Advances in Rheumatology最新文献

{"title":"Performance of ultrasonography in diagnosis of calcium pyrophosphate deposition disease amongst Bangladeshi patients: an observational study.","authors":"Farzana Shumy, Jannatul Ferdous, Ahmad Mursel Anam, George A W Bruyn, Zahid Amin, Minhaj Rahim Choudhury, Md Ismail Hosen","doi":"10.1186/s42358-025-00469-0","DOIUrl":"10.1186/s42358-025-00469-0","url":null,"abstract":"<p><p>OBJECTIVE: Due to protean presentations, poor sensitivity of radiographs and variable reliability of synovial fluid analysis, diagnosis of Calcium pyrophosphate deposition disease (CPPD) is a challenge. This study addressed the diagnostic performance of musculoskeletal ultrasound (MSK-USG) in identifying CPPD features in hyaline cartilage, fibrocartilage, tendon, and synovial fluid. We compared ultrasound findings in CPPD to those in osteoarthritis (OA) and gout and healthy control. MATERIALS & METHODS: In this retrospective exploratory study, MSK-USG performed between February 2022 and July 2023 were reviewed. Patients retrospectively fulfilled the ACR/ EULAR classification criteria 2023 (score ≥ 56) were included (n = 16). Clinical phenotypes included acute CPP arthritis (44%), CPPD with OA (44%), and chronic CPP arthritis (12%). Ultrasound images were evaluated at common CPPD target sites: hyaline cartilage and fibrocartilage of the knee, wrist triangular fibrocartilage, metacarpophalangeal joints, joint capsules, tendons, and synovial membranes. Ultrasound images of CPPD cases were compared to those of OA, gout, and healthy controls. Sensitivity, specificity, and predictive values were calculated for Ultrasound features. RESULTS: Compared to healthy controls, Ultrasound features showed a sensitivity of 94.12% (CI: 71.31–99.85), specificity of 100% (CI: 86.77–100), positive predictive value of 100%, and negative predictive value of 99.59% in diagnosing CPPD. Ultrasound findings in hyaline cartilage showed a sensitivity & a specificity of 100% each. Fibrocartilage involvement showed a sensitivity of 93.75% and specificity of 86.67%. Whereas these figures were lowest for tendons with sensitivity of 12.5% (CI: 1.55–38.35) and specificity of 86.67% (CI: 69.28–96.24), respectively. Compared to OA, sensitivity and specificity were 100% and 93.75%, respectively. Specificity was lower when compared to gout (40%). CONCLUSIONS: MSK-USG demonstrated high diagnostic accuracy in identifying CPPD, especially in hyaline cartilage and fibrocartilage. While these findings support the use of Ultrasound as an adjunctive diagnostic tool, particularly in distinguishing CPPD from OA, the small sample size and retrospective design limit generalizability. Prospective studies with larger cohorts and crystal-confirmed cases are needed for validation. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"50"},"PeriodicalIF":2.8,"publicationDate":"2025-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488683/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145368990","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":"Systematic review and meta-analysis of analgesic treatment options in patients with rheumatoid arthritis related pain.","authors":"Caleb Lautenschlager, Ashton Stropes, Andrew Smith, Maureen E Knell, Morgan Sperry","doi":"10.1186/s42358-025-00484-1","DOIUrl":"10.1186/s42358-025-00484-1","url":null,"abstract":"<p><strong>Background: </strong>Rheumatoid arthritis is a chronic autoimmune disorder characterized by joint destruction and inflammation. Persistent pain is a common symptom, often impacting quality of life, physical function, and mental health. Despite its prevalence, limited guidance exists for managing chronic rheumatoid arthritis-related pain. This systematic review and meta-analysis aimed to evaluate the effectiveness of various analgesic therapies for managing rheumatoid arthritis-related pain symptoms.</p><p><strong>Methods: </strong>A comprehensive search of PubMed, EMBASE, Cochrane, and ClinicalTrials.gov was conducted from database inception through November 7, 2024. Eligible studies included randomized controlled trials and prospective cohorts reporting pain outcomes in adult rheumatoid arthritis patients. Pain score data was stratified by scale (5-point, 10-point, 100-point) and analyzed using a random-effects model.