Current opinion in rheumatology最新文献_第5页

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-10-03 DOI: 10.1097/BOR.0000000000001046

引用次数: 0

Gastrointestinal disease in systemic sclerosis: the neglected organ system? 系统性硬化症的胃肠道疾病：被忽视的器官系统？

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-28 DOI: 10.1097/BOR.0000000000001052

Zsuzsanna McMahan, John Pandolfino, Harris Perlman, Francesco Del Galdo, Monique Hinchcliff

{"title":"Gastrointestinal disease in systemic sclerosis: the neglected organ system?","authors":"Zsuzsanna McMahan, John Pandolfino, Harris Perlman, Francesco Del Galdo, Monique Hinchcliff","doi":"10.1097/BOR.0000000000001052","DOIUrl":"10.1097/BOR.0000000000001052","url":null,"abstract":"Purpose of review: Identifying outcomes and clinical trial endpoints enabled the discovery of new inflammatory bowel disease (IBD) treatments. Herein, we describe efforts to advance the study of gastrointestinal (GI) manifestations in systemic sclerosis (SSc).Recent findings: Insights into the scope of the problem, as well as advancements in the measurement and treatment of SSc-GI, are underway. Proposed SSc esophageal endophenotypes are now defined, risk stratification methods are growing, and imaging and functional studies are now employed to guide therapeutic interventions. Additional progress is being made in characterizing the gut microbiome in patients with SSc. Research into the role of the immune response in the pathogenesis of SSc-GI disease is also ongoing, evolving simultaneously with the development of methods to facilitate data collection with real-time capture of diet, exercise, and medication data.Summary: Multidisciplinary teams are working to deepen our understanding of SSc-GI disease pathogenesis, to identify biomarkers for risk stratification and the assessment of disease activity, and to develop and validate outcomes and clinical trial endpoints to pave the way toward effective therapy for SSc-GI disease.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"374-378"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588520/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079590","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

Antimelanoma differentiation antigen 5-positive dermatomyositis: an update. 抗黑色素瘤分化抗原 5 阳性皮肌炎：最新进展。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-07-15 DOI: 10.1097/BOR.0000000000001034

Xin Lu, Qinglin Peng, Guochun Wang

{"title":"Antimelanoma differentiation antigen 5-positive dermatomyositis: an update.","authors":"Xin Lu, Qinglin Peng, Guochun Wang","doi":"10.1097/BOR.0000000000001034","DOIUrl":"10.1097/BOR.0000000000001034","url":null,"abstract":"Purpose of review: Antimelanoma differentiation antigen 5-dermatomyositis (MDA5-DM) is a complex and serious systemic autoimmune disease that primarily affects the skin and lungs. In this review, we aimed to provide new insights into the clinical features, pathogenesis, and practical management approach for this disease.Recent findings: Although lung lesions are prominent in most patients with MDA5-DM, they are now recognized as heterogeneous diseases. Peripheral blood lymphocyte count can serve as a simple and reliable laboratory parameter for categorizing MDA5-DM into three subgroups: mild, medium, and severe. Recent studies have implicated viral infection, genetic factors, autoimmunity against MDA5, multiple immune cells, and interferons as significant contributors to MDA5-DM pathogenesis. In addition to traditional treatments with glucocorticoids and immunosuppressants, many new approaches, including new biologics and targeted agents, have been explored. Additionally, infection is a common complication of MDA5-DM, and prophylaxis or treatment of the infection is as important as treating the primary disease.Summary: Knowledge of clinical characteristics and pathogenesis of MDA5-DM has grown in recent years. Although many new therapeutic approaches have been explored, further studies are required to confirm their efficacy.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"459-465"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141616078","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

Treatment of interstitial lung disease in systemic sclerosis: guidelines and new clinical trial results. 系统性硬化症间质性肺病的治疗：指南和新的临床试验结果。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-27 DOI: 10.1097/BOR.0000000000001049

