Current opinion in rheumatology最新文献_第9页

New therapies in anti-MDA5 antibody-positive dermatomyositis. 抗mda5抗体阳性皮肌炎的新疗法。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1097/BOR.0000000000000979

Masahiro Yasui, Taro Iwamoto, Shunsuke Furuta

{"title":"New therapies in anti-MDA5 antibody-positive dermatomyositis.","authors":"Masahiro Yasui, Taro Iwamoto, Shunsuke Furuta","doi":"10.1097/BOR.0000000000000979","DOIUrl":"10.1097/BOR.0000000000000979","url":null,"abstract":"Purpose of review: This review focuses on treatments for anti-MDA5 antibody-positive dermatomyositis (MDA5-DM), which is a subgroup of dermatomyositis and characterized by frequent rapidly progressive interstitial lung disease and the high mortality rate. Despite conventional immunosuppressive therapies, there are still refractory cases. Newer treatment options are needed.Recent findings: The triple combination therapy (high-dose glucocorticoids, calcineurin inhibitor, and intravenous cyclophosphamide) improved patient survival compared to high-dose glucocorticoids and step-wise addition of the immunosuppressants. The triple therapy now has been widely used, but there are still refractory cases. In addition to the conventional-type immunosuppressants, recently the efficacy of Janus kinase inhibitors, biologic agents such as rituximab, plasma exchange, and polymyxin B perfusion for refractory MDA5-DM patients have been reported. However, the majority of those reports regarding new treatments are limited to case series, retrospective studies, and small single-arm studies. Adding antifibrotic drugs to immunosuppressive therapies might have some ancillary benefits.Summary: Several new therapies for MDA5-DM patients have emerged, although the optimal use of those therapies is still unknown. Further research and evidence accumulation will be needed. It is also noted that the intensive immunosuppressive therapies are associated with the higher infection risk.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"61-68"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10238899","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

Cluster analysis as a clinical and research tool in Behçet's syndrome. 聚类分析作为Behçet综合征的临床和研究工具。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-09-18 DOI: 10.1097/BOR.0000000000000980

Ufuk Ilgen

{"title":"Cluster analysis as a clinical and research tool in Behçet's syndrome.","authors":"Ufuk Ilgen","doi":"10.1097/BOR.0000000000000980","DOIUrl":"10.1097/BOR.0000000000000980","url":null,"abstract":"Purpose of review: The purpose of this review was to comprehensively summarize recent phenotype research findings in Behçet's syndrome.Recent findings: Cluster analysis has recently been employed as a phenotype research tool in Behçet's syndrome. Studies reported different clustering patterns caused by biological variation and some degree of artificial heterogeneity. However, some clusters were more consistent than others: 1) oral ulcers, genital ulcers, and skin lesions 2) oral ulcers, genital ulcers, skin lesions, and arthritis 3) oral ulcers, genital ulcers, skin lesions, and uveitis 4) oral ulcers, genital ulcers, skin lesions, and gastrointestinal involvement. A number of loci suggestive of differential risk for individual disease manifestations were proposed. Peripheral blood gene expression profile and plasma proteome exhibited significant differences in patients with different organ involvements and were able to differentiate between disease phenotypes. However, these observations require further validation and functional studies.Summary: Clustering patterns in Behçet's syndrome is highly heterogeneous. Artificial heterogeneity might obscure the true biological variation of disease expression. Preliminary genetic, transcriptomic and proteomic data suggest that different pathogenetic mechanisms may operate in different phenotypes of Behçet's syndrome.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"3-8"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41120238","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

T lymphocytes-related cell network in the pathogenesis of juvenile idiopathic arthritis: a key point for personalized treatment. T淋巴细胞相关细胞网络在幼年特发性关节炎发病机制中的作用：个性化治疗的关键。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-10-27 DOI: 10.1097/BOR.0000000000000991

