Mediterranean Journal of Rheumatology最新文献

{"title":"KIM-1: A Non-Invasive Marker for Kidney Injury and Treatment Efficacy in FMF.","authors":"Oktay Bagdatoglu, Esra Fırat Oguz, Ahmet Kor, Sukran Erten, Mıne Sebnem Karakan","doi":"10.31138/mjr.210625.are","DOIUrl":"https://doi.org/10.31138/mjr.210625.are","url":null,"abstract":"<p><strong>Objective: </strong>Familial Mediterranean Fever (FMF) arises from mutations in the MEFV gene, which encodes the immune-regulatory protein pyrin. Early detection of FMF-associated kidney injury and identification of noninvasive biomarkers to monitor disease progression and treatment response are critical. This study aimed to measure serum Kidney Injury Molecule-1 (sKIM-1) levels in FMF patients, assess its potential as an early indicator of renal damage, and evaluate its utility in monitoring treatment efficacy.</p><p><strong>Methods: </strong>Fifty FMF patients and 36 healthy controls were enrolled. Serum KIM-1 levels were determined by ELISA. Clinical and laboratory data were extracted from patient records. The relationships between sKIM-1, urine protein/creatinine ratio (UPCR), and estimated glomerular filtration rate (eGFR) were analyzed. Subgroup analyses compared sKIM-1 levels in patients treated with anakinra or canakinumab.</p><p><strong>Results: </strong>Median sKIM-1 was significantly higher in FMF patients than controls [571.30 pg/mL (562.50-586.90) vs. 562.40 pg/mL (558.10-580.40), p=0.040]. No correlation was observed between sKIM-1 and UPCR (p=0.547) or eGFR (p=0.232) in the FMF group. Canakinumab-treated patients exhibited significantly lower sKIM-1 levels [561.10 pg/mL (556.10-567.00) vs. 575.4 pg/mL (564.00-591.20), p=0.036], whereas anakinra treatment showed no significant difference [561.20 (558.40-595.70), 572 (564.60-588), (p=0.430)].</p><p><strong>Conclusion: </strong>Elevated sKIM-1 in FMF patients and its reduction with canakinumab support KIM-1 as a noninvasive biomarker of renal involvement in FMF. These findings suggest KIM-1 may serve as a tool for monitoring disease activity and treatment response.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"179-185"},"PeriodicalIF":0.0,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843692","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":"Real-World Effectiveness of MEpolizuMaB in Eosinophilic Granulomatosis with Polyangiitis in Greece: A Protocol for a Multicentre Retrospective Observational Study - The MEMBER Study.","authors":"Christos Koutsianas, Katerina Antoniou, Dimitrios Boumpas, Theodoros Dimitroulas, Christina G Katsiari, Menelaos Manoussakis, Kostantinos Porpodis, Kostantinos Samitas, Paschalis Steiropoulos, Paraskevi V Voulgari, Zafeiris Louvaris, Dimitrios Vassilopoulos","doi":"10.31138/mjr.070825.arn","DOIUrl":"https://doi.org/10.31138/mjr.070825.arn","url":null,"abstract":"<p><p>Eosinophilic granulomatosis with polyangiitis (EGPA) is a rare systemic vasculitis occurring predominantly in patients with eosinophilic asthma. Glucocorticoids (GCs) are the cornerstone of treatment for EGPA to achieve disease remission, however, relapses despite GCs therapy are common. Mepolizumab (Nucala^®) is a humanised monoclonal antibody that binds interleukin (IL)-5 and randomised controlled trials have shown that it effectively targets eosinophil-driven manifestations of EGPA. Since the vasculitic component of EGPA may not be solely driven by eosinophils, the aim of this retrospective observational study is to use real-world evidence to assess clinical outcomes following treatment with mepolizumab (Nucala^®). A retrospective, observational, cohort study will be conducted in 10 hospital centres specialised in the treatment and monitoring of patients with EGPA in Greece. Data will be retrospectively collected and analysed from medical records of 70 patients with EGPA treated with mepolizumab (Nucala^®) for ≥ 6 months, covering the period from September, 2021, to December, 2024.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"251-257"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145276/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843746","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":"Immunoglobulin-G4 Related Disease: A Rare Entity with Many Clinical Faces - Literature Review and Case Illustration.","authors":"Vijay Krishnan R, Hariharan Seshadri, Suganya Balachandran, V Aribalaji, Umadevi T B","doi":"10.31138/mjr.150825.era","DOIUrl":"https://doi.org/10.31138/mjr.150825.era","url":null,"abstract":"<p><strong>Introduction: </strong>Immunoglobulin-G4 Related Disease (IgG4-RD) is a group of multi-system, fibro-inflammatory conditions characterised by elevated IgG4 levels and unique histopathological features. Clinical presentations of the disease are highly variable, albeit there exist distinct phenotypes in the presentations of the disease. IgG4-RD is a differential diagnosis that should be missed in any case of chronic inflammatory and tumefactive pathology.