Nature Reviews Rheumatology最新文献

{"title":"Towards better management of sterile bone inflammation","authors":"Jürgen Braun","doi":"10.1038/s41584-025-01226-9","DOIUrl":"https://doi.org/10.1038/s41584-025-01226-9","url":null,"abstract":"The first expert consensus recommendations for the treatment and diagnosis of adult sterile bone inflammation have been developed, in which the term ‘chronic non-bacterial osteitis’ is proposed as a disease definition. Will these recommendations pave the way for better diagnosis, management and treatment of this rare disease?","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"2 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143451647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Connecting the structure and function of cartilage using spatial ‘-omics’","authors":"Indira Prasadam, Xiwei Fan","doi":"10.1038/s41584-025-01225-w","DOIUrl":"https://doi.org/10.1038/s41584-025-01225-w","url":null,"abstract":"Advances in spatial ‘-omics’, such as transcriptomics and proteomics, have provided vital insights into cartilage microenvironments, revealing cellular diversity, zonal organization and links between cartilage structure and function. Analysing cartilage using spatial ‘-omics’ could deepen the understanding of diseases such as osteoarthritis and guide the development of targeted, disease-modifying therapies.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"30 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143417254","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An international perspective on the future of systemic sclerosis research","authors":"David J. Abraham, Carol M. Black, Christopher P. Denton, Jörg H. W. Distler, Robyn Domsic, Carol Feghali-Bostwick, Pravitt Gourh, Monique Hinchcliff, Fred Kolling, Masataka Kuwana, Robert Lafyatis, Ulf Landegren, J. Matthew Mahoney, Javier Martin, Marco Matucci-Cerinic, Zsuzsanna H. McMahan, Ana L. Mora, Luc Mouthon, Marlene Rabinovitch, Mauricio Rojas, Kristofer Rubin, Maria Trojanowska, John Varga, Michael L. Whitfield, Armando Gabrielli, Thomas Krieg","doi":"10.1038/s41584-024-01217-2","DOIUrl":"https://doi.org/10.1038/s41584-024-01217-2","url":null,"abstract":"<p>Systemic sclerosis (SSc) remains a challenging and enigmatic systemic autoimmune disease, owing to its complex pathogenesis, clinical and molecular heterogeneity, and the lack of effective disease-modifying treatments. Despite a century of research in SSc, the interconnections among microvascular dysfunction, autoimmune phenomena and tissue fibrosis in SSc remain unclear. The absence of validated biomarkers and reliable animal models complicates diagnosis and treatment, contributing to high morbidity and mortality. Advances in the past 5 years, such as single-cell RNA sequencing, next-generation sequencing, spatial biology, transcriptomics, genomics, proteomics, metabolomics, microbiome profiling and artificial intelligence, offer new avenues for identifying the early pathogenetic events that, once treated, could change the clinical history of SSc. Collaborative global efforts to integrate these approaches are crucial to developing a comprehensive, mechanistic understanding and enabling personalized therapies. Challenges include disease classification, clinical heterogeneity and the establishment of robust biomarkers for disease activity and progression. Innovative clinical trial designs and patient-centred approaches are essential for developing effective treatments. Emerging therapies, including cell-based and fibroblast-targeting treatments, show promise. Global cooperation, standardized protocols and interdisciplinary research are vital for advancing SSc research and improving patient outcomes. The integration of advanced research techniques holds the potential for important breakthroughs in the diagnosis, treatment and care of individuals with SSc.</p>","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"29 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143418361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A direct link between SARS-CoV-2 and bone loss","authors":"Sarah Onuora","doi":"10.1038/s41584-025-01224-x","DOIUrl":"https://doi.org/10.1038/s41584-025-01224-x","url":null,"abstract":"Research demonstrates that the SARS-CoV-2 protein ORF8 drives osteoclastogenesis, establishing a direct link between viral infection and bone loss.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"29 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143375659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antigen-driven T cell responses in rheumatic diseases: insights from T cell receptor repertoire studies","authors":"Jose Garrido-Mesa, Matthew A. Brown","doi":"10.1038/s41584-025-01218-9","DOIUrl":"https://doi.org/10.1038/s41584-025-01218-9","url":null,"abstract":"<p>Advances in T cell receptor (TCR) profiling techniques have substantially improved our ability to investigate T cell responses to antigens that are presented on HLA class I and class II molecules and associations between autoimmune T cells and rheumatic diseases. Early-stage studies in axial spondyloarthritis (axSpA) identified disease-associated T cell clonotypes, benefiting from the relative genetic homogeneity of the disease. However, both the genetic and the T cell immunological landscape are more complex in other rheumatic diseases. The diversity or redundancy in the TCR repertoire, epitope spreading over disease duration, genetic heterogeneity of HLA genes or other loci, and the diversity of epitopes contributing to disease pathogenesis and persistent inflammation are all likely to contribute to this complexity. TCR profiling holds promise for identifying key antigenic drivers and phenotypic T cell states that sustain autoimmunity in rheumatic diseases. Here, we review key findings from TCR repertoire studies in axSpA and other chronic inflammatory rheumatic diseases including psoriatic arthritis, rheumatoid arthritis, systemic lupus erythematosus and Sjögren syndrome. We explore how TCR profiling technologies, if applied to better controlled studies focused on early disease stages and genetically homogeneous subsets, can facilitate disease monitoring and the development of therapeutics targeting autoimmune T cells, their cognate antigens, or their underlying biology.