and chondrocytes sustains chronic low-grade inflammation, oxidative stress, and extracellular matrix degradation. Single-cell analyses have revealed fibroblast and macrophage subsets that mediate depot-specific inflammatory circuits. Recent findings also point to metabolic modulators (GLP-1 receptor agonists), anti-adipokine agents, and regenerative strategies as promising interventions to modify disease progression. Obesity-induced OA arises from multi-level metabolic and inflammatory crosstalk between adipose and joint tissues. Deciphering adipose-joint crosstalk provides a foundation for precision therapies that address the upstream metabolic and inflammatory drivers of joint degeneration.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13452861/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697143","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":"Type I Interferonopathies: Fifteen Years On, From Concept to Therapeutic Perspectives.","authors":"Dilara Ünal, Isabelle Melki, Marie-Louise Frémond","doi":"10.1007/s11926-026-01228-w","DOIUrl":"10.1007/s11926-026-01228-w","url":null,"abstract":"<p><strong>Purpose of review: </strong>Fifteen years after the initial description of type I interferonopathies, this review aims to provide an updated overview of the field by integrating recent genetic and mechanistic advances. It also seeks to outline practical diagnostic approaches and highlight current and emerging targeted therapeutic strategies.</p><p><strong>Recent findings: </strong>Type I interferonopathies are a group of monogenic autoinflammatory diseases caused by inappropriate activation of type I interferon signaling. Multiple pathogenic mechanisms have been identified, including abnormalities in nucleic acid metabolism or sensing, constitutive activation of innate immune pathways, proteasome dysfunction, endosomal Toll-like receptor hyperactivation, and impaired negative regulation of IFNAR signaling. These mechanisms result in overlapping neuroinflammatory, cutaneous, and systemic manifestations, with variable severity and often significant morbidity and mortality. Advances in the understanding of the molecular basis of type I interferonopathies have refined their classification and improved diagnostic strategies. These insights are paving the way for more precise, mechanism-based treatments, offering promising perspectives for patient management despite the persistent severity of these disorders.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-07-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148387436","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":"Intensive Care Management of ANCA-associated Vasculitides: a Narrative Review.","authors":"Elisa Bazin, Lucas Morand, Nihal Martis","doi":"10.1007/s11926-026-01227-x","DOIUrl":"10.1007/s11926-026-01227-x","url":null,"abstract":"<p><strong>Purpose of review: </strong>Anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitides, particularly granulomatosis with polyangiitis and microscopic polyangiitis, are rare but severe systemic diseases frequently requiring intensive care unit (ICU) admission due to life-threatening renal and pulmonary involvement. Despite advances in immunosuppressive therapy, these patients remain at high risk of mortality and end-stage kidney disease, with prognosis driven by organ failure (notably diffuse alveolar haemorrhage [DAH]) and treatment-related complications such as infection. ICU management is complex and relies on rapid diagnosis, aggressive induction therapy, and tailored organ support.</p><p><strong>Recent findings: </strong>Current remission-induction strategies centre on high-dose glucocorticoids combined with cyclophosphamide or rituximab, with growing emphasis on minimizing steroid exposure. Plasma exchange (PLEX), once widely used for severe renal disease and DAH, remains debated, although selected high-risk subgroups may still derive benefit. Optimal management in the ICU requires a multidisciplinary approach, including careful selection of immunosuppressive regimens, individualized use of adjunctive therapies such as PLEX and the management of infectious complications. Advances in supportive care, including lung-protective ventilation, renal replacement therapy, and extracorporeal support, have improved short-term outcomes. However, significant uncertainty persists regarding optimal therapeutic strategies in the critically ill populations, highlighting the need for further research and phenotype-driven approaches.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148338135","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 Musculoskeletal Ultrasound in Psoriatic Arthritis: From Preclinical Detection to Treatment Monitoring.","authors":"Emilio D'Ignazio, Didem Sahin, Caterina Baldi, Paul Emery, Dennis McGonagle, Richard Wakefield, Helena Marzo-Ortega, Alen Zabotti, Emilio Filippucci, Katya Meridor, Andrea Di Matteo","doi":"10.1007/s11926-026-01225-z","DOIUrl":"10.1007/s11926-026-01225-z","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriatic arthritis (PsA) is a chronic, immune-mediated inflammatory disease with highly heterogeneous clinical manifestations associated with psoriasis (PsO). The wide variability in presentation, together with the absence of definitive serological biomarkers, makes early diagnosis particularly challenging. This review evaluates the role of ultrasound in identifying and characterising musculoskeletal involvement across the psoriatic disease (PsD) continuum-from asymptomatic PsO to established PsA.