Advances in Rheumatology最新文献

{"title":"Cytomegalovirus infection in patients with rheumatic disorders under rituximab treatment: a scoping review.","authors":"Erta Rajabi, Kousha Farhadi, Hesam Aldin Varpaei, Maryam Sadat Fakhri Bafghi, Fateme Ghanbari, Ali Afshari, Abdolrahman Rostamian, Hossein Khalili, Mohammadreza Salehi","doi":"10.1186/s42358-025-00514-y","DOIUrl":"10.1186/s42358-025-00514-y","url":null,"abstract":"<p><p>BACKGROUND: Cytomegalovirus (CMV), a DNA virus known for asymptomatic infections in immunocompetent individuals, can lead to fatal complications in the setting of immunosuppression. Rituximab (RTX) is an anti-CD20 monoclonal antibody with immunosuppressive properties, used as a first-line treatment choice for various rheumatic disorders. Although multiple reviews have analyzed the effects of RTX on CMV infection incidence in the population with a history of transplantation and malignancies, limited data are available on CMV incidence in those with rheumatic disorders under RTX treatment. METHODS: In August 2025, a thorough search in PubMed, EMBASE, Web of Science, MEDLINE (Ovid), and Scopus was conducted according to the framework proposed by Arksey and O’Malley, and the PRISMA-ScR guidelines were employed for reporting and structuring the research question (Population: individuals with rheumatic disorders, Concept: association between RTX administration and CMV infection, Context: RTX exposure) Tricco (Ann Intern Med 169(7):467-73, 2018). Original English studies on human subjects with rheumatic disorders infected with CMV infection or disease were included. The RTX dosage range was defined as low (doses < 500 mg per infusion), moderate (doses ranging from 500 to 1000 mg per infusion), and high (doses ≥ 1000 mg per infusion). Following abstract and full-text screening, relevant data were compiled into an Excel spreadsheet. RESULTS: A total of 13 studies, involving 459 patients, were recorded, among which 23 (5.01%) CMV infectious episodes were identified, most commonly reported as reactivation (39.13%, n = 9). The majority of CMV episodes occurred in individuals with anti-neutrophil cytoplasmic antibody-associated vasculitis and dermatomyositis, accounting for six cases. Six (2.57%), 10 (83.33%), and one (1.31%) infectious episode were reported among those with a history of low-, moderate-, and high-dose infusions, respectively. One fatal episode of CMV pneumonia occurred in a female patient diagnosed with MPA who was previously treated with four low-dose infusions of RTX. CONCLUSION: This review’s findings illustrated a 5% prevalence of CMV infection following RTX infusion in patients with rheumatic disorders. Accurately estimating the infection burden of this population requires more extensive and precise studies. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918902","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":"Impact of male sex in clinical and laboratory features of systemic sclerosis.","authors":"Ana Paula Luppino-Assad, Rodrigo Vidaurre, Osvaldo Camata, Renata Miossi, Adriana Bruscato Bortoluzzo, Eduardo Ferreira Borba, Ana Cristina Medeiros-Ribeiro, Percival D Sampaio-Barros","doi":"10.1186/s42358-025-00517-9","DOIUrl":"10.1186/s42358-025-00517-9","url":null,"abstract":"<p><p>BACKGROUND: Although systemic sclerosis (SSc) predominantly affects the female sex, male patients tend to present a more severe visceral profile and worse prognosis. This study aims to analyze the clinical and laboratory characteristics of male patients in a large single SSc cohort. METHODS: This retrospective study analyzed 700 patients followed regularly at a single tertiary outpatient SSc center. Patients were classified according to the 2013 ACR/EULAR SSc criteria, and all data were retrieved from an electronic database. Statistical analyses included comparing demographic and clinical data, Kaplan-Meier survival curves, and multivariate analyses using SigmaStat 14.5. RESULTS: There were 612 women (87.4%) and 88 men (12.6%). Male patients were more frequently African-Brazilians (p = 0.005), and showed a significantly shorter disease duration compared to females (10.1 vs. 13.8 years, p < 0.001), with higher rates of environmental exposures (37.5% vs. 8.2%, p < 0.001), and more severe fibrotic manifestations, including skin thickening score (p = 0.004), diffuse SSc (p = 0.005), and extensive interstitial lung disease (p = 0.013). Men also had higher rates of group 3 pulmonary hypertension (p = 0.018), congestive heart failure (p = 0.001), and required more aggressive treatments such as cyclophosphamide (p < 0.001) and rituximab (p = 0.002). Although there were no