Current rheumatology reviews最新文献

{"title":"Uncommon Presentation of Giant Tophaceous Gout in the Hand: A Case Report.","authors":"Hassan Zmerly, Ibrahim Akkawi, Damiano Alfio Ruinato, Manuela Moscato, Maurizio Draghetti, Francesco Pegreffi","doi":"10.2174/0115733971374467250522093438","DOIUrl":"https://doi.org/10.2174/0115733971374467250522093438","url":null,"abstract":"<p><strong>Background: </strong>Tophaceous gout masses are characterized by the accumulation of monosodium urate crystals in peripheral joints and soft tissues. The most commonly involved areas are the metatarsophalangeal and knee joints. Finger/hand localization is uncommon. If not correctly treated, a finger tophaceous mass can grow and, in rare cases, reach an abnormally large size, termed \"giant.\"</p><p><strong>Aim: </strong>The aim of our study is to present a rare case of a large tophaceous mass of the hand, localized in the fourth finger, and to highlight the role of surgical excision combined with a multidisciplinary team approach.</p><p><strong>Case report: </strong>We present a rare case of an 82-year-old woman affected by giant tophaceous gout in the left hand, localized to the extensor region of the proximal interphalangeal joint of the fourth finger. Clinical evaluation, MRI, and ultrasound imaging showed a 35 x 30 mm nodule in the soft tissue. The lesion was successfully treated by mass excision and debridement of the extensor tendon. Histopathologic examination confirmed the diagnosis of tophaceous gout. Post-operatively, a combination of medical and nutritional therapy was given. At a 3-year follow-up, the patient was free of symptoms with no evidence of disease in the fourth finger.</p><p><strong>Conclusion: </strong>Management of giant tophaceous gout in hand necessitates extensive mass excision combined with pharmacological therapy, dietary adjustments, and lifestyle modifications. Effective treatment of such cases requires a multidisciplinary team approach to address the complexity of the condition comprehensively.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing Climate-Adaptive Strategies to Mitigate the Burden of Rheumatic Diseases.","authors":"Saurabh RamBihariLal Shrivastava, Prateek Sudhakar Bobhate","doi":"10.2174/0115733971398448250521034847","DOIUrl":"https://doi.org/10.2174/0115733971398448250521034847","url":null,"abstract":"<p><p>Climate change has been acknowledged as a major global public health concern that has influenced the general population. The reported changes in climate have been identified as a common risk factor in the development of rheumatic diseases in multiple ways. Extreme weather events can interfere with timely access to healthcare services, supply chain management of drugs and equipment, and the provision of rehabilitation services, which altogether can worsen the management of different rheumatic diseases. Acknowledging the impending changes in climate and their potential impact on the occurrence and progression of different rheumatic diseases, there is an immense need to implement targeted public health measures. In conclusion, climate change can influence the development and progression of existing rheumatic diseases in multiple ways. This calls for the need to design climate adaptation policies and implement targeted public health interventions to improve resilience to climate change.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144141690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Periorbital Erythema and Swelling as an Initial Presentation of Systemic Lupus Erythematosus: A Rare Case.","authors":"Jitendra Singh, Anju Dinkar, Nilesh Kumar, Kailash Kumar, Isha Atam","doi":"10.2174/0115733971381153250418075039","DOIUrl":"https://doi.org/10.2174/0115733971381153250418075039","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a chronic autoimmune disease characterized by multisystem involvement due to autoantibody production and immune complex deposition. While classical cutaneous manifestations, such as malar rash, are common, atypical presentations, like periorbital erythema and swelling, are rare and pose diagnostic challenges. Early recognition is crucial to prevent disease progression and complications.</p><p><strong>Case presentation: </strong>A 16-year-old girl presented with a three-month history of intermittent bilateral periorbital swelling. Clinical examination revealed pallor and localized alopecia with no significant systemic abnormalities. Laboratory investigations showed pancytopenia with normal renal, hepatic, and thyroid functions and unremarkable urinalysis, chest X-ray, and ECG. Autoimmune markers were positive, with a strongly positive ANA titer of 1:1000 and significantly elevated anti- dsDNA antibodies of 380 IU/mL (reference range: 0-200 IU/mL). According to the 2019 EULAR/ ACR classification criteria, a diagnosis of SLE was established. The patient was treated with pulse intravenous methylprednisolone (1g daily for three days), followed by oral prednisolone (1 mg/kg/day), in a tapering regimen and hydroxychloroquine at standard doses. She showed marked improvement, with resolution of periorbital swelling, recovery of pancytopenia, and hair regrowth. At two-month follow-up, she remained asymptomatic and continued hydroxychloroquine for maintenance therapy.