Current opinion in rheumatology最新文献_第9页

Patient-reported outcomes in systemic sclerosis: insights into quality of life and disease burden. 系统性硬化症患者报告的结果：对生活质量和疾病负担的见解

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-07-11 DOI: 10.1097/BOR.0000000000001111

Alain Lescoat, Yen T Chen, Dinesh Khanna

{"title":"Patient-reported outcomes in systemic sclerosis: insights into quality of life and disease burden.","authors":"Alain Lescoat, Yen T Chen, Dinesh Khanna","doi":"10.1097/BOR.0000000000001111","DOIUrl":"10.1097/BOR.0000000000001111","url":null,"abstract":"Purpose of review: Assessing the impact of active therapy on how patients 'feel and function' is considered a necessary requirement by regulatory agencies for the approval of future treatments for SSc. In this context, patient-reported outcome measures (PROMs) have become a cornerstone of therapeutic assessment in randomized controlled trials (RCTs).Recent findings: This narrative review will discuss a selection of main available PROMs used in SSc RCTs, with a specific focus on recently developed PROMs, highlight ongoing initiatives related to SSc-PROMs, and provide points to consider for future use of SSc-PROMs.Summary: Several recent initiatives include a patient-centered approach [such as the Systemic Sclerosis-Associated Raynaud's Phenomenon (ASRAP), the MCQ (Mawdsley Calcinosis Questionnaire], the COAST (Clinical Outcome Assessments for Systemic Sclerosis Clinical Trials), and the CRISTAL (Combined Response index for scleroderma trials assessing limited systemic sclerosis) initiatives] to develop new PROMs and actively involve patient partners in each step of the process. Using a combined response index incorporating PROMs as the primary outcome measure in future SSc trials, such as the CRISS index for diffuse cutaneous SSc, could ensure that the perspectives of both physicians and patients would be incorporated to assess the efficacy of future interventions.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"335-342"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144607728","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

Gouty inflammation: genetic mechanisms towards flare therapy. 痛风炎症：耀斑治疗的遗传机制。

IF 5.4 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-08-20 DOI: 10.1097/BOR.0000000000001119

Daniel Lyth, Megan Leask

引用次数: 0

Updates in uricase therapy for gout. 痛风尿酸酶治疗的最新进展。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1097/BOR.0000000000001122

Naomi Schlesinger, Dan Kaufmann

{"title":"Updates in uricase therapy for gout.","authors":"Naomi Schlesinger, Dan Kaufmann","doi":"10.1097/BOR.0000000000001122","DOIUrl":"10.1097/BOR.0000000000001122","url":null,"abstract":"Purpose of review: Urate-lowering therapy (ULT) plays a pivotal role in treating gout patients. Unfortunately, some patients receiving oral ULT fail to achieve the target serum urate levels of < 6.8 mg/dl, the solubility level of uric acid. Exogenous uricases, considered \"enzyme replacement therapy,\" are a therapeutic option for patients with uncontrolled gout in whom oral ULT has not been efficacious, is not tolerated, or is contraindicated, in some due to underlying comorbidities. Currently, two uricases are available: pegloticase and rasburicase. Pegloticase is indicated for treating uncontrolled gout, while rasburicase is used to prevent tumor lysis syndrome.Recent findings: The main limitations of pegloticase include gout flares and infusion reactions, which are linked to the formation of antidrug antibodies. Immunomodulation and anti-inflammatory prophylaxis can help reduce these issues. New PEGylated uricases, including nanoencapsulated sirolimus combined with pegadricase (NASP) and PRX-115, are being developed and may offer improved options.Summary: Exogenous uricases available and those under development are discussed, focusing on immunomodulation and anti-inflammatory prophylaxis to reduce flares, prevent antidrug antibody formation and infusion reactions, and mitigate loss of efficacy in patients with uncontrolled gout needing uricase replacement therapy.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"422-429"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014086","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

Decoding vascular dysfunction in systemic sclerosis: from endothelial damage to clinical implications. 解读系统性硬化症血管功能障碍：从内皮损伤到临床意义。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-11-01 Epub Date: 2025-09-03 DOI: 10.1097/BOR.0000000000001126