</p><p><strong>Case discussion: </strong>We present the case of a 47-year-old diabetic female who presented with features suggestive of acute pyelonephritis. On further evaluation, our findings unmasked a rare constellation of pancreatitis, orbital pseudotumor, and venous thrombosis. After an astute clinical observation by our team, we were able to decipher these as features of distinct phenotypes under the IgG4-RD spectrum with minimal overlap (pancreato-hepatobiliary disease, head and neck disease, and retroperitoneal disease groups, respectively).</p><p><strong>Literature review: </strong>We have presented an extensive review of the recent literature pertaining to the etiopathogenesis, clinical features, diagnostic protocol and management consensus for IgG4-related disease. A detailed account of the possible clinical presentations and work-up strategy for suspected patients has been emphasised in particular.</p><p><strong>Conclusion: </strong>IgG4-RD is diverse clinico-pathological entity that warrants a high degree of clinical suspicion. Once identified, efforts must be made to screen all possible foci of disease activity characteristic to the disease, as a multi-focal disease presentation of IgG4-RD is not unlikely.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"126-135"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145280/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843735","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":"Mononeuritis Multiplex Presenting with Retroperitoneal Inflammation: A Case-Based Review in the Light of Diagnostic and Therapeutic Challenges.","authors":"Michail-Angelos Mourtzos, Natalia-Maria Keklikoglou, Dimitrios I Patoulias","doi":"10.31138/mjr.280725.ecz","DOIUrl":"https://doi.org/10.31138/mjr.280725.ecz","url":null,"abstract":"<p><strong>Background: </strong>Mononeuritis multiplex (MNM), is an uncommon, peripheral neuropathy, presenting with asymmetric involvement of multiple individual nerves. It is frequently associated with vasculitic disorders and other immune-related conditions. Early manifestations can often be non-specific, which might complicate diagnosis.</p><p><strong>Case presentation: </strong>A 56-year-old woman with no significant medical history developed sudden abdominal and right gluteal pain followed by progressive and asymmetric sensorimotor deficits. Initial imaging demonstrated fat stranding and infiltration in the retroperitoneum, lateral pelvic walls, and lumbosacral plexus, suggestive of an inflammatory process. Laboratory testing demonstrated marked leucocytosis, eosinophilia, elevated erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP), sterile pyuria, hypoalbuminemia and elevated alpha- and beta-globulins. Markers of infectious and autoimmune diseases, as well as neoplastic markers were unrevealing. Nerve biopsy was inconclusive. Therefore, a diagnosis of immune-mediated vasculitic neuropathy was favoured but not confirmed. She was treated with high-dose oral corticosteroids tapered over 12 months, with additional antibiotics to reduce risk of infection. At follow-up, she remained ambulatory and independent, with mild residual deficits and intermittent inflammatory marker elevation.</p><p><strong>Conclusions: </strong>This case illustrates how MNM presenting with gradual evolution, mixed infectious and autoimmune features, and in the context of retroperitoneal inflammation, can complicate the diagnostic process. In absence of biopsy confirmation, management required balancing empirical immunosuppression with infection risk. Comparison with prior reports underlines the importance of complete autoimmune workup, biopsy and imaging techniques such as positron emission tomography scan in minimising diagnostic uncertainty.