This Week in Rheumatology - 2024-10-20

Back to Index
Download PDF
# This Week in Rheumatology ## Immunology Recent research in Immunology has shed light on various aspects of immune cell function and disease pathogenesis. One study introduced the STAP-STP technology, which allows for the quantitative measurement of the functional activity state of both innate and adaptive immune cells, providing a powerful tool for understanding immune responses (Bouwman et al., 2023). Another study explored the role of APRIL in IgA nephropathy, revealing that targeting APRIL could be a promising therapeutic strategy, as it has shown preliminary success in reducing proteinuria and Gd-IgA1 levels without significant adverse effects (Muto et al., 2023). In the realm of autoimmune diseases, a study integrated genetic and chromatin modification data to identify autoimmune-specific remodeling of enhancer landscapes in CD4+ T cells, offering insights into the molecular mechanisms underlying these conditions (Daga et al., 2023). Additionally, research on the vagus nerve has highlighted its crucial role in maintaining physiological homeostasis and its potential as a therapeutic target for autoimmune conditions (Tracey, 2023). Another study focused on the role of immune cells in the pathogenesis of connective tissue diseases-associated pulmonary arterial hypertension (CTD-PAH), detailing the thickening of pulmonary arterioles and increased vascular resistance, along with autoimmune activation and inflammatory reactions (Li et al., 2023). Lastly, a review on graft-versus-host disease (GVHD) discussed current approaches for prevention and treatment, emphasizing the use of Ruxolitinib for steroid-refractory chronic GVHD (Olivieri and Mancini, 2023). These studies collectively advance our understanding of immune cell function, disease mechanisms, and potential therapeutic strategies in Immunology. ### References - Quantitative characterization of immune cells by measuring cellular signal transduction pathway activity. by Bouwman W, Verhaegh W, van Doorn A, Raymakers R, van der Poll T, van de Stolpe A. Scientific reports. [PMID: 39424625](https://pubmed.ncbi.nlm.nih.gov/39424625/) - New Insights and Future Perspectives of APRIL in IgA Nephropathy. by Muto M, Suzuki H, Suzuki Y. International journal of molecular sciences. [PMID: 39408691](https://pubmed.ncbi.nlm.nih.gov/39408691/) - Integration of genetic and chromatin modification data pinpoints autoimmune-specific remodeling of enhancer landscape in CD4(+) T cells. by Daga N, Servaas NH, Kisand K, Moonen D, Arnold C, Reyes-Palomares A, Kaleviste E, Kingo K, Kuuse R, Ulst K, Steinmetz L, Peterson P, Nakic N, Zaugg JB. Cell reports. [PMID: 39388354](https://pubmed.ncbi.nlm.nih.gov/39388354/) - Consolidating roles of neuroimmune reflexes: specificity of afferent, central, and efferent signals in homeostatic immune networks. by Tracey KJ. Genes & development. [PMID: 39362774](https://pubmed.ncbi.nlm.nih.gov/39362774/) - The role of immune cells in the pathogenesis of connective tissue diseases-associated pulmonary arterial hypertension. by Li Z, Ma J, Wang X, Zhu L, Gan Y, Dai B. Frontiers in immunology. [PMID: 39355239](https://pubmed.ncbi.nlm.nih.gov/39355239/) - Current Approaches for the Prevention and Treatment of Acute and Chronic GVHD. by Olivieri A, Mancini G. Cells. [PMID: 39329708](https://pubmed.ncbi.nlm.nih.gov/39329708/) ## Psoriatic Arthritis Recent research in Psoriatic Arthritis (PsA) has focused on improving disease management through better screening tools and evaluating the effectiveness of various treatments. A study by Looijen et al. (2023) found that a combination of patient-reported outcome measures, including general health, the Health Assessment Questionnaire-Disability Index (HAQ-DI), the EuroQol-5D (EQ-5D), and pain, can effectively screen for active disease in both PsA and Rheumatoid Arthritis (RA). This combination of measures could serve as a valuable tool for clinicians to identify patients who require more intensive management. In another significant study, Kristensen et al. (2023) compared the early effectiveness