Current opinion in rheumatology最新文献_第7页

Update on antineutrophil cytoplasmic autoantibody vasculitis in children. 儿童抗中性粒细胞胞浆自身抗体血管炎的最新进展。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2024-07-10 DOI: 10.1097/BOR.0000000000001033

Jessica L Bloom, Eveline Y Wu

{"title":"Update on antineutrophil cytoplasmic autoantibody vasculitis in children.","authors":"Jessica L Bloom, Eveline Y Wu","doi":"10.1097/BOR.0000000000001033","DOIUrl":"10.1097/BOR.0000000000001033","url":null,"abstract":"Purpose of review: Antineutrophil cytoplasmic autoantibody (ANCA)-associated vasculitis (AAV) is often organ- or life-threatening in children and impacts them during important periods of psychosocial and physical development. This review covers recent advances in the pathophysiology, diagnosis, management, and outcomes of AAV in children and highlights the ongoing need for funding and increased research collaboration.Recent findings: Recent work has improved our understanding of AAV disease pathogenesis, potentially identifying new biomarkers and therapeutic targets. Collaborative clinical studies have also highlighted the variable manifestations in children and identified potential factors associated with poorer outcomes. Consensus-based treatment guidelines are also appearing, but clinical trials are still essential to better understanding treatment efficacy and safety in children affected by AAV. New, validated outcome measures, including those that are patient-reported, will facilitate these much-needed clinical trials in pediatric AAV.Summary: There is a continued need for more rigorous study in pediatric AAV, however, there is certainly excitement with the increase in recent research relevant to the pediatric population.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"336-343"},"PeriodicalIF":5.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141579188","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 systemic sclerosis. 系统性硬化症中的钙化。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-09-01 Epub Date: 2023-10-10 DOI: 10.1097/BOR.0000000000000900

Srijana Davuluri, Christian Lood, Lorinda Chung

{"title":"Calcinosis in systemic sclerosis.","authors":"Srijana Davuluri, Christian Lood, Lorinda Chung","doi":"10.1097/BOR.0000000000000900","DOIUrl":"10.1097/BOR.0000000000000900","url":null,"abstract":"Purpose of review: To provide updated information on the prevalence, pathogenesis, diagnostics, and therapeutics of calcinosis cutis associated with systemic sclerosis (SSc).Recent findings: Observational studies show ethnic and geographical differences in the prevalence of calcinosis. In addition to clinical and serological associations, biochemical studies and in-vivo models have attempted to explain theories behind its pathogenesis, including prolonged state of inflammation, mechanical stress, hypoxia, and dysregulation in bone and phosphate metabolism. Long-term use of proton pump inhibitors may increase the risk for calcinosis in SSc. Few single center observational studies have shown mild benefit with minocycline and topical sodium thiosulfate.Summary: Calcinosis cutis is the deposition of insoluble calcium in the skin and subcutaneous tissues. It affects up to 40% of SSc patients and causes significant morbidity. Long disease duration, features of vascular dysfunction, and osteoporosis have been associated with calcinosis. Altered levels of inorganic pyrophosphate and fibroblast growth factor-23 have been implicated in dysregulated phosphate metabolism that may lead to calcinosis in SSc. Plain radiography can help with diagnosis and quantifying the calcinosis burden. Surgical treatment remains the most effective therapy when feasible. At present, no medical therapies have proven efficacy in large randomized controlled trials.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"360-369"},"PeriodicalIF":5.2,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41194417","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

Disease modification in axial spondyloarthritis - still a controversy? 轴性脊柱关节炎的疾病改变--仍有争议吗？

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-07-01 Epub Date: 2024-05-07 DOI: 10.1097/BOR.0000000000001025

Manouk de Hooge, Désirée van der Heijde

{"title":"Disease modification in axial spondyloarthritis - still a controversy?","authors":"Manouk de Hooge, Désirée van der Heijde","doi":"10.1097/BOR.0000000000001025","DOIUrl":"10.1097/BOR.0000000000001025","url":null,"abstract":"Purpose of review: This review evaluates recent advancements in disease-modifying therapies for axial spondyloarthritis (axSpA).Recent findings: A recent study could not demonstrate an additional effect of NSAID therapy on golimumab [Tumor Necrosis Factor-α inhibitor (TNFi)] on structural progression; however, this might be due to the fact that the study was underpowered. While DMARDs have shown promise in suppressing inflammation, their impact on structural progression remains uncertain. A well powered trial showed no difference in spinal progression between secukinumab [Interleukin17A inhibitor (IL17Ai)] and adalimumab-biosimilar (TNFi). Preliminary data on Janus kinase inhibitors (JAKi) focus on MRI findings but lack evidence on radiographic spinal progression. While some studies suggest promising outcomes, others reveal limitations and inconclusive findings.Summary: Recent studies explore the effectiveness of NSAIDs, biological disease-modifying antirheumatic drugs like TNFi and IL-17i, as well as JAK inhibitors in axSpA. Conflicting evidence surrounds these therapies' ability to impede structural progression, with challenges in study design and interpretation. Moreover, changes in demographics and treatment methods underscore the importance of examining trends over time when assessing disease outcomes. Ultimately, ongoing research could benefit from new imaging tools when evaluating therapeutic strategies for modifying disease progression in axSpA.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"302-308"},"PeriodicalIF":5.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140861368","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

