Rheumatology and immunology research最新文献

{"title":"Neuropsychiatric systemic lupus erythematosus subtypes identified by unsupervised clustering: A single-center cohort study.","authors":"Weiting Fang, Jiuliang Zhao, Dong Xu, Ziqian Wang, Mengtao Li, Siyuan Fan, Tao Li, Manqing Xie, Zeyu Liu, Hui You, Yanhong Wang, Shangzhu Zhang, Xiaofeng Zeng","doi":"10.1515/rir-2026-0002","DOIUrl":"https://doi.org/10.1515/rir-2026-0002","url":null,"abstract":"<p><strong>Background and objectives: </strong>Neuropsychiatric (NP) manifestations are common, heterogeneous and severe in systemic lupus erythematosus (SLE) patients, with attribution to SLE remaining diagnostically challenging. Traditional classification focuses on clinical syndromes, overlooking neuropsychiatric systemic lupus erythematosus (NPSLE) immunological heterogeneity. To address the heterogeneity of NPSLE, this study aimed to delineate distinct disease subgroups by clustering patients based on their antibody profiles. These subgroups were then evaluated for diferences in clinical presentation and prognosis, to better characterize disease subsets and support individualized approaches to diagnosis and management.</p><p><strong>Methods: </strong>This retrospective single-center study included hospitalized SLE patients with NP manifestations, collecting demographic, clinical and laboratory data. Patients were classified as NPSLE or non-NPSLE by clinical judgment after excluding alternative causes. Hierarchical cluster analysis explored autoantibody-clinical feature associations.</p><p><strong>Results: </strong>Among the 167 patients analyzed, 152 had NP manifestations attributed to SLE. Central nervous system (CNS) involvement was predominant (89.1%), with seizures, cerebrovascular disease, acute confusional state (ACS), and demyelinating syndrome being most prevalent manifestations. Hierarchical clustering of 152 NPSLE patients identified two subgroups: Cluster 1 (23.7%) demonstrated cerebrovascular injury as the predominant manifestation, with higher positivity rates of antiphospholipid antibodies (APLs) (<i>P</i> < 0.01) and a higher incidence of cerebrovascular disease (<i>P</i> < 0.01). Cluster 2 (76.3%) showed immune-mediated inflammatory profile, with higher positivity of anti-SSA (<i>P</i> < 0.01), antidsDNA (<i>P</i> < 0.05), and anti-RiboP antibodies (<i>P</i> < 0.05). Neurological involvement predominantly manifesting as ACS (<i>P</i> < 0.05), accompanied by a higher frequency of fever and joint involvement.</p><p><strong>Conclusions: </strong>In this study, NPSLE exhibited distinct serological profiles and segregated into two immunologically defined clusters, reflecting its clinical and biological heterogeneity, and suggesting that immunological profiling may enhance precise classification and personalized management of affected patients.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"14-23"},"PeriodicalIF":2.5,"publicationDate":"2026-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066665/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679331","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comment on: \"Sirolimus versus mycophenolate mofetil for the treatment of lupus nephritis: Results from a real-world CSTAR cohort study\".","authors":"Umut Bakay","doi":"10.1515/rir-2026-0009","DOIUrl":"https://doi.org/10.1515/rir-2026-0009","url":null,"abstract":"","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"58-59"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066657/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diffuse alveolar hemorrhage in rheumatic diseases: Clinical features, diagnosis, and management.","authors":"Nilanjana Dutta, Harshwardhan Patil, Vishnupriya Gopinath, Yashas Belliah Prakash, Sri Mounya Jampala, Naveenkumar Nallathambi, Mahabaleshwar Mamadapur","doi":"10.1515/rir-2026-0008","DOIUrl":"https://doi.org/10.1515/rir-2026-0008","url":null,"abstract":"<p><p>Diffuse alveolar hemorrhage (DAH) is a catastrophic pulmonary manifestation of systemic autoimmune and rheumatic diseases, particularly systemic lupus erythematosus (SLE), ANCA-associated vasculitis (AAV), and antiphospholipid syndrome (APS). It arises from immune-mediated injury to the pulmonary microcirculation, leading to intra-alveolar bleeding, respiratory failure, and high mortality. Despite advances in immunosuppression, DAH continues to pose major diagnostic and therapeutic challenges, with limited consensus on optimal management. We conducted an updated and comprehensive review of the epidemiology, pathogenesis, clinical