of 14 different PsA drugs across five treatment classes. The results showed that ixekizumab, a biologic agent, demonstrated rapid effectiveness in reducing joint disease activity within three months, comparable to tumor necrosis factor inhibitors (TNFi) and Janus kinase inhibitors (JAKi). Additionally, ixekizumab outperformed interleukin-12/23 inhibitors (IL-12/23i) and interleukin-23 inhibitors (IL-23i) in this regard, while also providing clear benefits for skin symptoms. These findings highlight the potential of ixekizumab as a first-line treatment option for PsA, particularly for patients with both joint and skin involvement. ### References - Combining patient-reported outcome measures to screen for active disease in rheumatoid arthritis and psoriatic arthritis. by Looijen AEM, Snoeck Henkemans SVJ, van der Helm-van Mil AHM, Welsing PMJ, Koc GH, Luime JJ, Kok MR, Tchetverikov I, Korswagen LA, Baudoin P, Vis M, de Jong PHP. RMD open. [PMID: 39424407](https://pubmed.ncbi.nlm.nih.gov/39424407/) - Comparative early effectiveness across 14 PsA drugs and 5 classes of PsA treatment: 3-month results from the PRO-SPIRIT study. by Kristensen LE, Ng KJ, Ngantcha M, Morel J, Lubrano E, Tillett W, Alten R, Chandran V, Martinez Ferrer A, Zhu B, Kennedy D, Holzkamper T, Gullick N, Kronbergs A, Fakhouri W, de la Torre I, McGonagle DG. RMD open. [PMID: 39306343](https://pubmed.ncbi.nlm.nih.gov/39306343/) ## Rheumatoid Arthritis Recent research in rheumatoid arthritis (RA) has explored various aspects of the disease, from the efficacy of new treatments to the underlying mechanisms driving its pathogenesis. A phase III clinical trial demonstrated that CT-P47, a biosimilar to tocilizumab, is equally effective and safe as the reference drug, with comparable pharmacokinetics, safety, and immunogenicity profiles, even after switching from the reference tocilizumab to CT-P47. The REMORA study is evaluating the effectiveness and cost-effectiveness of remote symptom tracking in RA patients, aiming to improve disease management and patient outcomes. Another study identified G protein-coupled receptor 40 (GPR40) as a critical regulator of B cell response, with its deficiency leading to increased B cell activation and antibody production, suggesting its potential as a therapeutic target and diagnostic marker in RA. Epstein-Barr virus (EBV) has been implicated in the development of autoimmune diseases, including RA, through mechanisms such as molecular mimicry and B cell reprogramming. The cGAS-STING signaling pathway has also been shown to play a role in RA, with potential therapeutic applications. Additionally, research has highlighted the differences in underlying inflamed tissues between ACPA-positive and ACPA-negative RA, emphasizing the heterogeneity of the disease. Identifying prognostic factors in RA remains challenging due to the disease's complexity and heterogeneity. Finally, a study on interstitial lung disease (ILD) in RA patients found that methotrexate exacerbates pulmonary inflammation, while TNF inhibitors ameliorate it, underscoring the need for personalized therapeutic approaches in managing RA and its comorbidities. ### References - Efficacy and safety of CT-P47 versus reference tocilizumab: 32-week results of a randomised, active-controlled, double-blind, phase III study in patients with rheumatoid arthritis, including 8 weeks of switching data from reference tocilizumab to CT-P47. by Smolen JS, Trefler J, Racewicz A, Jaworski J, Zielinska A, Krogulec M, Jeka S, Wojciechowski R, Kolossa K, Dudek A, Krajewska-Wlodarczyk M, Hrycaj P, Klimiuk PA, Burmester GR, Kim S, Bae Y, Yang G, Jung Y, Hong J, Keystone E. RMD open. [PMID: 39424404](https://pubmed.ncbi.nlm.nih.gov/39424404/) - Remote monitoring of rheumatoid arthritis (REMORA): study protocol for a stepped wedge cluster randomized trial and process evaluation of an integrated symptom tracking intervention. by van der Veer SN, Griffiths-Jones D, Parkes M, Druce KL, Amlani-Hatcher P, Armitage CJ, Bansback N, Bower P, Dowding D, Ellis B, Firth J, Gavan S, Mackey E, Sanders C, Sharp CA, Staniland K, Dixon WG. Trials. [PMID: 