Arthritis Research & Therapy最新文献

{"title":"Roles of VWA1 and Rac2 in compensatory and decompensatory responses via FGF9/FGFR3 and p38 MAPK signaling pathways in condylar chondrocytes under distinct mechanical stress","authors":"Yuqi Liu, Fangwen Jia, Kangya Li, Chao Liang, Yanxi Li, Wei Geng","doi":"10.1186/s13075-025-03579-8","DOIUrl":"https://doi.org/10.1186/s13075-025-03579-8","url":null,"abstract":"Few studies paid attention to compensatory and decompensatory responses of condylar cartilage under different mechanical conditions and the underlying mechanism. Compensatory and decompensatory models were established. In vivo compensatory (0.5 mm occlusal elevation) and decompensatory (1.5 mm elevation) models were established in rats using zirconia occlusal plates. Parallel in vitro models subjected condylar chondrocytes to physiological (6%) or pathological (18%) cyclic tensile strain (CTS). Pivotal candidates that mediate the states of compensation and decompensation were screened through proteomic analysis, and validated through qRT-PCR, Western blot analyses, immunohistochemistry, and Alcian blue staining. Compensatory phenotypes dominated in 0.5 mm iOVD and 6% CTS groups, characterized by upregulated VWA1 expression and FGF9/FGFR3 pathway activation. Conversely, decompensation markers prevailed in 1.5 mm iOVD and 18% CTS groups, showing Rac2 elevation and p38 MAPK pathway induction. Further validation revealed that Vwa1 silencing attenuated compensatory responses under 6% CTS, while exogenous FGF9 restored them. Conversely, Vwa1 overexpression mitigated decompensation under 18% CTS, an effect nullified by FGFR3 inhibition. Rac2 knockdown reduced decompensatory responses to 18% CTS, whereas p38 MAPK activation reinstated these effects. Rac2 overexpression exacerbated decompensation under 6% CTS, reversible via p38 MAPK inhibition. VWA1 can modulate compensatory responses in condylar cartilage via regulating FGF9/FGFR3 signaling pathway, while Rac2 can mediate decompensatory responses via the modulation of p38 MAPK signaling pathway, which provide prospects for developing precise diagnostic and therapeutic strategies for temporomandibular joint osteoarthritis (TMJOA). Not applicable.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"184 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144184177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Osteoclast development from peripheral blood monocytes is reduced in patients with radiographic axial spondyloarthritis on biological therapy","authors":"Cecilia Engdahl, Malin C. Erlandsson, Magnus Hallström, Anna Deminger, Helena Forsblad-d’Elia","doi":"10.1186/s13075-025-03578-9","DOIUrl":"https://doi.org/10.1186/s13075-025-03578-9","url":null,"abstract":"Radiographic axial spondyloarthritis (r-axSpA) is a chronic inflammatory disease that primarily affects the axial skeleton and entheses, leading to pathological spinal bone formation and systemic bone loss. Treatments with tumor necrosis factor inhibitors (TNFi) and interleukin-17 inhibitors (IL-17i) have shown efficacy in reducing inflammation and potentially impacting bone remodeling in r-axSpA. Osteoclasts, crucial for bone resorption, are derived from the monocytic cell lineage and regulated by proinflammatory cytokines. This study aimed to evaluate the osteoclast development capacity from peripheral blood monocytes in patients with r-axSpA with different treatment strategies and compare it to controls. This study included 28 patients with long-standing r-axSpA receiving various treatments, including disease-modifying anti-rheumatic drugs (DMARDs) and NSAIDs, as well as 16 blood-donor controls. Disease activity was assessed using the Ankylosing Spondylitis Disease Activity Score (ASDAS). CD14 + monocytes were isolated from blood samples and differentiated into osteoclasts in vitro by stimulation with three different conditions: (I) macrophage colony-stimulating factor (M-CSF), (II) M-CSF and receptor activator of nuclear factor-κβ (RANKL), and (III) M-CSF, RANKL, and tumor necrosis factor-alpha (TNF). Osteoclast and osteoclast precursor formation were assessed using tartrate-resistant acid phosphatase (TRAP) staining, and TRAP5b concentration in supernatants was measured by ELISA. The frequency of CD14 + monocytes was similar in patients with r-axSpA and controls, but the capacity to develop osteoclasts and osteoclast precursors was significantly