Sindhu R Johnson, Elana J Bernstein

{"title":"Treatment of interstitial lung disease in systemic sclerosis: guidelines and new clinical trial results.","authors":"Sindhu R Johnson, Elana J Bernstein","doi":"10.1097/BOR.0000000000001049","DOIUrl":"10.1097/BOR.0000000000001049","url":null,"abstract":"Purpose of review: Interstitial lung disease (ILD) is the leading cause of death in patients with systemic sclerosis-associated interstitial lung disease (SSc-ILD). The American College of Rheumatology (ACR), in conjunction with the American College of Chest Physicians (CHEST), recently published clinical practice guidelines for the treatment of adults with systemic autoimmune rheumatic disease-associated ILD, including SSc-ILD. Herein, we summarize evidence from randomized trials evaluating the safety and efficacy of pharmacologic therapies for the treatment of SSc-ILD.Recent findings: In this review, we present findings from recent randomized controlled trials in SSc-ILD. The pharmacologic therapies discussed include immunosuppressive medications (mycophenolate, cyclophosphamide, rituximab, and tocilizumab) and antifibrotic medications (nintedanib and pirfenidone).Summary: Randomized trials provide an evidence base for the SSc-ILD treatment recommendations put forth in the ACR/CHEST Guidelines for the treatment of ILD in people with systemic autoimmune rheumatic diseases. These guidelines will help inform clinical practice and highlight areas in which further research is needed.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"420-426"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11588535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142079591","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

Heart involvement in systemic sclerosis: emerging concepts. 系统性硬化症的心脏受累：新概念。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-09 DOI: 10.1097/BOR.0000000000001038

Jessica L Fairley, Laura Ross, Mandana Nikpour

{"title":"Heart involvement in systemic sclerosis: emerging concepts.","authors":"Jessica L Fairley, Laura Ross, Mandana Nikpour","doi":"10.1097/BOR.0000000000001038","DOIUrl":"10.1097/BOR.0000000000001038","url":null,"abstract":"Purpose of review: Systemic sclerosis (SSc)-associated heart involvement (SHI) is a significant cause of both morbidity and mortality in individuals with SSc. SHI can take many different forms, and likely is a spectrum of fibroinflammatory cardiac disease. Presenting features include arrhythmia, ventricular systolic or diastolic dysfunction, pericardial disease, and exercise intolerance. Risk of sudden cardiac death in SSc is likely 10-30-fold greater than general population estimates. In this review, we explore what is known about the pathogenesis of SHI, its prevention and management, and discuss available strategies for screening for SHI in light of new recommendations for the routine screening of SHI in all SSc patients.Recent findings: We describe the spectrum, clinical features, and pathogenesis of SHI. Furthermore, we review the new recommendations for screening for SHI in individuals with SSc.Summary: There is a large, under-recognized burden of SHI in people living with SSc, which likely contributes to the significant increase in sudden cardiac death observed in SSc. However, a broad-based screening approach, including asymptomatic, low-risk patients should be viewed with caution given the lack of evidence-based treatments and interventions for SHI particularly in this group.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"393-400"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906149","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

Autoantibody testing in myositis: an update. 肌炎的自身抗体检测：最新进展。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-19 DOI: 10.1097/BOR.0000000000001039