Alessio Mazzoni, Francesco Annunziato, Laura Maggi

{"title":"T lymphocytes-related cell network in the pathogenesis of juvenile idiopathic arthritis: a key point for personalized treatment.","authors":"Alessio Mazzoni, Francesco Annunziato, Laura Maggi","doi":"10.1097/BOR.0000000000000991","DOIUrl":"10.1097/BOR.0000000000000991","url":null,"abstract":"Purpose of review: Juvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritis of unknown origin occurring in children under 16 years of age and persisting for at least 6 weeks. Given that JIA is an inflammatory disorder, treatment strategies, including also biologicals, are focused on suppressing excessive inflammation. The finding that different patients display different responses to biological drugs supports the concept that different pathogenic mechanisms can exist in JIA, with specific cellular and molecular mechanisms driving inflammation in each patient. The aim of this review is to highlight the most recent advances in understanding the role of immune cells in JIA pathogenesis.Recent findings: This review encompasses the role of the different cell subsets involved in sustaining inflammation in JIA, with a particular emphasis on T cells, as they orchestrate both innate and adaptive auto-reactive immunity in affected joints.Summary: The characterization of the cellular and molecular pathways supporting inflammation will be crucial to design novel therapeutic approaches in the context of personalized medicine.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"40-45"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71411090","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

Introduction, Vasculitis 2023. 导论，血管炎2023。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-11-30 DOI: 10.1097/BOR.0000000000000984

Hasan Yazici, Yusuf Yazici

引用次数: 0

Pregnancies in women with antineutrophil cytoplasmatic antibody associated vasculitis. 抗中性粒细胞细胞质抗体相关性血管炎妇女的妊娠。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2024-01-01 Epub Date: 2023-09-07 DOI: 10.1097/BOR.0000000000000977

Ann-Christin Pecher, Melanie Henes, Joerg C Henes

{"title":"Pregnancies in women with antineutrophil cytoplasmatic antibody associated vasculitis.","authors":"Ann-Christin Pecher, Melanie Henes, Joerg C Henes","doi":"10.1097/BOR.0000000000000977","DOIUrl":"10.1097/BOR.0000000000000977","url":null,"abstract":"Purpose of review: Antineutrophil cytoplasmatic antibody associated vasculitis (AAV) usually manifests after age fifty, thus making it very rare during reproductive age. Although rare, AAV, particularly eosinophilic granulomatosis with polyangiitis, can manifest at a younger age. AAV can also appear for the first time during pregnancy.Recent findings: Data from pregnant patients with AAV mostly derive from case reports or retrospective studies, with an absolute number of <100 published cases. Therefore, numbers of results of pregnancy outcome vary widely.Summary: As with other chronic autoimmune diseases, patients and infants seem to be at a higher risk for preterm delivery, intrauterine growth retardation and preeclampsia. Possible treatment for AAV in pregnancy depends upon gestational age and include glucocorticosteroids, azathioprine, intravenous immunoglobulins, and in severe cases rituximab and even cyclophosphamide. Plasma exchange might be an option in selected patients. Aside from cyclophosphamide these medications can also be used during breastfeeding. Acetylsalicylic-acid 100-150 mg/day reduces the risk of preeclampsia, also in this population. Patients should be counseled prior to conception and medication that is suitable for pregnancy should be established early on. During pregnancy, we recommend close monitoring of disease activity, blood pressure and ideally to co-consult with a gynecologist in an interdisciplinary approach.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"16-20"},"PeriodicalIF":5.1,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10535754","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

Long-term safety of biologic and targeted synthetic disease modifying drugs in rheumatology. 风湿病学中生物制剂和靶向合成疾病调节药物的长期安全性。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2023-12-21 DOI: 10.1097/bor.0000000000000995

Kaia Barth, Harsimrat Gill, Namrata Singh

引用次数: 0

Cardiovascular disease in spondyloarthritis: a narrative review of risk factors and the effect of treatments. 脊柱关节炎的心血管疾病：风险因素和治疗效果综述。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2023-12-21 DOI: 10.1097/bor.0000000000000999

Rouhin Sen, Liron Caplan, Maria I Danila

引用次数: 0

Chimeric antigen receptor T-cell therapy in rheumatology: B-cell depletion 2.0. 风湿病学中的嵌合抗原受体 T 细胞疗法：B 细胞耗竭 2.0。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2023-12-18 DOI: 10.1097/bor.0000000000000994