Sacroiliitis in inflammatory bowel disease. 炎症性肠病中的骶髂关节炎。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-07-01 Epub Date: 2024-04-30 DOI: 10.1097/BOR.0000000000001017

Fardina Malik, Michael H Weisman

{"title":"Sacroiliitis in inflammatory bowel disease.","authors":"Fardina Malik, Michael H Weisman","doi":"10.1097/BOR.0000000000001017","DOIUrl":"10.1097/BOR.0000000000001017","url":null,"abstract":"Purpose of review: This review summarizes the recent evidence regarding the epidemiology of inflammatory bowel disease (IBD) associated sacroiliitis, including the prevalence, pathogenesis, role of imaging, and therapeutic challenges.Recent findings: Sacroiliitis is an underappreciated musculoskeletal manifestation of IBD, a chronic inflammatory condition of the gut affecting the younger population. Untreated sacroiliitis can lead to joint destruction and chronic pain, further adding to morbidity in IBD patients. Recent publications suggest sacroiliitis can be detected on abdominal imaging obtained in IBD patients to study bowel disease, but only a small fraction of these patients were seen by rheumatologists. Early detection of IBD-associated sacroiliitis could be achieved by utilization of clinical screening tools in IBD clinics, careful examination of existing computed tomography and MRI studies, and timely referral to rheumatologist for further evaluation and treatment. Current treatment approaches for IBD and sacroiliitis include several targeted biologic therapies, but IBD-associated sacroiliitis has limited options, as these therapies may not overlap in both conditions.Summary: With the advances in imaging, sacroiliitis is an increasingly recognized comorbidity in IBD patients. Future studies focusing on this unique patient population will expand our understanding of complex pathophysiology of IBD-associated sacroiliitis and lead to identification of novel targeted therapies for this condition.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"274-281"},"PeriodicalIF":5.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853003","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

Navigating the complexity of pain in psoriatic arthritis and axial spondyloarthritis. 了解银屑病关节炎和轴性脊柱关节炎疼痛的复杂性。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-07-01 Epub Date: 2024-05-01 DOI: 10.1097/BOR.0000000000001023

Philip J Mease

{"title":"Navigating the complexity of pain in psoriatic arthritis and axial spondyloarthritis.","authors":"Philip J Mease","doi":"10.1097/BOR.0000000000001023","DOIUrl":"10.1097/BOR.0000000000001023","url":null,"abstract":"Purpose of review: Pain is the most common and often most troublesome feature of chronic autoimmune diseases such as psoriatic arthritis (PsA) and axial spondyloarthritis (AxSpA). A predominant concept is that the main source of pain is from disease-induced tissue inflammation and structural damage, activating peripheral nerve fibers which relay to the central nervous system. This mechanism is nociceptive pain and the presumption has been that controlling inflammation will be sufficient to reduce this form of pain. However, despite control of inflammation, patients may still have significant residual pain.Recent findings: We are learning that there are additional pain mechanisms, neuropathic and nociplastic, that are often operative in patients with rheumatologic conditions, that can significantly influence pain experience, quantitation of disease activity, and may benefit from therapeutic approaches distinct from immunotherapy. Neuropathic pain arises from diseased or damaged nerve tissue and nociplastic pain reflects sensitization of the central nervous system due to multiple genetic, neurobiologic, neural network dysregulation, and psychosocial factors. Pain arising from these mechanisms influence assessment of disease activity and thus needs to be factored into decision-making about immunotherapy efficacy.Summary: This review addresses the importance of accurately assessing the complex mechanisms of pain experience in patients with PsA and AxSpA to more appropriately manage immunomodulatory, neuromodulatory, and nonpharmacologic therapies.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"282-288"},"PeriodicalIF":5.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140864333","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