Fionnuala K McMorrow, Natalie Anwyll, Sarah L Tansley

{"title":"Autoantibody testing in myositis: an update.","authors":"Fionnuala K McMorrow, Natalie Anwyll, Sarah L Tansley","doi":"10.1097/BOR.0000000000001039","DOIUrl":"10.1097/BOR.0000000000001039","url":null,"abstract":"Purpose of review: This review aims to provide an update on myositis autoantibody testing strategies. We have focussed on the reliability and usefulness of different myositis autoantibody detection methods, including commonly used solid phase immunoassays and newer discovery techniques.Recent findings: Several studies have highlighted the limitations of currently available immunoassays, particularly when used in populations with low pretest probability and without supporting clinical evidence. While many autoantibodies, such as anti-Jo1, are detected with high sensitivity and specificity, the low incidence of myositis autoantibodies in tested populations reduces their positive predictive value. The low sensitivity of line immunoassays to detect key myositis autoantibodies, including anti-TIF1γ and rarer antisynthetase autoantibodies, is a concern.Summary: Myositis autoantibodies are widely accepted as important clinical tools, and hence, there is a significant demand for reliable, accessible, and affordable detection methods. False positives and negative results have the potential to impact on patient care, particularly for malignancy and lung disease associated autoantibodies. Increased availability of myositis autoantibody testing has led to a rise in requests from a broader range of clinicians. It is critically important that clinicians are aware of specific limitations of tests and interpret results in the context of clinical findings.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"481-487"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141999525","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 approach to muscle imaging in myositis. 肌炎肌肉成像的当前方法。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-22 DOI: 10.1097/BOR.0000000000001043

Didem Saygin, Jemima Albayda

{"title":"Current approach to muscle imaging in myositis.","authors":"Didem Saygin, Jemima Albayda","doi":"10.1097/BOR.0000000000001043","DOIUrl":"10.1097/BOR.0000000000001043","url":null,"abstract":"Purpose of review: Muscle imaging is commonly utilized in idiopathic inflammatory myopathies (IIM) for diagnostic evaluation, selection of muscle biopsy site, and differentiating between disease activity versus damage. In this review, we discuss the current state and recent developments in the use of muscle imaging modalities including muscle magnetic resonance imaging (MRI), ultrasound (US), and positron emission tomography (PET) scan.Recent findings: Muscle MRI is a clinically useful tool in evaluation of IIM with studies showing good correlations between pattern of morphological changes on MRI and histopathological findings on muscle biopsy. The use of computer aided diagnostics to enable quantification of muscle pathology will be a welcome development for future studies and trials. New studies highlight that muscle US could be a particularly useful point of care tool in longitudinal monitoring of patients with active myositis. Muscle FDG-PET scan shows inflammatory activity in IIM muscle and can also provide additional information on extra-muscular manifestations and cancer screening. Utilization of novel tracers is an exciting development for IIM evaluation.Summary: Muscle MRI remains the gold standard for muscle imaging in IIM. Growing literature on muscle US and PET scan highlight their promising applications in IIM.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"445-452"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142016686","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

Autologous hematopoietic stem cell transplant for systemic sclerosis associated interstitial lung disease. 自体造血干细胞移植治疗系统性硬化症相关间质性肺病。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-09-27 DOI: 10.1097/BOR.0000000000001050

Jana Zielonka, Jean Paul Higuero Sevilla

{"title":"Autologous hematopoietic stem cell transplant for systemic sclerosis associated interstitial lung disease.","authors":"Jana Zielonka, Jean Paul Higuero Sevilla","doi":"10.1097/BOR.0000000000001050","DOIUrl":"10.1097/BOR.0000000000001050","url":null,"abstract":"Purpose of review: Over the last 25 years, the role of autologous hematopoietic stem cell transplant (HSCT) in the treatment of diffuse cutaneous systemic sclerosis (dcSSc) has been elucidated. However, multiple critical questions remain regarding this therapy. Of particular interest is the role of HSCT in the treatment of systemic sclerosis (SSc)-associated interstitial lung disease since this is the leading cause of death in SSc.Recent findings: Most clinical trials and observational studies of HSCT for the treatment of dcSSc have reported pulmonary outcomes as secondary outcomes, Also, most studies have excluded patients with significant pulmonary function impairment. Despite these limitations, there is increasing evidence that suggests that HSCT leads to interstitial lung disease stabilization and possibly improvement of lung function based on pulmonary function tests and imaging.Summary: HSCT has demonstrated improved long-term outcomes compared to conventional therapies for dcSSC. Future research is needed to refine or expand patient selection, optimize conditioning regimens, and evaluate the potential role of maintenance immunosuppression. We recommend an increased focus on interstitial lung disease since this is the primary cause of death in SSc.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"410-419"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142343413","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

