Nature Reviews Rheumatology最新文献_第5页

Methotrexate does not improve knee OA 甲氨蝶呤不能改善膝关节OA

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-06-10 DOI: 10.1038/s41584-025-01274-1

Sarah Onuora

引用次数: 0

Methotrexate as first-line therapy for pulmonary sarcoidosis 甲氨蝶呤作为肺结节病的一线治疗

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-06-10 DOI: 10.1038/s41584-025-01273-2

Sarah Onuora

引用次数: 0

Clonal dominance: mutations in VEXAS syndrome take advantage of inflammation 克隆优势：VEXAS综合征的突变利用炎症

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-06-06 DOI: 10.1038/s41584-025-01270-5

Samuel J. Magaziner, David B. Beck

引用次数: 0

Advances in the treatment of ANCA-associated vasculitis anca相关性血管炎的治疗进展

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-06-05 DOI: 10.1038/s41584-025-01266-1

Giorgio Trivioli, Marta Casal Moura, Andreas Kronbichler, Rona M. Smith, Benjamin Terrier, Stephen McAdoo, Rachel B. Jones, Peter A. Merkel, David R. W. Jayne

{"title":"Advances in the treatment of ANCA-associated vasculitis","authors":"Giorgio Trivioli, Marta Casal Moura, Andreas Kronbichler, Rona M. Smith, Benjamin Terrier, Stephen McAdoo, Rachel B. Jones, Peter A. Merkel, David R. W. Jayne","doi":"10.1038/s41584-025-01266-1","DOIUrl":"10.1038/s41584-025-01266-1","url":null,"abstract":"Antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV) consists of a group of small-vessel vasculitides that often present with organ-threatening or life-threatening manifestations. Current immunosuppressive treatments have improved survival and rates of remission, but are not curative, have frequent toxicities, and do not effectively prevent relapse. Clinical trials have established the role of rituximab, an anti-CD20 B cell-depleting monoclonal antibody, in both the remission-induction and maintenance phases of the disease and demonstrated that glucocorticoid doses can be substantially reduced from historical dosing levels without affecting treatment efficacy. Therapies that have the potential to be more effective and safer have become available or are under investigation. Avacopan, an oral C5a receptor antagonist, was approved as an adjunctive treatment for AAV and use of this drug in combination with rituximab or cyclophosphamide and markedly reduced glucocorticoid dosing demonstrated superior efficacy and potentially greater kidney recovery than prior standard of care. Other agents under study for treatment of AAV include next-generation anti-CD20 monoclonal antibodies, anti-CD19 chimeric antigen receptor T cells, novel complement inhibitors and agents that can target fibrosis. Alongside traditional randomized controlled trials with clinical endpoints, experimental medicine studies are focusing on mechanistic endpoints and disease biomarkers. This Review discusses current treatments and the advances in the management of AAV. This Review discusses the advances and challenges of managing antineutrophil cytoplasmic antibody-associated vasculitis. The authors discuss current treatment options, emerging therapies and unmet needs in the management of this disease.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 7","pages":"396-413"},"PeriodicalIF":32.7,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144218936","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

Insights into Lyme arthritis 深入了解莱姆病

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-05-28 DOI: 10.1038/s41584-025-01269-y

Holly Webster

引用次数: 0

How JAK inhibitors tip the prothrombotic balance in rheumatoid arthritis JAK抑制剂如何改变类风湿关节炎的血栓形成平衡

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-05-16 DOI: 10.1038/s41584-025-01263-4

Vibeke Strand

引用次数: 0

Fibroblasts in immune responses, inflammatory diseases and therapeutic implications 成纤维细胞在免疫反应、炎症性疾病及其治疗意义

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-05-14 DOI: 10.1038/s41584-025-01259-0

Angela E. Zou, Suppawat Kongthong, Alisa A. Mueller, Michael B. Brenner

{"title":"Fibroblasts in immune responses, inflammatory diseases and therapeutic implications","authors":"Angela E. Zou, Suppawat Kongthong, Alisa A. Mueller, Michael B. Brenner","doi":"10.1038/s41584-025-01259-0","DOIUrl":"10.1038/s41584-025-01259-0","url":null,"abstract":"Once regarded as passive bystander cells of the tissue stroma, fibroblasts have emerged as active orchestrators of tissue homeostasis and disease. From regulating immunity and controlling tissue remodelling to governing cell growth and differentiation, fibroblasts assume myriad roles in guiding normal tissue development, maintenance and repair. By comparison, in chronic inflammatory diseases such as rheumatoid arthritis, fibroblasts recruit and sustain inflammatory leukocytes, become dominant producers of pro-inflammatory factors and catalyse tissue destruction. In other disease contexts, fibroblasts promote fibrosis and impair host control of cancer. Single-cell studies have uncovered striking transcriptional and functional heterogeneity exhibited by fibroblasts in both normal tissues and diseased tissues. In particular, advances in the understanding of fibroblast pathology in rheumatoid arthritis have shed light on pathogenic fibroblast states in other chronic diseases. The differentiation and activation of these fibroblast states is driven by diverse physical and chemical cues within the tissue microenvironment and by cell-intrinsic signalling and epigenetic mechanisms. These insights into fibroblast behaviour and regulation have illuminated therapeutic opportunities for the targeted deletion or modulation of pathogenic fibroblasts across many diseases. This Review provides a comprehensive overview of fibroblast biology in rheumatoid arthritis and other chronic inflammatory diseases. The authors discuss insights into fibroblast behaviour and pathogenicity from single-cell and functional studies and describe how these findings have informed efforts to therapeutically target fibroblasts.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 6","pages":"336-354"},"PeriodicalIF":32.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143979459","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