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering SLE in patients with atypical presentations, like periorbital erythema and pancytopenia. Early diagnosis based on clinical and serological findings, followed by appropriate therapy, can achieve remission and prevent complications. The case highlights the need for heightened clinical suspicion and multidisciplinary management in young patients.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987325","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Synovitis and Latent Transcription Factors in the Pathogenesis of Rheumatoid Arthritis.","authors":"Lavkush Tiwari, Nitu Nigam, Amod Kumar Sachan, Urmila Dhakad, Puneet Kumar, Chandana Venkateshwara Rao, Shubha Shukla","doi":"10.2174/0115733971346656250403051144","DOIUrl":"https://doi.org/10.2174/0115733971346656250403051144","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid Arthritis (RA) is a chronic autoimmune inflammatory disease that affects synovial membranes, leading to relentless progressive joint damage. This pathological process is regulated by transcription factors, such as NF-κB, STAT3, TGF-β, WNT, p38 MAPK, mTOR, AP-1, TLR-4, SOCS-4, YY-1, IRF, and FGF-20, which enhance the production of matrix-degrading enzymes and proinflammatory cytokines. Dysregulation of these transcription factors amplifies inflammation and accelerates joint damage, making them potential therapeutic targets.</p><p><strong>Objectives: </strong>The purpose of this review was to summarize the role of transcription factors in RA and the onset of synovitis and identify potential therapeutic targets to mitigate joint damage.</p><p><strong>Methodology: </strong>A comprehensive search of electronic databases (PubMed, Google Scholar, and Web of Science) was conducted. Additionally, searches of government health ministries and websites were performed to retrieve relevant information. Records available until March 12, 2024, were considered. Screening (primary and secondary) of the records and data extraction from eligible studies were carried out.</p><p><strong>Results: </strong>Synovitis sustains a proinflammatory environment mediated by dysregulated transcription factors, as mentioned earlier. These transcription factors promote the production of inflammatory cytokines and matrix-degrading enzymes, leading to progressive joint destruction. Therefore, targeting these transcription factors or their upstream regulators may offer promising therapeutic interventions for RA.</p><p><strong>Conclusion: </strong>The pathogenesis of RA centers on transcription factors responsible for the inflammatory and destructive processes in synovitis. These molecules are ideal targets for developing novel treatments. Further elucidation of their complex molecular interactions and advancements in personalized therapies for RA patients is necessary.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nasal Chondrocytes Intensively Invade and Repair Pathologically Altered Cartilage Through Intrinsic Genomic Mechanisms: A Narrative Review.","authors":"Victoria A Shestakova, Ekaterina I Smirnova, Longfeng Rao, Ilya V Kolobaev, Dmitry A Atiakshin, Michael A Ignatyuk, Mikhail E Krasheninnikov, Bagavdin G Ahmedov, Sergey A Ivanov, Ilya D Klabukov, Peter V V Shegay, Andrey D Kaprin, Denis S Baranovskii","doi":"10.2174/0115733971359145250329194434","DOIUrl":"https://doi.org/10.2174/0115733971359145250329194434","url":null,"abstract":"<p><p>Articular cartilage, a crucial component of joint structure, ensures smooth articulation and efficient load distribution within the joint. However, its integrity is compromised in various pathological conditions, such as osteoarthritis, leading to significant alterations in its structure and function. This process was significantly correlated with Extracellular Matrix (ECM) degradation, loss of collagen type II, and increased expression of matrix metalloproteinases (MMPs), particularly MMP-13. The ability of chondrocytes to invade into the ECM in pathologically altered tissue leads to cartilage repair and regeneration, and becomes the basis of chondrocyte cell therapy. Furthermore, the altered mechanical properties of the ECM in diseased cartilage, alongside the upregulation of chemotactic factors, contribute to the enhanced migratory behavior of chondrocytes. Interestingly, chondrocytes invading the ECM displayed signs of phenotypic changes, such as increased proliferation and expression of markers associated with chondrocytes' intrinsic genetic properties. The invasion of chondrocytes into the ECM is a response to cartilage damage, possibly driven by an attempt to repair the degraded ECM, and varies in chondrocytes from different sources, i.e., articular cartilage or nasal septum. Nasal chondrocytes highlight the increase of ACAN, SOX9, N-cadherin, COL2A expression and decrease of IL1B, CXCL8, and MMPs gene family expression, which could relate to their unique phenotype properties. However, this response may paradoxically contribute to the progression of cartilage pathology by disrupting the tissue architecture and promoting further degeneration. Our review highlights the endogenous genetic properties of nasal chondrocytes to invade and repair damaged cartilage, offering promising avenues for cartilage repair and regeneration.