Seminars in arthritis and rheumatism最新文献

{"title":"How to analyze and understand the human immune system","authors":"Kazuhiko Yamamoto","doi":"10.1016/j.semarthrit.2025.152696","DOIUrl":"10.1016/j.semarthrit.2025.152696","url":null,"abstract":"<div><div>To enhance our understanding of the pathogenesis of diseases, including rheumatic diseases, and to improve disease control, it is essential to attain a thorough understanding of the human immune system, alongside mouse immunology. Historically, the investigation of the human immune system has posed significant challenges due to methodological limitations. Nonetheless, recent advancements in genomic studies of multifactorial diseases have elucidated that numerous risk-associated genetic variants affecting quantitative differences in cell-specific gene expression. In light of these findings, we are currently examining individual genetic variations in both healthy individuals and patients, as well as categorizing cells into distinct subsets in order to construct a comprehensive dataset concerning the human immune system. This is accomplished by combining data on gene expression, factors influencing the expression mechanisms, protein expression, metabolomics, and environmental variables pertinent to immune functionality—such as gut microbiota. These datasets will facilitate the comprehensive characterization of the human immune system. Using these datasets and through the integrative analyses of data related to risk genetic variations and gene expression profiles of each disease and individual, we anticipate uncovering novel insights into the human immune system, the heterogeneity of diseases, immune function mechanisms, and their regulatory strategies that may not be achievable through murine models.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152696"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557524","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Validation of the polymyalgia rheumatica-activity score: A prospective cohort study","authors":"Lien Moreel ,&nbsp;Michaël Doumen ,&nbsp;Albrecht Betrains ,&nbsp;Ellen De Langhe ,&nbsp;Daniel Blockmans ,&nbsp;Steven Vanderschueren","doi":"10.1016/j.semarthrit.2025.152695","DOIUrl":"10.1016/j.semarthrit.2025.152695","url":null,"abstract":"<div><h3>Objective</h3><div>To validate the polymyalgia rheumatica-activity score (PMR-AS).</div></div><div><h3>Methods</h3><div>Prospective cohort study at the University Hospitals Leuven (Belgium) between July 2022 and December 2023. We created a new alternative PMR-AS in which ability to elevate the upper limbs (EUL) was replaced by visual analogue scale (VAS) of functionality and both the severity and the duration of stiffness were evaluated. The discriminatory capacity for detecting active disease of the PMR-AS, the change in PMR-AS and several alternative scores were assessed using area under the receiver operating characteristic curves (AUC) and compared using Delong's tests. GEE-logistic prediction models were used to correct for repeated measures.</div></div><div><h3>Results</h3><div>We included 133 PMR patients (419 visits). PMR-AS had a good discriminatory power with an AUC of 0.938 and an optimal cut-off point of 11.0 with corresponding sensitivity of 87 % and specificity of 87 %. The change in PMR-AS (AUC 0.862), clinical-PMR-AS (AUC 0.928) and imputed-PMR-AS (AUC 0.928) significantly performed worse in detecting active disease (all p≤0.010). The ESR-PMR-AS also tended to have a lower discriminatory capacity (AUC 0.932, p=0.050). Our alternative PMR-AS had a higher AUC (AUC 0.948, p=0.010) with an optimal cut-off point of 13.5 and corresponding sensitivity of 87 % and specificity of 88 %.</div></div><div><h3>Conclusion</h3><div>PMR-AS had a good discriminatory capacity for detecting active disease, but the alternative PMR-AS performed slightly better. Alternative activity scores which do not require the use of CRP performed slightly worse but can be used in case of treatment with glucocorticoid-sparing agents affecting the CRP level.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152695"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521252","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on IgG4-related periaortitis/retroperitoneal fibrosis and periarteritis -recent clinical, diagnostic and therapeutic advances","authors":"Mitsuhiro Kawano","doi":"10.1016/j.semarthrit.2025.152691","DOIUrl":"10.1016/j.semarthrit.2025.152691","url":null,"abstract":"<div><h3>Background</h3><div>IgG4-related disease (IgG4-RD) is a systemic, chronic immune-mediated inflammatory disorder that, similar to sarcoidosis, can affect various organs and tissues. IgG4-related periaortitis (PAo)/retroperitoneal fibrosis (RPF) is among the five major manifestations of IgG4-RD. Despite introduction of the ACR and EULAR classification criteria for IgG4-RD in 2019, diagnosing IgG4-related PAo/RPF and periarteritis (PA) remains challenging because obtaining biopsies from these lesions is difficult. Additionally, while glucocorticoids are highly effective in treating IgG4-RD, managing aortic or arterial lesions poses unique challenges.