</p>","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"48 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143367398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Genome-wide mutagenesis reported in systemic sclerosis","authors":"Carol M. Artlett, John Varga","doi":"10.1038/s41584-025-01219-8","DOIUrl":"https://doi.org/10.1038/s41584-025-01219-8","url":null,"abstract":"The mechanisms that drive the diverse disease manifestations and increased cancer risk associated with systemic sclerosis are unclear. Investigating the genomic alterations observed in patients with systemic sclerosis could contribute towards untangling this complex disease.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"57 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143191765","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational dust and chemical exposures and the development of autoimmune rheumatic diseases","authors":"Mandana Nikpour, Kathleen Morrisroe, Alicia Calderone, Deborah Yates, Alan Silman","doi":"10.1038/s41584-024-01216-3","DOIUrl":"https://doi.org/10.1038/s41584-024-01216-3","url":null,"abstract":"<p>Although the association between certain occupational exposures and the development of autoimmune rheumatic disease was first described over a century ago, this association has only become more widely recognized in the past 10 years because of the use of high-silica-content engineered stone in construction and home renovation. There is now a substantial and growing body of evidence that occupational dust and chemical exposure, be it through mining, stonemasonry, building or other trades, increases the risk of various systemic autoimmune rheumatic diseases (SARDs) including rheumatoid arthritis and systemic sclerosis. Although the pathogenic mechanisms of silica-induced autoimmunity are not fully elucidated, it is thought that alveolar macrophage ingestion of silica and the ensuing phagosomal damage is an initiating event that ultimately leads to production of autoantibodies and immune-mediated tissue injury. The purportedly causal association between occupational exposure to chemicals, such as organic solvents, and an increased risk of SARDs is less frequently recognized compared with silica dust, and its immunopathogenesis is less well understood. An appreciation of the importance of occupational dust and chemical exposures in the development of SARDs has implications for workplace health and safety regulations and offers a unique opportunity to better understand autoimmune disease pathogenesis and implement preventative strategies.</p>","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"37 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-02-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143124449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"T cells in Sjögren disease","authors":"Holly Webster","doi":"10.1038/s41584-025-01220-1","DOIUrl":"https://doi.org/10.1038/s41584-025-01220-1","url":null,"abstract":"A mouse model that reflects Sjögren disease in humans provides insights into the role of regulatory T cells and type 1 helper T cells in disease pathogenesis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"28 19 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143072154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virome associations in autoimmunity and COVID-19","authors":"Maria Papatriantafyllou","doi":"10.1038/s41584-025-01221-0","DOIUrl":"https://doi.org/10.1038/s41584-025-01221-0","url":null,"abstract":"The detection of anellovirus or eHHV-6B genomes in the blood virome seems to correlate with the risk or severity of rheumatic diseases and COVID-19.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"49 1","pages":""},"PeriodicalIF":33.7,"publicationDate":"2025-01-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143049728","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Opportunities and limitations of B cell depletion approaches in SLE","authors":"Marit Stockfelt,&nbsp;Y. K. Onno Teng,&nbsp;Edward M. Vital","doi":"10.1038/s41584-024-01210-9","DOIUrl":"10.1038/s41584-024-01210-9","url":null,"abstract":"B cell depletion with rituximab, a chimeric monoclonal antibody that selectively targets B cells by binding CD20, has been used off&nbsp;label in severe and resistant systemic lupus erythematosus (SLE) for over two decades. Several biological mechanisms limit the efficacy of rituximab, including immunological reactions towards the chimeric molecule, increased numbers of residual B cells, including plasmablasts and plasma cells, and a post-treatment surge in B cell-activating factor (BAFF) levels. Consequently, rituximab induces remission in only a proportion of patients, and safety issues limit its use. However, the use of rituximab has established the value of B cell depletion strategies in SLE and has&nbsp;guided the development of several improved B cell depletion therapies for SLE. These include enhanced monoclonal antibodies, modalities that redirect the specificity of patient T cells using chimeric antigen receptor T cells or bispecific T cell engagers, and combination treatment that simultaneously inhibits the BAFF pathway. In this Review, we consider evidence gathered from over two decades of using rituximab in SLE and examine how B cell depletion therapies could be further optimized to achieve immunological and clinical efficacy. In addition, we discuss the prospects of B cell depletion strategies for personalized treatment in SLE based on genetic research and studies in pre-symptomatic individuals. This Review summarizes lessons learned from the use of rituximab in patients with systemic lupus erythematosus, and discusses the future of B cell targeting therapies, highlighting therapeutic options after rituximab failure and opportunities for personalized treatment.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 2","pages":"111-126"},"PeriodicalIF":29.4,"publicationDate":"2025-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142981504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}