significant sex differences in the frequency of vascular manifestations or joint involvement, men had lower rates of positivity for antinuclear antibodies (ANA) (p = 0.047) and anti-centromere antibodies (ACA) (p = 0.001). Male sex was associated with increased mortality (hazard ratio 2.3; 95% CI 1.4 to 3.8; p = 0.002) and survival rates at 1, 3, 5, and 10 years from diagnosis were 99.2%, 96%, 89%, and 75% for men, and 99%, 98%, 97%, and 93% for women (p < 0.001). CONCLUSION: Our study reinforces the association between male sex and more severe SSc, marked by greater skin involvement, worse pulmonary and cardiac outcomes, a higher prevalence of environmental exposures, and lower ACA positivity. These factors contributed to poorer survival outcomes in men compared to women. These findings underscore the need for a more comprehensive evaluation of clinical manifestations to better assess disease progression in male SSc patients. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":" ","pages":"12"},"PeriodicalIF":2.8,"publicationDate":"2026-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145918900","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":"Blood levels of brain-derived neurotrophic factor (BDNF) in psoriasis: a systematic review and meta-analysis.","authors":"Mohammad Sharifi Sarasyabi, Niloofar Seighali, Maryam Abdolmaleki, Parnian Shobeiri, Mohammad R Movahed, Farshid Bozorgnia, Saba Maleki","doi":"10.1186/s42358-025-00515-x","DOIUrl":"10.1186/s42358-025-00515-x","url":null,"abstract":"<p><p>INTRODUCTION: Psoriasis is a chronic inflammatory skin condition affecting 0.1–1.5% of the global population. The condition is linked to impaired quality of life and increased morbidity. Brain-derived neurotrophic factor (BDNF) is a neurotrophin associated with neuronal development and synaptic plasticity; its dysregulation has been implicated in the pathogenesis of psoriasis. This study systematically reviews and analyzes the relationship between BDNF levels and psoriasis. METHODS: A systematic review and meta-analysis were conducted by the PRISMA 2020 guidelines. Comprehensive searches were performed on MEDLINE, Scopus, EMBASE, and Web of Science databases up to January 19th, 2024. Eligible studies measured circulating BDNF levels in psoriasis patients and compared them with healthy controls. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of included studies. Meta-analyses were performed using standardized mean differences (SMD) with either fixed or random-effects models based on heterogeneity measures. RESULTS: Six studies met the inclusion criteria, with data from 2006 to 2020. Meta-analysis revealed a significant reduction in BDNF levels in psoriasis patients compared to healthy controls (SMD −0.577, 95% CI [−0.915, −0.239], p = 0.0008). Heterogeneity was substantial (I2 = 70.2%). Sensitivity analysis identified one study as a major contributor to heterogeneity. No significant factors contributing to heterogeneity were identified through meta-regression. CONCLUSION: This study found a significant reduction in BDNF levels in psoriasis patients, suggesting a potential link between BDNF dysregulation and the pathophysiology of psoriasis. Understanding the role of BDNF in these conditions may inform future research and therapeutic strategies for patients suffering from both. Further research is needed to explore the relationship and the mechanisms underlying the associations of psoriasis and any probable related comorbidities, such as depression. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"66 1","pages":"2"},"PeriodicalIF":2.8,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488749/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906890","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":"Tuberculosis incidence in patients treated with secukinumab - a real-world study in Brazil.","authors":"Felipe Merchan Ferraz Grizzo, Sineida Maria Berbert Ferreira, Maria Victória Suárez Restrepo, Anber Ancel Tanaka, André Vicente Esteves de Carvalho, Roberto Ranza, Felipe Thies, Juliana Cabrera Garrido","doi":"10.1186/s42358-025-00496-x","DOIUrl":"10.1186/s42358-025-00496-x","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB) remains a global health challenge, especially in low- and middle-income countries. Tumor necrosis factor alpha (TNFα) plays a crucial role in the immune response to TB. TNF inhibitors were the first biologic agents approved for treating chronic inflammatory diseases such as psoriasis (PsO), axial spondyloarthritis (axSpA) and psoriatic arthritis (PsA). Despite their efficacy, TB risk is a concern. The development of new biological therapies, as IL-17 inhibitors, has improved these diseases' management; however, data regarding TB risk remain scarce. This study assessed TB incidence in Brazilian patients with PsO, axSpA and PsA treated with secukinumab.