Advances in Rheumatology最新文献

{"title":"Determinants of myocardial fibrosis in patients with immune-mediated inflammatory diseases.","authors":"Nicholas Black, Joshua Bradley, Fardad Soltani, John P Farrant, Josephine H Naish, Matthias Schmitt, Maya H Buch, Christopher A Miller","doi":"10.1186/s42358-025-00451-w","DOIUrl":"10.1186/s42358-025-00451-w","url":null,"abstract":"<p><strong>Background: </strong>Myocardial fibrosis is an important adverse prognostic marker, however; determinants of myocardial fibrosis in immune-mediated inflammatory diseases (IMIDs) remain poorly defined. We aimed to identify determinants of myocardial fibrosis in patients with IMIDs, as measured by cardiovascular magnetic resonance (CMR) extracellular volume (ECV).</p><p><strong>Methods: </strong>Cross-sectional study of 116 patients with IMIDs undergoing clinical CMR at Manchester University NHS Foundation Trust. IMIDs included rheumatoid arthritis, systemic lupus erythematosus, systemic sclerosis (SSc), ankylosing spondylitis, psoriatic arthritis and vasculitis. CMR included pre- and post-contrast T1 mapping to measure myocardial ECV, with same day blood sampling. Determinants of ECV were investigated with univariable and multivariable linear regression.</p><p><strong>Results: </strong>ECV varied significantly according to IMID diagnosis (ANOVA F statistic 2.80, P = 0.015); ECV was higher in patients with SSc compared to other IMIDs. Major determinants of ECV as a continuous variable were SSc, smoking and body mass index (BMI); regression coefficients 3.33 (95% confidence interval 0.82-5.84), 3.08 (0.73-5.43), and - 0.19 (-0.29 - -0.09) respectively, P < 0.01 (SSc, smoking and lower BMI were associated with increased ECV). Approximately a quarter of the variability in ECV could be explained by these predictors (optimism adjusted R² 0.265).</p><p><strong>Conclusion: </strong>SSc is associated with a higher burden of myocardial fibrosis compared to other IMIDs. In patients with IMIDs, independent determinants of myocardial fibrosis were presence of SSc, smoking and BMI. Importantly, participants underwent CMR for clinical indications and may not be representative of IMID populations in the community.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"28"},"PeriodicalIF":2.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12167332/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144295081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fibromyalgia with concomitant immune-mediated rheumatic diseases: an evaluation of clinical characteristics, diagnostic criteria and multimodal treatment outcomes.","authors":"Johanna Mettler, Pedro Ming-Azevedo, Thomas Hügle","doi":"10.1186/s42358-025-00457-4","DOIUrl":"https://doi.org/10.1186/s42358-025-00457-4","url":null,"abstract":"<p><strong>Objectives: </strong>Fibromyalgia (FM) is a relevant comorbidity in immune-mediated rheumatic diseases (IMRD). Immune mechanisms have been postulated to trigger FM, potentially leading to distinct clinical features compared to FM occurring without IMRDs. This study aims to provide a comprehensive comparison of FM characteristics in patients with and without concomitant IMRD and to evaluate the differences in diagnostic FM criteria between the two groups.</p><p><strong>Methods: </strong>A comprehensive dataset of clinical, psychosocial, and sleep variables, along with validated questionnaires, was prospectively collected from 341 patients with chronic musculoskeletal pain syndromes who participated in a rheumatology-led, two-week multimodal inpatient program at the University Hospital of Lausanne between 2018 and 2024. Participants were included if they met either the Fibromyalgia Rapid Screening Tool (FiRST) or the American College of Rheumatology (ACR) 2010 criteria for FM. The disease activity of the underlying IMRD was assessed by two rheumatologists. Data were separately analyzed in two cohorts: one fulfilling the FiRST criteria and the other fulfilling the ACR 2010 criteria.