</p><p><strong>Results: </strong>Twenty-six studies covering 52 treatment regimens were included. Etodolac demonstrated significant pain reduction on a 5-point scale (200 mg: 3.24; 95% CI: 2.86 to 3.63; p < 0.001; 300 mg: 3.35; 95% CI: 2.96 to 3.74; p = 0.00). Piroxicam also showed benefit (20 mg: 3.35; 95% CI: 2.91 to 3.78; p < 0.001). On the 10-point scale, only extracorporeal shock wave therapy significantly reduced pain (3.36; 95% CI: 2.25 to 4.48; p < 0.001). Celecoxib (Celbesta) (200 mg BID) was most effective in the 100-point subgroup (1.73; 95% CI: 1.32 to 2.15; p < 0.001). Heterogeneity was high (I² = 91.1%, 94.1%, 60.2%; all p < 0.05), and publication bias was present.</p><p><strong>Conclusion: </strong>Several therapies demonstrated substantial pain relief, but heterogeneity, publication bias, and varying study quality limit generalizability. High-quality, long-term trials with standardized pain assessments are needed to guide personalized rheumatoid arthritis pain management.</p><p><strong>Clinical trial number: </strong>PROSPERO CRD42024593971, 4 October 2024.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"48"},"PeriodicalIF":2.8,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313991","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":"Cytokine-induced memory-like natural killer cells in systemic lupus erythematosus patients.","authors":"Chien-Ya Hsu, Yen-Chang Lee, Hsiu-Shan Hsiao, Pei-Tzu Lee, Ji-Yih Chen, Syh-Jae Lin","doi":"10.1186/s42358-025-00477-0","DOIUrl":"10.1186/s42358-025-00477-0","url":null,"abstract":"<p><p>BACKGROUND: Natural killer (NK) cell abnormalities may contribute to the pathogenesis of systemic lupus erythematosus (SLE). Interleukin (IL)-15, an immunoregulatory cytokine crucial for NK survival, is overexpressed in SLE patients. Cytokine-induced memory-like (CIML) NK cells, which are NK cells pre-activated with short-term IL-12+IL-15+IL-18 followed by incubation with low-dose IL-15 for 1-2 weeks, exhibit enhanced NK effector function upon re-stimulation. METHODS: We collected blood samples from 54 patients with SLE and 38 healthy volunteers. Extended IL-15 stimulation of peripheral blood mononuclear cells (PBMCs) was performed. Surface marker analysis, IFN-γ, TNF-α production, and cytotoxicity evaluation were conducted. Next, we generated CIML NK cells by culturing PBMCs with IL-12+IL-15+IL-18. The influence of short-term and long-term IL-15 treatment on CIML NK cells was assessed. Finally, we examined the effect of re-stimulation with IL-12+IL-15+IL-18 on CIML NK cells from SLE patients and healthy controls. Cytotoxicity, CD107a degranulation, and surface marker expression were analyzed. RESULTS: We found that 1. The percentage of CD3-CD56+ NK cells was initially decreased in SLE patients compared with controls, but was enhanced after long-term IL-15 incubation; 2. Long-term IL-15 stimulation facilitated the conversion from CD3-CD56dim to CD3-CD56bright NK cells; 3. CIML NK cells were successfully generated in SLE patients, showing increased percentages of CD3-CD56+ and CD3- CD56bright NK cells and a concomitant decrease in CD3-CD56dim NK cells; 4. SLE CIML NK cells showed decreased IFN-γ, CD69, CD94, NKG2A, NKG2C, NKP30, NKP44, NKP46, and granzyme B expression compared with healthy controls; 5. On day 8, re-stimulation with IL-12+IL-15+IL-18 further enhanced the expression of IFN-γ, CD69, CD94, NKG2A, perforin, and granzyme B expression on SLE CIML NK cells; 6. Granzyme B expression in SLE CIML NK cells was higher on day 8 than on day 15. CONCLUSION: Our findings revealed phenotypic differences and functional deficiencies in SLE CIML NK cells. Further investigation into the role of SLE CIML NK cells in providing antiviral and anti-tumor responses is warranted. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"47"},"PeriodicalIF":2.8,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145294145","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":"Efficacy of switching from originator adalimumab to biosimilar adalimumab-AACF in patients with rheumatoid arthritis: a 12-month observational study.","authors":"Fanny Reyes-Neira, Barbara Bayeh, Karina Rossi Bonfiglioli, Nadia Emi Aikawa, Ana Paula Luppino Assad, Renata Miossi, Fernando Henrique Carlos de Souza, Carlos Emilio Insfran, Henrique Ayres Mayrink Giardini, Emily Figueiredo Neves Yuki, Eloisa Bonfa, Carla Gonçalves Schahin Saad, Julio Cesar Bertacini de Moraes, Ana Cristina de Medeiros-Ribeiro, Andrea Yukie Shimabuco","doi":"10.1186/s42358-025-00480-5","DOIUrl":"10.1186/s42358-025-00480-5","url":null,"abstract":"<p><p>BACKGROUND: TNF-inhibitors like adalimumab (ADA) have