</p><p><strong>Methods: </strong>This real-world retrospective study included Brazilian patients treated for at least 24 months, aged ≥ 18 years, without confirmed tuberculosis diseaseTBD. Data were extracted from medical charts. Descriptive analyses used mean or median, standard deviations, and quartiles for continuous variables and absolute frequencies and percentages for categorical variables with 95% confidence intervals calculation, as applicable.</p><p><strong>Results: </strong>152 participants were included, with a mean follow-up of 40.1 months, predominantly PsA (n = 90) and white (84.6%), with an average age of 52 years (IQR: 42-61) and a slightly male predominance (50.7%). Hypertension for PsA (11.9%) and PsO (16.3%), and fibromyalgia for axSpA (16.0%) patients were the most common comorbidities. PsO patients had the longest disease duration (184.6 months). Secukinumab loading doses were administered to 141 patients, with 78% receiving 300 mg. Maintenance doses were 300 mg for 77% of the patients. Secukinumab treatment was discontinued in 18 patients (11.8%). On average, patients were on 3.35 concomitant medications before secukinumab, dropping to 2.26 afterward, with methotrexate being the most used medication before secukinumab. No TBD cases were recorded. Tuberculosis infection (TBI) testing showed some positive results, and preventiveantibiotic therapy was administered as needed. Most patients remained negative for TBI after treatment. No safety-related information was detailed.</p><p><strong>Conclusion: </strong>This real-world evidence study demonstrated that no TBD cases were recorded even after receiving secukinumab, and most patients were negative for TBI. Further studies are recommended to enhance the knowledge of TB prevention among patients with axSpA, PsO, and PsA.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"65"},"PeriodicalIF":2.8,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488818/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858564","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":"Interleukin-4 and clinical activity in rheumatoid arthritis: a sex-based analysis.","authors":"Eduardo Jahir Angulo-De La Cruz, José de Jesús Ruelas-Hernández, Gabriela Athziri Sánchez-Zuno, Samuel García-Arellano, Edsaúl Emilio Pérez-Guerrero, Valeria Miroslava Limón-López, José Francisco Muñoz-Valle, Sergio Cerpa-Cruz, Christian Johana Baños-Hernández, Ilce Valeria Román-Fernández","doi":"10.1186/s42358-025-00500-4","DOIUrl":"10.1186/s42358-025-00500-4","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis (RA) is an autoimmune inflammatory disease characterized by the dysregulation of multiple cytokines. In RA, Interleukin (IL)-4 levels fluctuate throughout disease progression, exerting a pathogenic role at onset and an anti-inflammatory role in later stages. Evidence suggests that IL-4 levels also differ between sexes and may be associated with disease severity. Thus, this study aimed to assess sex-based differences in IL-4 serum levels among patients with RA and determine whether these differences correlate with clinical parameters.</p><p><strong>Methods: </strong>A total of 51 patients with RA (34 females and 17 males) and a control group of 24 sex- and age-matched individuals were included. IL-4 serum levels were quantified using a multiplex bead-based assay, and clinical parameters-including disease duration, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), rheumatoid factor (RF), anti-citrullinated protein antibodies (ACPA), disease activity score (DAS28), and health assessment questionnaire disease index (HAQ-DI)-were analyzed using the Mann-Whitney U test and Spearman's correlation coefficient. Non-parametric effect size was determined using the Hodges-Lehmann estimator of the median difference, and a multivariate linear regression analysis was performed to account for potential confounding variables.</p><p><strong>Results: </strong>IL-4 levels were significantly lower in RA patients compared to controls (p < 0.0001), with male patients exhibiting higher IL-4 levels than female patients (p = 0.001). IL-4 levels were negatively correlated with RF (p = 0.037) and DAS28 (p = 0.005) in the overall population, with disease duration in female patients (p = 0.033), and with CRP (p = 0.046) and DAS28 (p = 0.024) specifically in male patients.