</p><p><strong>Results: </strong>Among the participants, 153 patients met the FiRST criteria, of whom 34 also had a history of clinically diagnosed IMRD. Similarly, 149 patients fulfilled the ACR 2010 criteria, with 32 of them also having IMRD. The most common IMRDs were HLA-B27-negative spondyloarthritis (53%), Sjögren's syndrome (16%), HLA-B27-positive spondyloarthritis (9%), psoriatic arthritis (9%), seronegative rheumatoid arthritis (9%), and seropositive rheumatoid arthritis (3%). In 88% of patients with IMRD, the disease was considered inactive. No significant clinical or epidemiological differences were found between FM patients with or without IMRD in either the FiRST or ACR 2010 cohorts, except for a higher prevalence of enthesopathies and childhood pain in patients with concomitant IMRD. FM patients with IMRD had slightly lower FiRST scores, and FiRST-positive IMRD patients showed a better short-term response to the multimodal program, particularly in FABQ-work, BPI-interference, and Pain Catastrophizing Scale scores. However, no significant difference was observed in the Pain Disability Index (PDI) three months post-program.</p><p><strong>Conclusion: </strong>HLA-B27-negative spondyloarthritis and Sjögren's syndrome were the most common concomitant IMRDs in this FM cohort. FM patients with and without IMRD exhibited similar clinical and epidemiological features, suggesting a common pathophysiological background. The FiRST criteria, which emphasize central hypersensitization rather than diffuse pain, appear to be a suitable tool for detecting FM in IMRD patients. This may be particularly useful in cases where enthesial pain might interfere with FM diagnosis, and vice versa.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"27"},"PeriodicalIF":2.0,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144286894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A real-life study of juvenile idiopathic arthritis from two Brazilian referral centers for pediatric rheumatology.","authors":"Ana María Loroño Terrazas, Raúl Gutiérrez Suárez, Reinan Tavares Campos, Claudio Arnaldo Len, Nadia Emi Aikawa, Jade Dib Fernandez, Mayra Lisyer Dantas, Clóvis Artur Silva, Gleice Clemente, Maria Teresa Terreri","doi":"10.1186/s42358-025-00459-2","DOIUrl":"10.1186/s42358-025-00459-2","url":null,"abstract":"<p><strong>Background: </strong>Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood, but its outcomes are still difficult to determine. We aimed to obtain outcome measurements of disease activity, functional capacity, disease damage, and therapeutic response, at one-year follow-up study on a real-life basis.</p><p><strong>Methods: </strong>An observational JIA cohort from two referral centers for pediatric rheumatology in Brazil Pediatric Rheumatology Centers was carried out over a period of one year. Clinimetric validated outcome measurements were applied over four visits. Multivariable logistic regression was performed to evaluate baseline variables associated with the following outcomes after one year of follow-up: disease activity, Minimal Disease Activity (MDA), disease flare, remission on medication and remission off medication.</p><p><strong>Results: </strong>A total of 127 patients were included in the study. Eighty-three (65.4%) were females, and median time to diagnosis was 6.0 months. JADAS71 and CHAQ improved during follow-up (mean Vbaseline 7.05 ± 9.3 vs. V52 3.52 ± 8.4; 0 ± 0.5 vs. 0.14 ± 0.4, p < 0.001, respectively) as well as JIA-ACR 30, 50, 70 and 90 (Vbaseline 79.8% vs. V52 88.8%; 71.4% vs. 84.1%; 59.7% vs. 77.6%; 49.6% vs. 69.2%, p < 0.05, respectively). Inactive disease was present in 33% of patients at baseline and in 67.9% at V52 (p < 0.001). Remission on medication, remission off medication and MDA were present in 46%, 11%, and 80.6% of patients at V52, respectively. Extra-articular and articular damage were not common at baseline (0.3 ± 0.7 and 1.1 ± 3.4 respectively) and did not decrease significantly during the period of the study. The presence of active joints 46/101 (45.5%) at baseline reduced the chance of the patient achieving remission off medication at the last visit by 84% (OR = 0.16; CI 95% from 0.03 to 0.91, p = 0.039).</p><p><strong>Conclusion: </strong>This study showed improvement in clinimetric outcome measurements and therapeutic responses in an inception cohort of JIA patients. The presence of active joints at baseline is related to not achieving remission at last visit. Long-term prospective and multicenter studies are needed to better assess the outcome of JIA and the differences among JIA subtypes.