Current opinion in rheumatology最新文献_第3页

Isolated aortitis - is it truly isolated? An approach to diagnosis and management. 孤立性大动脉炎--真的孤立吗？诊断和处理方法。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-05-01 Epub Date: 2025-03-17 DOI: 10.1097/BOR.0000000000001084

Ora Gewurz-Singer, Elizabeth Lee

引用次数: 0

An update on the pathogenesis of idiopathic inflammatory myopathies. 特发性炎性肌病发病机制的最新进展。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-05-01 Epub Date: 2025-02-12 DOI: 10.1097/BOR.0000000000001077

Eleni Tiniakou

{"title":"An update on the pathogenesis of idiopathic inflammatory myopathies.","authors":"Eleni Tiniakou","doi":"10.1097/BOR.0000000000001077","DOIUrl":"10.1097/BOR.0000000000001077","url":null,"abstract":"Purpose of review: As the question of the pathogenesis of inflammatory myopathies remains unanswered, there has been a significant effort in recent years to investigate various components of the innate and adaptive immune systems, with evidence pointing that they work together to initiate and propagate the autoimmune response. This review aims to explore recent advancements in understanding the mechanisms underlying myopathies.Recent findings: Recent research has concentrated on uncovering potential triggers, examining the role of immune cells, both lymphocytes and myeloids, and investigating the contribution of inflammatory mediators to the autoimmune response in inflammatory myopathies. Unsuccessful clinical trials helped reshape established hypotheses about pathogenesis, while genetic mutations offered clues to the disease's root causes. The pathogenic role of autoantibodies is being reconsidered based on transcriptional data. Repurposing existing medications to combat muscle fiber dysfunction is also emerging as a potential therapeutic approach.Summary: Our understanding of inflammatory myopathies has evolved significantly as our understanding of the disease has grown. Even though breakthroughs have been documented on the underlying mechanisms of myopathies, important questions remain unanswered.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"192-198"},"PeriodicalIF":5.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143406157","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

Management of cutaneous manifestations of systemic sclerosis: current approaches and emerging therapies. 系统性硬化症皮肤表现的管理：目前的方法和新兴疗法。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-05-01 Epub Date: 2025-03-04 DOI: 10.1097/BOR.0000000000001082

Rocio Bautista Sanchez, Yasmin Khader, Dinesh Khanna

{"title":"Management of cutaneous manifestations of systemic sclerosis: current approaches and emerging therapies.","authors":"Rocio Bautista Sanchez, Yasmin Khader, Dinesh Khanna","doi":"10.1097/BOR.0000000000001082","DOIUrl":"10.1097/BOR.0000000000001082","url":null,"abstract":"Purpose of review: This review summarizes the most recent approaches in managing cutaneous involvement, one of the main clinical manifestations of systemic sclerosis (SSc). The following article is written for clinicians and researchers looking for optimizing patient care and exploring new therapies.Recent findings: Recent studies have shown advancements in the management of cutaneous manifestations of SSc. While mycophenolate remains the first-line treatment, other immunosuppressive therapies targeting different pathways have shown promising results. B-cell depleting agents, such as Rituximab (RTX), are being increasingly utilized for cutaneous scleroderma with positive outcomes. Intravenous immunoglobulins (IVIG) have also demonstrated potential benefit for refractory cases with advanced skin fibrosis.Moreover, emerging approaches such as autologous hematopoietic stem cell transplant (AHSCT) have been evaluated in clinical trials, with evidence suggesting its ability to reset the immune system and achieve remission in skin involvement in severe cases. Chimeric antigen receptor (CAR) T cell therapy is the most recent potential pathway to target refractory skin and systemic disease.Summary: Management of cutaneous involvement in SSc remains challenging. The following study provides a comprehensive review of the most recent updates in treating cutaneous aspects (and associated complications) of SSc to help clinicians establish a more effective approach managing this condition.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"167-175"},"PeriodicalIF":5.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143540514","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

Pediatric antiphospholipid syndrome: expanding our understanding of antiphospholipid syndrome in children. 儿童抗磷脂综合征：扩大我们对儿童抗磷脂综合征的认识。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-05-01 Epub Date: 2025-02-21 DOI: 10.1097/BOR.0000000000001083

