Current opinion in rheumatology最新文献

{"title":"Biomarker discovery in psoriatic disease.","authors":"Darshini Ganatra, Vinod Chandran","doi":"10.1097/BOR.0000000000001086","DOIUrl":"10.1097/BOR.0000000000001086","url":null,"abstract":"<p><strong>Purpose of review: </strong>Psoriasis, a chronic skin condition, characterized by scaly erythematous plaques, is prevalent in around 2% of the population. Around 25% of psoriasis patients have psoriatic arthritis (PsA), an inflammatory musculoskeletal disease that often leads to progressive joint damage and disability. Psoriatic diseases (PsD) encompassing psoriasis and PsA, are often associated with pathophysiologically related conditions like uveitis and inflammatory bowel disease as well as comorbidities such as cardiovascular disease. Due to the heterogeneous nature of PsD, diagnosis and treatment is a challenge. Biomarkers can objectively measure variables, such as disease state, disease progress, and treatment outcomes, thus offering the possibility for better management of disease. This review focuses on some of the biomarker research that was carried out in PsD in the past year.</p><p><strong>Recent findings: </strong>Diverse biomarker types ranging from SNPs, mRNA, proteins, metabolites and immune cell profiles have been categorized as per the Biomarkers, EndpointS and other Tools (BEST) resource developed by the FDA/NIH. Some of the latest research has focused on multiomic assays and these along with advanced bioinformatic tools can help in better disease management.</p><p><strong>Summary: </strong>Recent developments in PsA biomarker research show promise in identifying markers that can help in diagnosis, assess disease activity and predict treatment response. However, most studies are in the early discovery and verification state. Large-scale studies to replicate findings and develop and validate predictive algorithms are required.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"225-232"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143536825","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":"Continental perspectives on managing axial spondyloarthritis and psoriatic arthritis: approaches and insights from Latin America.","authors":"Wilson Bautista-Molano","doi":"10.1097/BOR.0000000000001097","DOIUrl":"10.1097/BOR.0000000000001097","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review provides a critical analysis of the management of axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA) in Latin America, emphasizing regional challenges, genetic diversity, healthcare disparities, and efforts to optimize patient care in resource-limited settings.</p><p><strong>Recent findings: </strong>Recent literature highlights significant differences in treatment accessibility, healthcare infrastructure, and disease burden across Latin America considering the management of axSpA and PsA. Pan American league of associations for rheumatology (PANLAR) has established region-specific treatment recommendations adapted to the region that address these disparities while complementing international guidelines from assessment of spondyloarthritis international society - European alliance of associations for rheumatology (ASAS-EULAR) and group for research and assessment of psoriasis and psoriatic arthritis (GRAPPA). Limited access to biologics, high rates of diagnostic delay, and unique genetic and environmental factors shape disease management in this region. From the clinical perspective, the higher frequency of peripheral manifestations and the low frequency of HLA-B27 are remarkable.</p><p><strong>Summary: </strong>Latin America faces distinct obstacles in axSpA and PsA management, requiring tailored strategies that integrate regional epidemiological characteristics, healthcare system disparities, and economic constraints. Supporting collaborative research networks across all countries and increasing access to advanced therapies are critical to enhance patient outcomes in SpA and PsA. Implementation of management strategies in the continent are required.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"276-281"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144076750","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":"Anatomical variation of the sacroiliac joints - what the rheumatologist should know.","authors":"Torsten Diekhoff, Katharina Ziegeler","doi":"10.1097/BOR.0000000000001091","DOIUrl":"10.1097/BOR.0000000000001091","url":null,"abstract":"<p><strong>Purpose of review: </strong>Anatomical variations of the sacroiliac joints (SIJ) pose challenges in the diagnosis of axial spondyloarthritis (axSpA). Increased reliance on magnetic resonance imaging (MRI) for early detection has led to concerns about specificity, as anatomical variants can mimic inflammatory changes. This review highlights common SIJ variations and their implications for rheumatologists interpreting imaging findings.</p><p><strong>Recent findings: </strong>Recent studies emphasize the high prevalence of SIJ anatomical variations, particularly in females, and their potential to influence imaging interpretation. Variations such as crescent-shaped ileum, intraarticular dysmorphisms, and accessory joint facets can lead to bone marrow edema and sclerosis, mimicking sacroiliitis. Additionally, lumbosacral transitional vertebrae alter SIJ biomechanics, potentially exacerbating symptoms in axSpA patients. Advances in MRI and computed tomography (CT) imaging protocols provide improved differentiation between anatomical variants and true inflammatory changes.</p><p><strong>Summary: </strong>Recognizing SIJ anatomical variations is crucial for avoiding misinterpretation of imaging findings and overdiagnosis of axSpA. MRI protocols incorporating additional imaging planes and CT correlation can enhance diagnostic accuracy. Awareness of these variations can refine patient management strategies, ensuring appropriate treatment for inflammatory and biomechanical SIJ pathologies.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"215-224"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143794922","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":"Understanding psoriatic disease at single-cell resolution: an update.","authors":"Tran H Do, Nicole L Ward, Johann E Gudjonsson","doi":"10.1097/BOR.0000000000001085","DOIUrl":"10.1097/BOR.0000000000001085","url":null,"abstract":"<p><strong>Purpose of review: </strong>This review examines recent advancements in psoriasis research through single-cell technologies, including single-cell RNA sequencing (scRNA-seq) and spatial transcriptomics. These methods have uncovered the cellular diversity underlying psoriasis, identifying immune cell, keratinocyte, and fibroblast subtypes that play pivotal roles in disease progression. Such insights are vital for addressing the complexity and heterogeneity of psoriasis, paving the way for targeted therapies.</p><p><strong>Recent findings: </strong>Recent studies emphasize the roles of IL-17-producing T cells (T17), keratinocytes, and fibroblasts in driving inflammation. T-cell cytokines, including IL-17A and IL-17F, induce keratinocyte hyperproliferation and amplify inflammation through an IL-36 feed-forward loop. Fibroblast subsets, such as SFRP2+ and WNT5A+/IL24+ fibroblasts, contribute to extracellular matrix remodeling and cytokine release, worsening the inflammatory environment. These studies also reveal the intricate fibroblast-keratinocyte crosstalk via the IL-17/IL-36 and PRSS3-F2R pathways. More recently, advancement with spatial transcriptomics has uncovered metabolic dysregulation in psoriatic keratinocytes, highlighting HIF1α-driven glycolysis and lactate production as critical in sustaining chronic inflammation. Furthermore, nonlesional skin from severe psoriasis patients exhibits transcriptomic changes resembling lesional skin, suggesting systemic \"prelesional\" state with the upregulation of lipid metabolism genes.</p><p><strong>Summary: </strong>These discoveries have significant clinical implications. Integrating single-cell and spatial technologies into psoriasis research offers promising avenues for developing tailored treatments and improving patient outcomes. Specifically, with spatial transcriptomics revealing immune signatures and cell-cell colocalization that may serve as early indicators of disease severity and systemic involvement. Targeting metabolic pathways in keratinocytes and localized immune microenvironments may enhance precision therapies for psoriasis.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"254-260"},"PeriodicalIF":5.2,"publicationDate":"2025-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143751750","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":"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":"<p><strong>Purpose to review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p><p><strong>Summary: </strong>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.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-06-23","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}