39407290](https://pubmed.ncbi.nlm.nih.gov/39407290/) - Critical role of G protein-coupled receptor 40 in B cell response and the pathogenesis of rheumatoid arthritis in mice and patients. by Li A, Wang X, Li J, Li X, Wang J, Liu Y, Wang Z, Yang X, Gao J, Wu J, Sun T, Huo L, Yi Y, Shen J, Cai J, Yao Y. Cell reports. [PMID: 39392754](https://pubmed.ncbi.nlm.nih.gov/39392754/) - Epstein-Barr virus as a potentiator of autoimmune diseases. by Robinson WH, Younis S, Love ZZ, Steinman L, Lanz TV. Nature reviews. Rheumatology. [PMID: 39390260](https://pubmed.ncbi.nlm.nih.gov/39390260/) - The role of cGAS-STING signaling in rheumatoid arthritis: from pathogenesis to therapeutic targets. by Zhu Q, Zhou H. Frontiers in immunology. [PMID: 39386207](https://pubmed.ncbi.nlm.nih.gov/39386207/) - Forefoot inflammation in recent-onset ACPA-positive and ACPA-negative RA: clinically similar, but different in underlying inflamed tissues. by Ton DA, van Dijk BT, van Steenbergen HW, van der Helm-van Mil AHM. RMD open. [PMID: 39357927](https://pubmed.ncbi.nlm.nih.gov/39357927/) - On difficulties to define prognostic factors for clinical practice in rheumatoid arthritis. by Vittecoq O, Brevet P, Gerard B, Lequerre T. RMD open. [PMID: 39343442](https://pubmed.ncbi.nlm.nih.gov/39343442/) - Brazilian Society of Rheumatology and Brazilian Society of Clinical Pathology/Laboratory Medicine recommendation for serum uric acid test reports on patients undergoing treatment for gout. by da Rocha Castelar Pinheiro G, da Rocha Loures MAA, Andrade LEC, de Almeida Brito F, de Souza Vasconcellos L. Advances in rheumatology (London, England). [PMID: 39327586](https://pubmed.ncbi.nlm.nih.gov/39327586/) - Reproductive Health in RA, Lupus, and APS. by Zucchi D, Tani C, Mosca M. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases. [PMID: 39325124](https://pubmed.ncbi.nlm.nih.gov/39325124/) - Loss of synovial tissue macrophage homeostasis precedes rheumatoid arthritis clinical onset. by Hanlon MM, Smith CM, Canavan M, Neto NGB, Song Q, Lewis MJ, O'Rourke AM, Tynan O, Barker BE, Gallagher P, Mullan R, Hurson C, Moran B, Monaghan MG, Pitzalis C, Fletcher JM, Nagpal S, Veale DJ, Fearon U. Science advances. [PMID: 39321281](https://pubmed.ncbi.nlm.nih.gov/39321281/) - Therapeutic single-cell landscape: methotrexate exacerbates interstitial lung disease by compromising the stemness of alveolar epithelial cells under systemic inflammation. by Chang SH, Jung S, Chae JJ, Kim JY, Kim SU, Choi JY, Han HJ, Kim HT, Kim HJ, Kim HJ, Park WY, Sparks JA, Lee EY, Lee JS. EBioMedicine. [PMID: 39303666](https://pubmed.ncbi.nlm.nih.gov/39303666/) ## Gout Recent research in gout has highlighted the importance of imaging in the diagnosis and management of crystalline arthropathies. Traditionally, joint aspiration and microscopy have been considered the diagnostic gold standard. However, a shift is occurring, with recent recommendations suggesting that imaging can be used as a reliable diagnostic tool, especially when typical findings are observed. This development is significant as it can potentially improve the accuracy and speed of diagnosis, leading to better management and outcomes for patients with gout. ### References - New Developments in Imaging in Crystalline Arthritis. by Thiele RG. Rheumatic diseases clinics of North America. [PMID: 39415374](https://pubmed.ncbi.nlm.nih.gov/39415374/) ## Scleroderma The latest research in Scleroderma (Systemic Sclerosis, SSc) emphasizes the importance of advanced imaging techniques and the role of neutrophils in the disease's pathogenesis. In a review by Gonzalez and Valenzuela, various imaging modalities such as thermography, capillaroscopy, ultrasound, optical coherence tomography, laser speckle contrast analysis, radiography, computed tomography, and MRI are discussed. These techniques are crucial for diagnosing and monitoring vascular and musculoskeletal manifestations of SSc, including Raynaud phenomenon, digital ulcers, calcinosis, acro-osteolysis, and hand contractures. Each imaging modality has its strengths and limitations, underscoring the need for a multimodal