International Journal of Rheumatic Diseases最新文献

{"title":"From Vasospasm to Precision Microvascular Medicine: Rethinking the Evaluation and Management of Raynaud's Phenomenon","authors":"Chieh Chen, Jeffrey Liao, Su-Boon Yong","doi":"10.1111/1756-185x.70902","DOIUrl":"10.1111/1756-185x.70902","url":null,"abstract":"<p>Raynaud's phenomenon (RP) has long been regarded as a benign vasospastic disorder characterized by episodic digital color changes triggered by cold exposure or emotional stress. However, accumulating evidence has fundamentally changed this perception. In patients with connective tissue diseases, particularly systemic sclerosis (SSc), RP represents far more than transient vasospasm. It is often the earliest manifestation of progressive microvascular injury and serves as a window into the pathobiology of systemic vascular disease. The challenge for clinicians is no longer merely recognizing RP, but identifying which patients are at risk for irreversible vascular damage, digital ulceration, and systemic complications.</p><p>Recent advances presented at the American College of Rheumatology Convergence and reflected in the updated British Society for Rheumatology (BSR) recommendations illustrate a paradigm shift from symptom-oriented management toward precision assessment of the microcirculation. One of the most significant developments has been the increasing role of nailfold capillaroscopy. Once considered a specialized research technique, capillaroscopy is rapidly becoming an essential component of routine rheumatology practice [<span>1</span>]. It enables direct visualization of the microvasculature, allowing clinicians to distinguish primary RP from secondary RP associated with systemic sclerosis and other connective tissue diseases. Beyond diagnosis, capillaroscopic findings such as giant capillaries, capillary loss, abnormal angiogenesis, and microhemorrhages provide valuable prognostic information regarding disease progression and digital vascular complications. The challenge is therefore no longer whether capillaroscopy should be performed, but how it can be implemented efficiently in busy clinical settings. Technological advances are making this transition increasingly feasible. Table 1 is comparison of Nailfold Microvascular Assessment Techniques in Systemic Sclerosis. Clinical interpretation of imaging modalities. Nailfold videocapillaroscopy currently provides the most established and standardized approach for assessing SSc-associated nailfold microangiopathy. Dermatoscopy and smartphone-based imaging offer advantages in portability and accessibility, but their broader clinical application is limited by differences in image quality, acquisition protocols, and device performance. AI-assisted analysis represents a promising approach for automated recognition and quantification of capillary abnormalities; however, current evidence should be distinguished from future applications involving individual-level prediction of disease progression or vascular complications. Accordingly, these technologies should presently be viewed as complementary approaches rather than interchangeable alternatives, with their clinical utility ultimately requiring prospective validation and demonstration of improved patient outcomes (Table 2).</p><p>Conventional ","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70902","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Bilateral Reversed Palmaris Longus: An Unexpected Cause of Carpal Tunnel Syndrome in Sjögren's Syndrome","authors":"Hilmi Berkan Abacıoğlu, Berkay Yalçınkaya, Ahmet Furkan Çolak, Gamze Kılıç","doi":"10.1111/1756-185x.70906","DOIUrl":"10.1111/1756-185x.70906","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Discordant Internal and External Validation Performance in a Multicenter Nomogram for Overlap Syndrome in Systemic Lupus Erythematosus","authors":"Hefziba Lorences Noguera, Esteban Cardenas-Duran","doi":"10.1111/1756-185x.70899","DOIUrl":"10.1111/1756-185x.70899","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109489","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case Report: Sequential Autoimmune Hemolytic Anemia, Acquired Hemophilia A, and Pure Red Cell Aplasia in Systemic Lupus Erythematosus","authors":"Xingjie Dong, Luying Gong, Shujie Li, Chunfeng Hou","doi":"10.1111/1756-185x.70908","DOIUrl":"10.1111/1756-185x.70908","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Beyond Stability: Rethinking Housekeeping Genes as Contributors to Rheumatoid Arthritis Pathogenesis","authors":"Wenhua Lv, Hao Tang, Ruijie Zhang, Mingming Zhang, Yongshuai Jiang","doi":"10.1111/1756-185x.70890","DOIUrl":"10.1111/1756-185x.70890","url":null,"abstract":"<p>The concept of housekeeping genes has evolved considerably since the term first appeared in the 1970s, when it was used primarily to describe genes encoding transfer RNA and ribosomal RNA. Over the subsequent five decades, housekeeping genes became defined as constitutive genes required for the maintenance of basic cellular functions, expressed in all cells of an organism under normal and pathophysiological conditions [<span>1-3</span>]. Their products participate in fundamental processes such as protein synthesis, energy metabolism, and cytoskeletal organization, making them essential for cell survival regardless of tissue type, developmental stage, or cell cycle state [<span>4</span>]. This presumed universality and stability led to their widespread adoption as reference controls for normalizing gene expression data in quantitative PCR and transcriptomic studies. It