ACR open rheumatology最新文献

{"title":"Whole-Blood RNA Sequencing Profiling of Patients With Rheumatoid Arthritis Treated With Tofacitinib.","authors":"Chiara Bellocchi, Ennio Giulio Favalli, Gabriella Maioli, Elena Agape, Marzia Rossato, Matteo Paini, Adriana Severino, Barbara Vigone, Martina Biggioggero, Elena Trombetta, Roberto Caporali, Lorenzo Beretta","doi":"10.1002/acr2.11761","DOIUrl":"https://doi.org/10.1002/acr2.11761","url":null,"abstract":"<p><strong>Objective: </strong>Patients with rheumatoid arthritis (RA) often fail to respond to therapies, including JAK inhibitors (JAKi), and treatment allocation is made via a trial-and-error strategy. A comprehensive analysis of responses to JAKi, including tofacitinib, by RNA sequencing (RNAseq) would allow the discovery of transcriptomic markers with a two-fold meaning: (1) an improved knowledge about the mechanisms of response to treatment (inference modeling) and (2) the definition of features that may be useful in treatment optimization and assignment (predictive modeling).</p><p><strong>Methods: </strong>Thirty-three patients with active RA were treated with a tofacitinib dose of 5 mg twice a day for 24 weeks and evaluated for EULAR Disease Activity Score in 28 joints using the C-reactive protein level response. Whole-blood RNA was collected before and after treatment to perform RNAseq transcriptome analysis. Linear models were used to determine differentially expressed genes (DEGs) (1) at baseline according to clinical responses and (2) in the pre-post comparison after tofacitinib treatment and in relation to EULAR responses. The capability of DEGs to predict a successful treatment was tested via machine learning modeling after extensive internal validation.</p><p><strong>Results: </strong>Of 26 patients who completed the study (per-protocol analysis), 15 (57.7%) achieved good responses, and 7 (26.9%) and 4 (15.3%) had moderate and no responses, respectively. Overall, 273 baseline genes were significantly associated with the attainment of good responses, contributing to several pathways linked to the immune system or RA pathogenesis (eg, citrullination processes and the negative regulation of natural killer function). The expression of several molecules was reverted by tofacitinib when good responses were reached, including AKT3, GK5, KLF12, FCRL3, BIRC3, TSPOAP1, and P2RY10. Finally, we isolated 14 markers that singularly were capable of predicting the attainment of good responses, including, NKG2D, CD226, CLEC2D, and CD52.</p><p><strong>Conclusion: </strong>Whole-blood transcriptome analysis of patients with RA treated with tofacitinib identified genes whose expression may be relevant in prognostication and understanding the mechanisms of responses to therapy.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":" ","pages":""},"PeriodicalIF":2.9,"publicationDate":"2025-05-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103184","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How and Who? Examining Real-World Evidence of Engagement and Use of an Electronic Patient-Reported Outcome Smartphone Application in Routine Clinical Care for Patients With Inflammatory Arthritides.","authors":"Iuliia Biliavska, Erik Lenguerrand, Jonathan H Tobias, Philip D H Hamann","doi":"10.1002/acr2.70049","DOIUrl":"10.1002/acr2.70049","url":null,"abstract":"<p><strong>Objective: </strong>We evaluate the use of an app to remotely collect electronic patient-reported outcomes (ePROs) in patients attending routine rheumatology clinics with inflammatory arthritis (IA) over a four year period.</p><p><strong>Methods: </strong>This is a secondary analysis of real-world data obtained from patients with IA who attended routine appointments between 2018 and 2022. Patients used an app to track their disease course by using Routine Assessment of Patient Index Data 3 (RAPID3), Health Assessment Questionnaire - Disability Index, or self-assessing tender and swollen joint counts. Elapsed days of the app use, number, and time between ePROs reports were analyzed using Poisson and Tobit regression models. Results were stratified by gender, age, diagnosis, baseline disease severity, and disability.</p><p><strong>Results: </strong>At least one ePRO report was provided by 673 patients. Mean age was 53.7 ± 13.9 years; 458 (68%) were female. RAPID3 was reported by 613 (91%) patients, 531 (79%) provided more than one RAPID3, and 82 (12%) provided one RAPID3; there was no difference between groups stratified by gender, age, IA type, and baseline arthritis severity. Median engagement was 14.8 months (interquartile range 12.8-17). The proportion of enrolled patients completing a RAPID3 every month reduced from 91% at baseline to 38% at 6 months, and 24% at month 12. Older patients (60-69 years old) were more likely to be long-term users than those aged less than 50 years old (P < 0.006). Patients aged over 60 provided more reports than younger users (P < 0.0001). Gender, baseline arthritis activity, and disability level were not associated with the length or frequency of app use.