spectrum, diagnostic strategies, therapeutic approaches, and outcomes of DAH in the context of rheumatic diseases through PubMed, Embase, and Scopus databases up to March 2025. DAH occurs in approximately 2%-5% of patients with SLE and up to 55% of patients with AAV, with reported mortality rates ranging from 20% to 80%. Hemoptysis is present in fewer than half of cases, highlighting the need for a high index of suspicion in patients presenting with anemia, dyspnea, and new bilateral infiltrates. Imaging typically reveals ground-glass opacities and consolidations on high-resolution CT, with a \"crazy-paving\" pattern observed during resolution. Bronchoscopy with bronchoalveolar lavage remains the diagnostic gold standard, confirming hemorrhage in sequential lavage aliquots. Histopathology demonstrates either pulmonary capillaritis or bland hemorrhage, with up to 73% of lupus-associated DAH cases showing the latter pattern without overt vasculitis. First-line therapy includes high-dose corticosteroids, frequently combined with cyclophosphamide or rituximab, while plasma exchange and intravenous immunoglobulin are considered in refractory disease. The PEXIVAS trial has challenged the universal role of plasma exchange, though it may retain a role in select patients with concomitant renal failure. Emerging therapies, such as complement inhibitors, B-cell targeted therapies, and mesenchymal stem cell transplantation, are under investigation. Supportive measures, including oxygen supplementation, noninvasive or invasive ventilation, and infection prophylaxis, are integral to management. Long-term survivors are at risk of recurrent hemorrhage and interstitial fibrosis. In conclusion, by consolidating current evidence and highlighting existing gaps, this review provides a clinically relevant framework to guide diagnosis, management, and future directions in the care of patients with DAH associated with rheumatic diseases.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"1-13"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066659/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-based epidemiological study on the prevalence and health status of Spondyloarthritis in residents of Wuyuan County, China, 2023.","authors":"Shichao Yu, Xiuling Zhang, Zhijie Liu, Dunwu Wu, Yuanjia Pan, Jinying Wang, Jinghong Li, Libo Zha, Yumin Dong, Senmiao Zhang, Guoliang Wu, Zhongpei Wang, Guixing Dong, Junbo Zhu, Nan Wang, Xinwang Duan, Zhirao Huang","doi":"10.1515/rir-2026-0001","DOIUrl":"https://doi.org/10.1515/rir-2026-0001","url":null,"abstract":"<p><strong>Background and objective: </strong>The prevalence of Spondyloarthritis (SpA) in China is approximately 1%, with ankylosing spondylitis (AS) at 0.25%. However, community-based incidence data remain scarce and are subject to medical reporting bias. This study aimed to investigate the prevalence of SpA and the health status of patients in Wuyuan County, to provide evidence for the national \"Rural Health Project for Ankylosing Spondylitis\".</p><p><strong>Methods: </strong>A cross-sectional survey was conducted from August to December 2023 using the WHO COPCORD methodology. A multi-stage stratified random cluster sampling method was employed, including 16, 996 residents. A screening questionnaire based on assessment of Spondyloarthritis international society (ASAS) criteria was used, and SpA diagnoses were confirmed by rheumatologists. Data analysis included Poisson distribution sample size estimation, Mann-Whitney <i>U</i> test, and Bootstrap proportion estimation (SPSS v29.0 and R v4.3.2).</p><p><strong>Results: </strong>The estimated prevalence of SpA among residents of Wuyuan County in 2023 was 0.14%. A total of 24 patients were diagnosed with SpA (16 males and 8 females). Half of these cases were previously undiagnosed and demonstrated a significant diagnostic delay (<i>P</i> = 0.021). Male patients exhibited more severe functional impairment, as indicated by higher bath ankylosing spondylitis functional index (BASFI) scores compared to their female counterparts (3.29 <i>vs</i>. 1.44, <i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>Community screening revealed a significant burden of SpA in rural China, underscoring the need to strengthen primary healthcare resource allocation.