This Week in Rheumatology - 2024-10-27

# This Week in Rheumatology ## Vasculitis Recent research in vasculitis highlights the significant impact of the condition on the cardiovascular system, particularly in the context of coronary artery disease and noninfectious thoracic aortitis. In the management of coronary artery diseases in systemic vasculitides, Shumnalieva et al. emphasize that the inflammatory processes inherent in vasculitis contribute to accelerated atherosclerosis and myocardial ischemia, posing a significant risk to patients. This underscores the need for tailored management strategies to address these complications. Similarly, Clifford's work on incidentally detected noninfectious thoracic aortitis underscores the importance of a thorough clinical approach, including comprehensive evaluation, laboratory tests, and imaging, to identify the etiology and manage the condition effectively. Both studies highlight the high risk of future vascular complications in patients with vasculitis, reinforcing the need for regular follow-up and a multidisciplinary approach to care. ### References - Management of Coronary Artery Diseases in Systemic Vasculitides: Complications and Strategies. by Shumnalieva R, Mileva N, Padjen I, Siliogkas P, Chervenkov L, Bakopoulou K, Kaouri IE, Vasilska A, Miteva D, Vassilev D, Velikova T. Medicina (Kaunas, Lithuania). [PMID: 39459361](https://pubmed.ncbi.nlm.nih.gov/39459361/) - Incidentally detected noninfectious thoracic aortitis: A clinical approach. by Clifford AH. Cleveland Clinic journal of medicine. [PMID: 39353662](https://pubmed.ncbi.nlm.nih.gov/39353662/) ## Rheumatoid Arthritis Recent research in rheumatoid arthritis (RA) has explored various aspects of the disease, from its interactions with SARS-CoV-2 to the molecular mechanisms underlying its pathogenesis. A systematic literature review by Vladulescu-Trandafir et al. (2023) highlights the complex immunologic issues and management challenges posed by the intersection of RA and COVID-19, emphasizing the importance of vaccination and careful disease management. On the molecular front, Zheng et al. (2023) and Zhu et al. (2023) have identified non-coding RNAs and the cGAS-STING signaling pathway, respectively, as key players in the pathogenesis of RA. Non-coding RNAs in fibroblast-like synoviocytes contribute to disease progression, while cGAS-STING signaling is involved in immune responses and could be a potential therapeutic target. Additionally, Li et al. (2023) have shown that G protein-coupled receptor 40 (GPR40) plays a critical role in B cell function, suggesting it as another potential therapeutic target and diagnostic marker. In terms of disease management, van der Veer et al. (2023) are conducting a trial to evaluate the effectiveness and cost-effectiveness of remote monitoring and integrated symptom tracking in RA patients, which could lead to better disease control and quality of life. Lastly, Tada et al. (2023) have found that biologic and targeted synthetic disease-modifying anti-rheumatic drugs (b/tsDMARDs) improve body composition more effectively than conventional synthetic disease-modifying anti-rheumatic drugs (csDMARDs), highlighting the importance of personalized treatment approaches. However, as noted by Vittecoq et al. (2023), identifying prognostic factors for RA remains a significant challenge due to the heterogeneity of the disease and the methods used to study it. ### References - Rheumatoid Arthritis and COVID-19 at the Intersection of Immunology and Infectious Diseases: A Related PRISMA Systematic Literature Review. by Vladulescu-Trandafir AI, Bojinca VC, Munteanu C, Anghelescu A, Popescu C, Stoica SI, Aurelian S, Balanescu A, Baetu C, Ciobanu V, Onose G. International journal of molecular sciences. [PMID: 39456932](https://pubmed.ncbi.nlm.nih.gov/39456932/) - The role of non-coding RNAs in fibroblast-like synoviocytes in rheumatoid arthritis. by Zheng Y, Cai X, Ren F, Yao Y. International journal of rheumatic diseases. [PMID: 39439368](https://pubmed.ncbi.nlm.nih.gov/39439368/) - 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/) - The