</p><p><strong>Conclusion: </strong>This analysis offers insights into engagement and long-term sustainability of remote ePRO collection in a real-world rheumatology setting.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70049"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12053926/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054986","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":"Key Features of Effective Yoga Interventions in Addition to Standard Medical Treatment for Rheumatoid Arthritis: A Systematic Review and Meta-Analysis.","authors":"Isha Biswas, Jaspreet Kaur, Fiona Pearce, Sarah Lewis, Kaushik Chattopadhyay","doi":"10.1002/acr2.70054","DOIUrl":"10.1002/acr2.70054","url":null,"abstract":"<p><strong>Objective: </strong>This systematic review aimed to synthesize the content, structure, and delivery characteristics of effective yoga interventions in addition to standard medical treatment for rheumatoid arthritis (RA).</p><p><strong>Methods: </strong>The Joanna Briggs Institute guidelines were followed. Seventeen databases were searched for randomized controlled trials (RCTs) assessing yoga's effectiveness in treating RA outcomes (disease activity score, pain, and function). Meta-analyses and narrative synthesis were conducted.</p><p><strong>Results: </strong>Nine articles representing five RCTs were included and had low methodological quality scores. Yoga interventions, in addition to standard medical treatment, improved disease activity scores (standardized mean difference [SMD] -0.46, 95% confidence interval [CI] -0.73 to -0.18) and function (SMD -0.42, 95% CI -0.78 to -0.07) but did not effectively reduce pain (SMD -1.06, 95% CI -2.62 to 0.50) compared to standard medical treatment alone. All five RCTs found yoga's beneficial effects on one or more outcomes. All yoga interventions included center-based (supervised, group) sessions, and two included additional home-based (unsupervised, individual) sessions. All interventions incorporated 20 yogic poses (6 standing, 5 supine, 5 prone, and 4 seated), 7 breathing practices, and 4 meditation and relaxation practices. Two interventions offered RA-specific yogic pose modifications. Center-based sessions were delivered at least once weekly for 8 weeks' median duration and around 68 minutes per session. Home-based yoga was recommended thrice weekly for a 10-week mean duration and 40 minutes per session.</p><p><strong>Conclusion: </strong>Yoga might be useful in addition to standard medical treatment for RA. Given previous studies' methodological limitations, a high-quality RCT should be conducted based on our synthesized key features of effective yoga interventions.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70054"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064992/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058650","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 of Immersive Virtual Reality Combined With Multisensor Biofeedback on Chronic Pain in Fibromyalgia: A Pilot Randomized Controlled Trial.","authors":"Luca Chittaro, Simone Longhino, Marta Serafini, Sofia Cacioppo, Luca Quartuccio","doi":"10.1002/acr2.70048","DOIUrl":"10.1002/acr2.70048","url":null,"abstract":"<p><strong>Objective: </strong>Fibromyalgia (FM) is a syndrome marked by chronic pain, fatigue, and mood disorders. Nonpharmacologic strategies are recommended to avoid overuse of opioids or nonsteroidal anti-inflammatory drugs, but current approaches often provide limited relief. This study aimed to preliminarily assess the efficacy and feasibility of a new combined intervention of immersive virtual reality with multisensor biofeedback (IVR-BF) in FM management.</p><p><strong>Methods: </strong>In this single-center, pilot, open-label, randomized controlled trial, adult patients with FM were randomly assigned 1:1 to either the treatment (TR) group, receiving IVR-BF immediately, or a waitlist control (WL) group, receiving IVR-BF after the TR group completed treatment. The primary outcome was reduction in visual analog scale (VAS) pain scores in the TR group, after five IVR-BF sessions, compared to the WL group, after the waiting period. Secondary outcomes included improvements in FM impact (FM Impact Questionnaire [FIQ] score) and qualitative aspect of pain (Short-form McGill Pain Questionnaire [SF-MPQ] score). A longitudinal analysis was conducted across all patients to examine the trends in VAS pain, SF-MPQ, and FIQ score during the trial.