The pathogenesis, clinical presentations and treatment of monogenic systemic vasculitis 单基因系统性血管炎的发病机制、临床表现及治疗

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-05-14 DOI: 10.1038/s41584-025-01250-9

Ahmet Gül, Ivona Aksentijevich, Paul Brogan, Marco Gattorno, Peter C. Grayson, Seza Ozen

{"title":"The pathogenesis, clinical presentations and treatment of monogenic systemic vasculitis","authors":"Ahmet Gül, Ivona Aksentijevich, Paul Brogan, Marco Gattorno, Peter C. Grayson, Seza Ozen","doi":"10.1038/s41584-025-01250-9","DOIUrl":"10.1038/s41584-025-01250-9","url":null,"abstract":"Many monogenic autoinflammatory diseases, including DADA2 (deficiency of adenosine deaminase 2), HA20 (haploinsufficiency of A20), SAVI (STING-associated vasculopathy with onset in infancy), COPA syndrome, LAVLI (LYN kinase-associated vasculopathy and liver fibrosis) and VEXAS (vacuoles, E1 enzyme, X-linked, autoinflammatory, somatic) syndrome, present predominantly with vasculitis and constitute a substantial subgroup of vasculitic conditions associated with a ‘probable aetiology’. The spectrum of monogenic vasculitis encompasses all sizes and types of blood vessel, ranging from large vessels to medium-size and small vessels, and from the arterial side to the venous side of the vasculature. Monogenic vasculitis typically starts early in life during infancy or childhood; VEXAS syndrome, which presents in late adulthood, is an exception. The activation of myeloid cells via inflammasome and nuclear factor-κB pathways, type I interferon-enhanced autoimmune mechanisms and/or dysregulated adaptive immune responses have an important role in the development of immune-mediated endothelial dysfunction and vascular damage. Genetic testing is essential for the diagnosis of underlying monogenic autoinflammatory diseases; however, the penetrance of genetic variants can vary. Increased awareness and recognition of distinctive clinical findings could facilitate earlier diagnosis and allow for more-targeted treatments. This Review discusses the clinical features, pathogenesis, diagnosis and management of monogenic forms of vasculitis. The authors emphasize that increased awareness of these rare diseases could aid earlier diagnosis and better, more-targeted treatment options for patients.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 7","pages":"414-425"},"PeriodicalIF":32.7,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143945762","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

Region-specific, data-driven guidelines are needed for rheumatic diseases in LMICs 中低收入国家需要针对特定区域、以数据为导向的风湿病指南

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-05-12 DOI: 10.1038/s41584-025-01265-2

Amita Aggarwal

引用次数: 0

Understanding rheumatic disease through continuous cell state analysis 通过连续的细胞状态分析了解风湿病

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2025-05-07 DOI: 10.1038/s41584-025-01253-6

Lysette Marshall, Soumya Raychaudhuri, Sebastien Viatte

{"title":"Understanding rheumatic disease through continuous cell state analysis","authors":"Lysette Marshall, Soumya Raychaudhuri, Sebastien Viatte","doi":"10.1038/s41584-025-01253-6","DOIUrl":"10.1038/s41584-025-01253-6","url":null,"abstract":"Autoimmune rheumatic diseases are a heterogeneous group of conditions, including rheumatoid arthritis (RA) and systemic lupus erythematosus. With the increasing availability of large single-cell datasets, novel disease-associated cell types continue to be identified and characterized at multiple omics layers, for example, ‘T peripheral helper’ (TPH) (CXCR5− PD-1hi) cells in RA and systemic lupus erythematosus and MerTK+ myeloid cells in RA. Despite efforts to define disease-relevant cell atlases, the very definition of a ‘cell type’ or ‘lineage’ has proven controversial as higher resolution assays emerge. This Review explores the cell types and states involved in disease pathogenesis, with a focus on the shifting perspectives on immune and stromal cell taxonomy. These understandings of cell identity are closely related to the computational methods adopted for analysis, with implications for the interpretation of single-cell data. Understanding the underlying cellular architecture of disease is also crucial for therapeutic research as ambiguity hinders translation to the clinical setting. We discuss the implications of different frameworks for cell identity for disease treatment and the discovery of predictive biomarkers for stratified medicine — an unmet clinical need for autoimmune rheumatic diseases. This Review explores the ongoing debate regarding the definition of cell identity, with a focus on the immune and stromal cell landscape within rheumatology. The authors discuss the implications of different frameworks of cell identity for disease treatment and the discovery of predictive biomarkers for stratified medicine.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"21 6","pages":"323-335"},"PeriodicalIF":32.7,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143920033","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