Nature Reviews Rheumatology最新文献

{"title":"Monocyte-driven vasculopathy distinguishes dermatomyositis from CLE","authors":"Jessica McHugh","doi":"10.1038/s41584-026-01358-6","DOIUrl":"10.1038/s41584-026-01358-6","url":null,"abstract":"Comparing dermatomyositis with cutaneous lupus erythematosus, single-cell analysis identifies monocyte-mediated endothelial injury as a dermatomyositis-specific feature and highlights JAK1 inhibition as a potential therapeutic approach.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 3","pages":"147-147"},"PeriodicalIF":32.7,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157691","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":"Novel approach mitigates immunogenicity of uricase treatment","authors":"Sarah Onuora","doi":"10.1038/s41584-026-01360-y","DOIUrl":"10.1038/s41584-026-01360-y","url":null,"abstract":"An erythrocyte-based strategy to achieve durable immunotolerance prevents the formation of neutralizing antibodies against uricase and facilitates urate clearance in animal models of gout.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 3","pages":"147-147"},"PeriodicalIF":32.7,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157707","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":"Fibroblast TGFβ drives treatment-refractory RA","authors":"Holly Webster","doi":"10.1038/s41584-026-01361-x","DOIUrl":"10.1038/s41584-026-01361-x","url":null,"abstract":"Spatial transcriptomics analyses reveal that fibrogenic fibroblasts dictate treatment outcomes in rheumatoid arthritis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"218-218"},"PeriodicalIF":32.7,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157643","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":"Vagus nerve stimulation shows clinical benefits for RA in pivotal trial","authors":"Sarah Onuora","doi":"10.1038/s41584-026-01359-5","DOIUrl":"10.1038/s41584-026-01359-5","url":null,"abstract":"The findings of the pivotal RESET-RA trial demonstrate the clinical benefits and safety of an implanted neuromodulation device that stimulates the vagus nerve for the treatment of rheumatoid arthritis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 3","pages":"148-148"},"PeriodicalIF":32.7,"publicationDate":"2026-02-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146157632","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":"Denosumab targets synovial inflammation to attenuate knee OA","authors":"Holly Webster","doi":"10.1038/s41584-026-01355-9","DOIUrl":"10.1038/s41584-026-01355-9","url":null,"abstract":"A study provides insight into the mechanisms that underlie the therapeutic efficacy of denosumab in osteoarthritis.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 3","pages":"148-148"},"PeriodicalIF":32.7,"publicationDate":"2026-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146150150","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":"Advances in cartilage imaging techniques","authors":"Ali Guermazi, Felix Eckstein, Garry Gold, Daichi Hayashi, Mohamed Jarraya, Feliks Kogan, Xiaojuan Li, Thomas M. Link, Sven Nebelung, Edwin H. G. Oei, Patrick Omoumi, Simo Saarakkala, Siegfried Trattnig, Wolfgang Wirth, Frank W. Roemer","doi":"10.1038/s41584-026-01353-x","DOIUrl":"10.1038/s41584-026-01353-x","url":null,"abstract":"Articular cartilage is crucial for joint function; however, it has limited regenerative capacity when damaged, a hallmark of many rheumatic diseases. Non-invasive imaging is essential for early diagnosis, therapeutic monitoring and prognostication. MRI remains the reference standard, offering detailed assessment of both morphological and compositional cartilage changes. Technological advances, including high-resolution and compositional MRI techniques such as T2 mapping, T1ρ, delayed gadolinium-enhanced MRI of cartilage, sodium imaging, diffusion imaging and ultra-short echo-time imaging, enable early detection of matrix alterations that precede structural breakdown. CT arthrography, although it involves radiation, serves as a valuable alternative when MRI is contra-indicated, offering high performance in the detection and evaluation of cartilage surface lesions. Emerging modalities, such as ultrasonography and PET, offer additional functional insights but are currently limited in scope. Artificial intelligence is poised to transform cartilage imaging through accelerated acquisition, automated segmentation, improved interpretation and enhanced efficiency, with growing clinical adoption. Advanced cartilage imaging will probably have an increasingly important role in clinical rheumatology, particularly for the optimization of individualized management of cartilage pathology. Non-invasive imaging of articular cartilage has evolved markedly and can be used to monitor response to treatment and predict disease outcomes. This Review provides rheumatologists with a comprehensive update on current and emerging imaging and analysis techniques for the assessment of cartilage.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"256-271"},"PeriodicalIF":32.7,"publicationDate":"2026-02-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146113591","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":"Recommendations for the use of CLASI as an outcome measure in cutaneous lupus erythematosus clinical trials","authors":"Grace Lu, Tyler Cepica, Catherine Barbey, Ilimbek Beketaev, Denesh Chitkara, Anthony P. Fernandez, Shimon Korish, Joseph F. Merola, Jill A. Lindstrom, Nikolay P. Nikolov, Hoang Nguyen, Christopher T. Richardson, Teodora P. Staeva, Victoria P. Werth, Benjamin F. Chong, on behalf of the Lupus Accelerating Breakthroughs Consortium CLASI Working Group","doi":"10.1038/s41584-025-01351-5","DOIUrl":"10.1038/s41584-025-01351-5","url":null,"abstract":"Cutaneous lupus erythematosus (CLE) is an autoimmune skin condition associated with a considerable treatment burden and diminished quality of life. The absence of a consensus outcome measure to evaluate therapeutic response has posed a challenge to CLE drug development. The Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) was developed in response to this need, incorporating morphological components including erythema, scale, dyspigmentation and scarring, to reflect disease activity and damage. Numerous studies have demonstrated the utility of CLASI in capturing relevant aspects of disease from clinician- and patient-based perspectives; however, no