Current opinion in rheumatology最新文献_第10页

Diagnosis and management of primary heart involvement in systemic sclerosis. 系统性硬化症原发性心脏受累的诊断和治疗。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-11-08 DOI: 10.1097/BOR.0000000000000990

Giacomo De Luca, Marco Matucci-Cerinic, Sophie I Mavrogeni

{"title":"Diagnosis and management of primary heart involvement in systemic sclerosis.","authors":"Giacomo De Luca, Marco Matucci-Cerinic, Sophie I Mavrogeni","doi":"10.1097/BOR.0000000000000990","DOIUrl":"10.1097/BOR.0000000000000990","url":null,"abstract":"Purpose of review: In systemic sclerosis (SSc) primary heart involvement (pHI) is frequent, even though often unrecognized due to its occult nature and to the lack of a specific diagnostic algorithm. The purpose of this review is to report the state of the art of the evidence in the current literature, as well as the overall diagnostic modalities and therapeutic strategies for primary heart involvement in SSc.Recent findings: SSc-pHI is defined by the presence of cardiac abnormalities that are predominantly attributable to SSc rather than other causes and/or complications; it may be sub-clinical and must be confirmed through diagnostic investigations. Novel electrocardiographic analysis and cardiac magnetic resonance (CMR) with mapping techniques have been recently proposed, showing a great utility in the early identification of SSc-pHI and in the noninvasive characterization of myocardial tissue. Immunosuppressive therapy emerged as fundamental to curb myocardial inflammation, and recent preclinical and clinical data support the role of antifibrotic drugs to treat SSc-pHI.Summary: our review will help clinicians to properly integrate the available diagnostic modalities for the assessment of SSc-pHI. The ultimate goal is to propose a feasible diagnostic algorithm for the early identification of patients with SSc-pHI, and a schematic therapeutic approach to manage SSc-pHI.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"76-93"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92153106","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}

引用次数: 0

The contribution of endothelial cells to tissue fibrosis. 内皮细胞对组织纤维化的贡献。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1097/BOR.0000000000000963

Eloisa Romano, Irene Rosa, Bianca Saveria Fioretto, Mirko Manetti

{"title":"The contribution of endothelial cells to tissue fibrosis.","authors":"Eloisa Romano, Irene Rosa, Bianca Saveria Fioretto, Mirko Manetti","doi":"10.1097/BOR.0000000000000963","DOIUrl":"10.1097/BOR.0000000000000963","url":null,"abstract":"Purpose of review: Tissue fibrosis is an increasingly prevalent condition associated with various diseases and heavily impacting on global morbidity and mortality rates. Growing evidence indicates that common cellular and molecular mechanisms may drive fibrosis of diverse cause and affecting different organs. The scope of this review is to highlight recent findings in support for an important role of vascular endothelial cells in the pathogenesis of fibrosis, with a special focus on systemic sclerosis as a prototypic multisystem fibrotic disorder.Recent findings: Although transition of fibroblasts to chronically activated myofibroblasts is widely considered the central profibrotic switch, the endothelial cell involvement in development and progression of fibrosis has been increasingly recognized over the last few years. Endothelial cells can contribute to the fibrotic process either directly by acting as source of myofibroblasts through endothelial-to-myofibroblast transition (EndMT) and concomitant microvascular rarefaction, or indirectly by becoming senescent and/or secreting a variety of profibrotic and proinflammatory mediators with consequent fibroblast activation and recruitment of inflammatory/immune cells that further promote fibrosis.Summary: An in-depth understanding of the mechanisms underlying EndMT or the acquisition of a profibrotic secretory phenotype by endothelial cells will provide the rationale for novel endothelial cell reprogramming-based therapeutic approaches to prevent and/or treat fibrosis.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"52-60"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10715704/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10549104","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}

引用次数: 0

Cryoglobulinemic vasculitis: a 2023 update. 冷球蛋白血症血管炎：2023年更新。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-11-01 DOI: 10.1097/BOR.0000000000000989