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143987682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual Screening Approaches Towards the Discovery of Toll-like Receptor 7 (TLR7) Antagonists for the Management of Rheumatoid Arthritis During COVID Infection.","authors":"Thangavelu Prabha, Saravanan Thangavelu, Dakshinesh Parameswaran, M K Kathiravan, Hemalatha Selvaraj, Chaitanya M V N L, S Sri Bhuvaneswari, Jubie Selvaraj","doi":"10.2174/0115733971351438250220063238","DOIUrl":"https://doi.org/10.2174/0115733971351438250220063238","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis(RA) patients prompt to have high level of TLR7, when coronavirus (CoV-2) infect to these patients, further the level of TLR7 cloud be upregulated and leads to severe condition of RA. Since, some TLR7 antagonists targeting the TLR7 protein are in the clinical trials, but yet to reach the market, and many lead to serious toxicities.</p><p><strong>Objective: </strong>So, we have framed a hypothesis to discover the TLR7 antagonist that may inhibit to the upregulation of TLR 7 in RA patients during the CoV-2infection via virtual screening meth-odology.</p><p><strong>Methods: </strong>Here we have focused to discover some novel TLR7 inhibitors from the ZINC data-base,which may effectively inhibit TLR7. Series of virtual screening analysis lead to the discov-ery of three active hits.</p><p><strong>Results: </strong>Among these three molecules, ZINC95412580 had a highest binding energy of -15.4273 kcal/mol against the TLR7 protein (PDB Id: 6LW1) that also showed the maximum interactions within the binding pocket.</p><p><strong>Conclusion: </strong>Thus, the compounds discovered through the use of various software can possibly be used for the management of rheumatoid arthritis during and after COVID infection. Hence, we can conclude that these molecules might be served as the inhibitors of TLR7 upregulation.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143996080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Frequency of Musculoskeletal Disorders and Nerve Entrapment Syndromes Around the Shoulder in a Cohort of Egyptian Patients.","authors":"Dalia Salah Saif, Suzan Omar, Aya Hanafy Ibrahiem, Mohamed Abdelaziz Fayed, Yousra Hisham Abdel Fattah","doi":"10.2174/0115733971338169250327074446","DOIUrl":"https://doi.org/10.2174/0115733971338169250327074446","url":null,"abstract":"<p><strong>Background: </strong>Shoulder pain is a common musculoskeletal (MSK) disorder. However, proper diagnosis of shoulder dysfunction and causes of pain remains challenging.</p><p><strong>Objective: </strong>The objective of this study is to identify the frequency of musculoskeletal and neurological disorders among a cohort of Egyptian patients with chronic shoulder pain.</p><p><strong>Methods: </strong>A cross-sectional study was conducted on 120 patients with chronic shoulder pain. Clinical, imaging, and electrophysiology studies were conducted on each participant to assess the frequency of musculoskeletal and neurological causes of shoulder pain.</p><p><strong>Results: </strong>The commonest causes of shoulder pain in the present study were musculoskeletal disorders, representing 94.2% of the whole cases, of which rotator cuff pathology was the commonest in 78.3%. Neurological disorders were found in 45.8%, of which suprascapular neuropathy was the commonest in 31.7%. At the same time, combined musculoskeletal and neurological disorders were found in 59.2% of cases. The frequency of musculoskeletal disorders was significantly associated with the duration of shoulder pain, as well as patients' occupation, specifically manual working. While the frequency of neurological disorders was significantly associated with shoulder pain duration, old age, sex, and patient's occupation (mainly manual working).</p><p><strong>Conclusion: </strong>Musculoskeletal disorders are the most common causes of chronic shoulder pain, especially rotator cuff disorders. While suprascapular neuropathy is the most common neurological cause of chronic shoulder pain. The combination of musculoskeletal and neurological disorders together is also an important cause of shoulder pain in many cases, which may not be obvious and must be detected early to provide early and appropriate therapeutic intervention. Manual work is a risk factor for developing MSK and neuropathic shoulder disease.