gut homeostasis-immune system axis: novel insights into rheumatoid arthritis pathogenesis and treatment. by Qi P, Chen X, Tian J, Zhong K, Qi Z, Li M, Xie X. Frontiers in immunology. [PMID: 39391302](https://pubmed.ncbi.nlm.nih.gov/39391302/) - 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/) - Biologic and targeted synthetic disease-modifying anti-rheumatic drugs improve body composition in rheumatoid arthritis patients more than conventional synthetic disease-modifying anti-rheumatic drugs: Results from the PRESENT study. by Tada M, Matsumoto Y, Koike T, Mamoto K, Nakamura T, Anno S, Iida T, Goto H, Hidaka N. International journal of rheumatic diseases. [PMID: 39381837](https://pubmed.ncbi.nlm.nih.gov/39381837/) - 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/) ## Systemic Lupus Erythematosus Recent research on Systemic Lupus Erythematosus (SLE) has shed light on various aspects of the disease, including its pathogenesis, treatment options, biomarkers, and neuropsychiatric manifestations. In terms of pathogenesis, studies have identified significant changes in peripheral lymphocyte structure and function, which play a critical role in initiating and perpetuating inflammatory and immune signaling pathways (Moysidou et al., 2023). Additionally, the BAFF-APRIL system has been highlighted as crucial for B cell survival and the maintenance of humoral autoimmunity, making it a potential therapeutic target (Martin et al., 2023). The immunopathogenesis of SLE is further characterized by dysregulated immune responses leading to widespread inflammation and organ damage (Arnaud et al., 2023). In the realm of treatment, several B cell-targeting biologics have shown promise. A systematic review and network meta-analysis found that obinutuzumab, belimumab, and rituximab, when used in conjunction with standard care, may be more effective and safer than the current standard therapy for lupus nephritis (Zhao et al., 2023). Immune-mediating and immunosuppressive pharmacotherapies, including antimalarial drugs like hydroxychloroquine, remain important in managing proliferative lupus nephritis, though challenges persist due to the severity of the condition and potential side effects (Moroni et al., 2023; Paredes-Ruiz et al., 2023). CAR immunotherapy, while still in its early stages, holds potential for treating autoimmune diseases, including SLE, but faces challenges related to safety and efficacy (Yu et al., 2023). Biomarkers and diagnostic tools are also advancing. CD44 has been identified as a novel biomarker for lupus nephritis, playing a pathogenic role in renal inflammation and fibrosis, and may facilitate early diagnosis of disease flares (Wong et al., 2023). Circulating extracellular vesicles (EVs) have been found to contribute to the hypercoagulation state and severity of pulmonary arterial hypertension in SLE patients (Ding et al., 2023). Furthermore, the secretion of CCL2 by dendritic cells has been linked to blood-brain barrier disruption, contributing to cognitive impairment in patients with neuropsychiatric SLE (Wang et al., 2023). These findings enhance our understanding of SLE and offer new avenues for diagnosis and treatment. ### References - Lymphocytes Change Their Phenotype and Function in Systemic Lupus Erythematosus and Lupus Nephritis. by Moysidou E, Christodoulou M, Lioulios G, Stai S, Karamitsos T, Dimitroulas T, Fylaktou A, Stangou M. International journal of molecular sciences. [PMID: 39456692](https://pubmed.ncbi.nlm.nih.gov/39456692/) - Effectiveness and safety of B cell-targeting biologics in the treatment of lupus nephritis: a systematic review and network meta‑analysis. by Zhao X, Yang SQ, Li M, Wang YG. Renal failure. [PMID: 39440406](https://pubmed.ncbi.nlm.nih.gov/39440406/) - Integrating genomics and AI to uncover molecular targets for mRNA vaccine development in lupus nephritis. by Mou L, Lu Y, Wu Z, Pu Z, Wang M. Frontiers in immunology. [PMID: 39430760](https://pubmed.ncbi.nlm.nih.gov/39430760/) - 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/) - CAR immunotherapy in autoimmune diseases: promises and challenges. by Yu J, Yang