</div></div><div><h3>Objectives</h3><div>This brief review discusses the utility of Japanese organ-specific diagnostic criteria for IgG4-related PAo/RPF and PA, along with recent advances in treatment strategies including management of organ-specific issues related to these lesions.</div></div><div><h3>Methods</h3><div>First, we analyzed 99 patients with IgG4-related PAo/RPF and PA based on expert diagnoses to propose organ-specific diagnostic criteria. Next, we retrospectively analyzed an additional 110 patients with IgG4-related PAo/RPF and PA, as well as 73 mimickers with clinical features requiring differentiation from true IgG4-RD to validate the proposed criteria.</div></div><div><h3>Results</h3><div>Histopathological specimens were obtained from only 33 patients (20 periaortic, 5 coronary arteries, 4 iliac arteries, 1 mesenteric artery, and 5 retroperitoneal lesions not involving arteries). Among these, 71.4 % showed storiform fibrosis, and 71.4 % displayed obliterative phlebitis. The mean number of IgG4-positive plasma cells exceeded 10 per high-power field in all specimens, and the IgG4/IgG-positive cell ratio exceeded 40 % in 32 specimens (91.4 %). Radiographic findings were essential for diagnosing IgG4-related PAo/RPF and PA, supported by elevated serum IgG4 levels and the presence of characteristic involvement of other organs affected by IgG4-RD. Validation analysis confirmed that incorporating “imaging findings of pericarditis”, “eosinophilic infiltration or lymphoid follicles”, and “probable diagnosis of extra-Pao/PA/RPF lesions” improved sensitivity from 68.4 % to 77.2 %, with only a minimal reduction in specificity (from 97.4 % to 94.7 %).</div></div><div><h3>Conclusions</h3><div>Diagnosing IgG4-related PAo/RPF and PA remains challenging even when using the latest diagnostic or classification criteria, compared to diagnosing IgG4-RD involving other major organs, such as lacrimal and salivary glands, pancreas, and kidneys. In addition, when treating patients with IgG4-related PAo/RPF and PA, organ-specific factors must be considered when developing treatment strategies.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152691"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557609","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mechanisms of joint pain: Five short lessons from osteoarthritis","authors":"Anne-Marie Malfait","doi":"10.1016/j.semarthrit.2025.152690","DOIUrl":"10.1016/j.semarthrit.2025.152690","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152690"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537715","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Imaging findings of scleroderma-associated myopathy: A systematic literature review","authors":"Elvina Ingrid ,&nbsp;Mathuja Bavanendrakumar ,&nbsp;Shereen Oon ,&nbsp;Warren Perera ,&nbsp;Jessica Day ,&nbsp;Laura Ross","doi":"10.1016/j.semarthrit.2025.152672","DOIUrl":"10.1016/j.semarthrit.2025.152672","url":null,"abstract":"<div><h3>Aims</h3><div>Systemic sclerosis (SSc) affects skeletal muscle directly, with SSc-associated myopathy (SSc-myopathy) increasingly recognised as a distinct immune-mediated myopathy. Manual muscle testing and creatine kinase (CK) are insensitive diagnostic tools for SSc-myopathy. We aimed to evaluate the role of imaging in SSc-myopathy diagnosis.</div></div><div><h3>Methods</h3><div>A systematic search of MEDLINE(Ovid), Pubmed, and EMBASE databases was performed to identify studies of ≥10 SSc patients that reported skeletal muscle imaging results. Eligibility criteria were defined a priori. Risk of bias assessment was performed using the National Heart, Lung and Blood Institute (NHLBI) quality assessment tool. Descriptive summaries were used to present data owing to inter-study heterogeneity.</div></div><div><h3>Results</h3><div>Of 2426 studies identified, 17 articles met the inclusion criteria. Imaging modalities varied, but magnetic resonance imaging (MRI) was the most commonly applied imaging technique (<em>n</em> = 9 studies). Abnormalities on MRI were reported in 38–100 % of patients and included muscle oedema, atrophy, and fatty infiltration. Changes were observed in skeletal muscles (<em>n</em> = 14 studies), axial muscles (<em>n</em> = 1), masseter muscle (<em>n</em> = 1), and accessory respiratory muscles (<em>n</em> = 2). Blood oxygenation level-dependent MRI, dynamic contrast-enhanced ultrasound, and scintigraphic evaluation have each been used to assess skeletal muscle perfusion. A lack of correlation between creatine kinase, clinical weakness, and imaging findings was consistently reported. We were unable to identify any distinct imaging patterns or relationship between imaging and histopathological skeletal muscle abnormalities owing to limited data available.