Michele Moretti, Francesco Ferro, Chiara Baldini, Marta Mosca, Rosaria Talarico

{"title":"Cryoglobulinemic vasculitis: a 2023 update.","authors":"Michele Moretti, Francesco Ferro, Chiara Baldini, Marta Mosca, Rosaria Talarico","doi":"10.1097/BOR.0000000000000989","DOIUrl":"10.1097/BOR.0000000000000989","url":null,"abstract":"Purpose of review: Cryoglobulinemic vasculitis (CV) is an immune complex mediated small vessel vasculitis characterized by the presence of cryoglobulins in serum, often associated with hepatitis C infection, systemic autoimmune diseases or hematological conditions. The focus of this review is to provide an update on new insights into pathogenesis, epidemiology and therapies of infectious and noninfectious type II and type III CV.Recent findings: The introduction of new antiviral drugs for treatment of hepatitis C infection implied major changes in HCV-related CV, allowing to shed new lights on CV pathogenesis and mechanisms of relapse and, therefore, to increase the relevance of autoimmune diseases in CV epidemiology. Specific B-cell clones are involved in the production of pathogenic immune complexes that leads to small-vessel vasculitis. Therefore, both antiviral treatments [direct-acting antivirals (DAAs) and oral nucleot(s)ide analogues] and targeted anti-CD20 therapies (rituximab) prove to be safe and effective options, leading to a better prognosis. Association of Sjögren syndrome and CV defines a specific phenotype of patients, characterized by severe manifestations and poor outcome.Summary: Removing viral stimulation on B-cells through direct-acting antivirals and blocking B-cells proliferation and differentiation with rituximab are the goals of treatment of CV. However, further research is needed to identify prognostic factors of refractory and relapsing disease.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"27-34"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71421647","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}

引用次数: 0

Current treatment approach to ANCA-associated vasculitis. ANCA相关血管炎的当前治疗方法。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-10-09 DOI: 10.1097/BOR.0000000000000982

Yusuf Yazici

引用次数: 0

New therapies in anti-MDA5 antibody-positive dermatomyositis. 抗mda5抗体阳性皮肌炎的新疗法。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1097/BOR.0000000000000979

Masahiro Yasui, Taro Iwamoto, Shunsuke Furuta

{"title":"New therapies in anti-MDA5 antibody-positive dermatomyositis.","authors":"Masahiro Yasui, Taro Iwamoto, Shunsuke Furuta","doi":"10.1097/BOR.0000000000000979","DOIUrl":"10.1097/BOR.0000000000000979","url":null,"abstract":"Purpose of review: This review focuses on treatments for anti-MDA5 antibody-positive dermatomyositis (MDA5-DM), which is a subgroup of dermatomyositis and characterized by frequent rapidly progressive interstitial lung disease and the high mortality rate. Despite conventional immunosuppressive therapies, there are still refractory cases. Newer treatment options are needed.Recent findings: The triple combination therapy (high-dose glucocorticoids, calcineurin inhibitor, and intravenous cyclophosphamide) improved patient survival compared to high-dose glucocorticoids and step-wise addition of the immunosuppressants. The triple therapy now has been widely used, but there are still refractory cases. In addition to the conventional-type immunosuppressants, recently the efficacy of Janus kinase inhibitors, biologic agents such as rituximab, plasma exchange, and polymyxin B perfusion for refractory MDA5-DM patients have been reported. However, the majority of those reports regarding new treatments are limited to case series, retrospective studies, and small single-arm studies. Adding antifibrotic drugs to immunosuppressive therapies might have some ancillary benefits.Summary: Several new therapies for MDA5-DM patients have emerged, although the optimal use of those therapies is still unknown. Further research and evidence accumulation will be needed. It is also noted that the intensive immunosuppressive therapies are associated with the higher infection risk.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"61-68"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238899","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}

引用次数: 0

Cluster analysis as a clinical and research tool in Behçet's syndrome. 聚类分析作为Behçet综合征的临床和研究工具。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-09-18 DOI: 10.1097/BOR.0000000000000980

Ufuk Ilgen

{"title":"Cluster analysis as a clinical and research tool in Behçet's syndrome.","authors":"Ufuk Ilgen","doi":"10.1097/BOR.0000000000000980","DOIUrl":"10.1097/BOR.0000000000000980","url":null,"abstract":"Purpose of review: The purpose of this review was to comprehensively summarize recent phenotype research findings in Behçet's syndrome.Recent findings: Cluster analysis has recently been employed as a phenotype research tool in Behçet's syndrome. Studies reported different clustering patterns caused by biological variation and some degree of artificial heterogeneity. However, some clusters were more consistent than others: 1) oral ulcers, genital ulcers, and skin lesions 2) oral ulcers, genital ulcers, skin lesions, and arthritis 3) oral ulcers, genital ulcers, skin lesions, and uveitis 4) oral ulcers, genital ulcers, skin lesions, and gastrointestinal involvement. A number of loci suggestive of differential risk for individual disease manifestations were proposed. Peripheral blood gene expression profile and plasma proteome exhibited significant differences in patients with different organ involvements and were able to differentiate between disease phenotypes. However, these observations require further validation and functional studies.Summary: Clustering patterns in Behçet's syndrome is highly heterogeneous. Artificial heterogeneity might obscure the true biological variation of disease expression. Preliminary genetic, transcriptomic and proteomic data suggest that different pathogenetic mechanisms may operate in different phenotypes of Behçet's syndrome.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"3-8"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120238","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}

