Current opinion in rheumatology最新文献_第2页

Unraveling the relationship between disordered sleep and systemic sclerosis outcomes. 揭示睡眠紊乱和系统性硬化症结果之间的关系。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-08-01 DOI: 10.1097/BOR.0000000000001113

Apichart So-Gnern, Ajanee Mahakkanukrauh, Siraphop Suwannaroj, Patnarin Pongkulkiat, Tippawan Onchan, Chingching Foocharoen

{"title":"Unraveling the relationship between disordered sleep and systemic sclerosis outcomes.","authors":"Apichart So-Gnern, Ajanee Mahakkanukrauh, Siraphop Suwannaroj, Patnarin Pongkulkiat, Tippawan Onchan, Chingching Foocharoen","doi":"10.1097/BOR.0000000000001113","DOIUrl":"10.1097/BOR.0000000000001113","url":null,"abstract":"Purpose of review: This review aimed to synthesize the current knowledge regarding the prevalence, underlying mechanisms, and clinical implications of sleep disturbances in patients with systemic sclerosis (SSc). Furthermore, it highlights the potential for targeted interventions to address sleep dysfunction and improve overall disease management and patient quality of life.Recent findings: Sleep disturbances, including poor sleep quality, insomnia, sleep apnea, and restless leg syndrome, are common in patients with SSc, with multiple contributing factors such as immune activation, fibrosis, pain, and gastrointestinal symptoms. However, comprehensive assessment methods and targeted treatments for sleep disorders in this population remain limited. Evidence suggests a close association between sleep disruption and disease severity or progression, with inflammatory cytokines (e.g., IL-6 and TNFα) implicated in sleep and SSc pathophysiology.Summary: Sleep disorders are an under-recognized but significant burden in SSc, driven by complex interactions among disease manifestations and psychological and physiological factors. Early comprehensive assessment and integrated management of sleep disturbances and underlying SSc symptoms may improve patient outcomes.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"343-352"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144759437","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

Gastrointestinal manifestations of systemic sclerosis: current approaches and emerging therapies. 系统性硬化症的胃肠道表现：目前的方法和新出现的治疗方法。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-07-14 DOI: 10.1097/BOR.0000000000001110

Luis G Alcala-Gonzalez, Monique Hinchcliff, Zsuzsanna H McMahan

{"title":"Gastrointestinal manifestations of systemic sclerosis: current approaches and emerging therapies.","authors":"Luis G Alcala-Gonzalez, Monique Hinchcliff, Zsuzsanna H McMahan","doi":"10.1097/BOR.0000000000001110","DOIUrl":"10.1097/BOR.0000000000001110","url":null,"abstract":"Purpose of review: This review highlights recent advances in the understanding and management of gastrointestinal manifestations in systemic sclerosis (SSc). It is intended for clinicians and researchers aiming to improve diagnostic accuracy and therapeutic strategies in managing SSc-related gastrointestinal disease.Recent findings: Gastrointestinal involvement in SSc is highly variable in terms of clinical presentation, symptom severity, progression, timing of onset, and response to treatment. Emerging research highlights early immune-mediated damage to neural and muscular gastrointestinal tissues, microbiome alterations, and vascular dysfunction - particularly in patients with late-onset gastrointestinal disease - as key factors guiding the development of personalized, precision-based approaches for well defined patient subgroups. Recent studies underscore the value of early, objective assessment of gastrointestinal motility using tools like whole-gut transit scintigraphy and abdominal vascular ultrasound. New treatment strategies are also being explored for severe manifestations, including investigating mechanisms behind acid-suppressive therapy-resistant gastroesophageal reflux disease and implementing adjunctive therapies for gastrointestinal dysmotility.Summary: Gastrointestinal involvement in SSc poses a complex clinical challenge, particularly in patients with severe dysmotility and symptoms refractory to standard management strategies. This review offers timely, evidence-based insights to support clinicians in delivering more personalized and effective patient care and highlights critical gaps to address in future research.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"365-372"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12258924/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607727","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

Fueling fibrosis: metabolic dysregulation in systemic sclerosis. 助长纤维化：系统性硬化症的代谢失调。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-09-12 DOI: 10.1097/BOR.0000000000001123