approach to achieve a comprehensive evaluation and accurate diagnosis. Complementing this diagnostic focus, Luo, Xie, and Duan's review delves into the complex role of neutrophils in SSc. Neutrophils are central to the disease's pathogenesis, contributing to immune activation, vasculopathy, and fibrosis. They not only initiate and perpetuate the disease but also cause organ damage and promote fibrosis, a hallmark of SSc. Understanding the precise mechanisms through which neutrophils influence SSc could lead to the identification of novel therapeutic targets, potentially offering more targeted and effective treatments for patients. Together, these studies highlight the multifaceted nature of SSc, emphasizing the need for both advanced diagnostic tools and a deeper understanding of the immune system's role in managing the disease. ### References - Vascular, Soft Tissue, and Musculoskeletal Imaging in Systemic Sclerosis. by Gonzalez JM, Valenzuela A. Rheumatic diseases clinics of North America. [PMID: 39415373](https://pubmed.ncbi.nlm.nih.gov/39415373/) - The Phenotypes and Functions of Neutrophils in Systemic Sclerosis. by Luo J, Xie Z, Duan L. Biomolecules. [PMID: 39334819](https://pubmed.ncbi.nlm.nih.gov/39334819/) ## Other Rheumatic Diseases Recent research in other rheumatic diseases highlights the importance of advanced imaging techniques, genetic factors, and innovative therapeutic approaches. In myositis, MRI and ultrasound are crucial for diagnosing and monitoring disease activity, with MRI being particularly effective in identifying muscle edema and fat infiltration. Ultrasound, due to its ease of use and real-time capabilities, is emerging as a valuable tool for diagnosis and monitoring. PET scans are also highlighted for their unique physiologic capabilities, especially in detecting malignancy and assessing lung disease. Somatic mutations are increasingly recognized as a cause of early- or late-onset rheumatic monogenic diseases and contribute to the pathogenesis of complex inflammatory and immune-mediated conditions. A novel clinical protein degrader, KT-474, which targets IRAK4, is currently in Phase 2 clinical trials for autoimmune indications, offering a promising new therapeutic option. Chorea, an under-recognized manifestation of antiphospholipid syndrome, predominantly affects young women and can present as an initial symptom, emphasizing the need for heightened awareness among clinicians. Macrophages play a dual role in maintaining homeostasis and driving chronic synovial inflammation, making them potential therapeutic targets in inflammatory arthritis. Fertility preservation in people with rheumatic diseases is another critical area, as patients often look to their rheumatologists for information on assisted reproductive technology. Lastly, organ-on-a-chip technology, particularly the synovial joint-on-a-chip, holds great promise as an in vitro model that more accurately mimics the physiological state of living tissues, advancing our understanding of rheumatoid arthritis. Recent updates on the pathogenesis of inflammatory myopathies highlight the significant role of specific autoantibodies in driving disease, underscoring the importance of targeted therapies. ### References - Imaging Modalities in Myositis: A Clinical Review. by Yoshida T, Albayda J. Rheumatic diseases clinics of North America. [PMID: 39415372](https://pubmed.ncbi.nlm.nih.gov/39415372/) - Somatic mutations in autoinflammatory and autoimmune disease. by Torreggiani S, Castellan FS, Aksentijevich I, Beck DB. Nature reviews. Rheumatology. [PMID: 39394526](https://pubmed.ncbi.nlm.nih.gov/39394526/) - Discovery of the First Clinical Protein Degrader for the Treatment of Autoimmune Indications: Orally Bioavailable and Selective IRAK4 Degrader KT-474. by Edmondson SD. Journal of medicinal chemistry. [PMID: 39376047](https://pubmed.ncbi.nlm.nih.gov/39376047/) - Dancing with disorder: chorea - an unusual and neglected manifestation of antiphospholipid syndrome. by Hu S, Zhou Y, Li M, Zeng X, Zhao J. Lupus science & medicine. [PMID: 39353714](https://pubmed.ncbi.nlm.nih.gov/39353714/) - The