Reumatologia最新文献

{"title":"Protocol for the development of Polish clinical guidelines for the management of patients with systemic lupus erythematosus.","authors":"Joanna Makowska, Brygida Kwiatkowska, Magdalena Krajewska-Włodarczyk, Bogdan Batko, Marcin Stajszczyk, Jerzy Świerkot, Zbigniew Żuber, Piotr Leszczyński, Agata Sebastian, Magdalena Władysiuk, Irena Walecka, Michał Chmielewski, Mariusz Stasiołek, Maria Maślińska","doi":"10.5114/reum/199640","DOIUrl":"https://doi.org/10.5114/reum/199640","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a complex, chronic autoimmune disease that causes multi-organ inflammation and damage. Left untreated or inadequately managed, SLE can lead to severe organ dysfunction, disability, and reduced quality of life. In Poland, the absence of standardized, evidence-based clinical guidelines tailored to local resources and practices has created inconsistencies in SLE management. The purpose of these guidelines is to provide clear, evidence-based recommendations for the treatment and management of adult patients with SLE in the Polish healthcare system. These recommendations aim to align clinical practices with international standards, optimize treatment strategies, standardize patient care, and improve health outcomes while guiding healthcare policy.</p><p><strong>Material and methods: </strong>The adaptation process follows the ADAPTE Collaboration guidelines, the GRADE methodology, and the Evidence to Decision (ETD) framework. An interdisciplinary Working Group (WG), comprising experienced rheumatologists, organ-specific specialists, young rheumatologists, and a patient representative, will develop the guidelines. Key steps will include: 1) creation of clinical questions using the PICO format; 2) systematic search of relevant international guidelines (EULAR, ACR) and national sources; 3) evaluation of identified guidelines using the AGREE II instrument to ensure methodological quality; 4) formulation of recommendations through consensus-based discussions, addressing clinical treatment, monitoring, and care organization.</p><p><strong>Scope and implementation: </strong>The guidelines cover pharmacological interventions for SLE, including hydroxychloroquine, glucocorticosteroids, immunosuppressive drugs biologics. Specific focus areas include treatment of organ-specific manifestations, management during pregnancy, treatment of disease flares, maintenance therapy, monitoring, and comorbidity management. The finalized document will undergo external review and be published in both Polish (on the Polish Society for Rheumatology website) and English (in the journal <i>Reumatologia</i>) as open access. Implementation strategies will include dissemination through scientific journals, presentations at conferences.</p><p><strong>Conclusions: </strong>These guidelines aim to provide a standardized framework for SLE management in Poland. By implementing evidence-based recommendations, they will support healthcare providers in improving patient outcomes, optimizing resource allocation, and addressing the unique challenges of SLE within the Polish healthcare system.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"35-40"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143981326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between immunoglobulin G4-related disease and malignancy.","authors":"Faiz Karim, Jan van Laar","doi":"10.5114/reum/200760","DOIUrl":"https://doi.org/10.5114/reum/200760","url":null,"abstract":"","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"1-2"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144043920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of tumor necrosis factor α (rs1800629) and interleukin-10 (rs1800896) gene polymorphisms with systemic lupus erythematosus: a meta-analysis.","authors":"Praveen Kumar Chandra Sekar, Ramakrishnan Veerabathiran","doi":"10.5114/reum/195431","DOIUrl":"https://doi.org/10.5114/reum/195431","url":null,"abstract":"<p><strong>Introduction: </strong>Systemic lupus erythematosus (SLE) is a complex autoimmune disease influenced by genetic, environmental, and immunological factors. Variations in cytokine genes, including tumor necrosis factor α (TNF-α) and interleukin-10 (IL-10), have been implicated in SLE pathogenesis, but their associations remain uncertain owing to conflicting study results.</p><p><strong>Material and methods: </strong>A systematic search of the Google Scholar, PubMed, and Embase databases was conducted to examine TNF-α (rs1800629) and IL-10 (rs1800896) polymorphisms in SLE. Eligible studies were selected based on specific inclusion criteria, and data were independently extracted. Quality assessment was performed using the Newcastle-Ottawa Scale, and the Hardy-Weinberg equilibrium was evaluated. Meta-analyses were conducted using Cochrane Rob Tool 2 and Review Manager version 5.4 to determine odds ratios and 95% confidence intervals.</p><p><strong>Results: </strong>According to the meta-analysis, a significant association was found between SLE risk and TNF-α-308 G/A polymorphism in allelic, dominant, and heterozygote models. However, no association was found between homozygous and recessive models. Interleukin-10 polymorphisms were not significantly associated with SLE risk in any model. Ethnicity-specific analysis revealed a significant association between the TNF-α allele and SLE susceptibility in Asian populations but not in Caucasians.