Artificial intelligence and machine learning in axial spondyloarthritis. 人工智能和机器学习在轴性脊柱关节炎中的应用。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI: 10.1097/BOR.0000000000001015

Lisa C Adams, Keno K Bressem, Denis Poddubnyy

{"title":"Artificial intelligence and machine learning in axial spondyloarthritis.","authors":"Lisa C Adams, Keno K Bressem, Denis Poddubnyy","doi":"10.1097/BOR.0000000000001015","DOIUrl":"10.1097/BOR.0000000000001015","url":null,"abstract":"Purpose of review: To evaluate the current applications and prospects of artificial intelligence and machine learning in diagnosing and managing axial spondyloarthritis (axSpA), focusing on their role in medical imaging, predictive modelling, and patient monitoring.Recent findings: Artificial intelligence, particularly deep learning, is showing promise in diagnosing axSpA assisting with X-ray, computed tomography (CT) and MRI analyses, with some models matching or outperforming radiologists in detecting sacroiliitis and markers. Moreover, it is increasingly being used in predictive modelling of disease progression and personalized treatment, and could aid risk assessment, treatment response and clinical subtype identification. Variable study designs, sample sizes and the predominance of retrospective, single-centre studies still limit the generalizability of results.Summary: Artificial intelligence technologies have significant potential to advance the diagnosis and treatment of axSpA, providing more accurate, efficient and personalized healthcare solutions. However, their integration into clinical practice requires rigorous validation, ethical and legal considerations, and comprehensive training for healthcare professionals. Future advances in artificial intelligence could complement clinical expertise and improve patient care through improved diagnostic accuracy and tailored therapeutic strategies, but the challenge remains to ensure that these technologies are validated in prospective multicentre trials and ethically integrated into patient care.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"267-273"},"PeriodicalIF":5.1,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140293083","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

Investigating gout flares: beyond a definition. 痛风发作的调查：超越定义。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-05-03 DOI: 10.1097/bor.0000000000001024

Charles Sutherland, Angelo L Gaffo

引用次数: 0

New molecular targets in the treatment of rheumatoid arthritis. 治疗类风湿性关节炎的新分子靶点。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-01-02 DOI: 10.1097/BOR.0000000000001000

Beth I Wallace, Laura Cooney, David A Fox

引用次数: 0

Autoantibodies in rheumatoid arthritis - rheumatoid factor, anticitrullinated protein antibodies and beyond. 类风湿性关节炎的自身抗体--类风湿因子、抗瓜氨酸蛋白抗体及其他。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-02-26 DOI: 10.1097/BOR.0000000000001006

Günter Steiner, René E M Toes

{"title":"Autoantibodies in rheumatoid arthritis - rheumatoid factor, anticitrullinated protein antibodies and beyond.","authors":"Günter Steiner, René E M Toes","doi":"10.1097/BOR.0000000000001006","DOIUrl":"10.1097/BOR.0000000000001006","url":null,"abstract":"Purpose of review: RA is characterized by the presence of autoantibodies among which rheumatoid factors (RFs) and antimodified protein antibodies (AMPA) are serological hallmarks of the disease. In recent years, several novel insights into the biology, immunogenetics and clinical relevance of these autoantibodies have been obtained, which deserve to be discussed in more detail.Recent findings: RFs from RA patients seem to target distinct epitopes which appear to be quite specific for RA. Determination of immunoglobulin A (IgA) isotypes of RF and anticitrullinated protein antibodies (ACPA) may provide prognostic information because their presence is associated with reduced therapeutic responses to TNF inhibitors. Furthermore, IgA levels are increased in RA patients and IgA immune complexes are more potent than immunoglobulin G (IgG) complexes in inducing NET formation. Concerning AMPAs, investigations on variable domain glycosylation (VDG) revealed effects on antigen binding and activation of autoreactive B cells. Studies on pathogenetic involvement of ACPA suggest Janus-faced roles: on the one hand, ACPA may be involved in joint destruction and pain perception while on the other hand protective anti-inflammatory effects may be attributed to a subset of ACPAs.Summary: The autoimmune response in RA is extremely complex and still far from being fully understood. Antibodies are not only valuable diagnostic biomarkers but also seem to play pivotal roles in the pathophysiology of RA.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"217-224"},"PeriodicalIF":5.2,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11139241/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139971266","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

Monogenic lupus: insights into disease pathogenesis and therapeutic opportunities. 单基因狼疮：洞察疾病发病机制和治疗机会。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2024-05-01 Epub Date: 2024-02-29 DOI: 10.1097/BOR.0000000000001008

Yuting Qin, Jianyang Ma, Carola G Vinuesa

引用次数: 0