decreased in the r-axSpA patients. Stratification of the patients based on treatment with or without biological DMARDs (bDMARDs) revealed no significant differences in ASDAS or frequency of CD14 + monocytes. Notably, only r-axSpA patients receiving bDMARDs exhibited a reduced ability to develop osteoclasts and osteoclast precursors compared to those not on bDMARDs and controls. Lower Trap5b concentrations in supernatants corroborated these findings. Our study demonstrates that patients with r-axSpA exhibit a reduced capacity for osteoclast formation from CD14 + monocytes isolated from peripheral blood. The process was modulated by treatment with bDMARDs, which might explain the previously shown sparing effect of bDMARDs on bone mineral density in r-axSpA.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"30 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144176622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing systemic lupus erythematosus treatment outcomes with an early initiation of belimumab: insights from a multicenter retrospective study within the first five years","authors":"Kanako Kojima, Kunihiro Ichinose, Masataka Umeda, Toshimasa Shimizu, Shuntaro Sato, Takahisa Suzuki, Yoshikazu Nakashima, Akitomo Okada, Yoshiro Horai, Keita Fujikawa, Toshiyuki Aramaki, Taiichiro Miyashita, Masako Furuyama, Naoki Matsuoka, Atsushi Kawakami","doi":"10.1186/s13075-025-03581-0","DOIUrl":"https://doi.org/10.1186/s13075-025-03581-0","url":null,"abstract":"The human monoclonal antibody belimumab (BEL) has emerged as a promising treatment for systemic lupus erythematosus (SLE), particularly for reducing the need for glucocorticoids and minimizing organ damage. The optimal timing of BEL initiation has been unclear; emerging evidence suggests that early intervention with BEL, particularly within the first 5 years of diagnosis, may yield better outcomes by modulating disease progression and reducing flare frequency. Understanding the relationship between disease duration and BEL efficacy is essential for the development of tailored strategies. We analyzed patients with SLE treated at our hospital and associated facilities who were diagnosed according to the 1997 ACR or 2012 SLICC criteria and who began BEL treatment between December 2017 and August 2021. Patients who were followed for ≥ 12 months after BEL initiation were included. We investigated the changes in the patients' Safety of Estrogens in Lupus National Assessment–Systemic Lupus Erythematosus Disease Activity Index (SELENA-SLEDAI) scores at 3, 6, 9, and 12 months after the introduction of BEL, comparing patients with disease durations ≤ 5 years to those with > 5 years. A mixed-effects model was adjusted for the patients' ages, prednisolone dosages, initial SELENA-SLEDAI scores, Systemic Lupus International Collaborating Clinics (SLICC) damage index (SDI), hydroxychloroquine use, and lupus nephritis. Clinical manifestations including arthritis, skin lesions, and hematological abnormalities were monitored to assess the broader impacts of BEL. One hundred eleven patients were initially registered; among them, 97 patients were included in the final analysis. The study population (mean age, 41 years; mean SELENA-SLEDAI, 7 points; 51% using hydroxychloroquine) included 19 patients with a ≤ 5-year SLE duration and 78 with SLE durations > 5 years. The baseline SELENA-SLEDAI scores were higher in the ≤ 5-year group (p = 0.047), indicating more active disease. Patients with ≤ 5 years of disease had significantly greater improvements in SELENA-SLEDAI scores at 6, 9, and 12 months (p < 0.05). These results highlight the importance of early BEL initiation in SLE, demonstrating that patients with shorter disease durations achieve more substantial improvements in disease activity with early BEL treatment. Our findings also reveal the potential benefits of early BEL intervention and suggest that incorporating the disease duration into treatment decisions may optimize patient outcomes.