Modern Rheumatology最新文献

{"title":"Mortality and risk factors in Japanese patients with rheumatoid arthritis: a 14-year observation of the IORRA cohort.","authors":"Naohiro Sugitani, Eiichi Tanaka, Eisuke Inoue, Eri Sugano, Moeko Ochiai, Katsunori Ikari, Ayako Nakajima, Hisashi Yamanaka, Masayoshi Harigai","doi":"10.1093/mr/roaf074","DOIUrl":"https://doi.org/10.1093/mr/roaf074","url":null,"abstract":"<p><strong>Objectives: </strong>To investigate standardized mortality ratio (SMR), causes of death, and mortality risk factors in Japanese patients with rheumatoid arthritis (RA) between 2007 and 2021, representing the biological disease-modifying antirheumatic drug (bDMARD) era.</p><p><strong>Methods: </strong>We analyzed Japanese patients in the Institute of Rheumatology, Rheumatoid Arthritis cohort. The SMR was calculated using the Japanese General Population Life Table. Multiple imputation methods were used for sensitivity analysis of lost to follow-up cases. Risk factors were analyzed using time-dependent Cox proportional hazards model.</p><p><strong>Results: </strong>Among 10,613 patients with RA, 915 deaths occurred for 99,364.8 patient-years. Major causes of death were malignancy (27.8%), respiratory disease (22.3%), and cardiovascular disease (16.3%). The SMR varied based on lost to follow-up assumptions: 0.92 (95% confidence interval (CI): 0.86 to 0.98) assuming all survived, 1.57 (95% CI: 1.47 to 1.68) assuming lost cases had equal mortality to followed cases, and 1.68 (95% CI: 1.58 to 1.79) assuming 1.65-times higher mortality than followed cases, respectively. Time-dependent analysis revealed protective associations with methotrexate (MTX) and bDMARDs, while even low-dose glucocorticoids showed increased mortality risk.</p><p><strong>Conclusion: </strong>Japanese patients with RA show excess mortality despite bDMARD-era treatments. MTX and bDMARDs were protective, while glucocorticoids increased mortality risk.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144760554","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":"Non-B27 HLA-B alleles lack diagnostic value, necessitating composite clinical indices to distinguish axial spondyloarthritis from radiographic mimics in Japanese patients.","authors":"Yukio Akasaki, Toshifumi Fujiwara, Daisuke Hara, Ryosuke Yamaguchi, Ichiro Kurakazu, Keitaro Yasumoto, Takahiro Natori, Toshiaki Sugita, Shotaro Kawamura, Takahiro Inoue, Hisakata Yamada, Yasuharu Nakashima","doi":"10.1093/mr/roaf073","DOIUrl":"https://doi.org/10.1093/mr/roaf073","url":null,"abstract":"<p><strong>Objective: </strong>To assess whether extended HLA-B typing, together with simple clinical indices, distinguishes axial spondyloarthritis (axSpA) from radiographic mimics in Japanese population.</p><p><strong>Methods: </strong>We retrospectively reviewed 127 patients who underwent HLA-B typing at a single centre between 2008 and 2024. Ankylosing spondylitis met the 1987 modified New York criteria, and non-radiographic axSpA met the 2009 ASAS criteria. Diffuse idiopathic skeletal hyperostosis (DISH), palmoplantar pustulosis arthritis (PAO) and osteitis condensans ilii (OCI) were identified by characteristic imaging and clinical findings. Two rheumatologists reassigned final diagnoses. HLA-B phenotypes, age at onset, sex and initial C-reactive protein (CRP) were compared across groups.</p><p><strong>Results: </strong>Twenty-five patients satisfied axSpA criteria; 80% were HLA-B27-positive. DISH, PAO and OCI showed apparent enrichment of common Japanese alleles (B52, B61/B62, B39). DISH and PAO presented later than axSpA (54.0 y and 42.5 y versus 25.2 y) and DISH had lower CRP (0.31 versus 1.51 mg/dL, p = 0.003). OCI occurred exclusively in women and was CRP-negative.</p><p><strong>Conclusion: </strong>In Japanese practice, no single non-B27 allele reliably separates axSpA from its mimics; instead, early age at onset, male sex and raised CRP provide the most practical safeguards against diagnostic error and unnecessary therapy.