Katja Lakota, Nika Boštic, Blaž Burja

{"title":"Fueling fibrosis: metabolic dysregulation in systemic sclerosis.","authors":"Katja Lakota, Nika Boštic, Blaž Burja","doi":"10.1097/BOR.0000000000001123","DOIUrl":"10.1097/BOR.0000000000001123","url":null,"abstract":"Purpose of review: This review examines how metabolic reprogramming drives fibrosis and immune dysregulation in systemic sclerosis (SSc), emphasizing the role of nutrient-sensing and energy pathways in disease progression.Recent findings: SSc is characterized by a shift from catabolic to anabolic metabolism, defined by reduced AMP-activated protein kinase (AMPK) and enhanced mechanistic target of rapamycin complex 1 (mTORC1) signaling. This promotes biosynthetic activity, with upregulated glycolysis supplying substrates for collagen production and supporting pro-inflammatory immune cell polarization. Remodeling of the tricarboxylic acid cycle yields key metabolites with extrametabolic roles. α-ketoglutarate (αKG) supports epigenetic regulation, collagen maturation, and AMPK activation, offering protective effects. In contrast, succinate and fumarate promote inflammation and fibrotic signaling. Despite increased anabolic activity, oxidative phosphorylation remains elevated in SSc fibroblasts, contributing to excess reactive oxygen species (ROS). Metabolomic analyses consistently show disrupted amino acid and lipid metabolism, including glutamine and tryptophan pathways, linked to immune activation and fibrogenesis. Single-cell transcriptomics reveal diverse fibroblast subtypes with distinct metabolic programs correlating with fibrosis severity.Summary: SSc is characterized by a metabolic reprogramming that favors anabolic, profibrotic, and proinflammatory states. These interconnected metabolic shifts illustrate how central carbon and nutrient pathways not only sustain energy demands but also actively regulate profibrotic signaling, offering new therapeutic targets for modulating fibrosis.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"404-412"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014058","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

What have we learned about systemic sclerosis from the EUSTAR database? 关于系统性硬化症，我们从EUSTAR数据库中学到了什么？

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-09-19 DOI: 10.1097/BOR.0000000000001128

Corrado Campochiaro, Madelon C Vonk, Thomas Osborne, Maria Grazia Lazzaroni, Michael Hughes, Tânia Santiago, Francesco Del Galdo, Marie-Elise Truchetet

{"title":"What have we learned about systemic sclerosis from the EUSTAR database?","authors":"Corrado Campochiaro, Madelon C Vonk, Thomas Osborne, Maria Grazia Lazzaroni, Michael Hughes, Tânia Santiago, Francesco Del Galdo, Marie-Elise Truchetet","doi":"10.1097/BOR.0000000000001128","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001128","url":null,"abstract":"Purpose of review: This review provides a timely synthesis of key findings derived from the EUSTAR (European Scleroderma Trials and Research) database, the largest international registry dedicated to systemic sclerosis (SSc), now including over 27 000 patients worldwide. As interest grows in real-world data and precision medicine in rare diseases, EUSTAR offers a uniquely rich, longitudinal dataset built over two decades of global collaboration. With sustained growth, more than 1000 new patients enrolled annually, this registry continues to inform clinical practice and research with contemporary, diverse patient data.Recent findings: Analyses from EUSTAR have clarified disease phenotypes and trajectories, identified predictors of organ involvement and mortality, and validated outcome measures including the EUSTAR Activity Index. Studies have also revealed heterogeneity in treatment patterns, supported the refinement of classification criteria, and highlighted regional disparities in care. The registry has been a foundation for innovative research approaches such as emulated clinical trials, comparative effectiveness analyses, and external control arms for interventional studies.Summary: EUSTAR has become a reference model for collaborative research in rare diseases. Its findings have directly informed guidelines and routine management of SSc. Future directions include integrating digital tools, artificial intelligence, and expanding the registry's role in clinical trial design and personalized medicine.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145079904","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

Pathogenesis of juvenile idiopathic arthritis. 青少年特发性关节炎的发病机制。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-09-01 Epub Date: 2025-05-05 DOI: 10.1097/BOR.0000000000001099