been vital for managing rheumatoid arthritis (RA) for over two decades. With the emergence of biosimilars, real-life evidence is crucial to confirm their sustained efficacy after switching from originator drugs. This study aims to provide comprehensive evaluation of the clinical outcomes of transitioning from adalimumab reference product (ADA-RP) to the biosimilar adalimumab–AACF (ADA-AACF) in patients with RA over a 12-month period in a real-world analysis. METHODS: This observational study included RA patients who had been on ADA-RP for at least three months before switching to ADA-AACF. Disease activity parameters, including DAS28-CRP, CDAI, SDAI, and CRP-levels, were assessed at baseline (T0) and compared at 6 (T6) and 12 months (T12) following the switch. RESULTS: Sixteen patients were included, with a mean duration of ADA-RP use of 69.9 months. DAS28-CRP remained stable when comparing T0 to T6 [2.36 (1.92–2.84) vs. 1.83 (1.72–3.16), p = 0.988] and T12 [2.36 (1.92–2.84) vs. 2.54 (2.09–2.86), p = 0.874], with similar results for SDAI and CDAI (p > 0.05). The frequency of low disease activity was consistent during the follow-up: 81.3% at T0; 68.8% at T6 (p = 0.617) and 81.3% at T12 (p = 0.480) for DAS28-CRP < 3.2. The same pattern was observed for CDAI ≤ 10 and SDAI ≤ 11 (p > 0.05). CRP-levels and prednisone doses did not show significant variation (p > 0.05) across time points. The biosimilar retention rate was 87.5%, with two patients discontinuing biosimilar before the 12-month mark. CONCLUSION: This real-world study demonstrates the feasibility and sustained efficacy of transitioning from ADA-RP to ADA-AACF in RA patients, reinforcing its role in long-term disease management. These findings in an ethnically diverse population contribute to the growing global evidence on biosimilar adoption, supporting their integration into routine clinical practice and expanding treatment accessibility. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"46"},"PeriodicalIF":2.8,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145276121","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":"Development of machine learning models for chronic fatigue prediction in granulomatosis with polyangiitis.","authors":"Alexandre Moura Dos Santos, Samuel Katsuyuki Shinjo","doi":"10.1186/s42358-025-00482-3","DOIUrl":"10.1186/s42358-025-00482-3","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;Chronic fatigue severely compromises the quality of life in patients with granulomatosis with polyangiitis (GPA). Traditional diagnostic methods are often time-consuming, relying on clinical expertise and detailed questionnaires. This study aimed to develop a machine learning model capable of predicting chronic fatigue in GPA patients based on clinical data, with a particular focus on improving diagnostic capacity in regions with limited access to specialists.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;This cross-sectional study collected data on fatigue (measured by the Modified Fatigue Impact Scale, MFIS), functional ability (Health Assessment Questionnaire, HAQ), disease activity (Birmingham Vasculitis Activity Score, BVAS), comorbidities, medication use, physical activity (International Physical Activity Questionnaire - Short Form, IPAQ-SF), and demographic characteristics. Four machine learning algorithms-logistic regression, decision tree, random forest, and extreme gradient boosting-were assessed using a 70/30 train-test split. Model performance was evaluated using area under the curve (AUC), accuracy, F1 score, recall, and precision. Statistical comparisons were performed using Welch's t-test and the Wilcoxon-Mann-Whitney U test for continuous variables, while the chi-square test or Fisher's exact test was applied to categorical variables, with significance set at P &lt; 0.05. All analyses were conducted using R version 4.4.1 for Windows.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;Forty-five patients were assessed: 62.2% were female, with a median BMI of 27.72 kg/m² (23.2-30.1), a median age of 55.5 years, and a median disease duration of 12.0 years (6.0-17.0). Fatigue was reported by 20 patients (MFIS score ≥ 38), and seven patients (15.5%) had active disease according to the BVAS, which was similar between the fatigued and no fatigued groups (P &gt; 0.05). The fatigued group had more acute-phase reactants and prednisone use (P &lt; 0.05). The tree-based models achieved an AUC of approximately 0.80, outperforming the other models.