holds an implicit assumption that these genes resist pathological perturbations impacting tissue-specific genes [<span>5</span>]. In routine experimental practice, a limited set of genes, such as GAPDH, ACTB, and 18S rRNA, has been widely adopted as internal controls. However, these genes were chosen largely for experimental convenience rather than for evidence of constitutive expression, and studies have shown that they can vary considerably across tissues [<span>6-8</span>]. With the advent of RNA-seq, systematic identification of housekeeping genes has become possible with unprecedented accuracy. In a landmark study using data from 16 normal human tissues, Eisenberg and Levanon (2013) applied three stringent criteria: expression in all tissues, low variance across tissues, and no exceptional expression in any single tissue to define 3804 high-confidence human housekeeping genes [<span>9</span>] (Table S1). This systematically defined set, rather than the limited set of conventional internal controls, serves as the foundation for our analysis.</p><p>However, this long-held view is increasingly being questioned. Recent advances in high-throughput sequencing have revealed that the expression patterns of housekeeping genes are more complex than previously appreciated. Studies in cancer biology have documented aberrant expression of several housekeeping genes in malignant tissues, suggesting that their dysregulation may contribute to disease progression [<span>10-12</span>]. In the context of autoimmune diseases, emerging evidence points to the involvement of housekeeping genes in inflammatory pathways [<span>13</span>], yet systematic investigations have remained scarce. Rheumatoid arthritis (RA), with its complex molecular architecture characterized by the collective dysregulation of hundreds of genes [<span>14</span>], provides an ideal context to examine whether these fundamental genes might play previously unrecognized roles in disease pathogenesis. The global burden of rheumatic diseases, exacerbated by the COVID-19 pandemic and limited access to specialist care in low-income","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/1756-185x.70890","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109232","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cases Report: Prominent Distal Pitting Edema Resembling Remitting Seronegative Symmetrical Synovitis With Pitting Edema in the Giant Cell Arteritis–Polymyalgia Rheumatica Spectrum: Diagnostic Value of Multimodal Imaging in Two Cases","authors":"Miyu Wakatsuki, Hiroyuki Yamashita, Ken Kawaue, Hiroshi Kaneko","doi":"10.1111/1756-185x.70901","DOIUrl":"10.1111/1756-185x.70901","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial Intelligence–Based Scoring System and Exploratory Multiomics in Ankylosing Spondylitis: Hip Severity and Age-at-Severe-Hip-Involvement Stratification","authors":"Chenxing Zhou, Xinli Zhan, Jichong Zhu, Tianyou Chen, Shaofeng Wu, Sitan Feng, Chengqian Huang, Jiarui Chen, Jiang Xue, Bin Zhang, Liyi Chen, ShengSheng Huang, Tuo Liang, Jie Jiang, Hao Li, Xuhua Sun, Wendi Wei, Zhenwei Yang, Chong Liu","doi":"10.1111/1756-185x.70888","DOIUrl":"10.1111/1756-185x.70888","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Accurate diagnosis and assessment of hip involvement are important for the clinical management of ankylosing spondylitis (AS). This study aimed to develop and internally validate an artificial intelligence–based Ensemble Scoring System (ESS) for AS diagnosis and hip-disease severity assessment and to explore its association with heterogeneous immune-cell infiltration and age at first documented severe hip involvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 5721 patients with pelvic radiographs and linked clinical records were retrospectively included. Participants were divided into training and held-out validation cohorts at a 7:3 ratio strictly at the patient level, with no patient or image overlap. Deep-learning features extracted by a convolutional neural network were integrated with clinical variables using XGBoost to construct task-specific ensemble deep-learning (EDL) models. Exploratory proteomic, transcriptomic, single-cell RNA-sequencing, immunohistochemical, and peripheral-blood analyses were performed to investigate AS-related immune infiltration. An exploratory immune ensemble (IE) score was constructed using the monocyte proportion and EDL score. Kaplan–Meier analysis was used to examine the association between the IE score and age at severe hip involvement.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The EDL model achieved AUCs of 0.978 for distinguishing AS from non-AS, 0.990 for identifying hip arthropathy among patients with AS, and 0.996 for identifying BASRI-Hip grade ≥ 3 among patients with hip arthropathy. Monocyte percentage was an influential feature across the three EDL classification tasks. Exploratory multiomics and immunohistochemical analyses showed higher LYN expression in AS than in the corresponding non-AS fracture-control groups and suggested that LYN expression was concentrated predominantly in monocytes. A high IE score was associated with earlier severe hip involvement, with estimated median ages at first documented severe hip involvement of 36 and 50 years in the high- and low-IE-score groups, respectively. This finding represents exploratory risk stratification and does not establish independent prediction of biological disease progression.