Megan M Simonds, AnneMarie C Brescia

{"title":"Pathogenesis of juvenile idiopathic arthritis.","authors":"Megan M Simonds, AnneMarie C Brescia","doi":"10.1097/BOR.0000000000001099","DOIUrl":"10.1097/BOR.0000000000001099","url":null,"abstract":"Purpose of review: To provide an overview of the most recent updates in the pathogenesis of juvenile idiopathic arthritis (JIA).Recent findings: Recent genetic studies on the pathogenesis of JIA have revolved around using in silico multiomic analyses to identify genetic variants that may play a role in the pathogenesis of JIA. Genome wide association studies (GWAS) have provided bulk-RNA and single cell-RNA sequencing datasets to identify groups of enhanced genes, signaling pathways, and other genetic variants. These data have led to the exploration of processes that regulate T-cell receptor signaling and T-cell differentiation, as well as genes linked to interferon-gamma signaling. Immune dysregulation is a major driver of JIA pathogenesis and neutrophil extracellular traps (NETs) are emerging as contributors to disease progression. The contribution of immune cells to the microenvironment in the inflamed joints of patients with JIA may hold the key to how inflammation is regulated and how the immune response from these cells contributes to disease progression.Summary: This review will focus on emerging insights from large scale multiomic studies, which reveal pathways involved in JIA pathogenesis. In addition, recent studies have identified immune dysregulation, especially in the microenvironment of the inflamed joint.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"321-326"},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143955600","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

Evolution of the axial spondyloarthritis disease activity score and uptake in clinical practice. 中轴性脊柱炎疾病活动度评分及临床应用的演变。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-09-01 Epub Date: 2025-05-21 DOI: 10.1097/BOR.0000000000001100

Saad Ahmed, Pedro M Machado

{"title":"Evolution of the axial spondyloarthritis disease activity score and uptake in clinical practice.","authors":"Saad Ahmed, Pedro M Machado","doi":"10.1097/BOR.0000000000001100","DOIUrl":"10.1097/BOR.0000000000001100","url":null,"abstract":"Purpose of review: This review outlines the development of the axial spondyloarthritis disease activity score (ASDAS) as a composite index to assess disease activity in axial spondyloarthritis (axSpA) and guide treatment decisions. Our review describes the iterative process by which the ASDAS was validated and its cut off values and improvement scores developed. We compare the ASDAS to the Bath ankylosing spondylitis disease activity index (BASDAI) as a tool for measuring disease activity in axSpA and how its better measurement properties have led to its widespread use in clinical and research settings.Recent findings: Recent international guidelines have recommended the use of the ASDAS as a tool for measuring and monitoring disease activity. ASAS has changed the nomenclature so that ASDAS is based on CRP values whereas ASDAS-ESR retains its original meaning. The BASDAI can be employed as an alternative tool when using the ASDAS is not possible. The ASDAS now forms an important outcome measure in clinical trials and aiming for ASDAS remission has been shown to retard radiographic progression in axSpA.Summary: The ASDAS demonstrates improved measurement properties, including greater validity and sensitivity to change, compared to single item variables. It offers a unified metric that enables healthcare professionals to collaborate and communicate more effectively about disease activity and treatment response to interventions in axSpA.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"327-333"},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144109514","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

Biomarkers in juvenile idiopathic arthritis: towards precision diagnosis and personalized therapy? 青少年特发性关节炎的生物标志物：走向精确诊断和个性化治疗？

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-09-01 Epub Date: 2025-06-20 DOI: 10.1097/BOR.0000000000001109