</p><p><strong>Results: </strong>Fifty patients were screened, and 20 female patients (10 TR and 10 WL) completed the trial and were analyzed. Those in the TR group showed significantly lower VAS pain scores compared to those in the WL group (P = 0.011), along with significant improvement in the FIQ score (P = 0.018). The longitudinal analysis revealed progressive improvements in VAS pain, SF-MPQ, and FIQ score, supported by physiologic improvements (heart rate variability, respiratory rate, skin conductance). No significant safety concerns were reported. Patients expressed a high level of satisfaction with the IVR experience.</p><p><strong>Conclusion: </strong>IVR-BF is a feasible treatment that shows potential in reducing pain and improving quality of life in patients with FM, supporting the need for larger trials to further evaluate its efficacy.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70048"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12080186/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082618","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":"Seropositive Rheumatoid Arthritis Following Complete Remission of Antineutrophil Cytoplasmic Antibody-Associated Vasculitis With Renal Involvement: A Case Report.","authors":"Aaron Shulkin, Naushad Abid, Mehmoodur Rasheed","doi":"10.1002/acr2.70050","DOIUrl":"https://doi.org/10.1002/acr2.70050","url":null,"abstract":"<p><p>Seropositive rheumatoid arthritis (RA) and antineutrophil cytoplasmic antibody-associated vasculitis (AAV) are two autoimmune conditions with unique etiologies and clinical presentations. Although few reports have documented rare cases in which a single individual has both conditions at the same time, it is much rarer to see them in sequence of each other. Here, we report a 69-year-old man diagnosed with AAV before achieving remission following six years of treatment. Following two years of remission, he was subsequently diagnosed with seropositive RA. This case invites unique insights to further explore underlying etiologies of autoimmune diseases and the interrelationship between them.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70050"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12042695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144058652","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":"Uncovering Genetic Variation in Systemic Lupus Erythematosus Risk Variants in Indigenous Peruvians.","authors":"Cristina M Lanata, Richard F Oppong, Mary K Horton, Victor Borda, Manuel F Ugarte-Gil, Joanne Nititham, Eduardo Tarazona-Santos, Timothy D O'Connor, Heinner Guio, Lindsey A Criswell","doi":"10.1002/acr2.70053","DOIUrl":"10.1002/acr2.70053","url":null,"abstract":"<p><strong>Objective: </strong>Systemic lupus erythematosus (SLE) results in worse clinical outcomes among individuals of Amerindian descent. The genetic basis for this is uncertain, and there is a significant lack of genetic research focused on Amerindian ancestry populations. This study aims to compare the frequencies of SLE risk variants and polygenic risk scores between Indigenous Peruvians and global populations with diverse ancestral backgrounds.</p><p><strong>Methods: </strong>We studied 670 individuals from the Peruvian Genome Project, 2,068 individuals from the 1000 Genomes Project Phase 3 release, and 47 patients with SLE from Lima, Peru. Ancestry was inferred using admixture and RFMix. Data were imputed with the TOPMed Imputation server and annotated to hg38. We compared the frequencies of 199 SLE-associated risk variants among study participants. We also calculated SLE genetic risk scores and fixation index (FST) statistics.</p><p><strong>Results: </strong>All 199 SLE risk single-nucleotide polymorphisms had highly significant differences in frequencies across Peruvian and other continental populations (P values <0.001). Indigenous Peruvian patients have higher polygenic risk for SLE compared to European, African, South Asian, and East Asian patients. FST analysis of SLE risk variants revealed the largest FST between Peruvian patients and African patients (mean FST 0.12), and the smallest between Peruvian patients and East Asian patients (mean FST 0.09).</p><p><strong>Conclusion: </strong>SLE-associated variants are common among Indigenous Peruvian patients, with varying frequencies across subpopulations. This underscores the need for ongoing genetic studies in Indigenous populations, potentially explaining SLE heterogeneity.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70053"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12099220/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129709","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":"Should Joint Deformity, which is More Common Than Swelling or Tenderness, be Assessed in all Rheumatoid Arthritis Patients and Databases?","authors":"Theodore Pincus, Tengfei Li, Kathryn A Gibson","doi":"10.1002/acr2.70025","DOIUrl":"10.1002/acr2.70025","url":null,"abstract":"<p><strong>Objective: </strong>We analyzed 28 joint counts in 173 contemporary routine care patients with rheumatoid arthritis (RA), who had disease duration of 10 years and were examined in 2021, for swollen joint count (SJC), tender joint count (TJC)/pain on motion, and deformity joint count (DJC)/limited motion. In addition, we computed DJC according to Disease Activity Score in 28 joints (DA28), Clinical Disease Activity Index (CDAI), and Routine Assessment of Patient Index Data 3 (RAPID3) as remission/low or moderate/high activity or severity.