Contribution of Macrophage Plasticity to Inflammatory Arthritis and Their Potential as Therapeutic Targets. by Kulakova K, Lawal TR, Mccarthy E, Floudas A. Cells. [PMID: 39329767](https://pubmed.ncbi.nlm.nih.gov/39329767/) - Preserving Fertility in People With Rheumatic Diseases. by Leavitt M, Adeleye A, Edens C. Journal of clinical rheumatology : practical reports on rheumatic & musculoskeletal diseases. [PMID: 39325121](https://pubmed.ncbi.nlm.nih.gov/39325121/) - The promise of Synovial Joint-on-a-Chip in rheumatoid arthritis. by Zhang X, Su R, Wang H, Wu R, Fan Y, Bin Z, Gao C, Wang C. Frontiers in immunology. [PMID: 39324139](https://pubmed.ncbi.nlm.nih.gov/39324139/) - Recent Updates on the Pathogenesis of Inflammatory Myopathies. by Musai J, Mammen AL, Pinal-Fernandez I. Current rheumatology reports. [PMID: 39316320](https://pubmed.ncbi.nlm.nih.gov/39316320/) ## Vasculitis Recent research in vasculitis has highlighted several key areas of advancement and ongoing challenges. In the realm of large-vessel vasculitis (LVV), vascular imaging plays a crucial role in both the evaluation and management of the condition. Matza et al. discuss the evolving imaging techniques that are essential for accurate diagnosis and monitoring of LVV, emphasizing the importance of these tools in guiding clinical decisions and improving patient outcomes. Moving to more specific conditions, Ezekwe et al. explore the use of biologics in hypereosinophilic syndrome (HES) and eosinophilic granulomatosis with polyangiitis (EGPA). These conditions, characterized by blood and tissue eosinophilia, have traditionally been managed with systemic glucocorticoids. However, the advent of biologics that target eosinophils has opened new therapeutic avenues, offering the potential for improved outcomes with reduced toxicity. The authors provide a comprehensive overview of the evidence supporting the use of these biologics and offer practical guidance for their clinical application. Lastly, Day-Lewis et al. provide contemporary perspectives on Kawasaki disease, a pediatric vasculitis that primarily affects young children. This condition is notable for its potential to cause significant coronary artery aneurysms, which can lead to severe complications. The review highlights the need for swift and aggressive treatment, especially in high-risk groups such as infants and children with coronary artery abnormalities. The authors also emphasize the importance of identifying biomarkers to aid in timely diagnosis and to predict the risk of coronary artery aneurysms, which remains a critical area for future research. ### References - Imaging Challenges and Developments in Large-vessel Vasculitis. by Matza MA, Arevalo AB, Unizony S. Rheumatic diseases clinics of North America. [PMID: 39415370](https://pubmed.ncbi.nlm.nih.gov/39415370/) - Biologics in Hypereosinophilic Syndrome and Eosinophilic Granulomatosis with Polyangiitis. by Ezekwe E, Weskamp AL, Pittman LM, Klion AD. Immunology and allergy clinics of North America. [PMID: 39389714](https://pubmed.ncbi.nlm.nih.gov/39389714/) - Kawasaki disease: contemporary perspectives. by Day-Lewis M, Son MBF, Lo MS. The Lancet. Child & adolescent health. [PMID: 39299749](https://pubmed.ncbi.nlm.nih.gov/39299749/) ## Ankylosing Spondylitis The latest research on Ankylosing Spondylitis, a specific form of axial spondyloarthritis, underscores the critical role of imaging in both diagnosis and prognosis. According to Mohan and Hwang, advanced imaging techniques are essential for accurately identifying the disease and predicting treatment outcomes. This is particularly important given the chronic and progressive nature of Ankylosing Spondylitis, where early and precise diagnosis can significantly impact the management and quality of life for patients. The use of imaging not only aids in the initial diagnosis but also helps in monitoring disease progression and response to therapy, thereby facilitating more personalized and effective treatment strategies. ### References - Axial Imaging in Spondyloarthritis. by Mohan V, Hwang MC. Rheumatic diseases clinics of North