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The ESS showed strong internal validation performance for AS diagnosis and hip-disease severity classification. Exploratory analyses linked LYN dysregulation in monocytes with heterogeneous immune infiltration, while the IE score was associated with earlier severe hip involvement. Prospective multicenter external validation is required before clini","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149108927","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Yoga on Rheumatoid Arthritis: A Systematic Review and Meta-Analysis","authors":"Abinaya Suresh,&nbsp;Shobana Ramaswamy,&nbsp;Santhi Silambanan,&nbsp;Mahesh Kumar Kuppusamy","doi":"10.1111/1756-185x.70896","DOIUrl":"10.1111/1756-185x.70896","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Yoga, a holistic mind–body practice used to improve physical function and psychological well-being in chronic inflammatory conditions such as rheumatoid arthritis (RA). This systematic review and meta-analysis aimed to assess the effectiveness of yoga in reducing psychological function and inflammation in individuals with RA.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A thorough literature search was performed in MEDLINE (via PubMed) for studies published between January 1994 and June 2025. Randomized controlled trials (RCT) investigating the impact of yoga on RA were selected. Data extraction was carried out independently by two reviewers. The outcomes evaluated included both subjective and objective indicators of Disease Activity Score (DAS), Health assessment questionnaire (HAQ-DI) and inflammatory markers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Result</h3>\u0000 \u0000 <p>Eight RCT involving 651 participants were eligible for this study. Yoga interventions significantly improved psychological outcomes, with reductions in DAS 28 (SMD = −0.44; 95% CI = [−0.56 to −0.31]; <i>p</i> &lt; 0.0001) compared to the control group. However, no significant changes were found in HAQ-DI (SMD = −0.23; 95% CI = [−0.81 to 0.36]; <i>p</i> = 0.30). Regarding inflammatory biomarkers, yoga significantly reduced serum Interleukin-6 (IL-6) levels (SMD = −0.65; 95% CI = [−1.17 to −0.13]; <i>p</i> = 0.03), while changes in Tumor Necrosis Factor-alpha (TNF-α) were not statistically significant (SMD = −0.71; 95% CI = [−1.74 to 0.33]; <i>p</i> = 0.10).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This meta-analysis indicates that yoga significantly improves mental health by reducing stress, anxiety, depression &amp; lowers inflammation through reduced IL-6 levels. However, its effect on physical health and TNF-α was not consistent, suggesting more research is needed. Further large-scale studies are needed to validate and standardize its use.</p>\u0000 </section>\u0000 </div>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":""},"PeriodicalIF":2.0,"publicationDate":"2026-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Global Real-World Validation of First-Day Urticaria Activity Score (UAS1)-Correlation Between UAS1 and UAS7.","authors":"Chieh Chen, Jeffrey Liao, Su-Boon Yong","doi":"10.1111/1756-185x.70919","DOIUrl":"https://doi.org/10.1111/1756-185x.70919","url":null,"abstract":"","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":"e70919"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149181776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Analysis of Gut Microbiota and Fecal Metabolites in Chinese Patients With Rheumatoid Arthritis: Associations With Disease Activity.","authors":"Jing Liang, Xiangyu Wei, Chen Shang, Siqi Shao, Wenting Hao, Yile Ren","doi":"10.1111/1756-185x.70905","DOIUrl":"10.1111/1756-185x.70905","url":null,"abstract":"<p><strong>Aim: </strong>Rheumatoid arthritis (RA) is a chronic autoimmune disease with intestinal dysbiosis implicated through the gut-joint axis. This study aimed to delineate fecal microbiome and metabolomic signatures in RA and identify biomarkers associated with disease activity.</p><p><strong>Method: </strong>Twenty-eight RA patients and 19 healthy controls were included in this cross-sectional study. Gut microbiota was characterized by 16S rRNA sequencing with operational taxonomic unit (OTU) and amplicon sequence variant (ASV) analysis. Fecal metabolites were profiled using untargeted metabolomics. Correlations between microbiota, metabolites, and disease activity indices were assessed.</p><p><strong>Results: </strong>RA patients showed altered alpha diversity and distinct microbial composition versus healthy controls. Eight differential genera and three species were identified based on the combined OTU and ASV analyses. Allisonella was enriched in RA and positively correlated with disease activity, whereas Bifidobacterium adolescentis showed a negative correlation trend with autoantibody/inflammatory markers. Metabolomic analysis revealed 31 and 36 altered metabolites in both ion modes. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment indicated dysregulation of unsaturated fatty acid biosynthesis and tryptophan metabolism. Microbiota-metabolite pairs correlated with disease activity.</p><p><strong>Conclusion: </strong>RA is characterized by distinct gut microbiota and fecal metabolite alterations associated with disease activity. Specific microbial taxa and metabolic pathways may serve as biomarkers, lending further support to the gut-joint axis in RA pathogenesis.</p>","PeriodicalId":14330,"journal":{"name":"International Journal of Rheumatic Diseases","volume":"29 10","pages":"e70905"},"PeriodicalIF":2.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149109491","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}