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"5 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144165265","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical features, treatment, and outcome of isotretinoin-associated sacroiliitis","authors":"Shaoli Zhao, Wei Sun, Liping Peng, Chunjiang Wang","doi":"10.1186/s13075-025-03582-z","DOIUrl":"https://doi.org/10.1186/s13075-025-03582-z","url":null,"abstract":"Sacroiliitis is a rare adverse reaction of isotretinoin. However, the data on the clinical features, treatment and outcomes of isotretinoin-associated sacroiliitis are limited. This study was conducted to explore the clinical characteristics of isotretinoin-associated sacroiliitis, providing a basis for diagnosis and treatment. The author retrieved clinical reports of isotretinoin-associated sacroiliitis from the database for a retrospective analysis up to March 31, 2025. A total of 67 patients were included, with a median age of 21 years (range 14, 44). Fifty-six (83.6%) of the patients were from Turkey. The median time of sacroiliitis was 2.5 months (range 0.4, 24) after isotretinoin administration. Low back pain (70.1%) and hip pain (44.8%) are the main symptoms of patients with sacroiliitis. Magnetic resonance imaging (MRI) mainly showed sacroiliitis (73.1%) and bone marrow edema (34.3%). After discontinuation of isotretinoin and treatment with non-steroidal anti-inflammatory drugs (NSAIDs) and biologics, the patient’s symptoms and MRI improved. Patients treated with isotretinoin who experience low back pain should consider the possibility of sacroiliitis. MRI is a useful tool for the diagnosis of sacroiliitis. The cessation of isotretinoin therapy, coupled with the administration of NSAIDs, can effectively alleviate the symptoms experienced by patients.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"142 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144137149","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of epaminurad, a potent hURAT1 inhibitor, in patients with gout: a randomized, placebo-controlled, dose-finding study","authors":"Jae-Bum Jun, Hye-Soon Lee, Sang-Hyon Kim, Seung-Geun Lee, Doo-Ho Lim, Jinhyun Kim, Yong-Beom Park, Mie Jin Lim, Seung-Jae Hong, Hyo-Jin Choi, Shin-Seok Lee, Hyun Ah Kim, Jiwon Hwang, Chang-Hee Suh, Seungwoo Han, Jung-Yoon Choe, Wan-Hee Yoo, Jung Soo Song","doi":"10.1186/s13075-025-03577-w","DOIUrl":"https://doi.org/10.1186/s13075-025-03577-w","url":null,"abstract":"Gout is the most common inflammatory arthritis. Current urate-lowering therapies have limitations, such as adverse drug reactions or limited efficacy. Epaminurad is a novel selective human urate transporter 1 (hURAT1) inhibitor that has been shown to reduce serum urate (sUA) levels in healthy volunteers and patients with gout. The aims of the current study were to evaluate the urate-lowering efficacy and safety of epaminurad compared with placebo in patients with gout, and to determine the optimal dose. This multicenter, randomized, double-blind, placebo-controlled, dose-finding phase 2b clinical trial, which incorporated a standard-treatment reference arm, enrolled patients aged 19–70 years with gout and sUA level ≥ 0.42 mmol/L. Participants received gout prophylaxis and followed therapeutic lifestyle changes, and were randomized to receive epaminurad 3 mg, 6 mg or 9 mg, or febuxostat 80 mg, or matching placebo, once daily for 12 weeks. The primary efficacy endpoint was the proportion of patients with sUA level < 0.36 mmol/L at week 4 after initiation of study treatment. Statistical comparisons were performed between the epaminurad and placebo groups. Overall, 169 patients received study medication (99.40% male, mean ± SD age 48.26 ± 13.15 years, sUA level 0.53 ± 0.09 mmol/L). Mean adherence to treatment was > 90% in all groups. The proportion of patients with sUA < 0.36 mmol/L at week 4 was significantly higher in each epaminurad group (9 mg, 88.89%; 6 mg, 71.79%; 3 mg, 54.05%) compared with placebo (0.00%) (all p < 0.0001). The response rate in the febuxostat group was 84.21%. The proportion of patients who achieved sUA < 0.30 mmol/L, and mean percent and absolute change in sUA, were also significantly greater in all epaminurad groups versus placebo at week 4. Outcomes were consistent at weeks 8 and 12. The adverse event rate did not differ between epaminurad groups and placebo, and most events were mild. There were no significant differences in mean serum creatinine levels or liver function parameters between the epaminurad groups and placebo. Epaminurad was effective at reducing sUA levels in patients with gout. The study also confirmed the safety and tolerability profile during 12 weeks of treatment. ClinicalTrials.gov NCT04804111 (registered on 15 November 2020).","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"33 