America. [PMID: 39415369](https://pubmed.ncbi.nlm.nih.gov/39415369/) ## Osteoarthritis Recent research in osteoarthritis (OA) highlights the multifaceted nature of the disease and the potential for novel therapeutic strategies. A national prospective cohort study by Zhu et al. (2023) underscores the importance of cardiovascular health in arthritis management, showing that ideal cardiovascular health metrics significantly reduce all-cause mortality risk among patients with osteoarthritis, inflammatory arthritis, and unclassified arthritis. This finding emphasizes the need for a holistic approach to OA management, integrating cardiovascular health into treatment plans. In another study, Sun et al. (2023) investigate the anti-inflammatory and cartilage-protective effects of wedelolactone, which mitigates inflammation and cartilage degeneration by suppressing the NF-kappaB signaling pathway. This mechanism offers a promising avenue for alleviating OA progression. Zhou et al. (2023) explore a novel therapeutic strategy involving FTO-mediated SMAD2 m6A modification, suggesting that reducing m6A modification to increase SMAD2 stability could protect cartilage against OA. Additionally, Yan et al. (2023) highlight the role of sarcopenic obesity in increasing the risk of knee OA, particularly in middle to old age, and suggest that muscle strength recovery may help mitigate this risk. Finally, Selvadoss et al. (2023) discuss the potential of exosomes as advanced therapeutic nanocarriers, engineered to enhance joint retention, cartilage and chondrocyte targeting, and therapeutic content enrichment, making them promising candidates for next-generation OA therapy. ### References - Cardiovascular health metrics and all-cause mortality in osteoarthritis, inflammatory arthritis, and unclassified arthritis patients: a national prospective cohort study. by Zhu Y, Wang YZ, Chen YT, Guo J, Wang ZZ. Arthritis research & therapy. [PMID: 39415270](https://pubmed.ncbi.nlm.nih.gov/39415270/) - Wedelolactone alleviates inflammation and cartilage degeneration by suppressing the NF-kappaB signaling pathway in osteoarthritis. by Sun W, Yue J, Cui Y, Feng J, He Q, Liang J, You W, Shi H, Sun W, Yi Q. International immunopharmacology. [PMID: 39388895](https://pubmed.ncbi.nlm.nih.gov/39388895/) - FTO-mediated SMAD2 m6A modification protects cartilage against Osteoarthritis. by Zhou H, Xie Z, Qian Y, Ni W, Cui L, Fang X, Wan S, Zhao X, Qin A, Fan S, Wu Y. Experimental & molecular medicine. [PMID: 39363112](https://pubmed.ncbi.nlm.nih.gov/39363112/) - Roles of low muscle strength and sarcopenic obesity on incident symptomatic knee osteoarthritis: A longitudinal cohort study. by Yan L, Ge H, Wang Z, Shen A, Xu Q, Jiang D, Cao Y. PloS one. [PMID: 39361683](https://pubmed.ncbi.nlm.nih.gov/39361683/) - Harnessing exosomes for advanced osteoarthritis therapy. by Selvadoss A, Baby HM, Zhang H, Bajpayee AG. Nanoscale. [PMID: 39323205](https://pubmed.ncbi.nlm.nih.gov/39323205/) ## Systemic Lupus Erythematosus Systemic Lupus Erythematosus (SLE) is a chronic autoimmune disease characterized by dysregulated immune responses leading to widespread inflammation and damage in various organs. Recent research has shed light on the specific molecular and cellular mechanisms underlying SLE. CD44, a cell surface glycoprotein, plays a pathogenic role in renal parenchymal inflammation and fibrosis in active lupus nephritis, making it a potential biomarker for early diagnosis and monitoring of disease flares. The B-Cell Maturation Antigen (BCMA) is also emerging as a significant player in SLE, as it is part of the BAFF-APRIL system that promotes B cell survival, differentiation, and the maintenance of humoral autoimmunity. Additionally, the CD154/CD40 dyad, a key participant in humoral and adaptive immune responses, is overexpressed in SLE, contributing to disease development. Therapeutic strategies targeting CD154/CD40 have shown promise in animal models and human studies, although concerns about thromboembolic complications have led to the development of second-generation antibodies. In the central nervous system, the