Nature Reviews Rheumatology最新文献_第8页

Innate lymphoid cells in rheumatoid arthritis as mediators of pathology and resolution 先天淋巴样细胞在类风湿关节炎中作为病理和消退的介质。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-11 DOI: 10.1038/s41584-026-01375-5

Ahmed K. Kabil, I-Chih Kuo, Marco Colonna, Kelly M. McNagny

{"title":"Innate lymphoid cells in rheumatoid arthritis as mediators of pathology and resolution","authors":"Ahmed K. Kabil, I-Chih Kuo, Marco Colonna, Kelly M. McNagny","doi":"10.1038/s41584-026-01375-5","DOIUrl":"10.1038/s41584-026-01375-5","url":null,"abstract":"Innate lymphoid cells (ILCs) are emerging as critical modulators of inflammation in rheumatoid arthritis, contributing to both disease pathology and resolution. Group 3 ILCs (ILC3s) mirror TH17 cells in their production of IL-17A and IL-22, promoting fibroblast activation, neutrophil recruitment and synovial inflammatory cascades. By contrast, group 2 ILCs (ILC2s) engage reparative and immunoregulatory pathways via secretion of IL-9, IL-13 and IL-10. Lymphoid tissue inducer (LTi) ILCs contribute to ectopic lymphoid tissue neogenesis and stromal remodelling in early disease. Clinically, alterations in ILC subset composition correlate with disease activity, therapeutic responsiveness and inflammatory burden. Advances in high-dimensional immunophenotyping, spatial transcriptomics and single-cell multi-omics now enable precise mapping of ILC subsets and their effector programmes across peripheral blood and synovial tissue, supporting their use in biomarker discovery and treatment pipelines. Furthermore, modulation of ILCs by targeting upstream cytokines, signalling pathways or the use of microbiota-derived metabolites is a potential therapeutic strategy. Finally, cell-based avenues include IL-10-producing ILC2s (ILC210) and engineered chimeric antigen receptor (CAR)-ILC2s for targeted, tissue-resident immune modulation. Although still in the preclinical stages, these approaches highlight the translational potential of ILCs as biomarkers and therapeutic targets in rheumatoid arthritis. Innate lymphoid cells (ILCs) influence rheumatoid arthritis by amplifying inflammatory circuits through ILC3 activity and promoting immune regulation via ILC2 responses. These context-dependent functions position ILC subsets as emerging biomarkers and targets for innovative therapies.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 6","pages":"390-402"},"PeriodicalIF":32.7,"publicationDate":"2026-05-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147874789","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

Senotherapeutics suppress disc degeneration 老年治疗药物抑制椎间盘退变。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-11 DOI: 10.1038/s41584-026-01384-4

Jessica McHugh

引用次数: 0

Adjunctive glucocorticoids in Kawasaki disease 川崎病的辅助糖皮质激素。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-11 DOI: 10.1038/s41584-026-01385-3

Sarah Onuora

引用次数: 0

Brepocitinib shows promise for dermatomyositis Brepocitinib有望治疗皮肌炎。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-11 DOI: 10.1038/s41584-026-01383-5

Sarah Onuora

引用次数: 0

T cells mediate tissue damage in lupus nephritis T细胞介导狼疮性肾炎的组织损伤。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-11 DOI: 10.1038/s41584-026-01382-6

Holly Webster

引用次数: 0

The gut–joint axis in osteoarthritis 骨关节炎中的肠-关节轴。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-07 DOI: 10.1038/s41584-026-01378-2

Jie Wei (, ), Yuqing Zhang (, ), Cen Xie (, ), Guanghua Lei (, ), Chao Zeng (, )

{"title":"The gut–joint axis in osteoarthritis","authors":"Jie Wei \u0000 (, ), Yuqing Zhang \u0000 (, ), Cen Xie \u0000 (, ), Guanghua Lei \u0000 (, ), Chao Zeng \u0000 (, )","doi":"10.1038/s41584-026-01378-2","DOIUrl":"10.1038/s41584-026-01378-2","url":null,"abstract":"Osteoarthritis (OA) is a complex condition driven by biomechanical, metabolic and inflammatory factors; however, effective disease-modifying treatments remain unavailable. Growing evidence suggests that gut microbiota dysbiosis has an important role in OA pathogenesis, giving rise to the emerging concept of a functional and targetable gut–joint axis. Gut microbiota dysbiosis can impair enteroendocrine signalling, intestinal immunity and gut barrier integrity, alter the secretion of hormones and cytokines and facilitate the translocation of gut microorganisms, pro-inflammatory molecules and metabolites into the circulation or joints. These processes can disrupt systemic and local homeostasis, promote metabolic dysregulation and obesity, trigger low-grade inflammation and contribute to both the onset and progression of OA. Although these insights open up new avenues for disease-modifying treatments and build on the long-standing paradigm in OA, which primarily focuses on pain relief rather than disease modification, evidence supporting therapeutic strategies that target the gut–joint axis remains limited. Further research is needed to translate this promising biology into clinical benefits, including deeper mechanistic elucidation through integrated multi-omics approaches, exploration of the interplay between host genetics, environmental factors and the gut microbiota and also multidimensional validation of the safety and efficacy of treatments that target this axis using complementary models (such as organoids and large animal models), clinical trials and real-world studies. In this Review, the authors provide a comprehensive overview of the gut–joint axis in osteoarthritis. They examine the biological mechanisms that link gut dysbiosis to joint degeneration, explore therapeutic strategies targeting this axis and highlight remaining challenges and considerations for future research.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 6","pages":"345-361"},"PeriodicalIF":32.7,"publicationDate":"2026-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840470","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