</p><p><strong>Conclusions: </strong>Higher IL-4 levels in males with RA may contribute to reduced inflammation, which is associated with lower disease activity. Conversely, lower concentrations of this cytokine in females may exacerbate disease progression. However, further studies are needed to confirm these findings.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"66"},"PeriodicalIF":2.8,"publicationDate":"2025-12-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145858641","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":"Use of Synofast® in routine rheumatology practice: diagnostic performance and impact on management of an acute arthritis.","authors":"F Badaire, C Lambert, C Chen Wa, Y Oyouba, R Marjorie, F Aupetit, N Guérin, Sylvain Mathieu, A Tournadre, Marion Couderc","doi":"10.1186/s42358-025-00506-y","DOIUrl":"10.1186/s42358-025-00506-y","url":null,"abstract":"<p><strong>Background: </strong>Septic arthritis (SA) is a rare but serious disease. There is no reliable marker for rapid diagnosis. Synofast® is a new device that analyses synovial fluid and can accurately rule out SA within 15 minutes.</p><p><strong>Objective: </strong>To evaluate the diagnostic performance of Synofast® in routine practice in patients with suspected SA and to assess its impact on patient care.</p><p><strong>Method: </strong>This was a monocentric prospective study of patients with acute arthritis of possible septic origin. In addition to the usual blood and synovial bacteriological tests, a drop of synovial fluid was taken for the Synofast® test, which provides three SA risk probabilities: \"low\", \"possible\" or \"high\". The physician recorded the management he would have given before the test and the management he actually gave after the test, knowing the diagnostic performance reported in previous studies.</p><p><strong>Results: </strong>Over one year, 43 patients were included, of whom eight had SA (18.6%). Sensitivity, negative predictive value (PV) and negative likelihood ratio (LR) were respectively of 75%, 93% and 0.32 when analysing for \"high\" and \"possible\" septic risk while specificity, positive PV and positive LR were respectively of 94%, 67% and 8.75 when analysing for \"high\" septic risk only. The test helps to avoid hospitalisations in 1/29 patients and to defer antibiotic in 1/7 patients. Follow-up and drug management remained unchanged in 95% and 89% of patients, respectively.</p><p><strong>Conclusion: </strong>Synofast® seems to be a valuable tool for the exclusion of SA. The results need to be confirmed in a larger population, especially the impact on management.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":" ","pages":"68"},"PeriodicalIF":2.8,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488796/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145811742","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":"The efficacy and safety of tocilizumab in juvenile localised scleroderma patients: a retrospective cohort study in Eastern China.","authors":"Yang Shen, Xiaoliang He, Jing Shan, Denghuan Chen, Yutong Gao, Xinrong Wang, Dingyun Chen, Shouwei Hang, Na Li, Daliang Xu","doi":"10.1186/s42358-025-00511-1","DOIUrl":"10.1186/s42358-025-00511-1","url":null,"abstract":"<p><strong>Background: </strong>Localised scleroderma is a rare autoimmune connective tissue disorder characterized by excessive collagen deposition leading to skin fibrosis. While methotrexate and glucocorticosteroid remain the first-line treatments, their limitations underscore the need to explore targeted biologic therapies. Tocilizumab, an IL-6 receptor antagonist, has shown promise in some systemic autoimmune diseases, but its role in juvenile localised scleroderma remains unclear. This study retrospectively evaluates the efficacy and safety of tocilizumab in juvenile localised scleroderma patients.</p><p><strong>Methods: </strong>This retrospective study analysed 12 juvenile localised scleroderma patients treated at Anhui Province Children's Hospital between January 2021 and December 2024. Patients were grouped based on early versus delayed initiation of tocilizumab. Clinical response was measured using mLoSSI and LoSDI scores. Laboratory markers (ALT, AST, cholesterol, triglycerides, CRP) and immune indicators (CD4, CD19, IgG) were assessed alongside treatment duration. Safety and glucocorticosteroid usage were also evaluated.</p><p><strong>Results: </strong>Five patients received tocilizumab from treatment onset, while seven were treated later. The tocilizumab initial use group had a significant lower relapse rate, compared to the delayed group. Longer treatment with tocilizumab had a protective effect on liver function and lipid metabolism, due to less abnormal ALT and triglyceride. No statistically significant relationship was observed between IgG deficiency and the duration of tocilizumab therapy; only one patient developed IgG deficiency, which resolved after a three-week interruption of treatment. Tocilizumab also reduced glucocorticosteroid reuse and duration of usage.