</p><p><strong>Conclusions: </strong>This meta-analysis identified a strong correlation between the TNF-α-308 G/A polymorphism and SLE susceptibility, particularly in Asian populations. However, no association was found between IL-10 polymorphisms and SLE. More extensive studies with diverse populations are required to validate and enhance these findings.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"41-53"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977506/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014730","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The gut microbiome and osteoarthritis.","authors":"Wiktoria Maria Krupka, Gabriela Motyl, Joanna Dmowska-Chalaba","doi":"10.5114/reum/197061","DOIUrl":"https://doi.org/10.5114/reum/197061","url":null,"abstract":"<p><p>Osteoarthritis (OA) is one of the most common degenerative diseases, and the number of patients has been constantly increasing. Non-steroidal anti-inflammatory drugs, glucocorticosteroids, opioids, etc., and surgical procedures, e.g. arthroplasty, are among the most common methods of treatment. There are reasons to believe that the gut microbiome (GMB) may influence inflammatory processes occurring in the pathomechanism of OA. The inflammatory processes occurring in the intestines may lead to disruption of tight junctions and increased concentrations of pro-inflammatory cytokines, resulting in increased permeability of intestines, causing low-grade inflammation, including in the joints. Methods of altering the GMB composition to reduce the inflammatory and joint degenerative processes are known only to some extent, and long-term research is required. Osteoarthritis, a particularly well-known and very widespread disease due to the aging population, is characterized by moderate and local inflammation. It occurs due to the effects of biomechanical cartilage wear with damage of joint structures, primarily through degenerative processes. OA represents a therapeutic challenge, and any element that can influence its inhibition is highly sought after. Therefore, these methods seem to offer a promising additional approach to treatment.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"54-60"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977504/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144028003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Isolated anti-ribosomal P antibodies are associated with reduced risk of renal and articular involvement in systemic lupus erythematosus patients. An observational study from one center.","authors":"Mourad Elghali, Boussoukaya Yosr, Daadaa Syrine, Jguirim Mahbouba, Sakly Nabil, Hammami Sonia","doi":"10.5114/reum/197390","DOIUrl":"https://doi.org/10.5114/reum/197390","url":null,"abstract":"<p><strong>Introduction: </strong>The aim of the study was to compare the specific clinical manifestations of systemic lupus erythematosus (SLE) or laboratory findings between patients with and without anti-ribosomal P (anti-P) antibodies and to investigate possible associations between isolated anti-P antibodies and these features.</p><p><strong>Material and methods: </strong>Seventy-five SLE patients were enrolled in this study. They were recruited from the Department of Internal Medicine and Department of Rheumatology at the University Hospital of Monastir, Tunisia (January 2008 - December 2022). All patients met at least four American College of Rheumatology criteria or Systemic Lupus Erythematosus International Collaborating Clinics criteria at the time of disease diagnosis. Antibody typing was performed using a commercial line blot technique. Statistical analysis was performed using the χ² test, Fisher's test when appropriate, Student's <i>t</i>-test, or Mann-Whitney <i>U</i> test according to normality of the data distribution.</p><p><strong>Results: </strong>Thirty patients (40%) were positive for anti-P (anti-P+). The anti-P+ had higher frequency of skin features (26/49 [53.1%] vs. 4/26 [15.4%], <i>p</i> = 0.003) and central nervous system (CNS) involvement (10/15 [66.7%] vs. 20/60 [33.3%], <i>p</i> = 0.018) than patients without anti-P. Interestingly, anti-P+ showed a lower frequency of SLE/rheumatoid arthritis overlap syndrome (1/11 [9.1%] vs. 29/64 [45.3%], <i>p</i> = 0.042). The comparison between groups of patients according to the presence of anti-P, anti-dsDNA, and anti-Sm showed that the group with anti-P lacking anti-dsDNA and anti-Sm had the highest frequency of neuropsychiatric SLE (75%, <i>p</i> = 0.034), and the lowest frequency of lupus nephritis (0%, <i>p</i> = 0.029) and arthritis (12.5%, <i>p</i> = 0.039).</p><p><strong>Conclusions: </strong>This study supports the association of anti-P antibodies with CNS and cutaneous manifestations. To the best of our knowledge, this is the first study to report a negative association between isolated anti-P antibodies and renal and articular involvement in SLE.