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144137151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Functional work disability from the perspectives of persons with systemic lupus erythematosus: a qualitative thematic analysis","authors":"Behdin Nowrouzi-Kia, Aaron S. Howe, Anson Li, Jeremy Tan, Natalia Saade-Cleves, Kevon Jules, Malak Sadek, Ali Bani-Fatemi, Antonio Avina-Zubieta, Mary T. Fox, William Shaw, Derek Haaland, Janet Pope, Paul R. Fortin, Kathleen S. Bingham, Christine Peschken, Jennifer Reynolds, Catherine Ivory, Dafna D. Gladman, Murray B. Urowitz, Jorge Sanchez-Guerrero, Lily S. H. Lim, Stephanie Keeling, Patti Katz, Mahta Kavkan, Dennisse Bonilla, Wils Nielsen, Zahi Touma","doi":"10.1186/s13075-025-03572-1","DOIUrl":"https://doi.org/10.1186/s13075-025-03572-1","url":null,"abstract":"Systemic lupus erythematosus (SLE) disease symptoms that can significantly restrict work ability and work participation resulting in reduced mental well-being. This study investigates the significant impact of work participation and disability on the mental wellbeing, health-related quality of life, and disease-related outcomes in individuals with SLE. With the objective of creating an SLE-related functional profile rooted in work disability (WD) prevention, 46 SLE patients were purposively recruited from Canadian medical centres. Through semi-structured interviews guided by a WD prevention framework, factors associated with WD and lived experiences of SLE-related WD were qualitatively explored. Braun and Clarke’s six-stage inductive thematic analysis was used to organize the data. Most participants experienced some form of work disability across their employment history related to their clinical manifestations of SLE, including hospitalizations, physical limitations, fatigue, and neurocognitive symptoms (e.g. brain fog). Thematic analysis revealed three key themes: (a) the influence of illness experience on work, (b) the stigmatization of illness disclosure, and (c) the availability of workplace resources/accommodations. Participants emphasized the desirability of work with reduced physical and mental demands, increased personal control, and workplace flexibility to prevent WD. The study underscores the need for a collaborative, multi-component, and multidisciplinary intervention targeting psychosocial and workplace factors to establish a goal-oriented preventative framework, potentially improving WD outcomes in SLE individuals.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"47 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144137150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physical activity in relation to health status, quality of life and compliance with World Health Organization recommendations in patients with axial spondyloarthritis","authors":"M. Carbo, B. Hilberdink, D. Paap, F. Wink, T. Vliet Vlieland, S. van Weely, A. Spoorenberg, S. Arends","doi":"10.1186/s13075-025-03575-y","DOIUrl":"https://doi.org/10.1186/s13075-025-03575-y","url":null,"abstract":"Physical activity (PA) has well-established benefits and is a fundamental component in the management of axial spondyloarthritis (axSpA). Our objective was to evaluate (1) compliance with the World Health Organization (WHO) PA recommendations, (2) specific types and duration of PA performed by patients, and (3) association of PA with health status and quality of life (QoL) in two large Dutch cohorts of axSpA patients. In the GLAS and LUMC patient cohorts, the modified (m) and original Short QUestionnaire to ASess Health-enhancing PA (SQUASH) was used to determine fulfillment of recommendations on aerobic and muscle-strengthening PA. Univariable and multivariable linear regressions were used to analyze PA in relation to health status (ASAS-HI) and QoL (ASQoL). In the GLAS (n = 148) and LUMC (n = 193) cohorts, patients were 49 ± 13 and 56 ± 14 years old, time since diagnosis was median 11 (IQR 5–21) and 23 (IQR 8–35) years and 59% and 69% were male, respectively. In total, 72% and 77% patients fulfilled the aerobic component, 40% and 36% the muscle-strengthening component and 37% and 34% both components of the WHO PA recommendations. Walking, cycling and gym or aquatic exercises were done most often. Higher (m)SQUASH score was associated with better outcome in disease-related health status (ASAS-HI) and QoL (ASQoL), also after adjusting for age, sex, BMI, disease activity and physical