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"34-40"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066663/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Dual-tracer PET/CT imaging with ⁶⁸Ga-DOTATATE and Al¹⁸F-NOTA-FAPI for dynamic evaluation of myocardial inflammation and fibrosis in antimitochondrial antibody-positive myositis.","authors":"Junyan Qian, Jiqing Chen, Xinyan Wen, Siqi Tang, Na Niu, Huaxia Yang","doi":"10.1515/rir-2026-0003","DOIUrl":"https://doi.org/10.1515/rir-2026-0003","url":null,"abstract":"","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"60-62"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066662/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679066","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of Xeligekimab (GR1501) in the treatment of axial Spondyloarthritis: Results from a Phase II clinical trial.","authors":"Xiaofeng Zeng, Shangzhu Zhang, Huaxiang Liu, Yi Zhao, Xiaomei Li, Zhenyu Jiang, Yu Xue, Ning Kong, Lingyun Sun, Shengyun Liu, Xiaoyun Fan, Jiankang Hu, Liying Shen, Dong Xu","doi":"10.1515/rir-2026-0016","DOIUrl":"https://doi.org/10.1515/rir-2026-0016","url":null,"abstract":"<p><strong>Objective: </strong>To evaluate the efficacy and safety of Xeligekimab (GR1501), a fully human monoclonal antibody against interleukin-17A, in Chinese patients with active axial spondyloarthritis (axSpA) who did not respond or were intolerant to nonsteroidal anti-inflammatory drugs (NSAIDs).</p><p><strong>Methods: </strong>This phase II, randomized, double-blind, placebo-controlled, multicenter study enrolled 160 patients with active axSpA. Participants were randomized equally to receive placebo or Xeligekimab at 100 mg, 200 mg, or 300 mg subcutaneously every two weeks for 16 weeks, followed by an 8-week follow-up. The primary endpoint was the Assessment of SpondyloArthritis International Society 20 (ASAS20) response at week 16. Secondary endpoints included ASAS40, ASDAS-CRP, BASDAI, BASFI, and patient-reported outcomes. Safety and immunogenicity were evaluated throughout the study.</p><p><strong>Results: </strong>At week 16, ASAS20 response rates were 52.5% with placebo and 77.5%, 75.0%, and 72.5% with Xeligekimab 100 mg, 200 mg, and 300 mg, respectively. The 100 mg and 200 mg groups showed significant improvement versus placebo (<i>P</i> < 0.05). Benefits in ASAS40, ASDAS-CRP, and BASDAI were maintained through week 24. Xeligekimab was generally well tolerated, and the overall incidence of adverse events was comparable to placebo. No treatment-emergent anti-drug antibodies were detected.</p><p><strong>Conclusion: </strong>Xeligekimab at 100 mg and 200 mg achieved meaningful clinical improvement with good tolerability in patients with active axSpA, supporting further clinical evaluation of this therapy.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"41-50"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066660/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hospital-based first diagnoses of systemic sclerosis: Defining initial clinical presentations and diagnostic pathways.","authors":"Teerapat Luengthanapol, Tippawan Onchan, Patnarin Pongkulkiat, Ajanee Mahakkanukrauh, Siraphop Suwannaroj, Chingching Foocharoen","doi":"10.1515/rir-2026-0007","DOIUrl":"https://doi.org/10.1515/rir-2026-0007","url":null,"abstract":"<p><strong>Background and objective: </strong>Early diagnosis of systemic sclerosis (SSc) is challenging due to heterogeneous presentation and lack of reliable biomarkers, resulting in many patients being diagnosed during hospitalization with advanced disease and severe complications. We aimed to characterize the clinical presentation, diagnostic pathway, and outcomes of patients first diagnosed with SSc during hospitalization.</p><p><strong>Methods: </strong>We retrospectively reviewed adult patients newly diagnosed with SSc during hospitalization (January 2016-July 2023), including those referred for SSc evaluation or with SSc features identified during admission for other diagnoses. Patients previously diagnosed as outpatients were excluded. Clinical presentations were compared between patients admitted for SSc-related reasons <i>vs</i>. those admitted for other reasons subsequently diagnosed with SSc.</p><p><strong>Results: </strong>Thirty-five patients were included (mean age 60.4 ± 12.8 years; 60% women). Most (68.6%) were incidentally diagnosed with SSc during hospitalization for unrelated conditions. Common indications for hospitalization included pericardial effusion (22.9%), progressive pulmonary hypertension (17.1%), and progressive interstitial lung disease (14.3%). Approximately 60% of both hospitalized patients in both groups initially saw general practitioners before were rheumatological referral. Age, sex, symptom duration, most clinical features, length of stay, hospital costs, and outcomes were similar between patients admitted for SSC-related <i>vs</i>. non-SSc-related reasons, except for greater gastrointestinal involvement in the latter group (<i>P</i> = 0.02).