</p><p><strong>Methods: </strong>This report presents a retrospective analyses of a cross-sectional Australian database for medians and prevalences of SJC, TJC, and DJC, including in RA index categories.</p><p><strong>Results: </strong>Median values were 0 for SJC, 2.0 for TJC, and 4.0 for DJC, respectively, including SJC of 0,1 in 123 patients (71%), TJC of 0,1 in 82 patients (47%), SJC+TJC of 0,1 in 73 patients (42%), and DJC of 0,1 in 65 patients (38%). Among 4,498 joints, 1,330 with any abnormality included 286 swollen joints (6%), 590 tender joints (13%), 879 deformed joints (20%), 37 only swollen joints (1%), 289 only tender joints (6%), 659 only deformed joints (15%), 458 joints with two abnormalities (10%), and 80 joints with three abnormalities (2%). The 73 of all 173 with patients with SJC and TJC 0,1 (42%), included 56% to 67% who were classified in remission or low DAS28 ESR erythrocyte sedimentation rate, CDAI, or RAPID3 activity or severity, of whom 47% to 58% had DJC ≥2, whereas 11% to 36% were classified as moderate or high RA index activity or severity, of whom 57% to 58% had DJC ≥2.</p><p><strong>Conclusion: </strong>SJC+TJC of 0,1 was more common than a DJC of 0,1 in contemporary patients with RA. DJC was ≥2 in the majority of patients who met SJC+TJC remission criteria for RA indices, as in patients who were classified as moderate/high although they met SJC+TJC remission criteria. DJC should be included in long-term routine care and RA databases.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70025"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12089699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144103182","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":"Exploring the Association of Sociodemographic Factors and Primary Diagnosis With Transition Readiness in Adolescents With Rheumatic Disease.","authors":"Maryem Al Manaa, Yuhan Ma, Chan-Hee Jo, Una E Makris, Nicole Bitencourt, Tracey Wright, Lorien Nassi","doi":"10.1002/acr2.70055","DOIUrl":"10.1002/acr2.70055","url":null,"abstract":"<p><strong>Objective: </strong>Transitioning from pediatric to adult care is challenging for adolescents with chronic health conditions. The Transition Readiness Assessment Questionnaire (TRAQ) is a validated tool for measuring transition readiness in pediatric patients with chronic diseases. This study examines the association of sociodemographic factors and primary diagnosis with transition readiness in adolescents with rheumatic disease using TRAQ scores.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of 882 adolescents with rheumatic diseases, aged 14 to 19 years, from September 2019 to December 2021. TRAQ scores, primary diagnosis, and demographic characteristics were collected. Bivariate and multiple linear regression analyses were used to identify predictors of transition readiness.</p><p><strong>Results: </strong>We collected 882 TRAQs. Lupus diagnosis was significantly associated with higher TRAQ scores, whereas juvenile dermatomyositis diagnosis negatively influenced transition readiness. Non-Hispanic ethnicity correlated with higher scores in managing medications and tracking health issues, and male gender was significantly linked to lower scores in tracking health issues and managing daily activities. There was no association between TRAQ scores and age, race, primary language of the parent, insurance type, median household income, and suicidality screen. A total of 118 patients completed two TRAQs with a mean interval of 13.5 months. There was no significant change in TRAQ scores over time. However, Hispanic patients, patients with Spanish-speaking parents, and patients with lupus scored higher on the second TRAQ.</p><p><strong>Conclusion: </strong>In our cohort, transition readiness varied by primary diagnosis. Transition plans tailored to the needs of vulnerable adolescents are required to enhance health management skills and facilitate a successful transition.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70055"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090365/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144113045","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":"Soluble Co-Inhibitory Immune Checkpoint Molecules Are Increased in Patients With Polymyalgia Rheumatica Without Significant Correlations With Clinical Status: A Case-Control Study.","authors":"Elvis Hysa, Dario Camellino, Christian Dejaco, Matteo Bauckneht, Giampaola Pesce, Silvia Morbelli, Marcello Bagnasco, Maurizio Cutolo, Eric L Matteson, Marco A Cimmino, Daniele Saverino","doi":"10.1002/acr2.70045","DOIUrl":"https://doi.org/10.1002/acr2.70045","url":null,"abstract":"<p><strong>Objective: </strong>A dysregulated immune response is involved in the pathogenesis of polymyalgia rheumatica (PMR) and giant cell arteritis (GCA). These diseases have been reported as immune-related adverse events in patients with cancer treated with immune checkpoints inhibitors. In this cross-sectional study, the relationship between soluble immune checkpoint molecules (sICMs) and clinical/imaging features of PMR and GCA was investigated.