</p><p><strong>Conclusion: </strong>Tocilizumab appears to be a safe and effective adjunctive therapy for juvenile localised scleroderma, particularly when initiated early, as it reduces relapse risk and the need for prolonged glucocorticosteroid use. It remains a promising adjunct in refractory or severe cases requiring long-term management.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2025-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488795/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145800073","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":"Shortened telomere length, anxiety and psychological stress in systemic lupus erythematosus: a cross-sectional study.","authors":"Anna Carolina Faria Moreira Gomes Tavares, Carolina Ruas Freire Santos, Jéssica Martins Amaral, Ivonne Carolina Bolaños Burgos, Daniela Valadão Freitas Rosa, Marco Aurélio Romano-Silva, Maria Aparecida Camargos Bicalho, Gilda Aparecida Ferreira, Adriana Maria Kakehasi","doi":"10.1186/s42358-025-00510-2","DOIUrl":"10.1186/s42358-025-00510-2","url":null,"abstract":"<p><strong>Background: </strong>Oxidative stress and inflammation contribute to telomere length (TL) attrition, a hallmark of cellular senescence. Systemic lupus erythematosus (SLE) is associated with premature cellular aging; however, the clinical relevance of TL shortening remains unclear. This study aimed to compare the relative TL of SLE patients and healthy controls and explore its association with clinical features and disease burden.</p><p><strong>Methods: </strong>We conducted a cross-sectional study including adult SLE patients and age- and sex-matched healthy controls (18-60 years). Demographic and clinical data were collected, and TL was measured using quantitative polymerase chain reaction (qPCR). Among SLE patients, disease activity, cumulative damage, fatigue, depression, anxiety, stress, and physical activity were also assessed. Statistical analyses included descriptive statistics, Student's t-test or Mann-Whitney test for group comparisons, Spearman's correlation, and multiple linear regression models selected based on the lowest Akaike information criterion (AIC).</p><p><strong>Results: </strong>Sixty SLE patients (37 years ± 11.5) and 55 controls (38 years ± 10.5) were enrolled. SLE patients exhibited significantly shorter TL [median (IQR): 0.80 (0.29-2.94)] compared to controls [1.07 (0.38-2.32); p = 0.005]. In multivariate analysis, moderate anxiety was associated with shorter TL compared to none/low anxiety [β= -0.353 (95%CI: -0.645; -0.061); p = 0.019]. An alternative model indicated that moderate stress was also associated with reduced TL [β= -0.411 (95%CI: -0.771; -0.050); p = 0.026]. No significant associations were found between TL and disease activity or cumulative damage.</p><p><strong>Conclusions: </strong>SLE patients presented significantly shorter telomeres than healthy controls, with anxiety and stress symptoms contributing to TL attrition. Longitudinal studies are warranted to elucidate the clinical implications of TL shortening in SLE.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":" ","pages":"8"},"PeriodicalIF":2.8,"publicationDate":"2025-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488778/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145769559","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":"AFG2B gene variants and elevated protein expression in lupus nephritis: new insights into childhood-onset systemic lupus erythematosus.","authors":"Paola Pinheiro Kahwage, Graziella Ribeiro de Sousa, Ronald Rodrigues de Moura, Fabiano Pinto Saggioro, Inalda Facincani, Denise do Nascimento Queiroga, Veridiana Kiill Suazo, Rosane Gomes de Paula Queiroz, Davi Casale Aragon, Virginia Paes Leme Ferriani, Paula Sandrin-Garcia, Luciana Martins de Carvalho","doi":"10.1186/s42358-025-00509-9","DOIUrl":"10.1186/s42358-025-00509-9","url":null,"abstract":"<p><p>BACKGROUND: Previous genome-wide association studies (GWAS) have associated chronic kidney disease with AFG2B variants. The AFG2B protein is linked to key immune-regulating processes through its interaction with proteasome proteins implicated in systemic inflammation. Dysregulation of these processes is a key factor in the onset of childhood-onset systemic lupus erythematosus (cSLE). This study aimed to investigate the