</div></div><div><h3>Conclusion</h3><div>Imaging detects inflammatory, atrophic, and vasculopathic changes in the skeletal musculature of SSc patients. The discordance between clinical assessment and imaging findings underscores the potential role for muscle imaging to both screen and diagnose SSc-myopathy.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152672"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143529601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Aortic disease in giant cell arteritis","authors":"Kenneth J Warrington","doi":"10.1016/j.semarthrit.2025.152677","DOIUrl":"10.1016/j.semarthrit.2025.152677","url":null,"abstract":"<div><div>The increasing use of non-invasive vascular imaging has allowed for improved detection of aortic disease in patients with vasculitis. Indeed, up to 70 % of patients have radiographic evidence of aortitis at GCA onset and aortic dilatation is already identified in about 15 %. Aortic inflammation is generally diagnosed by imaging studies such as CT angiography, MR angiography or FDG-PET, and occasionally by histopathology following resection of the aorta for aneurysm repair. Aortic inflammation may be clinically silent but is a risk factor for progressive aortic dilatation and aneurysm formation in GCA. By comparison, aortitis in Takayasu arteritis may lead to aortic dilatation or stenosis, particularly in the descending thoracic and abdominal aorta. The risk of thoracic aortic aneurysm in patients with GCA has been estimated to be up to 17-fold higher than that of the general population, with up to 1/3 of patients developing aortic aneurysm at 10 years of follow-up. Moreover, chronic smoldering aortitis may be refractory to current therapy, lasts for several years and contributes to progressive aortic dilatation. A rare but life-threatening complication of GCA-associated aortic disease is dissection or rupture. Observational studies are informing outcomes and management of inflammatory aortic aneurysms, while transcriptomic and molecular studies on aortic tissue are yielding important information regarding disease pathogenesis. These endeavors are critical to reducing the excess mortality related to aortic disease in GCA. Also, improved understanding of the pathophysiology of the disease is allowing the development of non-glucocorticoid targeted therapies.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152677"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531725","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The joint accumulation model of arthritis","authors":"Peter A. Nigrovic","doi":"10.1016/j.semarthrit.2025.152685","DOIUrl":"10.1016/j.semarthrit.2025.152685","url":null,"abstract":"<div><div>Most inflammatory arthritides are systemic diseases. In an individual patient, however, disease flares are more common in joints affected previously, a phenomenon termed joint-specific memory. A key driver of localized recurrence is the accumulation of CD8+ T resident memory (T_RM) cells in inflamed synovial tissues. These cells remain during remission and initiate recurrent disease when activated by arthritogenic antigens. The joint accumulation model is a paradigm that recognizes the contribution of local as well as systemic immune mechanisms to arthritis chronicity, highlighting new targets for disease intervention, including but not limited to T_RM cells. The joint accumulation model underscores the importance of preventing extension of arthritis to new joints, even in established disease, translating into a rolling window of opportunity for optimal long-term arthritis management.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152685"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143537717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metabolic regulators of crystal-induced arthritis","authors":"Chinh Nghia Pham ,&nbsp;Charles Leroy ,&nbsp;Hang Korng Ea","doi":"10.1016/j.semarthrit.2025.152688","DOIUrl":"10.1016/j.semarthrit.2025.152688","url":null,"abstract":"","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152688"},"PeriodicalIF":4.6,"publicationDate":"2025-02-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143586799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Summary of findings tables for measurement property reviews: The evolution and application of OMERACT's summary of measurement properties (SOMP) Table.","authors":"Dorcas Beaton ,&nbsp;Maarten Boers ,&nbsp;Clifton O Bingham ,&nbsp;Lara J Maxwell ,&nbsp;Philip G Conaghan ,&nbsp;Shawna Grosskleg ,&nbsp;Catherine Hofstetter ,&nbsp;Beverley J Shea ,&nbsp;Lee Simon ,&nbsp;Peter Tugwell ,&nbsp;George A Wells","doi":"10.1016/j.semarthrit.2025.152664","DOIUrl":"10.1016/j.semarthrit.2025.152664","url":null,"abstract":"<div><h3>Background</h3><div>Literature reviews of measurement