</p><p><strong>Methods: </strong>Consecutive patients with PMR diagnosed according to the criteria by Bird et al were compared with age- and sex-matched healthy controls. Patients with PMR and overlapping GCA had to also satisfy the 1990 ACR classification criteria for GCA. All patients underwent standardized clinical, laboratory examination, and ¹⁸F-fluorodeoxyglucose positron emission tomography/computed tomography scans. The sICM anticytotoxic T Ly-4, the programmed cell death protein 1 (PD-1), and PD-1 ligands PD-L1 and PD-L2 were measured by enzyme-linked immunosorbent assay.</p><p><strong>Results: </strong>Forty patients (80% women, mean age 76 years, and mean disease duration 88 days) were assessed. Of these, 30 had isolated PMR and 10 had PMR with GCA. Patients showed significantly higher concentrations of all sICMs compared with controls (P < 0.001). Conditional logistic regression revealed the strong discriminative capacity of these molecules between patients and healthy controls, with PD-1 showing complete separation among groups (effect size = 0.78) and PD-L1 (odds ratio [OR] 134.33, P < 0.001) and PD-L2 (OR 63.00, P < 0.001) demonstrating the strongest ability to distinguish patients from controls. Correlations between sICM levels and clinical features were generally weak or absent, with no significant differences based on disease phenotype or glucocorticoid exposure. Results were similar in glucocorticoid-naive patients.</p><p><strong>Conclusion: </strong>sICMs are significantly elevated in PMR and GCA and strongly differentiate patients from healthy controls. Although they do not correlate with clinical or imaging features, their consistent elevation in active disease might suggest a complex interplay between innate and adaptive immunity.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70045"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12063068/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031921","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":"Urinary V-Set Ig Domain-Containing Protein 4 and Immune Complexes for Tracking Lupus Nephritis and Renal Pathology.","authors":"Aygun Teymur, Chenling Tang, Fariz Nazir, Neda Ostadnejad, Qi Cai, Ramesh Saxena, Tianfu Wu","doi":"10.1002/acr2.70044","DOIUrl":"10.1002/acr2.70044","url":null,"abstract":"<p><strong>Objective: </strong>This study aims to investigate whether V-set Ig domain-containing protein 4 (VSIG4; also known as complement receptor of the Ig superfamily [CRIg]) forms immune complexes (ICxs) with IgG and complement component 3 (C3) in the kidneys of patients with lupus nephritis (LN) and to assess the potential of urinary VSIG4 and VSIG4-ICx as noninvasive biomarkers of LN.</p><p><strong>Methods: </strong>Immunofluorescent staining was employed to detect the deposition of VSIG4 (CRIg), IgG, and C3 in kidney tissue. Urine samples from 102 patients with LN, 51 healthy controls (HCs), and 13 patients with chronic kidney disease (CKD) were analyzed via enzyme-linked immunosorbent assay for VSIG4-ICx and free-form VSIG4.</p><p><strong>Results: </strong>Immunofluorescence costaining demonstrated the colocalization of VSIG4, IgG, and C3 in the kidneys of those with LN and elevated VSIG4 protein expression in the glomeruli regions in LN. Compared with HCs and those with CKD, patients with LN exhibited significantly elevated levels of urinary VSIG4 in both free form and ICx. Urinary VSIG4-ICx correlated with clinical parameters, including the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) (R = 0.55, P < 0.0001), renal SLEDAI (R = 0.52, P < 0.0001), estimated glomerular filtration rate (-0.5, P < 0.001), activity index (R = 0.25, P < 0.05), chronicity index (R = 0.32, P < 0.05), complement C3 (R = -0.33, P < 0.05), and complement C4 (R = -0.31, P < 0.05). The strong association of the urinary VSIG4-ICx with disease activity metrics and histopathologic evidence underscores its potential for clinical utility in diagnosing and monitoring LN.</p><p><strong>Conclusion: </strong>VSIG4-ICx shows promise as a novel urine biomarker for LN, with potential utility for diagnosis and disease monitoring.</p>","PeriodicalId":93845,"journal":{"name":"ACR open rheumatology","volume":"7 5","pages":"e70044"},"PeriodicalIF":2.9,"publicationDate":"2025-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144032990","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}