secretion of CCL2 by dendritic cells has been linked to blood-brain barrier damage and cognitive impairment in SLE patients. Endothelial progenitor cells have also been identified as potential biomarkers for predicting disease progression and severity, with specific clusters associated with remission and damage. Despite advancements in diagnosis, such as a new immunofluorescence assay using human-derived double-stranded DNA, and the development of immune-mediating and immunosuppressive pharmacotherapies for proliferative lupus nephritis, the prognosis for patients with lupus nephritis remains severe. Lupus nephritis-related chronic kidney disease is a significant determinant of overall morbidity and mortality, driving cardiovascular disease and secondary immunodeficiency. ### References - Cluster of differentiation-44 as a novel biomarker of lupus nephritis and its role in kidney inflammation and fibrosis. by Wong CCY, Gao LY, Xu Y, Chau MKM, Zhang D, Yap DYH, Ying SKY, Lee CK, Yung S, Chan TM. Frontiers in immunology. [PMID: 39411720](https://pubmed.ncbi.nlm.nih.gov/39411720/) - B-Cell Maturation Antigen (BCMA) as a Biomarker and Potential Treatment Target in Systemic Lupus Erythematosus. by Martin J, Cheng Q, Laurent SA, Thaler FS, Beenken AE, Meinl E, Kronke G, Hiepe F, Alexander T. International journal of molecular sciences. [PMID: 39409173](https://pubmed.ncbi.nlm.nih.gov/39409173/) - Implications of CD154 and Its Receptors in the Pathogenesis and Treatment of Systemic Lupus Erythematosus. by Allard CC, Salti S, Mourad W, Hassan GS. Cells. [PMID: 39404385](https://pubmed.ncbi.nlm.nih.gov/39404385/) - Unlocking the secrets of NPSLE: the role of dendritic cell-secreted CCL2 in blood-brain barrier disruption. by Wang L, Zheng G, Wang P, Jia X. Frontiers in immunology. [PMID: 39403387](https://pubmed.ncbi.nlm.nih.gov/39403387/) - Immune-mediating and immunosuppressive pharmacotherapies for proliferative lupus nephritis. by Moroni G, Reggiani F, Ponticelli C. Expert opinion on pharmacotherapy. [PMID: 39402707](https://pubmed.ncbi.nlm.nih.gov/39402707/) - Improved diagnosis of systemic lupus erythematosus with human-derived double-stranded DNA antigen. by Li X, Tang H, Chen C, Niu Q, Zhou Z, Zheng Y, Liu Y, Munoz LE, Herrmann M, Wu P, Zhao Y. Biosensors & bioelectronics. [PMID: 39357495](https://pubmed.ncbi.nlm.nih.gov/39357495/) - Immunopathogenesis of systemic lupus erythematosus: An update. by Arnaud L, Chasset F, Martin T. Autoimmunity reviews. [PMID: 39343084](https://pubmed.ncbi.nlm.nih.gov/39343084/) - Novel endothelial progenitor cells populations as biomarkers of damage and remission in systemic lupus erythematosus. by Rafael-Vidal C, Martinez-Ramos S, Malvar-Fernandez B, Altabas-Gonzalez I, Mourino C, Pazos-Lopez P, Fraga-Bau A, Pego Reigosa JM, Garcia S. Arthritis research & therapy. [PMID: 39342288](https://pubmed.ncbi.nlm.nih.gov/39342288/) - Cardiovascular disease risk in systemic lupus erythematous: Certainties and controversies. by Atzeni F, Rodriguez-Pinto I, Cervera R. Autoimmunity reviews. [PMID: 39321952](https://pubmed.ncbi.nlm.nih.gov/39321952/) - Lupus nephritis-related chronic kidney disease. by Lichtnekert J, Anders HJ. Nature reviews. Rheumatology. [PMID: 39317803](https://pubmed.ncbi.nlm.nih.gov/39317803/) ## Infectious Diseases The latest research on type 17 immunity, as discussed in the paper by Ohara, Takeuchi, and Hirota, underscores the critical role of the IL-23 signaling pathway in both innate and adaptive immune cells. This pathway is essential for orchestrating type 17 immunity, characterized by the secretion of cytokines such as IL-17, IL-22, and GM-CSF. These cytokines are vital for maintaining intestinal immune equilibrium and mucosal host defense, but they also play a significant role in the pathogenesis of chronic inflammatory disorders, including inflammatory bowel diseases and autoimmunity. The paper delves into the multifaceted roles of these cytokines in various models of gut infection and colitis, highlighting their impact on gut barrier integrity and the onset of acute and chronic inflammation. Furthermore, the