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"212-219"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843680","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 Hidden Enemy: A Case Report of Early-Onset Rheumatoid Vasculitis Masquerading as Peripheral Artery Disease.","authors":"Shrreya Agarawal, Gorantla Sai Susmitha, Joydeep Samanta, Jhasaketan Meher, Vinay R Pandit","doi":"10.31138/mjr.230625.erv","DOIUrl":"https://doi.org/10.31138/mjr.230625.erv","url":null,"abstract":"<p><p>Rheumatoid vasculitis (RV) is a rare, severe extra-articular manifestation of rheumatoid arthritis (RA), typically occurring after long-standing erosive disease. Advances in RA therapy have reduced its incidence; however, RV can occasionally present early in high-risk patients. We report a man in his thirties from Central India with a 3-year history of inadequately treated seropositive RA, who presented with progressive polyarthritis, neuropathy, and distal ischemic changes. Over five months, he developed worsening joint pain and swelling, followed by tingling, numbness, and subsequently dry gangrene of the 2^nd-5^th toes of the left foot. Examination revealed palpable peripheral pulses, normal ankle-brachial index, active synovitis in 24/28 joints, and sensorimotor deficits with weakness and absent ankle reflex. Laboratory evaluation showed anaemia, thrombocytosis, markedly elevated ESR and CRP, and high RF (288 U/mL) and ACPA (>300 U/mL). ANA and ANCA were negative. CT angiogram ruled out peripheral arterial occlusion, and echocardiography excluded cardiac emboli. Nerve conduction study demonstrated sensorimotor axonal neuropathy. Sural nerve biopsy confirmed vasculitis with axonal damage and perivascular inflammation. A diagnosis of rheumatoid vasculitis was made. Treatment with high-dose intravenous methylprednisolone, followed by oral prednisolone, rituximab, and methotrexate, led to rapid control of joint inflammation and halting of gangrene progression. At 6-month follow-up, the patient was asymptomatic on methotrexate 25 mg/week with steroids tapered off, and no further vascular events. This case highlights that RV may rarely occur early in seropositive RA with poorly controlled disease. Prompt recognition, biopsy confirmation, and aggressive immunosuppression are crucial for favourable outcomes.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"243-246"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843728","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":"Predictors of Cyclophosphamide Resistance in Granulomatosis with Polyangiitis: A Retrospective Cohort Study.","authors":"Pınar Akyüz Dağlı, Esra Kayacan Erdoğan, Hatice Ecem Konak, Bahar Özdemir Ulusoy, Serdar Can Güven, Berkan Armağan, Rezan Koçak Ulucaköy, Kevser Orhan, Ebru Atalar, İsmail Doğan, Yüksel Maraş, Ahmet Omma, Orhan Küçükşahin, Şükran Erten, Hakan Babaoğlu","doi":"10.31138/mjr.150736.pcr","DOIUrl":"https://doi.org/10.31138/mjr.150736.pcr","url":null,"abstract":"<p><strong>Objective: </strong>Cyclophosphamide remains a cornerstone of remission induction therapy in granulomatosis with polyangiitis (GPA); however, the presence of resistant patients necessitating a switch to alternative agents, such as rituximab, remains a clinical challenge. Identifying predictors of cyclophosphamide resistance could improve patient stratification and optimise treatment strategies.</p><p><strong>Methods: </strong>This retrospective cohort study included 75 patients diagnosed with GPA and treated at Ankara Bilkent City Hospital between 2018 and 2023.Clinical and laboratory data were extracted from electronic medical records. Baseline characteristics, organ involvement, and serological profiles were compared between cyclophosphamide-responsive and cyclophosphamide-resistant patients. Logistic regression analysis was performed to identify independent predictors of treatment resistance.</p><p><strong>Results: </strong>75 patients with GPA analysed. The mean age was 46.1years (SD=14.0).56 patients received cyclophosphamide as first-line therapy, of whom 34 (60.7%) achieved remission, while 22 (39.3%) switched to rituximab. Of these, 17 patients (30.4%) were classified as cyclophosphamide-resistant, while 5 patients (8.9%) switched due to other reasons. Younger age was a significant predictor of cyclophosphamide resistance (OR=0.915, 95%CI:0.856-0.977, p=0.008). The presence of arthritis showed a trend toward association (OR=5.191, 95%CI:0.960-28.065, p=0.056) but did not reach statistical significance. No significant differences were observed in gender, ANCA subtypes, major organ involvement, or comorbidity burden between groups.