Kevin Lewis, Ajay Tambralli, Jacqueline A Madison

{"title":"Pediatric antiphospholipid syndrome: expanding our understanding of antiphospholipid syndrome in children.","authors":"Kevin Lewis, Ajay Tambralli, Jacqueline A Madison","doi":"10.1097/BOR.0000000000001083","DOIUrl":"10.1097/BOR.0000000000001083","url":null,"abstract":"Purpose of review: Antiphospholipid syndrome (APS) is an autoimmune, thromboinflammatory disease, which affects children and adults. There are particular features of the disease and nuances to diagnosis and management in a pediatric population, which must be appreciated to improve clinical care.Recent findings: Pediatric-specific epidemiological studies highlight that pediatric APS is quite rare with incidence in some populations of 0.2 per 100 000. There are new classification criteria in APS, which include a wider range of clinical features increasingly identified in registry data and case series of pediatric APS, though validation in pediatric APS is still needed. There is a particularly high proportion of pediatric APS patients with noncriteria antiphospholipid antibodies (aPL). Recurrent thrombosis is especially common in pediatric APS, highlighting the difficulty of management of this disease with high morbidity in children.Summary: Recent research has enhanced understanding of pediatric-specific APS epidemiology, laboratory findings, the wide variety of clinical features, and challenges in successful treatment. Future directions could include evaluation of potentially unique features in pediatric pathophysiology, an evaluation of the new APS classification criteria in children, broader prospective data on clinical and laboratory features, and a continued search for treatment beyond committing young patients to lifelong anticoagulation.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"176-184"},"PeriodicalIF":5.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11945550/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143467308","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

The gut microbiota in spondyloarthritis: an update. 脊柱关节炎的肠道微生物群：最新进展。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-05-01 Epub Date: 2025-02-19 DOI: 10.1097/BOR.0000000000001079

Valeria Rios Rodriguez, Morgan Essex, Denis Poddubnyy

{"title":"The gut microbiota in spondyloarthritis: an update.","authors":"Valeria Rios Rodriguez, Morgan Essex, Denis Poddubnyy","doi":"10.1097/BOR.0000000000001079","DOIUrl":"10.1097/BOR.0000000000001079","url":null,"abstract":"Purpose of review: This review provides an updated overview of the gut microbiota's involvement in spondyloarthritis (SpA) from a clinical perspective. It explores mechanisms by which the gut microbiota may influence SpA pathogenesis and considers the therapeutic implications of targeting the microbiome in SpA treatment.Recent findings: The pathogenesis of SpA is multifactorial, involving genetic predisposition, external factors and dysregulation of the immune system. Recent studies have identified alterations in the gut microbiome of patients with SpA, including changes in microbial diversity and specific taxa linked to disease activity. HLA-B27 status seems to influence gut microbiota composition, potentially impacting disease progression. In HLA-B27 transgenic rats, the association between gut microbiota and SpA development has been confirmed, supporting findings from human studies. A compromised gut barrier, influenced by proteins like zonulin, may allow microbial antigens to translocate, triggering immune responses associated with SpA.Summary: These findings highlight the potential for microbiota-modulating therapies, such as probiotics, prebiotics, diet and exercise, in managing SpA. However, methodological variability in human studies exposes the need for more rigorous research to better understand these associations. This may offer the opportunity to refine treatment strategies, offering a personalized approach to managing the disease.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"199-206"},"PeriodicalIF":5.2,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143448553","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

AI am the future: artificial intelligence in pediatric rheumatology. 人工智能是未来：儿童风湿病学中的人工智能。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-03-12 DOI: 10.1097/BOR.0000000000001087

Saverio La Bella, Latika Gupta, Vincenzo Venerito

{"title":"AI am the future: artificial intelligence in pediatric rheumatology.","authors":"Saverio La Bella, Latika Gupta, Vincenzo Venerito","doi":"10.1097/BOR.0000000000001087","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001087","url":null,"abstract":"Purpose of review: There is a growing interest in the applications of artificial intelligence in pediatric rheumatology. Although concerns with training datasets, ethical considerations, and the need for a major utilization of explainable artificial intelligence are still ongoing challenges, significant advancements have been made in recent years. In this review, we explore the most recent applications of artificial intelligence in pediatric rheumatology, with a special focus on machine learning models and their outcomes.Recent findings: Supervised and unsupervised machine learning models have been largely employed to identify key biomarkers, predict treatment responses, and stratify patients based on disease presentation and progression. In addition, innovative artificial intelligence driven imaging tools and noninvasive diagnostic methods have improved diagnostic accuracy and emerged as encouraging solutions for identifying inflammation and disease activity. Large language models have been utilized for patient-based questions with promising results. Nevertheless, critical examination and human oversight are still crucial in interpreting artificial intelligence's outputs.Summary: Artificial intelligence is revolutionizing pediatric rheumatology by improving diagnosis and disease classification, patient stratification and personalized treatment. However, we are only at the beginning, and the adventure has just begun.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143603852","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 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-03-11 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":""},"PeriodicalIF":5.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","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":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Genetic and epigenetic factors shape phenotypes and outcomes in systemic lupus erythematosus - focus on juvenile-onset systemic lupus erythematosus. 遗传和表观遗传因素塑造系统性红斑狼疮的表型和结果-关注青少年发病的系统性红斑狼疮。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-03-01 Epub Date: 2024-12-11 DOI: 10.1097/BOR.0000000000001072