Rohith Appalaneni, Nikhila Achanta, Chandra Mohan

引用次数: 0

Pathogenesis of vasculopathy in systemic sclerosis and its contribution to fibrosis. 系统性硬化症血管病变的发病机制及其对纤维化的影响。

IF 5.1 2区医学

Current opinion in rheumatology Pub Date : 2023-11-01 Epub Date: 2023-07-24 DOI: 10.1097/BOR.0000000000000959

Yasushi Kawaguchi, Masataka Kuwana

{"title":"Pathogenesis of vasculopathy in systemic sclerosis and its contribution to fibrosis.","authors":"Yasushi Kawaguchi, Masataka Kuwana","doi":"10.1097/BOR.0000000000000959","DOIUrl":"10.1097/BOR.0000000000000959","url":null,"abstract":"Purpose of review: In patients with systemic sclerosis (SSc), vascular manifestations precede skin and organ fibrosis. There is increasing evidence demonstrating a pathogenic link between early vascular injury and subsequent development of tissue fibrosis.Recent findings: Our knowledge of cellular and molecular mechanisms underlying a unique relationship between SSc-related vasculopathy and fibrosis has changed over the last few years. There is increasing evidence showing viral infection as a potential trigger elucidating vascular injury. Due to defective vascular repair machinery, this initial event results in endothelial cell activation and apoptosis as well as the recruitment of inflammatory/immune cells, leading to endothelial-to-mesenchymal transition. This sequential process induces destructive vasculopathy in capillaries, fibroproliferative vascular lesions in arteries, and excessive fibrosis in the surrounding tissue. A variety of molecular mechanisms and pathways involved in vascular remodeling linked to subsequent excessive fibrosis have been identified and serve as attractive therapeutic targets for SSc.Summary: Endothelial injury may play a central role in connecting three features that characterize SSc pathogenesis: vasculopathy, chronic inflammation, and fibrosis. Our understanding of the processes responsible for myofibroblast differentiation triggered by vascular injury will provide the rationale for novel targeted therapies for SSc.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"309-316"},"PeriodicalIF":5.1,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10228649","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: 1

Methods for objective assessment of skin involvement in systemic sclerosis. 系统性硬化症皮肤受累的客观评估方法。

IF 5.2 2区医学

Current opinion in rheumatology Pub Date : 2023-11-01 Epub Date: 2023-08-21 DOI: 10.1097/BOR.0000000000000968

Ruhani Desai, Harshdeep Chawla, Kirill Larin, Shervin Assassi

{"title":"Methods for objective assessment of skin involvement in systemic sclerosis.","authors":"Ruhani Desai, Harshdeep Chawla, Kirill Larin, Shervin Assassi","doi":"10.1097/BOR.0000000000000968","DOIUrl":"10.1097/BOR.0000000000000968","url":null,"abstract":"Purpose of review: Skin fibrosis is the most prominent disease manifestation of systemic sclerosis (SSc). Although the treatment for other SSc manifestations has expanded over the years, there is limited progress in identifying effective treatment options for SSc skin involvement. This is in part due to limitations in the utilized outcome measures for assessment of skin fibrosis. This review focuses on different emerging assessment tools for SSc skin involvement and their potential use for clinical care and multicenter trials.Recent findings: Durometer and other device-based methodologies requiring application of direct pressure to the affected skin have been studied in SSc. However, there are concerns that the required application of pressure might be a source of variability. Ultrasound-based methods have been compared with modified Rodnan Skin Score in several studies, indicating acceptable construct validity. However, few studies have examined their criterion validity by providing comparisons to skin histology. Optical coherence-based methods show promising preliminary results for simultaneous assessment of skin fibrosis and vasculopathy. Further standardization and validation (including comparison to skin histology) of these promising novel assessment tools in large, longitudinal SSc cohort studies are needed to establish them as clinically useful outcome measures with acceptable sensitivity to change.Summary: Recent advances in imaging techniques provide a promising opportunity for development of a valid and reliable assessment tool for quantification of SSc skin fibrosis, which can pave the way for approval of effective treatment options for this high burden disease manifestation.","PeriodicalId":11145,"journal":{"name":"Current opinion in rheumatology","volume":" ","pages":"301-308"},"PeriodicalIF":5.2,"publicationDate":"2023-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11015902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10039281","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