properties of an outcome measurement instrument are fast becoming the evidence base for making decisions about the suitability of the instrument for a given application. In our case at OMERACT it is the fitness of an instrument for inclusion in a Core Outcome Set. Transparency in the processes and decision making at each step are important to allow consumers of the literature review to have a clear understanding of the decision-making process. We used an iterative process between methodologists and users to develop a summary of measurement properties table (SOMP) as a knowledge translation tool to communicate what was done, what was found, and what recommendations can be made from it. This, in turn, would provide a readily accessible, summary of findings for those who may need this information to make informed decisions about the adequacy of evidence concerning a measurement instrument.</div></div><div><h3>Methods</h3><div>Working with key collaborators and end users, including patients, clinical trialists, clinicians, and methodologists across several disease areas, the information that is needed to be included in a SOMP was determined, and initial designs laid out. Users provided feedback and revisions, which were integrated while ensuring the core elements were also being communicated.</div></div><div><h3>Results</h3><div>Several features emerged for inclusion in the SOMP: the background context for the review, all the evidence that went into the review, what was done in the review process, and the decision made based on the review. The SOMP was designed to capture this in a single document. Working group feedback helped to improve overall understandability.</div></div><div><h3>Conclusions</h3><div>The SOMP was designed to capture the body of evidence available on the measurement properties for a given instrument, and the processes used to come to a decision about its fit with the intended application. In our case whether it was of good enough quality for use in a Core Outcome Set to represent the domain of interest. The SOMP's iterative development within a multidisciplinary consensus-based organization has helped us develop a tool useful in transparent communication about methods and decision-making made in a given review.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152664"},"PeriodicalIF":4.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143611036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Classification criteria of joint activity using joint index vector for patients with rheumatoid arthritis: An evaluation and verification","authors":"Ichiro Yoshii ,&nbsp;Susumu Nishiyama ,&nbsp;Naoya Sawada ,&nbsp;Tatsumi Chijiwa","doi":"10.1016/j.semarthrit.2025.152659","DOIUrl":"10.1016/j.semarthrit.2025.152659","url":null,"abstract":"<div><h3>Objectives</h3><div>We developed an activity classification of the joint index vector (JIV) for rheumatoid arthritis (RA) using monitoring data of RA cases at our institute. We verified its validity using an external big dataset (BD).</div></div><div><h3>Methods</h3><div>JIV is a novel joint involvement evaluation method that presents three-axis coordinates. We have set JIV classification criteria to determine a cut-off index (COI) of the combined vector on the x-y axis (Vxy). The z-axis (Vz) in the JIV was determined by Receiver Operating Characteristic analysis (ROC) in referring to the Clinical Disease Activity Index (CDAI) disease activity threshold and Health Assessment Questionnaire Disability Index (HAQ-DI) remission criteria. The criteria of JIV were evaluated in relation to indicators such as the CDAI and HAQ-DI. After determining the criteria, the validity was verified by referring to the simplified disease activity index (SDAI) classification and the HAQ score in BD.</div></div><div><h3>Results</h3><div>A total of 617 patients were studied. These were defined as 0.1&gt;Vxy as remission (REM), 0.45&gt;Vxy≥0.1 and 0.125≥Vz as low joint activity (LJA), 1.0&gt;Vxy≥0.45 or 0.45&gt;Vxy and Vz&gt;0.125 as moderate joint activity (MJA), and Vxy≥1.0 was defined as high joint activity (HJA). The external big dataset consists of 11,013 RA patients. Vxy and the SDAI score correlated significantly <em>(p</em> &lt; 0.0001). Mean values of SDAI and HAQ-DI increase stepwise as the criteria upgrade. It has been suggested that JIV may be able to pick up patients at risk of being missed by SDAI when large joints are involved.</div></div><div><h3>Conclusions</h3><div>JIV has been assessed and verified for its appropriateness, unbiased evaluation of the joints, and advantages in covering an unmet need in SDAI.</div></div>","PeriodicalId":21715,"journal":{"name":"Seminars in arthritis and rheumatism","volume":"72 ","pages":"Article 152659"},"PeriodicalIF":4.6,"publicationDate":"2025-02-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143521253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}