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;Tree-based models demonstrated superior predictive performance in identifying chronic fatigue. The Random Forest model, in particular, highlighted higher disability in activities of daily living (HAQ), older age, and longer disease duration as key predictors. Although the models performed well, additional data and incorporation of clinically relevant variables may further enhance predictive accuracy. Patients with GPA who experienced fatigue showed higher glucocorticoid use and elevated acute-phase reactants, despite similar levels of disease activity, suggesting mechanisms beyond inflammation. Machine learning shows strong potential as a clinical tool for fatigue identification, especially in settings with limited access to specialist care.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Trial registration: &lt;/strong&gt;Universal Trial Number (UTN): U1111-1271-6003; Brazilian Clinical Trials Registry (ReBEC): RB","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"45"},"PeriodicalIF":2.8,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488802/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145259700","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":"Body composition by dual X-ray absorptiometry (DXA) in healthy Brazilian children and adolescents: normative data.","authors":"Melissa Mariti Fraga, Filipe Pedroso de Sousa, Gleice Clemente, Marcelo M Pinheiro, Maria Teresa Terreri","doi":"10.1186/s42358-025-00479-y","DOIUrl":"10.1186/s42358-025-00479-y","url":null,"abstract":"<p><p>BACKGROUND: There is a lack of information regarding body composition (BC) measurements by Dual X-ray emission absorptiometry (DXA) in pediatric age group, mostly normative data to allow comparison among different populations and establish cut-off values. Aging itself, several chronic diseases and use of concomitant medications are associated with changes in BC, which can lead to cardiovascular events, metabolic complications, increased risk of functional loss, falls and death. Our purpose of the study is to establish BC normative data by DXA in healthy Brazilian children and adolescents. METHODS: Healthy, eutrophic/overweight children and adolescents aged between 5 and 19 years were included. Medical conditions that could interfere with bone mass or BC were excluded. Participants underwent a clinical interview including details about food intake, sun exposure and physical activity. In addition, anthropometric data, pubertal stage analysis, and lumbar spine and whole body DXA measurements using Hologic QDR 4500 were performed in all participants. Individuals were divided into 4 groups: female and male with two age intervals each (between 5 and 9 years and between 10 and 19 years). BC parameters were bone mineral density (BMD), bone mineral content (BMC), total lean mass (TLM), appendicular lean mass (ALM), appendicular lean mass index (ALMI), fat mass (FM), fat mass index (FMI) and android to gynoid fat ratio (A/G) to obtain normative data according to age and gender. RESULTS: A total of 349 healthy volunteers were eligible and enrolled for the study. Females had significantly higher values ​​of fat mass values ​​than males. All BC measurements were significantly higher in pubescent than prepubescent girls and boys. CONCLUSION: Our data provided BC normative data for healthy male and female Brazilian children and adolescents. CLINICAL TRIAL NUMBER: Not applicable. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"44"},"PeriodicalIF":2.8,"publicationDate":"2025-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488831/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145193559","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":"Determinants of self-perceived burden among rheumatoid arthritis patients: a cross-sectional study.","authors":"Yuping Tang, Yinghui Zhang, Lei Shi, Jieyu Zhang, Cailing Wang, Wei Wei, Liyu Zhang","doi":"10.1186/s42358-025-00473-4","DOIUrl":"10.1186/s42358-025-00473-4","url":null,"abstract":"<p><strong>Purpose: </strong>To investigate the current status of self-perceived burden (SPB) among rheumatoid arthritis (RA) patients and analyze its influencing factors.</p><p><strong>Methods: </strong>A cross-sectional study was conducted with 140 RA patients recruited from four tertiary hospitals in Taiyuan city, Shanxi Province. The data was collected through structured questionnaires assessing: General Information Questionnaire, Self-Perceived Burden Scale (SPBS), Activities of Daily Living (ADL) Scale, Social Support Rating Scale(SSRS).Multiple linear regression were employed to identify key predictors of SPB.