</p><p><strong>Conclusion: </strong>Our findings suggest that younger age is associated with a higher likelihood of cyclophosphamide resistance in GPA, potentially indicating a more aggressive disease course. Although arthritis showed a potential association with resistance, further studies are needed to confirm its role.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"199-205"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843671","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":"Pan-Immune-Inflammation Value Predicts Disease Activity and Ocular Involvement in Behçet's Disease: A Case-Control Study.","authors":"Eman M Shawky, Maha S I Abdelrahman, Sara Farrag","doi":"10.31138/mjr.200625.era","DOIUrl":"https://doi.org/10.31138/mjr.200625.era","url":null,"abstract":"<p><strong>Objective/aim: </strong>Behçet's disease (BD) lacks distinctive laboratory findings, so this study aimed at evaluating the pan-immune-inflammation value (PIV), neutrophil to lymphocyte ratio (NLR), platelets to lymphocytes ratio (PLR), and monocytes to lymphocytes ratio (MLR) in BD in addition to investigating their relationship with disease activity.</p><p><strong>Methods: </strong>This case control study included 40 BD patients and 40 age and sex matched healthy volunteers. Complete clinical evaluation and disease activity scoring were conducted. Complete blood count was done for all participants with calculation of PIV, NLR, PLR and MLR.</p><p><strong>Results: </strong>BD patients showed significantly higher PIV, NLR, PLR and MLR level than healthy participants (p=0.04, 0.04, < 0.001 and 0.007, respectively). PIV showed significant positive correlation with BDCAF and erythrocyte sedimentation rate (p= 0.025 and 0.039, respectively). We detected a significantly greater PIV in patients with active ocular and musculoskeletal disease (p=0.001 and 0.037 respectively). At a cutoff of 238.26, PIV yielded an AUC of 0.81 (95% CI, p=0.001), with 83% sensitivity and 82% specificity for detecting active ocular involvement.</p><p><strong>Conclusion: </strong>PIV showed positive correlation with disease activity. PIV is superior to other studied blood cells derived ratios in detecting active ocular involvement in BD patients.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"193-198"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145281/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843648","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":"Vision-Threatening Juvenile Lupus Retinopathy: A Report of Two Cases and Review of the Literature.","authors":"Kaustav Bhowmick, Somnath Chakraborty, Sonali Dey, Saptadeep Misra, Juber Khan, Arghya Chattopadhyay, Pasang Lhamu Sherpa","doi":"10.31138/mjr.220625.rra","DOIUrl":"https://doi.org/10.31138/mjr.220625.rra","url":null,"abstract":"<p><strong>Aim: </strong>The present case-based review aims to highlight two successfully treated cases of juvenile lupus retinopathy in a 15-year-old and a 17-year-old female with a review of literature highlighting the clinical profile and the treatment modalities used in those cases.</p><p><strong>Methods: </strong>A comprehensive literature search for vision-threatening juvenile lupus retinopathy on Medline/PubMed, Scopus, Web of Science, and Directory of Open Access Journals (DOAJ) revealed 27 cases from 25 case reports.</p><p><strong>Results: </strong>The interval between visual loss and treatment initiation was three days (range: 0- 2 months). The most prevalent fundoscopic findings were cotton-wool spots in 18 (66.7%). IV Cyclophosphamide (CYC) was the most commonly used immunosuppressive agent in 12 cases (44.4%). Retinal photocoagulation was the principal intraocular treatment modality employed in 11 cases (40.7%). The majority of JLR cases (17; 63%) showed excellent vision recovery.</p><p><strong>Conclusion: </strong>Juvenile lupus retinopathy is a rare yet severe manifestation of juvenile lupus and can have excellent outcomes if addressed early and aggressively.