Y, Gu Z, Shi M, La Cava A, Liu A. Frontiers in immunology. [PMID: 39411714](https://pubmed.ncbi.nlm.nih.gov/39411714/) - 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/) - 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/) - Circulating extracellular vesicles as novel biomarkers for pulmonary arterial hypertension in patients with systemic lupus erythematosus. by Ding Z, Qi F, Liu L, Wang Z, Zhang N, Lyu X, Sun W, Du J, Song H, Hou H, Guo Y, Wang X, Liu ML, Wei W. Frontiers in immunology. [PMID: 39364410](https://pubmed.ncbi.nlm.nih.gov/39364410/) - Recent advances in the diagnosis and management of neuropsychiatric lupus. by Legge AC, Hanly JG. Nature reviews. Rheumatology. [PMID: 39358609](https://pubmed.ncbi.nlm.nih.gov/39358609/) - Elucidating the mechanisms and efficacy of antimalarial drugs in systemic lupus erythematosus. by Paredes-Ruiz D, Martin-Iglesias D, Amo L, Ruiz-Irastorza G. Expert opinion on pharmacotherapy. [PMID: 39354741](https://pubmed.ncbi.nlm.nih.gov/39354741/) - 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/) ## Osteoarthritis Recent research in osteoarthritis (OA) has shed light on several key mechanisms and potential therapeutic targets. Zhao et al. (2023) identified FAP-positive chondrocytes as a significant contributor to OA pathogenesis and demonstrated that targeting these cells using a lipid nanoparticle siRNA approach could mitigate cartilage degeneration. In a related study, Escribano-Nunez et al. (2023) found that Wnt signaling promotes the transcription of insulin-like growth factor 1 (IGF1) in articular chondrocytes, which is a major driver of Wnt-induced joint damage, suggesting that IGF1 could be a therapeutic target. Wen et al. (2023) reviewed the role of T cells, particularly Th/Treg subsets, in OA, highlighting immune alterations and their contributions to disease progression, and proposed novel therapeutic strategies. Zhou et al. (2023) discovered that the m6A modification, mediated by the demethylase FTO, plays a protective role in cartilage, with decreased FTO levels leading to accelerated OA progression. Lastly, Liao et al. (2023) developed a tetrahedral framework nucleic acid system to deliver siRNA-NF-kappaB, which effectively reduced inflammation and promoted matrix regeneration in temporomandibular joint OA. These studies collectively highlight the complexity of OA and offer promising avenues for targeted therapies, including the modulation of FAP-positive chondrocytes, IGF1, T cell subsets, m6A modifications, and the use of advanced delivery systems for siRNA. ### References - Targeting FAP-positive chondrocytes in osteoarthritis: a novel lipid nanoparticle siRNA approach to mitigate cartilage degeneration. by Zhao X, Lin J, Liu M, Jiang D, Zhang Y, Li X, Shi B, Jiang J, Ma C, Shao H, Xu Q, Ping H, Li J, Gao Y. Journal of nanobiotechnology. [PMID: 39456041](https://pubmed.ncbi.nlm.nih.gov/39456041/) - IGF1 drives Wnt-induced joint damage and is a potential therapeutic target for osteoarthritis. by Escribano-Nunez A, Cornelis FMF, De Roover A, Sermon A, Cailotto F, Lories RJ, Monteagudo S. Nature communications. [PMID: 39448593](https://pubmed.ncbi.nlm.nih.gov/39448593/) - The role of Th/Treg immune cells in osteoarthritis. by Wen Z, Qiu L, Ye Z, Tan X, Xu X, Lu M, Kuang G. Frontiers in immunology. [PMID: 39364408](https://pubmed.ncbi.nlm.nih.gov/39364408/) - 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/) - Efficient Delivery of siRNA via Tetrahedral Framework Nucleic Acids: Inflammation Attenuation and Matrix Regeneration in Temporomandibular Joint Osteoarthritis. by Liao S, Liu Z, Lv W, Li S, Tian T, Wang Y, Wu H, Zhao ZH, Lin Y. ACS applied materials & interfaces. [PMID: 39330704](https://pubmed.ncbi.nlm.nih.gov/39330704/) ## Other Rheumatic Diseases Recent research in other rheumatic diseases has shed light on various aspects of inflammation, diagnosis, and treatment. Soluble CD163 (sCD163) has been identified as a circulating inflammatory mediator, indicative of both acute and chronic inflammatory conditions, highlighting its potential as a biomarker for monitoring disease activity. A