function. The minority of axSpA patients fulfilled the WHO PA recommendations. Patients were less likely to meet the muscle strengthening component than the aerobic component. A higher level of PA was associated with better disease-related health status and QoL. Little over a third of axSpA patients fulfilled the WHO PA recommendations. Patients were less likely to meet the muscle strengthening component than the aerobic component of the recommendations. Walking and cycling were often done by axSpA patients and the most frequently performed sports were gym exercises and aquatic exercises. A higher level of PA was associated with better disease-related health status and quality of life in axSpA patients.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"6 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144104579","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early prediction of bone destruction in rheumatoid arthritis through machine learning analysis of plasma metabolites","authors":"Zihan Wang, Tianyi Lan, Yi Jiao, Xing Wang, Hongwei Yu, Qishun Geng, Jiahe Xu, Cheng Xiao, Qingwen Tao, Yuan Xu","doi":"10.1186/s13075-025-03576-x","DOIUrl":"https://doi.org/10.1186/s13075-025-03576-x","url":null,"abstract":"To develop a predictive model for bone destruction in patients with rheumatoid arthritis (RA), based on the characteristics of plasma metabolites and common clinical indicators. The cohort comprised 60 patients with RA, with baseline metabolite features identified using the liquid chromatograph-mass spectrometer system. Radiographic outcomes were assessed using the van der Heijde-modified total Sharp score (mTSS) following a one-year follow-up period to quantify bone destruction. The longitudinal association between metabolites and radiographic progression was analyzed using several machine learning algorithms, and the significance of core metabolites was calculated. A new model incorporating metabolites and clinical indicators was created to evaluate its predictive performance for radiographic progression; the model was compared with other prediction models. The median increase in mTSS was 3.50. Of the 774 detected metabolites, 77 differed between patients with different outcomes. Core metabolites identified using the Gaussian Naive Bayes algorithm included mangiferic acid, O-acetyl-L-carnitine, 5,8,11-eicosatrienoic acid, and 16-methylheptadecanoic acid. A standardized bone erosion risk score (BERS) was developed based on these core metabolite features for assessing the radiographic progression outcome. Individuals with a high BERS exhibited a lower risk of rapid radiographic progression than those with a lower score (OR = 0.01, 95% CI = 0.01–0.03, P = 0.003). The “China-Japan Friendship Hospital-BERS Model” (CjBM), combining BERS with clinical features (methotrexate and C-reactive protein), produced an area under the receiver operating characteristic curve of 0.800. Moreover, compared with the reported models, the CjBM showed near statistical significance in identifying rapid radiographic progression; adding BERS can improve the discrimination of the original reported model (PDeLong=0.035). The CjBM was developed for early prediction of bone destruction in patients with RA, and the evaluation of BERS emphasizes the significance of metabolite features.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"32 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144104591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinicopathological profile of eosinophilic fasciitis: a retrospective cohort study from a neuromuscular disorder center in China","authors":"Xiaoyuan Wang, Lining Zhang, Ying Hou, Tingjun Dai, Xiaotian Ma, Kai Shao, Chuanzhu Yan, Bing Zhao","doi":"10.1186/s13075-025-03574-z","DOIUrl":"https://doi.org/10.1186/s13075-025-03574-z","url":null,"abstract":"To characterize the clinical and myo-fascial histopathological features, along with long-term treatment outcomes of patients with eosinophilic fasciitis (EF). We performed a retrospective analysis of the clinical, serological, myo-fascial pathological features, as well as the long-term follow-up outcomes of EF patients between January 2011 and August 2023 at our neuromuscular disorder (NMD) center. Seventeen patients were included, and a male predominance (12/17, 70.6%) was identified. The most common clinical manifestation was skin thickening (100%), always distal to the elbow