</p><p><strong>Results: </strong>From 112 distributed questionnaires, 104 were returned valid, with a 92.85% response rate. RA patients (40.38%) exhibited a moderate SPB, with a mean score of 29.10 ± 10.27. The primary concern was the emotional impact on caregivers, with the highest scores reflecting worry about caregiver burden (3.33±1.47). Multivariate linear regression analysis identified marital status (β = 0.19, P = 0.028), Activities of Daily Living (β=-0.26, P = 0.006), and family monthly income (β=-0.30, P = 0.002) as significant predictors of SPB in RA patients.</p><p><strong>Conclusions: </strong>The findings underscore the moderate but significant SPB in RA patients, with key influences being Activities of Daily Living, marital status, and economic factors. These insights are vital for tailoring supportive care and shaping public health strategies to better serve this patient population.</p><p><strong>Clinical trial registration number: </strong>Not applicable.</p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"41"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488653/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179664","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":"Glycosaminoglycans in osteoarthritis cartilage promote inflammation by preferential activation of the lipoxygenase rather than the cyclooxygenase pathway.","authors":"Ana Carolina Matias Dinelly Pinto, Rodolfo de Melo Nunes, Vivian Louise Soares de Oliveira, Flavio Almeida Amaral, Francisco Airton Castro Rocha","doi":"10.1186/s42358-025-00478-z","DOIUrl":"10.1186/s42358-025-00478-z","url":null,"abstract":"<p><p>AIM: To determine whether glycosaminoglycans (GAG) of cartilage with osteoarthritis promote inflammation through activation of cyclooxygenase (COX)-2 and/or 5-lipoxygenase (ALOX5) pathways. MATERIALS: GAG (50 µg/25µL) extracted from the cartilage of 30 patients subjected to total joint arthroplasty secondary to osteoarthritis (OA) or fracture or saline were injected intra-articularly (i.art.) into wild-type or ALOX5−/− SV129 mice; cell counts as well as COX2 and ALOX5 gene expression were assessed in joint washes after 6 h. RESULTS: GAG injection promoted acute cell migration, with predominance (> 85%) of mononuclear cells with GAG from women having greater activity than men. GAG injection significantly increased ALOX5 but not COX2 gene expression in cells of the joint washes, as compared to control. Injection of GAG from patients that sustained a fracture did not alter cell influx in ALOX5-/- mice but cell counts were significantly lower following injection of GAG from OA patients (P = 0.0016). CONCLUSION: GAG promote inflammatory cell migration into joints through triggering of the 5-lipoxygenase pathway. Sex issues may be linked to an increased inflammatory potential of GAG from female OA patients. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"42"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488718/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179613","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 vital role of CD19⁺CD24^hiCD38^hi regulatory B cells in rheumatoid arthritis: correlations with disease activity and treatment response.","authors":"Lijun Chen, Jianjun Xu, Baodong Sun, Xiaoping Hong, Dongzhou Liu, Heng Li","doi":"10.1186/s42358-025-00474-3","DOIUrl":"10.1186/s42358-025-00474-3","url":null,"abstract":"<p><p>INTRODUCTION: Regulatory B cells (Bregs) play a pivotal role in the immune modulation of rheumatoid arthritis (RA). The levels of CD19+CD24hiCD38hi Bregs in peripheral blood and their association with clinical indicators in RA patients have not been extensively studied. The aim of this study was to investigate the alterations in peripheral blood CD19+CD24hiCD38hi Breg levels in RA patients and their association with clinical indicators. Additionally, we explored the variations in Breg levels before and after treatment. METHODS: Overall, 90 patients with newly diagnosed RA and 32 healthy controls were prospectively enrolled. Symptoms and laboratory findings were collected. Flow cytometry and three-color fluorescence antibody labeling were employed to detect CD19+CD24hiCD38hi Breg levels in peripheral blood mononuclear cells (PBMCs). The proportion of CD19+CD24hiCD38hi