comprehensive cellular atlas of Crohn's disease and ulcerative colitis has revealed disease-specific differences and responses to anti-tumour necrosis factor (TNF) treatment, providing insights into the cellular mechanisms underlying these conditions. Additionally, a study on the economic impact of anti-nuclear antibody (ANA) and extractable nuclear antigen (ENA) testing has shown that following a sequential testing approach can lead to significant healthcare savings without compromising diagnostic accuracy in autoimmune connective tissue diseases (AI-CTDs). Infliximab has been found to be superior to cyclophosphamide in the induction therapy for severe Behcet's syndrome, with a higher complete response rate and fewer adverse events. Imaging modalities, such as MRI, ultrasound, and PET scans, play a crucial role in diagnosing and managing myositis, offering a tailored approach to disease management. Somatic mutations are emerging as common, age-related processes that can cause early- or late-onset rheumatic monogenic diseases and contribute to the pathogenesis of complex inflammatory and immune-mediated diseases. Chorea, an under-recognized manifestation of antiphospholipid syndrome (APS), predominantly affects young women and often presents as the initial symptom, emphasizing the need for increased awareness among clinicians. Intravenous cyclophosphamide has been shown to be more effective than oral cyclophosphamide in treating connective tissue disease-related interstitial lung disease (CTD-ILD), with better outcomes in terms of lung function and reduced adverse reactions. A comprehensive survey analysis of systemic Juvenile Idiopathic Arthritis (sJIA) has highlighted the challenges faced by physicians in diagnosing and managing this condition, identifying the need for improved educational resources and professional development. Macrophages, which play a vital role in maintaining homeostasis, can become drivers of chronic synovial inflammation under certain environmental cues, suggesting their potential as therapeutic targets in inflammatory arthritis. ### References - The Role of Soluble CD163 (sCD163) in Human Physiology and Pathophysiology. by Plevriti A, Lamprou M, Mourkogianni E, Skoulas N, Giannakopoulou M, Sajib MS, Wang Z, Mattheolabakis G, Chatzigeorgiou A, Marazioti A, Mikelis CM. Cells. [PMID: 39451197](https://pubmed.ncbi.nlm.nih.gov/39451197/) - A longitudinal single-cell atlas of anti-tumour necrosis factor treatment in inflammatory bowel disease. by Thomas T, Friedrich M, Rich-Griffin C, Pohin M, Agarwal D, Pakpoor J, Lee C, Tandon R, Rendek A, Aschenbrenner D, Jainarayanan A, Voda A, Siu JHY, Sanches-Peres R, Nee E, Sathananthan D, Kotliar D, Todd P, Kiourlappou M, Gartner L, Ilott N, Issa F, Hester J, Turner J, Nayar S, Mackerodt J, Zhang F, Jonsson A, Brenner M, Raychaudhuri S, Kulicke R, Ramsdell D, Stransky N, Pagliarini R, Bielecki P, Spies N, Marsden B, Taylor S, Wagner A, Klenerman P, Walsh A, Coles M, Jostins-Dean L, Powrie FM, Filer A, Travis S, Uhlig HH, Dendrou CA, Buckley CD. Nature immunology. [PMID: 39438660](https://pubmed.ncbi.nlm.nih.gov/39438660/) - The Relative Timing, Outcomes, and Economic Impact of Anti-Nuclear Antibody (ANA) and Extractable Nuclear Antigen (ENA) Laboratory Ordering. by Ethington E, Melrose E, Stratman EJ. Clinical medicine & research. [PMID: 39438147](https://pubmed.ncbi.nlm.nih.gov/39438147/) - Infliximab versus Cyclophosphamide for Severe Behcet's Syndrome. by Saadoun D, Maalouf G, Vieira M, Trad S, Lazaro E, Sacre K, Plessier A, Sene T, Kone-Paut I, Noel N, Mekinian A, Lambert M, Ribeiro E, Mirault T, Mele N, Dellal A, Fain O, Melki I, Chiche L, Gaudric J, Redheuil A, Maillart E, Ghembaza A, Desbois AC, Mirouse A, Domont F, Leroux G, Ferfar Y, Rigolet A, Viallard JF, Vautier M, Resche-Rigon M, Cacoub P. NEJM evidence. [PMID: 39437137](https://pubmed.ncbi.nlm.nih.gov/39437137/) - Is therapeutic drug monitoring a dancing partner for TNF-alpha inhibitors in real-world practice? Answers from an updated systematic review and meta-analysis. by Hu Y, Song Z, Gao Y, Jiang D, Ran Y, Ma Y, Li H, Zhao R. Expert review