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732353","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":"Analysis of microRNA expression in synovial fluid and intra-articular tissues of osteonecrosis of the femoral head.","authors":"Hideki Shozen, Takeshi Shoji, Shinichi Ueki, Hiroki Kaneta, Nobuo Adachi","doi":"10.1093/mr/roaf071","DOIUrl":"https://doi.org/10.1093/mr/roaf071","url":null,"abstract":"<p><strong>Objectives: </strong>Osteonecrosis of the femoral head (ONFH) is a progressive hip disorder often misdiagnosed owing to overlapping symptoms and radiographic findings. MicroRNAs (miRNAs) have emerged as potential diagnostic biomarkers; however, their role in ONFH remains unclear. This study analysed miRNA expression in synovial fluid and hip joint tissues of patients with ONFH to identify diagnostic markers.</p><p><strong>Methods: </strong>Synovial fluid and hip joint tissues were collected from 24 patients with ONFH and 12 patients with osteoarthritis (OA) undergoing total hip arthroplasty. miRNA expression was assessed using microarray and validated using real-time polymerase chain reaction (PCR). Statistical analyses compared ONFH and OA groups and examined clinical factor correlations. Tissue-specific expression was evaluated in subchondral and cancellous bone, synovia, and labrum.</p><p><strong>Results: </strong>Real-time PCR revealed significant upregulation of miR-210 (p < 0.01), miR-296, miR-659, and let-7c (p < 0.05) in ONFH synovial fluid compared to that of OA. Expression patterns were independent of clinical factors. miR-210 was also significantly upregulated in cancellous bone of the reparative zone in patients with ONFH (p < 0.05).</p><p><strong>Conclusion: </strong>miR-210, miR-296, miR-659, and let-7c upregulations in ONFH synovial fluid independent of clinical factors indicates their potential as diagnostic markers. Localized increase in miR-210 in cancellous bone may indicate its role in ONFH pathophysiology.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.9,"publicationDate":"2025-07-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144732352","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":"Vaccination in paediatric, adolescent, and transitional-age rheumatic diseases: A systematic review.","authors":"Takuma Ohnishi, Hiroyuki Wakiguchi, Shingo Ishimori, Naohiro Itoh, Masato Yashiro, Susumu Yamazaki, Ikuo Okafuji, Yoshiyuki Ohtomo, Ichiro Kobayashi","doi":"10.1093/mr/roaf069","DOIUrl":"https://doi.org/10.1093/mr/roaf069","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review evaluated the efficacy and safety of vaccination in patients with paediatric, adolescent, and transitional-age rheumatic diseases as per the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 statement.</p><p><strong>Methods: </strong>An independent investigator systematically searched PubMed to identify relevant studies published by September 2022. The search results were divided into vaccines or toxoids for diphtheria, pertussis, tetanus, pneumococcus, influenza virus, hepatitis A virus, hepatitis B virus, human papillomavirus, poliovirus, measles virus, mumps virus, rubella virus, varicella zoster virus, and tuberculosis.</p><p><strong>Results: </strong>A meta-analysis was not feasible due to the lack of randomized controlled trials with standardized patient backgrounds and conditions. Non-live vaccines are generally immunogenic and safe for patients with rheumatic diseases. In contrast, live attenuated vaccines should usually be withheld in patients on immunosuppressants, corticosteroids, biologics, or Janus kinase inhibitors. However, for necessary immunizations against measles, rubella, mumps, or varicella, live attenuated vaccines may be considered for patients receiving low-dose corticosteroids, methotrexate, or tumour necrosis factor inhibitors.</p><p><strong>Conclusion: </strong>This review highlights the significant gap in evidence for paediatric populations compared with adults, particularly concerning new biological therapies and Janus kinase inhibitors. Further evidence is needed regarding vaccination in paediatric patients with rheumatic diseases.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708167","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":"Validation of the MCK model for predicting outcomes in myopathy-associated interstitial lung disease: a multicentre MYKO cohort study.","authors":"Hirofumi Miyake, Ran Nakashima, Hideaki Tsuji, Tsuneo Sasai, Yasuhiro Nohda, Tsuneyasu Yoshida, Yoichi Nakayama, Yuto Nakakubo, Atsubumi Ogawa, Kazuma Yoshida, Keisuke Hirobe, Yuki Aitani, Yudai Koshida, Chifumi Akiyama, Mahiro Yamamoto, Katsumasa Oe, Shogo Matsuda, Takayasu Suzuka, Takuya Kotani","doi":"10.1093/mr/roaf070","DOIUrl":"https://doi.org/10.1093/mr/roaf070","url":null,"abstract":"<p><strong>Objectives: </strong>To validate the MCK model's prognostic utility in patients with idiopathic inflammatory myopathy (IIM)-associated interstitial lung disease (ILD).