regulatory precedent for use of clinical trial data employing CLASI to evaluate treatment response in CLE exists. Thus, the Lupus Accelerating Breakthroughs Consortium commissioned a working group of members from industry, academia, the US Food and Drug Administration (FDA) and CLE patient advocates to address the potential knowledge gaps with CLASI through evidence-based research. Upon reviewing and submitting these data to the FDA, the working group reached alignment that CLASI is a suitable outcome measure for CLE clinical trials, enabling a clearer regulatory path for clinical drug development. The group recognizes the need for additional information to assess what degree of change in CLASI captures clinically meaningful improvement. In this Expert Recommendation, a working group integrating diverse perspectives presents a comprehensive overview of the clinical relevance and applicability of the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) and the rationale for its use as an outcome measure in clinical trials, addressing a long-standing roadblock in the development of new drugs for CLE.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"272-278"},"PeriodicalIF":32.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146048223","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":"Mechanisms of fibrotic tissue remodelling: insights from systemic sclerosis","authors":"Jörg H. W. Distler, David Launay, Carol Feghali-Bostwick, Alexandru-Emil Matei, Maria Trojanowska, Johann E. Gudjonsson","doi":"10.1038/s41584-025-01349-z","DOIUrl":"10.1038/s41584-025-01349-z","url":null,"abstract":"Systemic sclerosis (SSc) is a prototypical systemic immune-mediated fibrosing disease that affects the skin, the lungs, the heart, the kidneys and the intestinal tract. Similar to many other fibrotic diseases, SSc is associated with high morbidity and mortality and therapeutic options are limited. Fibrosis arises from a complex interplay of vascular damage, inflammation and prolonged, misdirected repair responses. The progressive accumulation of extracellular matrix perturbs the physiological tissue architecture and commonly leads to failure of the affected organs. Understanding the mechanisms of fibrotic tissue remodelling can lead to the identification of preclinical targets. Novel fibrosis-promoting cell subpopulations, the interplay of fibroblasts with B cells and macrophages, the nerve–fibroblast axis, matrikines and matricryptins, senescence, profibrotic transcription factors, developmental pathways and epigenetic tissue memory are all important drivers of fibrotic tissue remodelling that might offer potential for novel therapies to improve outcomes for patients with SSc and possibly other fibrotic conditions. Systemic sclerosis (SSc) is a severe fibrotic disease that affects multiple organs, driven by vascular damage, inflammation and dysregulated repair. The authors of this Review explore the key mechanisms that promote fibrosis in SSc and highlight emerging therapeutic targets.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"221-238"},"PeriodicalIF":32.7,"publicationDate":"2026-01-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146048224","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":"Inflammation and pain as interconnected targets in axial spondyloarthritis","authors":"Xenofon Baraliakos, Victoria Navarro-Compán, Nelly Ziade, Denis Poddubnyy","doi":"10.1038/s41584-025-01348-0","DOIUrl":"10.1038/s41584-025-01348-0","url":null,"abstract":"Axial spondyloarthritis (axSpA) is a chronic inflammatory disease characterized by complex pain mechanisms that extend beyond inflammation. Although inflammatory nociceptive pain — primarily mediated by pro-inflammatory cytokines — represents the classic pathway and therapeutic target, many patients continue to experience pain despite suppression of inflammation. This residual pain often reflects non-inflammatory processes, including nociplastic and neuropathic pain. Central sensitization, a key mechanism of nociplastic pain, contributes to pain amplification and poor response to treatment. Fibromyalgia, considered the typical phenotype of nociplastic pain, can co-occur with axSpA and is associated with increased symptom burden and reduced efficacy of anti-inflammatory therapies. Neuropathic pain, albeit less common, can result from structural complications and requires targeted therapeutic approaches. In addition, biological sex differences further influence pain perception and treatment outcomes: female patients report more widespread pain, show higher rates of central sensitization and have a worse response to biologic therapies than male patients. Current treatment paradigms are effective for inflammation-driven symptoms but often fail to address the broader spectrum of pain phenotypes in axSpA. Future work should include the development of biomarkers to differentiate pain mechanisms, the refinement of assessment tools and the evaluation of multimodal therapies that target both inflammation and pain processes. This evolving understanding necessitates a shift from an inflammation-centric to a mechanism-informed approach to pain management in axSpA. Although current treatments for axial spondyloarthritis can reduce inflammation, many patients continue to experience pain. This Review examines the complex interplay between pain and inflammation in axial spondyloarthritis and argues that both should be addressed as interconnected therapeutic targets to achieve meaningful pain relief.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 3","pages":"185-198"},"PeriodicalIF":32.7,"publicationDate":"2026-01-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146015157","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":"COPA syndrome spans multiple organs but is defined by STING in the lung","authors":"Anthony K. Shum","doi":"10.1038/s41584-025-01350-6","DOIUrl":"10.1038/s41584-025-01350-6","url":null,"abstract":"A large European cohort clarifies COPA syndrome as a multi-organ interferonopathy defined by STING-driven interstitial lung disease (ILD). These findings refine diagnosis and treatment and establish COPA syndrome as a model for systemic autoimmune rheumatic disease-associated ILD.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 4","pages":"219-220"},"PeriodicalIF":32.7,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145908215","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}