frequency of AFG2B gene variants and the renal expression of the AFG2B protein in cSLE. METHODS: This two-phase, cross-sectional observational study included 45 patients with cSLE from a tertiary hospital in Brazil. In the first phase, we determined the frequency of variants in the AFG2B gene using PCR followed by Sanger sequencing. In the second phase, we analyzed AFG2B protein expression via immunohistochemistry in renal biopsies from patients with lupus nephritis (LN) and analyzed two publicly available databases from the Gene Expression Omnibus (GEO)—GSE32591 and GSE127797. To compare AFG2B expression in the LN, we used renal biopsy samples from patients undergoing nephrectomy for non-renal diseases (disease-free controls). We also performed modeling and molecular dynamics of AFG2B protein variants with pathogenic potential. RESULTS: One patient with cSLE (2.2%) had a missense variant in exon 5 of the AFG2B gene (c.1774 A > G); molecular dynamics studies indicated this variant (p.N592D) is more stable than the wild-type protein. Twenty-five patients (55.5%) had an intronic variant (g.12211 A > G), and one patient (2.2%) had a novel intronic variant in heterozygosity (g.13196 A > G). Kidney tissue samples from patients with cSLE exhibited significantly increased AFG2B protein expression compared to normal kidney tissues (p < 0.01). We also observed a positive correlation between AFG2B protein expression in the tubules and the urinary protein-to-creatinine ratio (UPCR) in patients with cSLE. CONCLUSIONS: AFG2B protein expression is significantly elevated in the renal tissues of patients with LN compared to that in controls. Furthermore, its expression in renal tubules correlated positively with the UPCR. These results suggest a potential role for this gene in the pathophysiology of cSLE and warrant further functional investigation. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":" ","pages":"11"},"PeriodicalIF":2.8,"publicationDate":"2025-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145752224","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":"Outcomes and Trends of Pneumocystis Pneumonia in hospitalized patients with autoimmune diseases: Insights from the National Inpatient Sample.","authors":"Sopio Motsonelidze, Farhana Alam, Hafiza Mahwish Sadiq, Tarun Parvataneni, Aneta Tarasiuk-Rusek, Khalid Abusaada","doi":"10.1186/s42358-025-00508-w","DOIUrl":"10.1186/s42358-025-00508-w","url":null,"abstract":"<p><p>INTRODUCTION: Pneumocystis jirovecii is an opportunistic fungus that can cause life-threatening Pneumocystis jirovecii pneumonia (PJP) in immunocompromised patients. This study compared the incidence, characteristics, and outcomes of PJP-related hospitalizations in patients with autoimmune rheumatic diseases (ARDs) to those in patients with human immunodeficiency virus (HIV) from 2016 to 2021. METHODS: We identified PJP-related hospitalizations recorded in the National Inpatient Sample (NIS) database between 2016 and 2021. ICD-10 diagnosis codes were used to identify patients with PJP, HIV, ARDs, malignancies, or organ transplants. Patients with both HIV and ARD were classified under the HIV group. This retrospective analysis utilized descriptive statistics and multivariable logistic regression to evaluate the impact of demographics and comorbidities on clinical outcomes. RESULTS: A total of 10,725 hospitalizations with a principal diagnosis of PJP were identified. Patients with ARDs—without concurrent HIV, malignancy, or organ transplant—accounted for 5.2% of PJP-related hospitalizations. Compared to patients with HIV, those with ARDs had a significantly higher in-hospital mortality rate (24.2% vs. 8.7%, p < 0.001), underwent bronchoscopy more frequently (51.8% vs. 36.6%, p < 0.001), had longer length of stay in the hospital (13.97 days vs. 11.51 days, p < 0.001), and had higher cost of care (196,083US$ vs. 136,978US$ p < 0.001). Non-HIV status remained an independent predictor of poor outcomes even after adjustment for confounders. CONCLUSION: Patients with ARDs face a significantly higher risk of PJP-related mortality and undergo bronchoscopies more frequently compared to those with HIV. Further research is warranted to identify predictive factors and to inform the development of early detection and treatment strategies aimed at improving outcomes in ARD patients with PJP. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":" ","pages":"6"},"PeriodicalIF":2.8,"publicationDate":"2025-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488757/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145745236","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}