</p><p><strong>Methods: </strong>This retrospective study included 242 patients with IIM-associated ILD from the multicentre MYKO cohort. Patients were classified as anti-melanoma differentiation-associated gene 5 (MDA5) antibody-positive or antibody-negative. The MCK score was defined by the number of criteria met: C-reactive protein (CRP) ≥ 0.8 mg/dL and Krebs von den Lungen 6 (KL-6) ≥ 1 000 U/mL for MDA5-positive patients; CRP ≥ 1.1 mg/dL and KL-6 ≥ 1 000 U/mL for MDA5-negative patients. Outcomes included all-cause mortality, disease flares, and infections requiring hospitalisation, which were assessed via Kaplan-Meier and Cox regression analyses.</p><p><strong>Results: </strong>Among MDA5-positive patients, an MCK score of 2 did not significantly predict mortality. However, in MDA5-negative patients, an MCK score of 2 was significantly associated with an increased risk of all-cause mortality, disease flares, and infections requiring hospitalisation. Subgroup analyses from 2018 onward showed similar patterns, although statistical significance was not maintained.</p><p><strong>Conclusions: </strong>The MCK model demonstrates strong predictive performance for all-cause mortality and disease complications, particularly in patients with MDA5-negative IIM. However, its predictive utility may have declined in recent years, possibly due to advancements in treatment approaches.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144699034","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":"Impact of ongoing glucocorticoid use on postoperative complications following Total knee arthroplasty: a Japanese Nationwide propensity score-matched cohort study.","authors":"Yu Mori, Kunio Tarasawa, Hidetatsu Tanaka, Ryuichi Kanabuchi, Hiroshi Hatakeyama, Naoko Mori, Kiyohide Fushimi, Toshimi Aizawa, Kenji Fujimori","doi":"10.1093/mr/roaf067","DOIUrl":"https://doi.org/10.1093/mr/roaf067","url":null,"abstract":"<p><strong>Background: </strong>Glucocorticoid use poses perioperative concerns in orthopaedic surgery, but its impact on postoperative outcomes following total knee arthroplasty (TKA) remains unclear.</p><p><strong>Methods: </strong>This retrospective cohort study utilized the Japanese Diagnosis Procedure Combination (DPC) database to examine postoperative complications in patients undergoing TKA between April 2016 and March 2023. Patients receiving continuous glucocorticoid therapy (≥5 mg/day prednisolone equivalent) were identified and matched 1:1 with non-glucocorticoid users using propensity score matching based on age, sex, body mass index, anaesthesia type, simultaneous bilateral surgery, and Charlson Comorbidity Index. Postoperative complications, including pneumonia, surgical site infection, venous thromboembolism, cerebrovascular events, and in-hospital mortality, were compared.</p><p><strong>Results: </strong>A total of 12 212 patients (6 106 per group) were analysed after matching. The glucocorticoid group showed significantly higher incidences of pneumonia (OR: 3.70, 95% CI: 1.89-7.26, p = 0.0001) and in-hospital mortality (OR: 3.59, 95% CI: 1.47-8.73, p = 0.005). No significant differences were observed in the incidence of deep vein thrombosis, pulmonary embolism, or surgical site infection, possibly due to short in-hospital observation and widespread use of prophylactic protocols. Male sex also emerged as an independent risk factor for mortality.</p><p><strong>Conclusions: </strong>Ongoing glucocorticoid use is associated with an increased risk of postoperative pneumonia and in-hospital mortality following TKA. These findings highlight the need for careful perioperative management in this high-risk population. Further prospective studies are warranted to assess long-term outcomes and clarify the effects of glucocorticoid dosage and duration.