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"26"},"PeriodicalIF":2.0,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144276271","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"2025 Chinese guideline for the imaging diagnosis and evaluation of Takayasu arteritis.","authors":"Yun Liu, Lingying Ma, Zhuoli Zhang, Yan Zhao, Xuerong Deng, Jiang Lin, Jianxing Qiu, Hongcheng Shi, Ke Wang, Zhu Chen, Lie Dai, Lingli Dong, Xuebing Feng, Lan He, Wenhui Huang, Fen Li, Guangtao Li, Qin Li, Ting Li, Yisha Li, Jin Lin, Jinying Lin, Wufang Qi, Haili Shen, Xiaofei Shi, Qiang Shu, Wenfeng Tan, Caihong Wang, Wei Wei, Huaxiang Wu, Lijun Wu, Qibing Xie, Pingting Yang, Liyun Zhang, Ling Zhao, Zhaohui Zheng, Wenjie Zheng, Jing Zhu, Xiaochun Zhu, Xiaoqin Wang, Jun Ying, Lindi Jiang","doi":"10.1186/s42358-025-00460-9","DOIUrl":"10.1186/s42358-025-00460-9","url":null,"abstract":"<p><strong>Background: </strong>Takayasu arteritis (TAK) presents as systemic vasculitis. Imaging is crucial for the diagnosis and evaluation of TAK, but the rational selection of imaging methods and interpretation of imaging results are major challenges in clinical practice, which can affect treatment decisions. This guideline aims to establish standardized protocols for selecting imaging modalities (as well as interpreting their findings) in TAK.</p><p><strong>Methods: </strong>Relevant clinical questions were formulated by an expert panel. Systematic reviews of evidence published from database establishment to 31 October 2023 were done. The grading system set by the Oxford University Evidence-Based Medicine Center was employed to assess the quality of evidence. Recommendations were developed through consensus using the Delphi method.</p><p><strong>Results: </strong>Seventeen recommendation statements were developed based on evidence summaries and consensus. The first four recommendations focused on overarching principles. Recommendations 5 to 14 covered the advantages and disadvantages of different imaging modalities, as well as the selection of imaging modalities in the diagnosis and evaluation of TAK, including ultrasound (three statements), magnetic resonance angiography (two), computed tomography angiography (two), positron emission tomography/computed tomography (two), and digital subtraction angiography (one). Recommendations 15 to 17 focused on the selection of imaging methods for special populations and organ perfusion.</p><p><strong>Conclusion: </strong>These recommendations could help to standardize the use of imaging modalities by clinicians in the diagnosis and evaluation of TAK.</p><p><strong>Clinical trial number: </strong>Not applicable.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"25"},"PeriodicalIF":2.0,"publicationDate":"2025-06-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144217342","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Demographic, clinical, treatment, outcome, and comorbidities of patients with relapsing polychondritis: experience from Brazilian tertiary center, and literature review.","authors":"Patricia Pilar Lury Ortale Ueda, Luiz Antonio Leandrini Komati, Samuel Katsuyuki Shinjo","doi":"10.1186/s42358-025-00456-5","DOIUrl":"https://doi.org/10.1186/s42358-025-00456-5","url":null,"abstract":"<p><strong>Background: </strong>Due to the rarity of relapsing polychondritis (RP), we described the demographic, clinical, treatment, outcomes, and comorbidities of patients with RP from our tertiary service. Additionally, a literature review was conducted.</p><p><strong>Methods: </strong>A total of 47 Brazilian patients with RP between 2000 and 2024 were analyzed. All patient data were collected from pre-parametrized and pre-standardized electronic medical records. A literature review using PubMed with \"relapsing polychondritis\" as the search term included 25 articles after applying the strict exclusion criteria.</p><p><strong>Results: </strong>A total of 47 patients were evaluated. The median age was 40 (34-51) years, with a female-to-male ratio of 1.4:1, and 89.4% were of white ethnicity. The median time from symptom onset to diagnosis was 39 months and the median follow-up duration was 7 years. Ear cartilage biopsy was performed in 12.8% of cases. The clinical manifestations included auricular chondritis, arthralgia, and ocular involvement. Approximately half of the patients had hypertension and dyslipidemia, one-third had diabetes mellitus, and one-fifth had hypothyroidism. Tracheostomy and cochlear implantation were required in 12.8% and 6.4% of the patients, respectively. Disease