Luciana Breda, Saverio La Bella, Armando Di Ludovico

{"title":"Biomarkers in juvenile idiopathic arthritis: towards precision diagnosis and personalized therapy?","authors":"Luciana Breda, Saverio La Bella, Armando Di Ludovico","doi":"10.1097/BOR.0000000000001109","DOIUrl":"10.1097/BOR.0000000000001109","url":null,"abstract":"Purpose to review: Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, characterized by persistent joint inflammation with heterogeneous clinical subtypes. Early diagnosis and targeted treatment remain critical to improving long-term outcomes. In recent years, research has increasingly focused on the identification and validation of biomarkers to enhance diagnostic precision, predict disease course, and guide therapeutic decisions.Recent findings: Calprotectin (S100A8/A9) is a pro-inflammatory protein complex released by activated neutrophils and monocytes. In JIA, serum and synovial fluid calprotectin levels correlate with disease activity and may outperform traditional markers like C-reactive protein and erythrocyte sedimentation rate. Evidence suggests that elevated calprotectin levels can predict flares and subclinical inflammation, making it a promising biomarker for monitoring and prognosis in JIA. Novel biomarkers including microRNAs show potential for differentiating disease subtypes and monitoring treatment response. Proteomic and metabolomic profiling are also uncovering candidates that may improve early diagnosis and personalized management.Summary: Biomarkers have emerged as pivotal tools in the management of JIA, offering significant advantages in both therapeutic decision-making and long-term monitoring. In the future, a robust biomarker framework holds the potential to improve early diagnosis, guide personalized treatment strategies, and enhance outcome prediction-ultimately contributing to more effective and individualized care for patients with JIA.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"308-315"},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144332553","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

Update on streptococcal-associated rheumatic disease. 关于链球菌相关风湿病的最新情况。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1097/BOR.0000000000001101

Sharon Shemesh, Ruby Haviv, Yosef Uziel

{"title":"Update on streptococcal-associated rheumatic disease.","authors":"Sharon Shemesh, Ruby Haviv, Yosef Uziel","doi":"10.1097/BOR.0000000000001101","DOIUrl":"10.1097/BOR.0000000000001101","url":null,"abstract":"Purpose of review: This review provides a comprehensive perspective on poststreptococcal rheumatic manifestations in pediatric patients by integrating recent updates and a literature review, with particular focus on poststreptococcal reactive arthritis and acute rheumatic fever.Recent findings: Poststreptococcal reactive arthritis presents with a unique clinical profile, distinguishing it from other poststreptococcal conditions in pediatric patients, especially acute rheumatic fever. Recent updates underscore the importance of diligent monitoring and management to mitigate potential cardiac complications, despite the relatively low incidence of carditis following poststreptococcal reactive arthritis.Summary: The diagnosis of poststreptococcal reactive arthritis is often challenging due to significant overlap with other poststreptococcal syndromes, particularly acute rheumatic fever. Given the potential for cardiac complications in acute rheumatic fever, accurate differentiation between the two conditions is imperative. Ongoing research continues to refine diagnostic criteria and treatment approaches, emphasizing the need for clinicians to remain vigilant in recognizing and differentiating between the two syndromes.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"289-295"},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144215188","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

Human genetics of Whipple's disease. 惠普尔氏病的人类遗传学。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-09-01 Epub Date: 2025-03-12 DOI: 10.1097/BOR.0000000000001088

Jérémie Rosain, Jean-Laurent Casanova, Jacinta Bustamante

{"title":"Human genetics of Whipple's disease.","authors":"Jérémie Rosain, Jean-Laurent Casanova, Jacinta Bustamante","doi":"10.1097/BOR.0000000000001088","DOIUrl":"10.1097/BOR.0000000000001088","url":null,"abstract":"Purpose of review: Whipple's disease (WD), triggered by Tropheryma whipplei ( T. whipplei ), is a rare, chronic, inflammatory, systemic infectious disease that typically manifests in adults. The most frequent initial manifestations include arthritis, followed by diarrhea, abdominal pain, and weight loss. Half the world's population is exposed to T. whipplei , but only one in a million develop WD. This suggests that acquired or inborn errors of immunity (IEI) may underlie WD. Anti-TNF treatment is a well established risk factor for flare-ups of WD.Recent findings: We have also reported two rare IEI in patients with WD. Six WD patients from two unrelated kindreds were found to have autosomal dominant IRF4 deficiency acting via a mechanism of haploinsufficiency. These patients were otherwise healthy. In addition, a single patient with a history of WD and other infections was found to have autosomal recessive CD4 deficiency.Summary: Rare IEI can underlie WD. Human genetic studies of patients with WD are warranted for the development of precision medicine for affected kindreds and to improve our understanding of the pathogenesis of this rare infectious disease.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"316-320"},"PeriodicalIF":4.3,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12303769/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143585122","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

Editorial introduction. 编辑介绍。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-09-01 Epub Date: 2025-07-31 DOI: 10.1097/BOR.0000000000001107

引用次数: 0