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675289","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":"The need for telemedicine for rheumatic diseases in adult medical care:A Survey of non-pediatric rheumatologists.","authors":"Shigeru Iwata, Keiichiro Nishida, Yuzaburo Inoue, Asami Abe, Kenei Sada, Eiichi Tanaka, Atsushi Kawakami, Yutaka Kawahito, Takako Miyamae","doi":"10.1093/mr/roaf068","DOIUrl":"https://doi.org/10.1093/mr/roaf068","url":null,"abstract":"<p><strong>Objectives: </strong>This study of telemedicine aims to clarify the needs and issues of patients with rheumatic diseases and the medical personnel involved in their care.</p><p><strong>Methods: </strong>A questionnaire survey, targeting members of the Japan Rheumatology Association and pertinent patients/companions, was conducted on the use of telemedicine in this field.</p><p><strong>Results: </strong>Questionnaires were collected from 351 internists, 133 orthopaedists, and 144 patients/their companions. According to the medical personnel, 77.5% and 58.6% of their patients require ≥1 h one-way travel to a medical institution, respectively. Among the patients, 28.5% and 19.5% were treated from remote areas or islands, and 52.1% and 38.3% were treated from areas with a shortage of specialized medical care. Meanwhile, a positive view of remote medical care was held by 67.2% of internists, 54.9% of orthopaedists, and 73.0% of patients/their companions. Medical personnel who treat patients from remote islands and in areas with a shortage of specialized medical care were especially open to performing remote medical care via telemedicine systems. Medical personnel expressed concerns about the quality of medical care, while the patients expressed concerns about reduced communication.</p><p><strong>Conclusions: </strong>This study reveals some of the concerns of medical personnel and patients with rheumatic diseases about telemedicine.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675290","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":"The Clinical Significance of Non-Criteria Antiphospholipid Antibodies in Atypical Antiphospholipid Syndrome.","authors":"Yue Xiong, Tingting Wu, Lei Wang, Xinyi Shen, Yufeng Yin, Jian Wu, Tian Ren, Jing Cao, Tao Cheng, Mingjun Wang","doi":"10.1093/mr/roaf060","DOIUrl":"https://doi.org/10.1093/mr/roaf060","url":null,"abstract":"<p><strong>Objective: </strong>To analyse the correlation between non-criteria antiphospholipid antibodies (non-criteria aPLs) and clinical symptoms (recurrent miscarriage) in patients with seronegative antiphospholipid syndrome (SNAPS).Methods:Ninety-four SNAPS patients who were treated in the First Affiliated Hospital of Soochow University from May 2022 to May 2024 were included. Chemiluminescence immunoassay was used to detect anti-β2 glycoprotein I antibody (aβ2GPI), anti-cardiolipin antibody (aCL), and lupus anticoagulant. ELISA was used to detect the levels of anti-annexin A5 (ANXA5), anti-phosphatidylethanolamine antibody (aPE), anti-prothrombin IgG antibody (aPT IgG), anti-prothrombin IgM antibody (aPT IgM), anti-phosphatidylserine/prothrombin IgG antibody (aPS/PT IgG), and anti-phosphatidylserine/prothrombin IgM antibody (aPS/PT IgM). The correlation between non-criteria antiphospholipid antibodies and clinical events was analysed.</p><p><strong>Results: </strong>Compared with the non-criteria antibody-negative group, the positive group had a higher rate of positive antinuclear antibodies (p < 0.05). The proportion of recurrent miscarriage in the positive non-criteria antibody group was significantly higher than in the negative group (p = 0.002). Compared with the negative group, patients with positive anti-annexin A5 antibody and aPT IgM were more likely to have recurrent miscarriage (p < 0.05). Compared with the aPE-negative group, those with aPE-positive were more likely to experience early miscarriage (p = 0.039). Both aPT IgM subtype (p = 0.004) and ANXA5 (p = 0.013) antibodies were the risk factors for recurrent miscarriage. Patients with positive ANXA5, aPT IgG, and aPT/PS IgM antibodies showed a significant decrease in antibody titers after treatment (p < 0.05).</p><p><strong>Conclusion: </strong>Detection of non-criteria aPLs contributes to improving the diagnosis of SNAPS, assessing its development trends, and intervening promptly to prevent recurrent miscarriage.