outcomes showed that 46.8% of patients were in remission, 29.8% had active disease, and 25.5% were controlled with immunosuppressive therapy. Mortality occurred in 6.4% of the cases. In the literature review, 25 studies were analyzed, most of which originated in Asia. Studies have reported the classical manifestations of RP, such as auricular chondritis, arthritis, and ocular involvement. The median age of the patients with RP was similar across studies, averaging 46.4 years, with a predominance of female patients. A comparison with the literature showed consistency in clinical manifestations, particularly auricular chondritis and septum nasal chondritis, although few studies have explored comorbidities, disease evolution, and outcomes.</p><p><strong>Conclusions: </strong>The reviewed articles described classical clinical manifestations, but few articles reported data on other manifestations and comorbidities that can occur in RP. Our study provided new insights by mapping symptom evaluations, thereby enhancing the understanding of disease evolution. Understanding and characterizing RP will allow for better assistance in its diagnosis and follow-up.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"24"},"PeriodicalIF":2.0,"publicationDate":"2025-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144081272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of interstitial lung disease on systemic sclerosis hospitalizations, a national study (2002-2020).","authors":"Julia Jobanputra, Nikhil Furtado, Ali Bin Abdul Jabbar, Danielle B Dilsaver, Noureen Asghar, Mohsin Mirza, Joseph Nahas, Abubakar Tauseef","doi":"10.1186/s42358-025-00455-6","DOIUrl":"https://doi.org/10.1186/s42358-025-00455-6","url":null,"abstract":"<p><p>Systemic sclerosis (SSc) is an autoimmune connective tissue disorder that can cause generalized inflammation and is characterized by fibrosis of the skin, organs, and vasculopathy. Limited SSc is more common and typically associated with a milder disease course, whereas diffuse SSc, although less common, is linked to a higher mortality rate due to more frequent visceral organ involvement. One of the most common complications of SSc is interstitial lung disease (ILD). ILD is characterized by fibrosis, scarring, and inflammation of the lungs. ILD has a 30% prevalence and a 40% 10-year mortality in patients with SSc worldwide. Hospitalizations for SSc from 2002 to 2020 were obtained using the National Inpatient Sample (NIS), an all-payer administrative database that captures 97% of hospital discharges in the United States. The primary aim was to evaluate whether inpatient mortality, length of stay (LOS), and hospital cost differed if SSc patients had underlying ILD. We estimated multivariable logistic regression and log-normal models controlling for age, biological sex, race/ethnicity, income, and hospital setting. ILD was associated with 88% greater adjusted odds of inpatient mortality (aOR 95% CI: 1.53 to 2.31, p < 0.001), 15% longer stays (aOR 95% CI: 1.04 to 1.28, p = 0.001), and 33% higher adjusted hospital costs (aOR 95% CI: 1.26 to 1.40, p < 0.001). These findings suggest that SSc-ILD has a significant impact on hospitalization outcomes.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"23"},"PeriodicalIF":2.0,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144026250","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patients with overlapping dermatomyositis and psoriasis: an experience from a tertiary center and review of the literature.","authors":"Beatriz Westphalen Pomianoski, Samuel Katsuyuki Shinjo","doi":"10.1186/s42358-025-00454-7","DOIUrl":"10.1186/s42358-025-00454-7","url":null,"abstract":"<p><strong>Background: </strong>The coexistence of dermatomyositis (DM)/clinically amyopathic DM (CADM) and psoriasis has been infrequently documented in the literature. Consequently, this study aimed to analyze this entity from our tertiary center and review the relevant literature.</p><p><strong>Methods: </strong>This retrospective observational cross-sectional study and case series included patients with DM/CADM and psoriasis between 1998 and 2024. A literature review was also conducted.