Advances in the diagnosis of multiorgan involvement in systemic sclerosis: a focus on MRI. 系统性硬化症多器官受累的诊断进展：聚焦核磁共振成像。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-07 DOI: 10.1097/BOR.0000000000001040

Attila Feher, Francesco Del Galdo, Sven Plein

{"title":"Advances in the diagnosis of multiorgan involvement in systemic sclerosis: a focus on MRI.","authors":"Attila Feher, Francesco Del Galdo, Sven Plein","doi":"10.1097/BOR.0000000000001040","DOIUrl":"10.1097/BOR.0000000000001040","url":null,"abstract":"Purpose of review: Systemic sclerosis (SSc) is a rare chronic multisystem autoimmune disease characterized by endothelial dysfunction, tissue hypoxia, and diffuse organ fibrosis. MRI provides a radiation free approach to noninvasively assess the key manifestations of SSc in multiple organs. The purpose of this review is to summarize recent advances in MRI techniques to provide diagnostic and prognostic information in patients with SSc.Recent findings: MRI can probe processes that play a key role in the development of SSc-related complications, including neointima proliferation, fibrosis, and hypoxia. Feature tracking and parametric mapping MRI can detect cardiac involvement at the subclinical level. Contrast-free MRI angiography with Digital Artery Volume Index (DAVIX) assessment allow comprehensive assessment of hand involvement. T1 mapping and BOLD imaging can assess SSc effects on skeletal muscle, and lung MRI is becoming a key method for imaging of interstitial lung disease. As a new exciting application, the sodium content of the skin can be quantified by 23 Na MRI reflective of glycosaminoglycan content.Summary: Recent advances in MRI provide a unique opportunity to study the key pathophysiologic processes and clinical manifestations of SSc in multiple organs noninvasively, which can pave the way for the development of effective therapies.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"387-392"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141901253","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

Calcinosis in dermatomyositis. 皮肌炎中的钙化症。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-11-01 Epub Date: 2024-08-09 DOI: 10.1097/BOR.0000000000001036

Srijana Davuluri, Lorinda Chung, Christian Lood

{"title":"Calcinosis in dermatomyositis.","authors":"Srijana Davuluri, Lorinda Chung, Christian Lood","doi":"10.1097/BOR.0000000000001036","DOIUrl":"10.1097/BOR.0000000000001036","url":null,"abstract":"Purpose of review: To provide the most recent literature on our understanding behind the pathogenesis and the treatment of calcinosis in dermatomyositis.Recent findings: Early diagnosis and controlling the overall disease activity are cornerstones to prevent calcinosis in juvenile dermatomyositis. Observational cohort studies showed that prolonged state of inflammation and features of vascular dysfunction like digital ulcers and abnormal nailfold capillaries are associated with calcinosis. Neutrophil activation and mitochondrial dysfunction have recently emerged as potential mechanistic pathways involved in calcinosis pathogenesis. Few recent case series have alluded to the efficacy of topical and intralesional sodium thiosulfate, while JAK inhibitors appear to be newer promising therapy in juvenile dermatomyositis.Summary: Calcinosis in dermatomyositis consists of deposition of insoluble calcium compounds in the skin and other tissues. It is prevalent in up to 75% of patients with juvenile dermatomyositis and up to 20% in adult dermatomyositis. While it leads to significant patient morbidity, we do not yet understand the pathogenesis in its entirety. Surgical excision although palliative is the mainstay of treatment and should be offered to patients. All available treatment options are only based on very low level of evidence.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"453-458"},"PeriodicalIF":5.2,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451928/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141906148","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