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"27-34"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977507/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143995931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Polymorphisms of <i>HSP70</i> genes are involved in the pathogenesis of idiopathic inflammatory myopathy.","authors":"Tana Svitalkova, Antonin Ambroz, Marketa Svetla, Martina Misunova, Libor Kolesar, Peter Novota","doi":"10.5114/reum/196740","DOIUrl":"https://doi.org/10.5114/reum/196740","url":null,"abstract":"<p><strong>Introduction: </strong>Idiopathic inflammatory myopathies (IIM) are a group of rare systemic autoimmune diseases characterized by muscle weakness, histopathological signs of inflammation in muscle tissues, elevated serum levels of muscle-associated enzymes, inflammatory mononuclear cells infiltrating muscle tissue and progressive symmetrical proximal muscle weakness. The current view is that they begin by immune activation in response to environmental factors in genetically predisposed people, but despite the number of investigations into the genetic background, the detailed etiopathogenesis remains unknown. The aim of this study was to examine the relationship between select polymorphisms located in the human major histocompatibility complex (MHC) and IIM. These genetic markers may take part in the onset of the autoimmune process, and their identification could aid in the diagnosis and classification of IIM subtypes.</p><p><strong>Material and methods: </strong>One hundred and fifty-two adult patients suffering from IIM (82 dermatomyositis and 70 polymyositis) and 150 healthy controls were analyzed in this study. All were from the Czech Republic. SNPs of the <i>HSP70</i> genes <i>HSPA1A</i> (rs1008438, rs1043618), <i>HSPA1B</i> (rs1061581, rs539689, pentanucleotide tandem duplication rs9281590) and <i>HSPA1L</i> (rs2227956) were analyzed in all patients and controls. For the detection of HLA polymorphisms, we used commercial kits from CareDx. Haplotypes were created using Arlequin 3.5.</p><p><strong>Results: </strong>Our results confirm the association of IIM with the ancestral haplotype HLA-DRB1*03-DQB1*02. The most important MHC haplotype related to IIM and covering all polymorphisms was HLA-DQB1*02-DRB1*03:01-T-C-C-G-C-INS (<i>p</i> < 0.05, OR = 1.90, 95% CI: 1.15-3.13). This haplotype is associated with the risk of IIM development.</p><p><strong>Conclusions: </strong>Our results show that polymorphism typing within the MHC might be a very strong tool for recognition of IIM.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"12-21"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977503/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143993909","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The relationship between dose of methotrexate and incidence of liver fibrosis in patients with rheumatoid arthritis.","authors":"Mina AkbariRad, Zahra Rezaieyazdi, Ali Tajik, Banafshe Ataei, Mehrdad Sarabi, Hasan MehradMajd, Hasan Vossoughinia, Abdollah Firoozi","doi":"10.5114/reum/199740","DOIUrl":"https://doi.org/10.5114/reum/199740","url":null,"abstract":"<p><strong>Introduction: </strong>Methotrexate (MTX) is a chemotherapy agent and immune system suppressant that can cause liver fibrosis in long-term usage. This study aimed to investigate the relationship between the dose of MTX and the incidence of liver fibrosis in patients with rheumatoid arthritis (RA).</p><p><strong>Material and methods: </strong>This cohort study was conducted on RA patients with normal liver function who took MTX. Liver FibroScan and laboratory tests, including α₂-macroglobulin, total bilirubin, g-glutamyltransferase, apolipoprotein A1, haptoglobin, and alanine transaminase was performed. The patients were divided into 2 groups regarding their cumulative dose of MTX and the rate of liver fibrosis incidence was compared between the 2 groups.</p><p><strong>Results: </strong>In total, 60 RA patients with the mean age of 55.2 ±11.8 years were enrolled. The mean duration of MTX use in patients was 6.9 ±3.8 years, and it was higher in the higher cumulative dose MTX group (> 2 g) than in the lower cumulative dose group (< 2 g; <i>p</i> < 0.0001). The overall prevalence of grade 3 fibrosis was 3.33%. The prevalence of second- and third-degree liver fibrosis in patients receiving a lower cumulative dose was respectively 9 (28.1%) and 1 (3.1%), and in patients receiving a higher cumulative dose it was 7 (25%) and 1 (3.6%), respectively. There was no statistically significant difference between the 2 groups regarding the prevalence of liver fibrosis (<i>p</i> = 0.88). Both aspartate aminotransferase to platelet ratio index and Fibrosis Index Based on 4 Factors indices showed no significant difference between the 2 groups (<i>p</i> = 0.594, <i>p</i> = 0.232).</p><p><strong>Conclusions: </strong>These results suggest that long-term treatment with a higher cumulative dose of MTX is not associated with a higher incidence of liver fibrosis in RA patients.