</p><p><strong>Recent findings: </strong>Ultrasound can detect subclinical synovitis, enthesitis, peritendonitis, tenosynovitis, bursitis, and structural damage in PsD. Evidence highlights its value in the early identification of musculoskeletal changes in patients with PsO who are at risk of progressing to PsA, with important implications for disease interception and prevention. Additional applications include differential diagnosis; assessment of enthesitis and distinction between inflammatory and non-inflammatory disease; and monitoring of therapeutic response, including in refractory disease. Ultrasound also demonstrates prognostic utility by detecting subclinical inflammation, predicting flares and future structural damage, and supporting personalized treatment strategies. Standardized ultrasound scoring systems and emerging methods for evaluating small hand entheses and dactylitis are also discussed. Ultrasound is an important tool for early detection, prognostic assessment, and management guidance in PsA, offering potential to prevent disease progression and inform precision medicine approach.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13260301/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148223862","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":"Correction to: Is Gout and Autoinflammatory Disease?","authors":"Naomi Schlesinger, Dan Kaufmann","doi":"10.1007/s11926-026-01226-y","DOIUrl":"10.1007/s11926-026-01226-y","url":null,"abstract":"","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148210066","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":"Risks and Management of Glucocorticoid Therapy for Patients with Rheumatic Disease Having Surgery.","authors":"Kunjam Modha, Christopher Whinney","doi":"10.1007/s11926-026-01221-3","DOIUrl":"10.1007/s11926-026-01221-3","url":null,"abstract":"<p><strong>Purpose of review: </strong>The purpose of this review was to identify and characterize the diverse risks and benefits of glucocorticoid use in the perioperative period in patients with rheumatic diseases.</p><p><strong>Recent findings: </strong>Glucocorticoids increase the risk of surgical site infection, wound dehiscence, pneumonia, unplanned intubation and readmissions. The risk of perioperative adrenal insufficiency is rare. Guidelines specifically for knee and hip arthroplasties do not recommend stress dosing of steroids. Continuation of home doses of glucocorticoids is adequate for most patients. Stress dosing of glucocorticoids should be reserved for patients with biochemically confirmed adrenal dysfunction or are receiving supraphysiologic doses of glucocorticoids going for moderate to high-risk surgeries.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13233973/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148155864","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":"Perioperative Management Considerations for Patients with Systemic Lupus Erythematosus.","authors":"Sofia Flouda, Romy Kallas, Kyriakos A Kirou","doi":"10.1007/s11926-026-01222-2","DOIUrl":"10.1007/s11926-026-01222-2","url":null,"abstract":"<p><strong>Purpose of review: </strong>Systemic lupus erythematosus (SLE) patients are complex with multisystem organ involvement and often organ damage due to the disease and its treatment. This review aims to shed light on surgical outcomes in SLE patients and how these can be optimized in the perioperative setting.</p><p><strong>Recent findings: </strong>SLE patients often require various surgical procedures as a direct result of their disease. Several studies, the majority orthopedic, have reported the often-increased incidence of infectious, thrombotic, hemorrhagic and other postoperative outcomes in SLE patients compared to controls, as well as the role of lupus activity, severity, comorbidities, and glucocorticoids (GC) in predicting poor outcomes. Unfortunately, most publications are limited by retrospective design, small numbers or lack of granular information on lupus activity and its treatment. Nevertheless, recent guidelines for the treatment of SLE and the perioperative management of immunosuppressive therapies (IST) in patients with rheumatic diseases undergoing hips/knee arthroplasty have been published and have filled an important gap in the management of these patients. Achievement of remission or low lupus activity by escalating IST and GC taper to prednisone doses ≤ 5-7.5 mg/day is recommended in general and in the perioperative setting. Severe SLE patients actively treated for organ involvement may be allowed to continue IST perioperatively, but others may withhold IST. Careful multidisciplinary planning of elective surgeries, considering disease activity, severity, and comorbidities, as well as prudent perioperative GC, IST and anticoagulant management, should optimize outcomes in SLE patients. Large prospective studies of SLE patients undergoing common surgeries should facilitate further progress.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147863778","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":"Management of IgG4-Related Disease.","authors":"Gabriela Hernández-Molina, Brian Uriel Anaya-Macías, Eduardo Martín-Nares","doi":"10.1007/s11926-026-01224-0","DOIUrl":"10.1007/s11926-026-01224-0","url":null,"abstract":"<p><strong>Purpose of the review: </strong>IgG4-related disease (IgG4-RD) is a chronic immune-mediated fibroinflammatory condition characterized by tumefactive lesions in multiple organs. Although glucocorticoids remain the cornerstone of therapy, high relapse rates and treatment-related toxicity have prompted the development of steroid-sparing strategies and targeted therapies. This review summarizes current evidence on pharmacological and non-pharmacological management of IgG4-RD and proposes a practical treatment approach based on available data and clinical experience.