</p><p><strong>Results: </strong>Nine of 331 patients with DM (n = 265)/CADM (n = 66) had psoriasis; six were female, and all were of white ethnicity. The median age at DM diagnosis was 38 years (range: 18-78), and at psoriasis diagnosis was 43 years (range: 18-81), with a median interval of four years between diagnoses. The follow-up revealed that six patients were discharged, two died, and one continued follow-up. The primary comorbidities included systemic arterial hypertension (n = 3) and diabetes mellitus (n = 3). Four patients presented with varicella zoster (n = 1) or pulmonary tuberculosis (n = 3). Regarding the literature review, 15 articles reported a total of 17 cases of overlapping DM/CADM and psoriasis. However, variability was observed in the DM/CADM diagnostic criteria. The mean age at DM diagnosis in the literature was 32.3 years (range: 2-59), whereas for psoriasis, it was 31 (7-63) years. Female patients were predominant.</p><p><strong>Conclusion: </strong>This investigation identified the coexistence of DMPs, with a median age of 38 years for DM and 43 years for psoriasis. The variability in the diagnostic criteria underscores the necessity for standardized approaches to enhance patient management.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"22"},"PeriodicalIF":2.0,"publicationDate":"2025-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144039496","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of prior intra-articular corticosteroid injection in elderly patients with knee osteoarthritis undergoing progressive resistance training: a randomized controlled trial.","authors":"Christine Brumini, Rita Nely Vilar Furtado, Anamaria Jones, Raphael Vilela Timóteo da Silva, Jamil Natour","doi":"10.1186/s42358-025-00452-9","DOIUrl":"10.1186/s42358-025-00452-9","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the effectiveness of intra-articular injections (IAIs) with triamcinolone hexacetonide (TH) combined with a progressive resistance exercise program (PREP) in improving pain, function, muscle strength, and quality of life in elderly patients with knee osteoarthritis (OA).</p><p><strong>Methods: </strong>Fifty-nine elderly individuals with knee OA were randomized into three groups: IAI with TH (IAI-TH) + PREP, IAI with saline solution (IAI-SS) + PREP, and IAI with placebo + PREP. The IAIs were administered once, one week before starting PREP, which was performed twice weekly for 12 weeks. Outcomes assessed at baseline and at 2, 6, and 12 weeks post-IAI included pain (Numerical Pain Scale - NPS), swelling, function (Western Ontario and McMaster Universities Osteoarthritis Index - WOMAC), quality of life (Short Form-36 - SF-36), performance tests (Six-Minute Walk Test - 6MWT, Timed Up and Go Test - TUGT, Short Physical Performance Battery - SPPB), and muscle strength (one-repetition maximum test - 1RM). Due to the COVID-19 pandemic, only 15 participants per group completed the study protocol.</p><p><strong>Results: </strong>All groups showed significant intragroup improvements over time in pain, function, muscle strength, and quality of life. However, no statistically significant differences were found between the groups for any of the assessed outcomes. The bodily pain domain of the SF-36 and analgesic consumption were the only measures showing differences over time.</p><p><strong>Conclusion: </strong>The combination of IAI-TH and a 12-week PREP (twice weekly) was not superior to IAI-SS or placebo combined with the same PREP in improving pain, function, or quality of life in elderly patients with knee OA. These findings highlight the role of exercise as a key therapeutic strategy, regardless of prior IAI. Future studies with larger sample sizes and long-term follow-ups are needed to better assess the role of intra-articular corticosteroid injections in OA rehabilitation.</p><p><strong>Clinical trial number: </strong>ensaiosclinicos.gov.br (RBR-556md5g). Registered 27 October 2022.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"21"},"PeriodicalIF":2.