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143802720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The TIM-3/Gal-9 Pathway: A Promising Therapeutic Target for Regulation of Immune Checkpoint in Rheumatoid Arthritis.","authors":"Debjeet Sur, Riya Pramanik","doi":"10.2174/0115733971330865250312075719","DOIUrl":"https://doi.org/10.2174/0115733971330865250312075719","url":null,"abstract":"<p><p>Rheumatoid arthritis (RA) is a chronic autoimmune ailment that is marked by persistent synovial joint inflammation, which causes joint destruction and other systemic consequences. The immune system is equipped with a wide range of effector mechanisms that are capable of inflicting severe harm on pathogens that invade it, as well as inflicting severe harm on the body itself. The immune system must carefully regulate itself to avoid such damage to host tissues and restore equilibrium following an inflammatory response. In the peripheral immune system, the immune cell responses are regulated by a balance of positive and negative signals that are sent to effector cells to adjust them to their environment. The identification of immunological checkpoints has opened up new avenues for studying and perhaps modifying immune responses in the context of RA pathogenesis. T-cell immunoglobulin and mucin domain-containing molecule 3 (TIM-3), a member of the TIM family, has emerged as a major regulator in immune checkpoint pathways, with several studies on its various functions in immunological homeostasis and autoimmune disorders. This review narrates the critical function of TIM-3 in the control of immunological checkpoints in rheumatoid arthritis also the potential role of TIM-3/GAL-9 signalling as a therapeutic target for the development of a new class of immunotherapeutic agents for the treatment of RA.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143669273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vaccine to Nano-Vaccine: Novel Technique to Treat Rheumatoid Arthritis.","authors":"Sandip Zine, Dhanashri Kadam, Pranita Lodha","doi":"10.2174/0115733971330575250121054355","DOIUrl":"https://doi.org/10.2174/0115733971330575250121054355","url":null,"abstract":"<p><p>Autoimmune diseases are a class of diseases wherein the immune system of the body targets itself through autoreactive T cells and autoantibodies. Autoimmune diseases are classified as organ-specific autoimmune diseases and systemic autoimmune diseases. Organ-specific autoimmune diseases such as primary biliary cirrhosis, Hashimoto's Thyroiditis (HT), Type 1 Diabetes mellitus (T1D), and Graves' Disease (GD) are characterized by a unique immune system response to autoantigens in a single organ. Systemic autoimmune diseases such as Systemic Lupus Erythematosus (SLE), Rheumatoid Arthritis (RA), and Sjogren syndrome are characterized by a systemic spread of autoantigens causing a multi-organ attack. In this review, we discuss rheumatoid arthritis, its prevalence in India, and its risk factors. We discuss the pharmacotherapies for RA that are currently available on the market. By identifying the disadvantages and side effects of the treatment, we mainly focus on how nanotechnology will be helpful in vaccine research and the advancement of anti-RA therapeutics from vaccines to nano-vaccines. In addition, the benefits of nano-vaccines are explored in future perspectives. In conclusion, nano-vaccines will be a novel technique for treating RA because they show possible outcomes from nanovaccine use.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined Axial and Peripheral Melorheostosis in a Young Boy: A Unique Case.","authors":"Hesham Hamoud, Ahmed M Elhilasy, Eman E A Elsalam, Basma M Elnaggar, Hemmat Ahmed Elabd, Hosam Arafa, Maha S S Mohamed, Mai Abdelhalim Moussa, Marwa Mohammed M Ali Abd El Rahim, Hala Mohamed Elzomor","doi":"10.2174/0115733971342621250305173428","DOIUrl":"https://doi.org/10.2174/0115733971342621250305173428","url":null,"abstract":"<p><strong>Background: </strong>Axial melorheostosis is a rare clinical condition with only a few cases identified worldwide. The combination of axial and peripheral melorheostosis has not reported before, to the best of our knowledge.</p><p><strong>Case presentation: </strong>Here, we present a case of a 9-year-old boy, who was referred with pain and swelling over the medial upper right leg with slight limping of insidious onset over a 3-month period. In addition, there was discomfort and irregular patchy skin lesions over the lower back. On examination, a tender swelling with irregular borders was felt over the right upper tibia. A diagnosis of axial and peripheral melorheostosis was confirmed by radiological imaging. A single dose of intravenous zolendronic acid (0.05 mg/kg) was administered. The patient showed significant improvement of symptoms within 2 months of treatment, with complete alleviation of symptoms after 6 months.</p><p><strong>Conclusion: </strong>Axial and peripheral melorheostosis can present together; however, peripheral lesions may adequately respond to zolendronic acid treatment.</p>","PeriodicalId":11188,"journal":{"name":"Current rheumatology reviews","volume":" ","pages":""},"PeriodicalIF":1.2,"publicationDate":"2025-03-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143604193","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}