Sex and gender differences in rheumatology: clinical impact and future directions 风湿病学中的性别差异：临床影响和未来方向。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-05 DOI: 10.1038/s41584-026-01376-4

Marina Pierdominici, Marta Borgi, Francesca Romana Spinelli, Fabrizio Conti, Huaxun Wu, Ki Won Moon, Uta Kiltz, Elena Ortona

{"title":"Sex and gender differences in rheumatology: clinical impact and future directions","authors":"Marina Pierdominici, Marta Borgi, Francesca Romana Spinelli, Fabrizio Conti, Huaxun Wu, Ki Won Moon, Uta Kiltz, Elena Ortona","doi":"10.1038/s41584-026-01376-4","DOIUrl":"10.1038/s41584-026-01376-4","url":null,"abstract":"Sex and gender shape disease presentation, diagnostic accuracy, treatment response and clinical outcomes in rheumatology, yet these dimensions remain insufficiently embedded in clinical practice. Owing to the markedly unbalanced sex prevalence ratios across many rheumatic diseases, the ‘minority’ sex is consistently under-represented in clinical studies, limiting the interpretation of long-term outcomes and treatment effectiveness. Sex-related differences in pain perception, inflammatory biomarkers and imaging patterns further complicate disease assessment, and treatment allocation and drug persistence also differ between women and men. Gender-related factors — including disparities in care-seeking behaviours, social roles and lifestyle factors — additionally modulate symptom burden and disease trajectories. Evidence remains particularly scarce for transgender, gender-diverse and intersex individuals, who are rarely captured in clinical cohorts, restricting the development of inclusive and generalizable evidence. Embedding sex-aware and gender-aware approaches into diagnostic reasoning, risk assessment and therapeutic decision-making is therefore essential for advancing precision, equity and truly personalized rheumatological care. Such integration enables clinicians to interpret disease signals more accurately, anticipate divergent multimorbidity trajectories and tailor treatment strategies to the biological and sociocultural contexts of each patient. Sex and gender influence disease presentation, diagnostic accuracy, treatment response and outcomes across rheumatology, yet remain insufficiently integrated into practice. Integrating sex-aware and gender-aware approaches can improve disease assessment, risk stratification and personalized care, advancing equity and precision in rheumatology.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 6","pages":"362-377"},"PeriodicalIF":32.7,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840517","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

Small but relevant effects of exercise therapy in osteoarthritis 运动疗法对骨关节炎的影响虽小但相关。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-05-05 DOI: 10.1038/s41584-026-01377-3

Sita Bierma-Zeinstra, Jos Runhaar

引用次数: 0

The complexity of pain in osteoarthritis 骨关节炎疼痛的复杂性。

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-04-30 DOI: 10.1038/s41584-026-01372-8

Kristian Kjær-Staal Petersen, Daniel Ciampi de Andrade, Gisèle Pickering, Rocco Giordano, Emma Hertel, Robert R. Edwards, Esther Pogatzki-Zahn, Ali Mobasheri, Lars Arendt-Nielsen

{"title":"The complexity of pain in osteoarthritis","authors":"Kristian Kjær-Staal Petersen, Daniel Ciampi de Andrade, Gisèle Pickering, Rocco Giordano, Emma Hertel, Robert R. Edwards, Esther Pogatzki-Zahn, Ali Mobasheri, Lars Arendt-Nielsen","doi":"10.1038/s41584-026-01372-8","DOIUrl":"10.1038/s41584-026-01372-8","url":null,"abstract":"Chronic pain is the hall-mark symptom of osteoarthritis (OA) and although several therapies are available, a sizeable number of patients do not gain adequate pain relief from these therapies. Predicting those patients who will not respond to current therapies remains a challenge. Although psychosocial, sensitivity, inflammation and genetic factors have been identified as pain mechanisms that predict response to pain therapy, none of these is a sufficiently strong predictor alone. An emerging approach to this challenge is the use of machine-learning algorithms that integrate several pain mechanisms, which are superior to previous prediction models. Importantly, these machine-learning algorithms identify networks of pain mechanisms that could be targeted therapeutically. From these models, a new mechanistic framework is proposed, in which pain in OA can be viewed either as a simpler joint disease with inflammation or as a complex pain problem that involves multiple factors. The latter is associated with a higher risk of poor response to standard OA pain therapy. Understanding the complexity of pain in OA and predicting those who are at risk of not responding to standard OA pain therapy are essential for improving the management of pain in OA. Managing pain in osteoarthritis (OA) remains a major clinical challenge. The authors of this Review explore the spectrum of pain complexity in OA and highlight how integrating multiple mechanistic domains could be used to predict outcomes and improve management of OA pain.","PeriodicalId":18810,"journal":{"name":"Nature Reviews Rheumatology","volume":"22 6","pages":"378-389"},"PeriodicalIF":32.7,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147817654","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

Is cam morphology a cause of osteoarthritis? 凸轮形态是骨关节炎的原因吗？

IF 32.7 1区医学

Nature Reviews Rheumatology Pub Date : 2026-04-20 DOI: 10.1038/s41584-026-01373-7

Benjamin G. Faber, George Davey Smith, Jonathan H. Tobias

引用次数: 0