</p><p><strong>Recent findings: </strong>Glucocorticoids continue to be the first-line therapy for remission induction, achieving high initial response rates; however, relapses are common, particularly after tapering or withdrawal. Conventional synthetic disease-modifying antirheumatic drugs (csDMARDs), such as mycophenolate mofetil, leflunomide, azathioprine, and methotrexate, are frequently used as steroid-sparing agents, although comparative evidence remains limited. B-cell targeted therapies have emerged as key treatment options. Rituximab has demonstrated high efficacy as first-line therapy and in refractory or relapsing disease, and is widely used despite remaining off-label in most regions. More recently, the anti-CD19 monoclonal antibody inebilizumab became the first therapy approved for IgG4-RD following the MITIGATE trial, which showed reduced disease flares and increased rates of glucocorticoid-free remission. Additional emerging therapies include obinutuzumab, obexelimab, CAR-T cell therapy, and cytokine-targeted agents such as dupilumab and tocilizumab, although evidence for most remains limited. Management of IgG4-RD requires an individualized approach based on disease severity, organ involvement, relapse risk, patient's comorbidities and preferences, and access to therapies. B-cell-directed therapies and other targeted agents are emerging as key components of treatment and may enable more effective and steroid-sparing disease control.</p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147834696","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":"Care of the Patient with Interstitial Lung Disease Perioperatively.","authors":"Kristin Berger, Genna Braverman, Aldis Siltumens, Jessica Gordon, Robert Kaner","doi":"10.1007/s11926-026-01223-1","DOIUrl":"10.1007/s11926-026-01223-1","url":null,"abstract":"<p><p>PURPOSE OF THIS REVIEW: Patients with interstitial lung disease (ILD) are at elevated risk of postoperative pulmonary complications (PPCs), including acute exacerbation, which carry high mortality. Surgical decision-making in this population requires careful preoperative risk stratification, medical optimization, and tailored intra- and postoperative management. This review summarizes current evidence to guide perioperative care for patients with ILD. RECENT FINDINGS: The ARISCAT (Assess Respiratory Risk in Surgical Patients in Catalonia) risk index is widely used for PPC prediction but likely underestimates risk in ILD. Recent studies highlight the high prevalence of comorbid obstructive sleep apnea in ILD, supporting the need for routine screening. Updated American College of Rheumatology guidelines inform perioperative antirheumatic drug management, while International Society for Heart and Lung Transplantation consensus recommendations guide care of patients with pulmonary hypertension and right heart failure, a common comorbid condition. Emerging evidence suggests that perioperative antifibrotic therapy is safe and may reduce the risk of acute exacerbation, although further investigation is needed. Regional anesthesia can be a feasible alternative to general anesthesia when possible, for further risk mitigation in this patient population. Intraoperative lung-protective ventilation and use of the lowest oxygen concentration that maintains safe oxygen saturation remain critical, while judicious fluid management, postoperative extubation to high-flow nasal cannula or noninvasive ventilation, early mobilization, and multimodal analgesia may further reduce PPC risk. Perioperative management of ILD patients is complex due to heightened vulnerability to PPCs. Current evidence supports adapting general perioperative strategies while incorporating disease-specific considerations. As therapeutic advances extend survival, further prospective studies are needed to establish evidence-based perioperative guidelines for this high-risk group. </p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13133189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764953","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":"Treat-to-Target Urate-lowering Therapy: Lessons Learned from the STOP Gout Study.","authors":"Ted R Mikuls, Lindsay Helget, Jeff Newcomb, Austin Wheeler, James R O'Dell","doi":"10.1007/s11926-026-01220-4","DOIUrl":"10.1007/s11926-026-01220-4","url":null,"abstract":"<p><p>PURPOSE OF THE REVIEW: The purpose of this review is to provide details of the STOP Gout trial, among the first randomized, blinded studies to compare allopurinol with febuxostat using a treat-to-target strategy. In addition to details of its design and trial results, this review summarizes findings from pre-planned and other analyses, as well as an associated biorepository that has enabled the identification of biomarkers impacted by highly effective urate-lowering therapy (ULT). RECENT FINDINGS: In addition to primary trial findings demonstrating the non-inferiority of allopurinol to febuxostat in flare prevention and the achievement of serum urate goals, data generated from the STOP Gout trial have provided additional insights that have included: 1) the relative efficacy and safety of both allopurinol and febuxostat in participants with stage 3 chronic kidney disease; 2) patient factors associated with the achievement of serum urate goals; 3) the frequency and determinants of mobilization flares during the early phases of treat-to-target treatment; 4) the heightened risk of flare following discontinuation of anti-inflammatory prophylaxis; 5) limited persistence of ULT following transitions back to real-world care; 6) rapid gains in health-related quality of life accompanying highly effective ULT that pre-date reductions in flare risk; and 7) the positive effects of urate-lowering on measures of systemic inflammation and other circulating biomarkers. In addition to informing the comparative efficacy and safety of allopurinol and febuxostat, STOP Gout and the resources generated from this trial have enabled research that has further informed our understanding of gout and its management. </p>","PeriodicalId":10761,"journal":{"name":"Current Rheumatology Reports","volume":"28 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2026-04-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147764961","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}