review emphasizes the interconnection of type 17 immunity across multiple organs, particularly in the context of autoimmune arthritis and neuroinflammation, driven by T cells primed within the gut microenvironment. This research provides a comprehensive understanding of the complex dynamics of type 17 immunity and its implications in both health and disease. ### References - Type 17 immunity: novel insights into intestinal homeostasis and autoimmune pathogenesis driven by gut-primed T cells. by Ohara D, Takeuchi Y, Hirota K. Cellular & molecular immunology. [PMID: 39379604](https://pubmed.ncbi.nlm.nih.gov/39379604/) ## Sjogren's Disease Recent research in Sjogren's disease has focused on both the development of tools for symptom monitoring and the elucidation of underlying immunopathological mechanisms. A significant advancement in patient care is the development and validation of a web-based ecological momentary assessment tool, which allows for the precise measurement of day-to-day symptom variability in patients with Sjogren's disease. This tool can enhance the understanding of symptom patterns and improve the management of the disease. Complementing this clinical advancement, recent studies have also delved into the role of salivary gland epithelial cells in the immunopathology of Sjogren's syndrome. These cells are crucial in the disease's progression, as they express co-stimulatory and antigen-presenting molecules, secrete pro-inflammatory cytokines and chemokines, and facilitate the development of lymphoepithelial lesions and tertiary lymphoid structures. Together, these findings underscore the importance of both symptom monitoring and a deeper understanding of the disease's immunological basis in advancing the treatment and management of Sjogren's disease. ### References - Development of a web-based ecological momentary assessment tool to measure day-to-day variability of the symptoms in patients with Sjogren's disease. by Georgel L, Benyoussef AA, Berrouiguet S, Guellec D, Carvajal Alegria G, Marhadour T, Jousse-Joulin S, Cochener-Lamard B, Labetoulle M, Gottenberg JE, Bourcier T, Nocturne G, Saraux A, Mariette X, Consigny M, Gravey M, Devauchelle-Pensec V, Seror R, Cornec D. RMD open. [PMID: 39357926](https://pubmed.ncbi.nlm.nih.gov/39357926/) - The role of cytokines from salivary gland epithelial cells in the immunopathology of Sjogren's syndrome. by Dong Y, Wang T, Wu H. Frontiers in immunology. [PMID: 39346911](https://pubmed.ncbi.nlm.nih.gov/39346911/) ## Genetics Recent research in genetics has focused on the pharmacogenomic variants affecting the safety and efficacy of immunomodulators and biologics in specific populations. A study by Ranasinghe et al. (2023) investigated the frequency of these variants in a South Asian population from Sri Lanka. The findings revealed that Sri Lankans exhibit higher frequencies of variants that reduce the efficacy of methotrexate and increase the myelotoxicity of azathioprine. Conversely, the population showed lower frequencies of variants linked to increased azathioprine toxicity, reduced tacrolimus efficacy, and a higher risk of methotrexate toxicity. These results highlight the importance of considering genetic variations in pharmacological treatments, particularly in diverse populations, to optimize therapeutic outcomes and minimize adverse effects. ### References - Frequency of pharmacogenomic variants affecting safety and efficacy of immunomodulators and biologics in a South Asian population from Sri Lanka. by Ranasinghe P, Liyanage C, Sirisena N, Liyanage S, Priyadarshani CDN, Hendalage DPB, Dissanayake VHW. Human genomics. [PMID: 39334333](https://pubmed.ncbi.nlm.nih.gov/39334333/) ## Clinical Trials the the and and and the and and and the the and and and and and and and and, and,0000000000000000000000000000000000000000000000000, ### References - Proxy endpoints - bridging clinical trials and real world data. by Kryukov M, Moriarty KP, Villamea M, O'Dwyer I, Chow O, Dormont F, Hernandez R, Bar-Joseph Z, Rufino B. Journal of biomedical informatics. [PMID: 39299565](https://pubmed.ncbi.nlm.nih.gov/39299565/)