Bregs among mature B lymphocytes was analyzed, and correlations with clinical indicators were examined. A follow-up study of 26 RA patients was conducted to compare changes in Breg levels before and after six months of treatment. RESULTS: The levels of CD19+CD24hiCD38hi Bregs in RA patients were 89.63% of those in healthy controls. No significant differences in Breg levels were observed among patients with different disease activities. There was a positive correlation between CD19+CD24hiCD38hi Breg levels and morning stiffness duration (r = 0.227, p = 0.027), and negative correlations with age and anti-CCP antibody titers (r=-0.234, p = 0.022; r=-0.218, p = 0.036). No significant correlations were found between Breg proportions and other clinical indicators. The follow-up study showed a decrease in disease activity scores and a significant increase in CD19+CD24hiCD38hi Breg levels after six months of treatment. CONCLUSIONS: These findings suggest a potential association between Breg levels and the pathogenesis and inflammatory activity of RA. CD19+CD24hiCD38hi Bregs may serve as potential biomarkers for evaluating disease activity and treatment efficacy. Further research is warranted to explore the underlying biological mechanisms and clinical significance of Bregs in RA. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"43"},"PeriodicalIF":2.8,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179667","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":"Development of a new scoring system for predicting recurrent thrombosis in patients with antiphospholipid syndrome.","authors":"Oh Chan Kwon, Jang Woo Ha, Min-Chan Park, Yong-Beom Park, Sang-Won Lee","doi":"10.1186/s42358-025-00476-1","DOIUrl":"10.1186/s42358-025-00476-1","url":null,"abstract":"<p><p>BACKGROUND: This study aimed to develop a new scoring system for predicting recurrent thrombosis in patients with antiphospholipid syndrome (APS). METHODS: This was a retrospective multicentre cohort study. Patients with APS were followed up from APS diagnosis to either recurrent thrombosis or their last follow-up date, whichever came first. A multivariable logistic regression analysis with a backward elimination was used to develop a new scoring system, incorporating conventional cardiovascular risk factors and antiphospholipid antibody (aPL) profile as covariates. Each covariate remaining in the final step was multiplied by its β coefficient, rounded to the nearest integer, and then summed. A multivariable Cox proportional hazard model, adjusted for medication use, assessed the association between the new scoring system and recurrent thrombosis risk. The accuracy of the new scoring system in predicting recurrent thrombosis was evaluated by estimating the area under the curve (AUC) and comparing it with the adjusted global APS score (aGAPSS). RESULTS: A total of 126 patients with APS were included. The median age of the cohort was 40 (interquartile range: 31–55) years and 49.2% were women. Hypertension, type 2 diabetes mellitus (T2DM), and dyslipidaemia were present in 20.6%, 18.3%, and 54.0% of the patients, respectively. 26.2% were current smokers and 23.8% had concomitant systemic lupus erythematosus. Lupus anticoagulant (LA), anti-β2 glycoprotein I (anti-β2GPI) IgG, anti-β2GPI IgM, anti-cardiolipin (aCL) IgG, and aCL IgM were positive in 76.2%, 27.0%, 11.9%, 27.0%, and 6.3% of the patients, respectively. During a median follow-up duration of 41.5 (interquartile range: 21.4–72.0) months, thrombosis recurred in 9 (7.1%) patients. Multivariable logistic regression analysis revealed the following scoring system: modified diabetes global APS score (mdGAPSS) = 1*T2DM + 2*LA + 1*anti-β2GPI. Multivariable Cox proportional hazard model showed that a higher score was significantly associated with an increased risk of recurrent thrombosis (adjusted hazard ratio 2.911, 95% confidence interval 1.090–7.770, p = 0.033). The AUC was higher using the mdGAPSS (AUC = 0.706) than the aGAPSS (AUC = 0.553). CONCLUSIONS: Compared to the aGAPSS, the mdGAPSS—comprising T2DM, LA, and anti-β2GPI—demonstrated a greater accuracy in predicting recurrent thrombosis in patients with APS. </p>","PeriodicalId":48634,"journal":{"name":"Advances in Rheumatology","volume":"65 1","pages":"40"},"PeriodicalIF":2.8,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13488639/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145138776","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}