{"title":"Update on streptococcal-associated rheumatic disease.","authors":"Sharon Shemesh, Ruby Haviv, Yosef Uziel","doi":"10.1097/BOR.0000000000001101","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001101","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p><p><strong>Summary: </strong>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.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-22","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}

{"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":"https://doi.org/10.1097/BOR.0000000000001100","url":null,"abstract":"<p><strong>Purpose of review: </strong>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.</p><p><strong>Recent findings: </strong>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.</p><p><strong>Summary: </strong>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.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-21","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}

{"title":"Pathogenesis of juvenile idiopathic arthritis.","authors":"Megan M Simonds, AnneMarie C Brescia","doi":"10.1097/BOR.0000000000001099","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001099","url":null,"abstract":"<p><strong>Purpose of review: </strong>To provide an overview of the most recent updates in the pathogenesis of juvenile idiopathic arthritis (JIA).</p><p><strong>Recent findings: </strong>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.</p><p><strong>Summary: </strong>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.</p>","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-05-06","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}

{"title":"Editorial introduction.","authors":"","doi":"10.1097/BOR.0000000000001081","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001081","url":null,"abstract":"","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":"37 3","pages":"v"},"PeriodicalIF":5.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708518","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":"Should CAR-T cells be used as monotherapy?","authors":"William Joseph McCune","doi":"10.1097/BOR.0000000000001078","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001078","url":null,"abstract":"","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":"37 3","pages":"165-166"},"PeriodicalIF":5.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143708546","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}