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"220-235"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145285/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843649","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":"Giant Cell Myocarditis: Is It Time to Redeploy Cytokine Inhibitors?","authors":"Deepak Nagra, Iyantha Sarindhi Kuruppurachchi, Kaiyang Song, Mark Russell, Katie Bechman, Maryam Adas, Zijing Yang, Chamith Rosa, Siwalik Banerjee, Olivia Flowers, Chris Wincup, Arti Mahto, Daniel Bromage, Nicola Gullick, James Galloway","doi":"10.31138/mjr.240725.eca","DOIUrl":"https://doi.org/10.31138/mjr.240725.eca","url":null,"abstract":"<p><p>Giant cell myocarditis (GCM) is a rare, aggressive T-lymphocyte-mediated inflammatory cardiac disorder associated with high mortality. Diagnosis relies on endomyocardial biopsy, revealing lymphocytic infiltrates, granulomas, and myocyte necrosis, with cardiac MRI serving as a valuable non-invasive adjunct. Due to its rarity and coding limitations, GCM remains poorly captured in epidemiological data, hindering robust clinical trials. Current treatment strategies are largely based on case reports and off-label immunosuppressive use, with limited success using conventional DMARDs. Emerging evidence supports targeting T-cell-mediated and cytokine-driven pathways, including TNF inhibitors, JAK inhibitors (e.g., tofacitinib, ruxolitinib), and IL-2-targeted therapies (e.g., basiliximab). Tofacitinib, in particular, offers rapid, broad-spectrum immunomodulation and favourable pharmacokinetics. Although high-quality evidence is lacking, real-world data and coordinated international efforts (e.g., multicentre case series, registries) may help define optimal therapeutic strategies. With increasing availability of biosimilars and off-patent biologics, early cytokine inhibition could represent a paradigm shift in the management of this life-threatening condition.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"247-250"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145283/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843133","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":"Age-Related Microbiota Signatures in Inflammatory Diseases: Comparative Insights into Paediatric and Adult Crohn's Disease, Ulcerative Colitis, and Spondyloarthritis.","authors":"Giancarlo Gimignani, Alessandro Borello, Cristina Panetta, Linda Lucchetti, Roberta Caorsi, Marco Gattorno, Alessandro Conforti","doi":"10.31138/mjr.290825.mid","DOIUrl":"https://doi.org/10.31138/mjr.290825.mid","url":null,"abstract":"<p><strong>Objectives: </strong>The study investigated the relationship among the human microbiota in the development and progression of inflammatory bowel diseases (IBD), specifically Crohn's Disease (CD) and Ulcerative Colitis (UC), as well as Spondyloarthritis (SpA), comparing paediatric and adult populations.</p><p><strong>Methods: </strong>The research elaborated the distinct characteristics and impacts of CD, UC, and SpA across age groups. It further explored the developmental stages of the paediatric microbiota, identifying factors like delivery method, feeding, and antibiotics as critical influencers. It examined specific dysbiosis patterns in paediatric IBD and SpA associated to disease activity. Subsequently, it addressed the adult microbiota's stability and variations due to diet, lifestyle, and medications, detailing microbial alterations in adult CD, UC, and SpA.</p><p><strong>Results: </strong>A comparative analysis underscores age-related differences in microbiota composition, clinical manifestations, and treatment responses, indicating greater yet weaker microbial populations in adults. In paediatric patients, there was a marked decrease in <i>Faecalibacterium prausnitzii</i> and other bacteria responsible for producing short-chain fatty acids. In contrast, adults tended to show a more persistent form of dysbiosis and lower microbiome resilience. These disparities in microbial and metabolic phenotypes were strongly associated with the activity of the disease and the response to the treatment, which suggests the potential of microbiota-based biomarkers to create age-specific diagnostic and therapeutic approaches.</p><p><strong>Conclusion: </strong>This research found that microbiota play a great role in the inflammatory diseases and they can be of great use in the current treatments as well as serve as a biomarker. The new targeted therapies underscored the necessity of patient specific microbiome studies to enhance diagnostics and therapies of these disorders throughout the lifespan.</p>","PeriodicalId":32816,"journal":{"name":"Mediterranean Journal of Rheumatology","volume":"37 1","pages":"146-155"},"PeriodicalIF":0.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13145294/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147843744","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}