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"3-11"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977502/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144045474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CECR 2024: Central European Congress of Rheumatology: 5-7 December 2024, Ljubljana, Slovenia.","authors":"","doi":"10.5114/reum/202377","DOIUrl":"https://doi.org/10.5114/reum/202377","url":null,"abstract":"","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"61-63"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977508/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessment of renal resistive index measurement in children with immunoglobulin A vasculitis.","authors":"Rabia Miray Kisla Ekinci, Burcak Cakir Pekoz, Sevgin Taner","doi":"10.5114/reum/197389","DOIUrl":"https://doi.org/10.5114/reum/197389","url":null,"abstract":"<p><strong>Introduction: </strong>Henoch-Schönlein purpura (HSP), also known as IgA vasculitis (IgAV), is the most prevalent systemic vasculitis. Renal involvement occurs in approximately one third of children with IgAV, while biopsy-proven nephritis could be diagnosed in only 6% of patients with prolonged proteinuria or nephritic syndrome. The renal resistive index (RRI) provides insights into intrarenal arterial resistance. The aim of this study was to assess the potential utility of RRI measurements in patients with IgA vasculitis (IgAV).</p><p><strong>Material and methods: </strong>This cross-sectional study included 27 children diagnosed with HSP/IgAV between January 2021 and January 2023. Additionally, 27 healthy controls were included to the study. Age, sex, symptoms recorded and initial laboratory test results, including renal function tests, serum albumin levels, complete blood count, erythrocyte sedimentation rate, C-reactive protein, renal function tests, spot urine protein/creatinine and albumin/creatinine ratio were obtained at study enrollment. The RRI measurements were obtained from intrarenal arteries using color Doppler ultrasonography.</p><p><strong>Results: </strong>Among the 27 IgAV patients (13 male, 14 female), 3 (11.1%) exhibited renal involvement, with renal biopsy performed in only one patient, revealing class IIIa nephritis. The RRI values were not significantly different between the IgAV and control groups. Additionally, RRI was 0.61 ±0.05 and 0.56 ±0.06 in patients with and without antecedent infection, respectively (<i>p</i> = 0.04). Furthermore, RRI was not significantly different among patients grouped based on the presence of arthritis, severe gastrointestinal symptoms, or renal involvement.</p><p><strong>Conclusions: </strong>Our findings indicate that RRI remains unaffected in patients with IgAV, reflecting the relatively benign nature of the disease, particularly in children. Further investigations, involving a larger cohort of patients with nephritis, are warranted to elucidate the utility of RRI in assessing renal involvement in IgAV.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"63 1","pages":"22-26"},"PeriodicalIF":1.4,"publicationDate":"2025-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11977509/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144014496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The kynurenine pathway in patients with rheumatoid arthritis during tumor necrosis factor α inhibitors treatment.","authors":"Joanna Witoszyńska-Sobkowiak, Dorota Sikorska, Karolina Niklas, Iwona Żychowska, Rafał Rutkowski, Włodzimierz Samborski","doi":"10.5114/reum/191752","DOIUrl":"https://doi.org/10.5114/reum/191752","url":null,"abstract":"<p><strong>Introduction: </strong>The importance of the kynurenine pathway in normal immune system function has led to an appreciation of its possible contribution to autoimmune disorders such as rheumatoid arthritis (RA). The aim of the study was to evaluate the effect of treatment with tumor necrosis factor α (TNF-α) inhibitors on the activity of the kynurenine pathway in patients with RA.</p><p><strong>Material and methods: </strong>This was an investigator-initiated, prospective, observational study. The study was performed on 30 RA patients (Caucasian, 11 male, 19 female; mean age 45 ±16 years) treated with TNF-α inhibitors. All patients were assessed before and after 6 months of therapy. As a control group, age- and sex-matched, 20 healthy volunteers were recruited. Disease activity was evaluated by the Modified Disease Activity Score with 28-joint count (DAS28). Inflammatory markers were assessed routinely by the hospital central laboratory. Serum concentrations of kynurenine, serotonin and tryptophan were measured with specific immunoassays. To estimate indoleamine 2,3-dioxygenase (IDO) activity, kynurenine-to-tryptophan ratio was calculated.</p><p><strong>Results: </strong>The results of our study showed changes in tryptophan metabolism in RA patients, compared with healthy controls. Surprisingly, RA patients had statistically significant decreased kynurenine-to-tryptophan ratio (<i>p</i> = 0.003), which could indicate diminished IDO activation in RA. Moreover, we found no significant changes in kynurenine-to-tryptophan ratio after treated with TNF-α inhibitors (<i>p</i> = 0.490), despite disease remission. Additionally, tryptophan metabolism activity did not correlate with objective markers of inflammation.</p><p><strong>Conclusions: </strong>The RA patients had altered tryptophan metabolism, compared with healthy controls. The mechanisms affecting tryptophan metabolism in RA may be complex. We believe that continuing elucidation of pathophysiological pathways relevant in RA offer substantial hope for the development of specific pharmacotherapy for treatment of RA - especially for comorbidity of RA and depression.</p>","PeriodicalId":21312,"journal":{"name":"Reumatologia","volume":"62 4","pages":"220-225"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11457307/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142392921","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}