Amandine Charras, Linda T Hiraki, Laura Lewandowski, Christian M Hedrich

{"title":"Genetic and epigenetic factors shape phenotypes and outcomes in systemic lupus erythematosus - focus on juvenile-onset systemic lupus erythematosus.","authors":"Amandine Charras, Linda T Hiraki, Laura Lewandowski, Christian M Hedrich","doi":"10.1097/BOR.0000000000001072","DOIUrl":"10.1097/BOR.0000000000001072","url":null,"abstract":"Purpose of review: Systemic lupus erythematosus (SLE) is a severe autoimmune/inflammatory disease. Patients with juvenile disease-onset and those of non-European ancestry are most severely affected. While the exact pathophysiology remains unknown, common and rare gene variants in the context of environmental exposure and epigenetic alterations are involved. This manuscript summarizes the current understanding of genetic and epigenetic contributors to SLE risk, manifestations and outcomes.Recent findings: Though SLE is a mechanistically complex disease, we are beginning to understand the impact of rare and common gene variants on disease expression and associated outcomes. Recent trans -ancestral and multigenerational studies suggest that differential genetic and environmental impacts shape phenotypic variability between age-groups and ancestries. High genetic burden associates with young age at disease-onset, organ involvement, and severity. Additional epigenetic impact contributes to disease-onset and severity, including SLE-phenotypes caused by rare single gene variants. Studies aiming to identify predictors of organ involvement and disease outcomes promise future patient stratification towards individualized treatment and care.Summary: An improved understanding of genetic variation and epigenetic marks explain phenotypic differences between age-groups and ancestries, promising their future exploitation for diagnostic, prognostic and therapeutic considerations.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"149-163"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11789615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142806470","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

Epidemiology of myositis. 肌炎的流行病学。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-03-01 Epub Date: 2024-12-10 DOI: 10.1097/BOR.0000000000001076

Fnu Duremala, Eleni Tiniakou, James Andrews

{"title":"Epidemiology of myositis.","authors":"Fnu Duremala, Eleni Tiniakou, James Andrews","doi":"10.1097/BOR.0000000000001076","DOIUrl":"10.1097/BOR.0000000000001076","url":null,"abstract":"Purpose of review: This review aims to synthesize recent developments in the epidemiology of idiopathic inflammatory myopathies (IIMs), focusing on incidence, prevalence, disease classification, and clinical outcomes.Recent findings: IIM is a rare group of autoimmune diseases characterized by muscle weakness and systemic involvement, with incidence rates ranging from 0.2 to 2 cases per 100 000 person-years. The role of myositis-specific autoantibodies (MSAs) in stratifying disease risk and prognosis is increasingly recognized, such as in anti-MDA5 positive DM, which is associated with a high risk of rapidly progressive interstitial lung disease. Furthermore, patients with IIM exhibit elevated risks of comorbidities, including cardiovascular disease and malignancy.Summary: IIM diseases are complex disorders with significant health impacts, necessitating enhanced awareness and research. Improved classification and understanding of MSAs are crucial for earlier diagnosis and tailored therapeutic strategies. Continued epidemiological research is essential to elucidate underlying mechanisms and inform future interventions, ultimately aiming to enhance the quality of life and clinical outcomes for affected patients.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"121-127"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142799667","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 psoriatic arthritis: new insights from a bone marrow perspective. 银屑病关节炎的发病机制：从骨髓角度的新认识。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2025-03-01 Epub Date: 2024-10-29 DOI: 10.1097/BOR.0000000000001064

Fatima Saeed, Iannis E Adamopoulos

{"title":"Pathogenesis of psoriatic arthritis: new insights from a bone marrow perspective.","authors":"Fatima Saeed, Iannis E Adamopoulos","doi":"10.1097/BOR.0000000000001064","DOIUrl":"10.1097/BOR.0000000000001064","url":null,"abstract":"Purpose of review: Psoriatic arthritis is an immune-mediated disease that primarily affects the skin and joints. It falls under the umbrella term of rheumatic diseases, which describes a group of closely related yet distinct disorders with many common underlying molecular pathways. Despite the distinct clinical manifestation of each disorder, the shared therapeutic strategies attest to the commonality of cellular and molecular underpinnings. Herein we provide a concise yet comprehensive overview of the interleukin (IL)-23/IL-17 axis and its involvement in mechanistic pathways leading to the pathogenesis of this dual skin and joint clinical manifestation which is characteristic of psoriatic arthritis and other rheumatic diseases.Recent findings: The interconnection between activated innate immune cells and adaptive immunity has transformed current thinking to include other organs such as the bone marrow as potential tissue of disease origin. A plethora of animal models and genetic studies converge on the critical role of IL-23/IL-17 axis, and highlight the importance of myeloid cell activation as common pathways between autoinflammatory and autoimmune diseases and chronic inflammation. These findings underscore the intricate immune mechanisms involved in inflammatory arthritis and highlight molecular mechanisms in disease pathogenesis.Summary: These insights pave the way for the development of novel diagnostic and therapeutic strategies, with a focus on translating these findings into improved clinical practice.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"136-141"},"PeriodicalIF":5.2,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11779588/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142521309","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