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144052757","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of clinical impact of Interleukin 8 gene expression in patients with fibromyalgia.","authors":"Carolina Dias da Silva Amorim, Marco Felipe Macêdo Alves, Marcella Dias Teixeira, Larissa Vasconcelos Queiroz, Thaysa Walleria de Aragão Santos, Aline Ranzolin, Danyelly Bruneska Gondin Martins, Claudia Diniz Lopes Marques","doi":"10.1186/s42358-025-00453-8","DOIUrl":"https://doi.org/10.1186/s42358-025-00453-8","url":null,"abstract":"<p><strong>Background: </strong>Fibromyalgia (FM) is a musculoskeletal syndrome characterized by diffuse and chronic pain associated with other symptoms such as fatigue, sleep/cognition disorders, headache, depression and anxiety, resulting from a change in pain processing. Previous research has shown an increase in some interleukins (IL) in patients with FM when compared to controls, however, there is still no uniformity and consensus in the results. There is no study that evaluates IL8 mRNA expression in FM and its association with obesity and other clinical parameters. This study aims to verify the impact of IL8 mRNA expression on the clinical parameters of patients with FM (FMG) in relation to the comparison group (CG).</p><p><strong>Method: </strong>This study evaluated patients diagnosed with FM treated at the rheumatology service of the Hospital das Clínicas of the Federal University of Pernambuco (HC-UFPE). The CG group was composed of individuals without chronic pain (companions of the patients and hospital employees). Clinical and demographic data were collected in both groups, and questionnaires for fatigue (FACIT-F), impact of FM (FIQ-R), depression (BDI), and sleep (NRS) were applied to both groups. Peripheral blood was collected for evaluation of IL8 gene expression through real time polymerase chain reaction (qPCR).</p><p><strong>Results: </strong>Patients with FM show a lower frequency of IL8 gene expression compared to the CG, but FMG presented mainly up regulated in relation to CG. There was no association of IL8 expression and worse FIQ-R indices, sleep disturbance, BMI or fatigue. However, there was an association between IL8 expression and moderate depression (p = 0.002) and physical activity (p = 0.039), where patients in FMG who did express IL8 were practicing less physical activity.</p><p><strong>Conclusion: </strong>Patients in FMG did not have a higher frequency of IL8 expression compared to CG, however patients with IL8 expression have a greater association with moderate depression.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"20"},"PeriodicalIF":2.0,"publicationDate":"2025-04-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144051344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rituximab combined with intravenous immunoglobulin in autoimmune diseases: a systematic review.","authors":"Jozélio Freire de Carvalho, Thelma Laroca Skare","doi":"10.1186/s42358-025-00450-x","DOIUrl":"10.1186/s42358-025-00450-x","url":null,"abstract":"<p><strong>Background: </strong>Although using Rituximab (RTX) and intravenous immunoglobulin (IVIg) alone or sequentially is a well-established treatment for several autoimmune diseases, the combination of these two forms of therapy is still rare, and its use is poorly studied.</p><p><strong>Aim: </strong>To perform a systematic review on the use of RTX associated with IVIG in autoimmune conditions.</p><p><strong>Methods: </strong>PubMed/MEDLINE, EMBASE, and Scielo databases were screened for articles on RTX plus IVIg in autoimmune diseases until May 2024.</p><p><strong>Results: </strong>The review encompassed 21 studies evaluating RTX and IVIg for autoimmune diseases. Ten studies focused on pemphigus, involving 85 patients with diverse subtypes (47 pemphigus vulgaris, 27 pemphigoids, and 11 other variants). Most were case reports or series, with one retrospective study including controls. Positive outcomes were reported across all but one case of paraneoplastic pemphigus. Infections, such as P. jirovecii pneumonia, were noted in three studies, highlighting a potential risk. The other 11 studies involved 24 patients with conditions like polyneuropathies, lupus with CNS involvement, and neuromyelitis optica. While most reported favorable outcomes, one trial on IVIg-dependent polyneuropathies found RTX ineffective in reducing IVIg needs. Adverse events included pneumonia, venous thrombosis with pulmonary embolism, and infusion reactions, demonstrating the need for careful monitoring.</p><p><strong>Conclusion: </strong>RTX plus IVIg seems to be an alternative option for the treatment of refractory autoimmune diseases. However, more studies with a larger number of participants and in different autoimmune diseases are desired.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"19"},"PeriodicalIF":2.0,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}