Nature Reviews Rheumatology最新文献_第10页

Antigen-driven T cell responses in rheumatic diseases: insights from T cell receptor repertoire studies 风湿病中的抗原驱动T细胞反应：来自T细胞受体库研究的见解

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-02-07 DOI: 10.1038/s41584-025-01218-9

Jose Garrido-Mesa, Matthew A. Brown

{"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":"10.1038/s41584-025-01218-9","url":null,"abstract":"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. Garrido-Mesa and Brown review findings from TCR profiling studies in rheumatic diseases and discuss how improved study design might help elicit information about autoreactive T cell clones and their contribution to disease pathogenesis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 3","pages":"157-173"},"PeriodicalIF":29.4,"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}

引用次数: 0

Genome-wide mutagenesis reported in systemic sclerosis 系统性硬化症中全基因组突变的报道

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-02-06 DOI: 10.1038/s41584-025-01219-8

Carol M. Artlett, John Varga

引用次数: 0

Occupational dust and chemical exposures and the development of autoimmune rheumatic diseases 职业性粉尘和化学物质暴露与自身免疫性风湿病的发展

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-02-05 DOI: 10.1038/s41584-024-01216-3

Mandana Nikpour, Kathleen Morrisroe, Alicia Calderone, Deborah Yates, Alan Silman

{"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":"10.1038/s41584-024-01216-3","url":null,"abstract":"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. This Review discusses the current evidence for the association between occupational exposures, particularly silica dust and solvents, and the risk of developing systemic autoimmune rheumatic diseases. The authors emphasize the importance of considering occupational history in the rheumatology clinic.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 3","pages":"137-156"},"PeriodicalIF":29.4,"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}

引用次数: 0

T cells in Sjögren disease T细胞在Sjögren疾病中的作用

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-01-31 DOI: 10.1038/s41584-025-01220-1

Holly Webster

引用次数: 0

Virome associations in autoimmunity and COVID-19 自身免疫与COVID-19的病毒组关联

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-01-28 DOI: 10.1038/s41584-025-01221-0

Maria Papatriantafyllou

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Opportunities and limitations of B cell depletion approaches in SLE 系统性红斑狼疮 B 细胞清除疗法的机遇与局限性

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-01-15 DOI: 10.1038/s41584-024-01210-9

Marit Stockfelt, Y. K. Onno Teng, Edward M. Vital

{"title":"Opportunities and limitations of B cell depletion approaches in SLE","authors":"Marit Stockfelt, Y. K. Onno Teng, 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 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 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}

引用次数: 0

Piezo1 as a therapeutic target for glucocorticoid-induced osteoporosis Piezo1作为糖皮质激素所致骨质疏松症的治疗靶点

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-01-10 DOI: 10.1038/s41584-024-01215-4

Holly Webster

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Breaking research silos to achieve equitable precision medicine in rheumatology 打破研究孤岛，在风湿病学中实现公平的精准医疗

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-01-10 DOI: 10.1038/s41584-024-01204-7

Hannah C. Ainsworth, DeAnna Baker Frost, S. Sam Lim, Paula S. Ramos

{"title":"Breaking research silos to achieve equitable precision medicine in rheumatology","authors":"Hannah C. Ainsworth, DeAnna Baker Frost, S. Sam Lim, Paula S. Ramos","doi":"10.1038/s41584-024-01204-7","DOIUrl":"10.1038/s41584-024-01204-7","url":null,"abstract":"Health disparities in rheumatic disease are well established and urgently need addressing. Obstacles to precision medicine equity span both the clinical and the research domains, with a focus placed on structural barriers limiting equitable health care access and inclusivity in research. Less articulated factors include the use of inaccurate population descriptors and the existence of research silos in rheumatology research, which creates a knowledge gap that precludes addressing the health disparities and fulfilling the goals of precision medicine to understand the ‘full patient’. The biopsychosocial model is a research framework that intertwines layers of biological and environmental effects to understand disease. However, very limited rheumatology research bridges across molecular and epidemiological studies of environmental exposures, such as physical and social determinants of health. In this Review, we discuss clinical obstacles to health care equity, including access to health care and the use of inaccurate language when labelling population groups. We explore the goals and data needed for research under the biopsychosocial model. We describe results from a rheumatic disease literature search that highlights the paucity of studies investigating the molecular influences of systemic exposures. We conclude with a list of considerations and recommendations to help achieve equitable precision medicine. This Review discusses obstacles to health care equity in rheumatic disease, including access to health care and the use of inaccurate language when labelling population groups. The authors also highlight the siloing of biological and epidemiological research in rheumatology. They conclude with recommendations for achieving equitable precision medicine.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 2","pages":"98-110"},"PeriodicalIF":29.4,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142939507","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}

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Advances in the calculation of minimal important change estimates for patient-reported outcome measures 患者报告的结果测量的最小重要变化估计的计算进展

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2025-01-02 DOI: 10.1038/s41584-024-01214-5

Ewa M. Roos

引用次数: 0

Precision weight management in people with knee osteoarthritis and overweight or obesity 膝关节骨关节炎和超重或肥胖患者的精确体重管理

IF 29.4 1区医学

Nature Reviews Rheumatology Pub Date : 2024-12-23 DOI: 10.1038/s41584-024-01209-2

Shiwen Yuan, David J. Hunter

引用次数: 0