and knee joints, occupied by limited joint mobility (12/17, 70.6%). The “prayer sign” was observed in 7 (41.2%) patients. Eosinophilia was identified in only 7 (41.2%) patients, including 6 in the blood and 3 in tissue. Anti-Ha antibody was confirmed in one patient (P17). Typical fascial edema with or without involvement of the adjacent subcutaneous tissues was exhibited on magnetic resonance imaging (MRI) in all 9 patients. The perifascicular pattern of MHC-I and/or MHC-II upregulation without MxA expression was identified in 56.3% (9/16) of the patients’ muscle specimens. Typical perifascicular atrophy was identified in 4 patients. Complete recovery was noted in 5 patients, including 4 patients treated with prednisone as monotherapy, and 1 patient treated with prednisone combined with D-penicillamine. The “prayer sign” might be an important clinical feature of EF. Perifascicular upregulation of MHC-I and/or MHC-II but negative expression of MxA, with or without PFA, represents a unique pathological phenotype of EF. Most patients show favorable outcome following steroid monotherapy or in combination with immunosuppressants, underscoring the autoimmune pathogenic nature of this disease.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"133 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144088262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Real-world data on the use of the Shingrix vaccine among patients with inflammatory arthritis and risk of cardiovascular events following herpes zoster","authors":"Jeffrey R. Curtis, Danielle M. Conrad, Whitney S. Krueger, Andrew P. Gara, Kevin L. Winthrop","doi":"10.1186/s13075-025-03565-0","DOIUrl":"https://doi.org/10.1186/s13075-025-03565-0","url":null,"abstract":"Risk of cardiovascular events may increase after herpes zoster; therefore, American College of Rheumatology guidelines strongly recommend vaccination against herpes zoster in patients aged ≥ 18 years with rheumatic and musculoskeletal diseases taking immunosuppressive medications. Here, we investigated the effectiveness of Shingrix among patients with inflammatory arthritis and estimated the post-herpes zoster risk of cardiovascular events. In this retrospective observational cohort study, data were obtained from the Optum™ Clinformatics™ Data Mart on patients aged ≥ 18 years with rheumatoid arthritis, psoriatic arthritis, or axial spondyloarthritis. The proportions of patients receiving any Shingrix dose, a second dose, and a second dose within 6, 9, and 12 months were calculated. Incidence of herpes zoster following inflammatory arthritis diagnosis was reported. Vaccine effectiveness was calculated as (1 – incidence rate ratio of herpes zoster) × 100. Relative risk of cardiovascular events was assessed independently in the 30-, 45-, 60-, and 90-day periods post-herpes zoster in a subgroup of patients who experienced cardiovascular events. The final cohort included 132,672 patients with inflammatory arthritis. Mean age was 60.4 years, 71.9% were female, and 80.0% were diagnosed with rheumatoid arthritis. Overall, 28,690 (21.6%) patients received ≥ 1 Shingrix dose, of whom only 73.2% received a second dose. Of those receiving a second dose, 17,598 (83.8%) received it within the recommended 2–6 months after the first. Herpes zoster occurred in 4,342 (3.3%) patients, of which 360 cases occurred after Shingrix vaccination. The incidence rate (95% confidence interval) of herpes zoster per 1,000 person-years was 7.41 (6.64, 8.17) after any Shingrix vaccination vs. 14.76 (14.30, 15.22) without vaccination (crude vaccine effectiveness: 50%). The risk of venous thromboembolic events was elevated in the 60–90 days post-herpes zoster; no significantly increased risk was observed for any other cardiovascular events. This study showed that the effectiveness of Shingrix in patients with inflammatory arthritis on immunomodulatory treatment was 50%, and the risk of venous thromboembolic events was increased in the 60–90 days after herpes zoster, supporting the recommendation that adults with inflammatory arthritis should receive vaccination against herpes zoster to reduce the risk of such events.","PeriodicalId":8419,"journal":{"name":"Arthritis Research & Therapy","volume":"96 1","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-05-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144066833","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}