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144608829","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":"The Trends in the Prevalence of Arthritis and Arthralgia and Their Associations with Extra-Articular Manifestations in Patients with Behcet's Disease: A Systematic Review and Meta-Analysis.","authors":"Aida Mohamadi, Elaheh Karimi, Sepehr Nayebirad, Hannaneh Yousefi-Koma, Zahra Karimi, Zahra Tamartash, Reza Atef-Yekta, Mehran Rezakhani, Hoda Kavosi","doi":"10.1093/mr/roaf049","DOIUrl":"https://doi.org/10.1093/mr/roaf049","url":null,"abstract":"<p><strong>Objectives: </strong>Articular involvement has been one of the most common findings of Behcet's disease. The present study aimed to systematically evaluate the trends in the prevalence of arthritis and arthralgia, as well as their potential associations with extra-articular manifestations of the disease.</p><p><strong>Methods: </strong>Observational studies that reported the prevalence of arthritis or arthralgia were included. Pooled prevalence with corresponding 95% confidence intervals were calculated. Univariate meta-regression was performed to evaluate the potential associations of articular manifestations with extra-articular manifestations of Behcet's disease.</p><p><strong>Results: </strong>A total of 120 articles were included. The pooled prevalence of arthritis and arthralgia were 0.34 (95%CI: 0.30-0.39) and 0.37 (96%CI: 0.30-0.45). The peripheral joints were mostly affected in the form of oligoarthritis. There were significant positive associations between the prevalence of arthralgia and the proportion of females and skin lesions, and between the prevalence of arthritis and skin lesions and erythema nodosum.</p><p><strong>Conclusions: </strong>The present study highlighted the decreasing trend of arthritis over the years and the predominance of peripheral involvement and oligoarthritis, particularly in the knees. Additionally, it showed that there are significant associations but not necessarily causal relationships between the prevalence of both arthritis and arthralgia and the prevalence of skin lesions.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144600976","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":"RNA-Seq analysis of lymphocyte-specific gene expression patterns in IgG4-related disease: comparison of submandibular glands and peripheral blood.","authors":"Hiroto Tsuboi, Fumika Honda, Hiromitsu Asashima, Hirofumi Toko, Ayako Kitada, Saori Abe, Yuito Tanaka, Ayako Ohyama, Mizuki Yagishita, Haruka Miki, Shinya Hagiwara, Yuya Kondo, Isao Matsumoto","doi":"10.1093/mr/roaf059","DOIUrl":"https://doi.org/10.1093/mr/roaf059","url":null,"abstract":"<p><strong>Objective: </strong>To clarify T/B cell-specific gene expression patterns using RNA-Seq in IgG4-related disease (IgG4-RD).</p><p><strong>Methods: </strong>Pathologically confirmed submandibular gland (SMG) (n=3) and PBMC (n=4) from 4 treatment-naïve patients with definite IgG4-RD, as well as PBMCs from primary Sjögren syndrome (pSS) (n=3) and healthy controls (HCs) (n=3), were collected, and subsequently Pan T and CD19+ B cells were sorted. We conducted RNA sequencing to compare the gene expressions of Pan T and CD19+ B cells in SMGs and PBMCs in IgG4-RD or IgG4-RD versus pSS and HCs in PBMCs. IPA and qPCR validation were performed for DEGs.</p><p><strong>Results: </strong>PCA results showed the gene expression patterns of Pan T and CD19+ B cells derived from SMGs differed from those derived from PBMCs in IgG4-RD. However, the gene expression patterns of Pan T and CD19+ B cells derived from PBMCs were not clustered between groups. 214 upregulated and 50 downregulated DEGs in Pan T cells and 630 upregulated and 109 downregulated DEGs in CD19+ B cells were identified in SMGs compared with PBMCs in IgG4-RD. The upregulated DEGs in SMGs of IgG4-RD included cytokines, chemokines, and transcription regulators. IPA for these DEGs clarified immune system-related pathways were positively regulated in SMGs compared with PBMCs in IgG4-RD. qPCR validated significantly increased mRNA expression of IL-21 and EGR2 by Pan T cells in SMGs compared with PBMCs of IgG4-RD.</p><p><strong>Conclusion: </strong>RNA-Seq clarified the DEGs of Pan T and CD19+ B cells from SMGs in comparison with PBMCs, which might contribute to the pathogenesis of IgG4-RD.</p>","PeriodicalId":18705,"journal":{"name":"Modern Rheumatology","volume":" ","pages":""},"PeriodicalIF":1.8,"publicationDate":"2025-07-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144591787","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}