Ryan Massay, Carleigh Zahn, Pei-Suen Tsou

{"title":"Decoding vascular dysfunction in systemic sclerosis: from endothelial damage to clinical implications.","authors":"Ryan Massay, Carleigh Zahn, Pei-Suen Tsou","doi":"10.1097/BOR.0000000000001126","DOIUrl":"10.1097/BOR.0000000000001126","url":null,"abstract":"Purpose of review: This review explores the evolving understanding of vascular dysfunction in systemic sclerosis (SSc), from early endothelial injury to clinical manifestations and emerging therapeutic strategies.Recent findings: Endothelial cell (EC) injury, senescence, and endothelial-to-mesenchymal transition are central to SSc vasculopathy. Single-cell and spatial omics have revealed distinct EC subtypes and dysregulated pathways, including interferon signaling and chromatin remodeling. Immune-mediated damage, viral triggers, and autoantibodies contribute to vascular pathology. Clinically, complications such as Raynaud's phenomenon, digital ulcers, pulmonary arterial hypertension, and renal crisis drive morbidity and healthcare burden. Diagnostic tools such as nailfold capillaroscopy enable early detection of microvascular changes. Novel therapies including CAR-T therapy, JAK inhibitors, and complement blockade, are under investigation.Summary: Vascular dysfunction is a hallmark of SSc and a key driver of disease progression. Advances in molecular profiling and imaging have improved our understanding of its mechanisms and opened new avenues for targeted intervention. Early diagnosis, biomarker-guided care, and multidisciplinary management are essential to improving outcomes.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"373-383"},"PeriodicalIF":4.3,"publicationDate":"2025-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12574716/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145014131","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

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

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

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 5.4 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":5.4,"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

Pathophysiology of glomerulonephritis in autoimmune diseases. 自身免疫性疾病肾小球肾炎的病理生理学研究。

IF 4.3 2区医学

Current opinion in rheumatology Pub Date : 2025-10-24 DOI: 10.1097/BOR.0000000000001134

Kayaho Maeda

{"title":"Pathophysiology of glomerulonephritis in autoimmune diseases.","authors":"Kayaho Maeda","doi":"10.1097/BOR.0000000000001134","DOIUrl":"https://doi.org/10.1097/BOR.0000000000001134","url":null,"abstract":"Purpose of review: Autoimmune glomerulonephritis (GN) emerges when self-reactive humoral and cellular immunity converge in the kidney. Combined immunofluorescence and electron microscopy aids in classifying GN; however, more stratification strategies are required for personalized therapy. We aimed to review biopsy-anchored clinicopathologic classification and pathophysiology of GN-associated disorders based on immunofluorescence and electron microscopy. Additionally, we sought to integrate mechanistic insights from multiomics and spatial profiling that resolve the composition and spatial organization of the cellular \"neighborhoods\" that drive injury and repair across IgA vasculitis/nephropathy, lupus nephritis, antiglomerular basement membrane disease, and antineutrophil cytoplasmic antibody-associated vasculitis.Recent findings: Although inciting antigens, immune complexes, and deposition patterns vary among entities, downstream injury pathways overlap. The convergent programs include complement activation, including locally produced renal complement, Fc receptor-driven myeloid effector functions, neutrophil extracellular traps with nucleic-acid sensing, the reprogramming of monocytes/macrophages, interleukin (IL)-23/IL-17, and type 1 interferon-primed cytotoxicity of T cells, and epithelial stress responses in podocytes and parietal epithelial cells.Summary: Despite diverse triggers, autoimmune GNs share targetable injury pathways. Integrating biopsy-defined immune deposits and the accompanying inflammatory context with spatial, single-cell, and proteomic readouts enables mechanistic subtyping and pathway-aligned therapy. Tailoring treatment to individual dominant injury programs may improve renal outcomes and reduce adverse effects.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":""},"PeriodicalIF":4.3,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145354088","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