</p><p><strong>Conclusion: </strong>Hospitalized patients first diagnosed with SSc predominantly present with diffuse cutaneous involvement and advanced cardiopulmonary complications. Most cases are identified during hospitalization for unrelated conditions, highlighting the need for increased clinical vigilance and systematic SSc evaluation in at-risk hospitalized patients to enable early detection and improve outcomes.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"24-33"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066661/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant cell arteritis initially presents as pulmonary embolism.","authors":"Xinyuan Xu, Dan Wang, Tienan Zhu, Jing Li","doi":"10.1515/rir-2026-0004","DOIUrl":"https://doi.org/10.1515/rir-2026-0004","url":null,"abstract":"","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"51-54"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066664/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679288","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nursing insights into CAR T-cell therapy for systemic lupus erythematosus: Highlights of a standardized nursing system for CAR T-cell therapy.","authors":"Yujie Yang, Lingling Gao, Kunling Wang, Xiangfeng Li","doi":"10.1515/rir-2026-0005","DOIUrl":"https://doi.org/10.1515/rir-2026-0005","url":null,"abstract":"","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"7 1","pages":"55-57"},"PeriodicalIF":2.5,"publicationDate":"2026-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13066658/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147679300","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unveiling the dual nature of late-onset systemic lupus erythematosus: A cross-sectional study.","authors":"Fengyun Lu, Dongyu Li, Xiaoxuan Sun, Qiang Wang, Chun Ouyang","doi":"10.1515/rir-2025-0028","DOIUrl":"10.1515/rir-2025-0028","url":null,"abstract":"<p><strong>Background and objective: </strong>Systemic lupus erythematosus (SLE) is a complex, heterogeneous autoimmune disease whose presentation can vary widely with patient age. While SLE in young adults has been extensively characterized, less is known about phenotypes of late-onset SLE.</p><p><strong>Methods: </strong>This study aimed to characterize the features of late-onset SLE patients in a Chinese cross-sectional study. Patients diagnosed with SLE at age 50 years or older were classified as having late-onset SLE. Early-onset SLE patients from the same cohort were included as controls. Demographic, clinical, and laboratory data were collected, and a two-step cluster analysis was employed to categorize late-onset SLE patients.</p><p><strong>Results: </strong>A total of 141 patients (27.48%) were classified as late-onset SLE. The onset of lupus in late-onset patients is more insidious, they exhibited lower systemic lupus erythematosus disease activity index-2000 (SLEDAI-2K) scores, and had significantly fewer instances of fever, mucocutaneous, and positive of antibodies compared to early-onset SLE (all <i>P</i> values < 0.05). However, late-onset SLE patients had a higher prevalence of comorbidities, particularly Sjögren's syndrome (<i>P</i> < 0.001). Additionally, late-onset SLE was associated with a high frequency of interstitial lung disease (ILD) and thrombotic events (<i>P <</i> 0.001, <i>P <</i> 0.001; respectively). Two distinct clusters of late-onset SLE patients were identified. Cluster 1 was characterized by the presence of SLE-specific autoantibodies such as anti-double stranded DNA (anti-dsDNA), anti-Smith (anti-Sm) with higher SLEDAI-2K scores (11.8 ± 5.2). In contrast, cluster 2 presented with a high frequency of anti-Sjögren syndrome antigen A (anti-SSA) antibodies and Sjögren's syndrome with a significantly lower SLEDAI-2K scores (8.8 ± 5.4) at diagnosis.</p><p><strong>Conclusion: </strong>This study refines our understanding of late-onset SLE by delineating two subgroups and suggests that age-stratified approaches to diagnosis and management may improve patient care.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"6 4","pages":"232-239"},"PeriodicalIF":2.5,"publicationDate":"2025-12-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12743268/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145851671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}