引用次数: 0

T lymphocytes-related cell network in the pathogenesis of juvenile idiopathic arthritis: a key point for personalized treatment. T淋巴细胞相关细胞网络在幼年特发性关节炎发病机制中的作用：个性化治疗的关键。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-10-27 DOI: 10.1097/BOR.0000000000000991

Alessio Mazzoni, Francesco Annunziato, Laura Maggi

{"title":"T lymphocytes-related cell network in the pathogenesis of juvenile idiopathic arthritis: a key point for personalized treatment.","authors":"Alessio Mazzoni, Francesco Annunziato, Laura Maggi","doi":"10.1097/BOR.0000000000000991","DOIUrl":"10.1097/BOR.0000000000000991","url":null,"abstract":"Purpose of review: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritis of unknown origin occurring in children under 16 years of age and persisting for at least 6 weeks. Given that JIA is an inflammatory disorder, treatment strategies, including also biologicals, are focused on suppressing excessive inflammation. The finding that different patients display different responses to biological drugs supports the concept that different pathogenic mechanisms can exist in JIA, with specific cellular and molecular mechanisms driving inflammation in each patient. The aim of this review is to highlight the most recent advances in understanding the role of immune cells in JIA pathogenesis.Recent findings: This review encompasses the role of the different cell subsets involved in sustaining inflammation in JIA, with a particular emphasis on T cells, as they orchestrate both innate and adaptive auto-reactive immunity in affected joints.Summary: The characterization of the cellular and molecular pathways supporting inflammation will be crucial to design novel therapeutic approaches in the context of personalized medicine.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"40-45"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411090","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}

引用次数: 0

Introduction, Vasculitis 2023. 导论，血管炎2023。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-11-30 DOI: 10.1097/BOR.0000000000000984

Hasan Yazici, Yusuf Yazici

引用次数: 0

Pregnancies in women with antineutrophil cytoplasmatic antibody associated vasculitis. 抗中性粒细胞细胞质抗体相关性血管炎妇女的妊娠。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1097/BOR.0000000000000977

Ann-Christin Pecher, Melanie Henes, Joerg C Henes

{"title":"Pregnancies in women with antineutrophil cytoplasmatic antibody associated vasculitis.","authors":"Ann-Christin Pecher, Melanie Henes, Joerg C Henes","doi":"10.1097/BOR.0000000000000977","DOIUrl":"10.1097/BOR.0000000000000977","url":null,"abstract":"Purpose of review: Antineutrophil cytoplasmatic antibody associated vasculitis (AAV) usually manifests after age fifty, thus making it very rare during reproductive age. Although rare, AAV, particularly eosinophilic granulomatosis with polyangiitis, can manifest at a younger age. AAV can also appear for the first time during pregnancy.Recent findings: Data from pregnant patients with AAV mostly derive from case reports or retrospective studies, with an absolute number of <100 published cases. Therefore, numbers of results of pregnancy outcome vary widely.Summary: As with other chronic autoimmune diseases, patients and infants seem to be at a higher risk for preterm delivery, intrauterine growth retardation and preeclampsia. Possible treatment for AAV in pregnancy depends upon gestational age and include glucocorticosteroids, azathioprine, intravenous immunoglobulins, and in severe cases rituximab and even cyclophosphamide. Plasma exchange might be an option in selected patients. Aside from cyclophosphamide these medications can also be used during breastfeeding. Acetylsalicylic-acid 100-150 mg/day reduces the risk of preeclampsia, also in this population. Patients should be counseled prior to conception and medication that is suitable for pregnancy should be established early on. During pregnancy, we recommend close monitoring of disease activity, blood pressure and ideally to co-consult with a gynecologist in an interdisciplinary approach.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"16-20"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10535754","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}

引用次数: 0

Long-term safety of biologic and targeted synthetic disease modifying drugs in rheumatology. 风湿病学中生物制剂和靶向合成疾病调节药物的长期安全性。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2023-12-21 DOI: 10.1097/bor.0000000000000995

Kaia Barth, Harsimrat Gill, Namrata Singh

引用次数: 0