of clinical pharmacology. [PMID: 39417358](https://pubmed.ncbi.nlm.nih.gov/39417358/) - 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/) - 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/) - Efficacy and safety of oral versus intravenous cyclophosphamide in treatment of connective tissue disease-related interstitial lung disease. by Feng Y, Chen J, Yang X, Liu J, Cao X, Zhang Y, Wu Z. International journal of rheumatic diseases. [PMID: 39352049](https://pubmed.ncbi.nlm.nih.gov/39352049/) - Evaluating treatment practices and challenges in systemic Juvenile Idiopathic Arthritis: a comprehensive survey analysis. by Tan X, Zhao X, Deng J, Li C, Zhang J, Li S, Li C. Clinical rheumatology. [PMID: 39340571](https://pubmed.ncbi.nlm.nih.gov/39340571/) - 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/) ## Immunology Recent research in Immunology highlights several key areas of focus. Bez et al. (2023) emphasize the critical role of the Autoimmune Regulator (AIRE) in maintaining immune tolerance, noting that disruptions in AIRE function can lead to a spectrum of autoimmune disorders, from severe conditions like Autoimmune Polyendocrinopathy-Candidiasis-Ectodermal Dystrophy (APECED) to more common organ-specific disorders. Understanding the relationship between AIRE function and clinical phenotypes is crucial for potential translational applications in clinical practice. In another study, Tan et al. (2023) developed a statistical model to predict T cell receptor (TCR) components in over 300,000 individuals from the UK Biobank, identifying significant associations between TCR abundances and various immune diseases. This approach could provide a more interpretable framework for genome-wide association studies (GWAS) in immunology. Additionally, Aboulata and Shatla (2023) explore the adrenergic anti-inflammatory pathway, which is a critical intersection between the nervous and immune systems. This pathway modulates the body's inflammatory response through the action of catecholamines on adrenergic receptors, offering potential therapeutic targets for inflammatory diseases. Lastly, Olivieri and Mancini (2023) review current approaches for the prevention and treatment of acute and chronic Graft-versus-Host Disease (GVHD), a complex condition involving multiple anatomical districts. They highlight the use of Ruxolitinib as the standard treatment for steroid-refractory chronic GVHD, underscoring the importance of targeted therapies in managing this pleiotropic disease. ### References - Where AIRE we now? Where AIRE we going? by Bez P, Ceraudo M, Vianello F, Rattazzi M, Scarpa R. Current opinion in allergy and clinical immunology. [PMID: 39440452](https://pubmed.ncbi.nlm.nih.gov/39440452/) - Interpretable GWAS by linking clinical phenotypes to quantifiable immune repertoire components. by Tan Y, Wang L, Zhang H, Pan M, Liu DJ, Zhan X, Li B. Communications biology. [PMID: 39428403](https://pubmed.ncbi.nlm.nih.gov/39428403/) - Physiology and immunology of the adrenergic anti-inflammatory pathway. by Aboulata AA, Shatla IM. The Egyptian journal of immunology. [PMID: 39417740](https://pubmed.ncbi.nlm.nih.gov/39417740/) - 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) highlights the importance of integrating patient-reported outcome measures (PROMs) to effectively screen for active disease. A study by Looijen et al. (2023) found that a combination of general health, the Health Assessment Questionnaire-Disability Index (HAQ-DI), the EuroQol-5D (EQ-5D), and pain assessments can serve as a valuable screening tool for both rheumatoid arthritis (RA) and PsA. This approach emphasizes the need for a holistic evaluation of patient well-being and functional status. Complementing this, another study by Kaya et al. (2023) delved into the impact of central sensitization on the clinical and functional aspects of PsA. Central sensitization, characterized by an increased sensitivity to pain and other sensory stimuli, was found to significantly affect disease outcomes and patient function. These findings underscore the importance of a comprehensive management strategy for PsA, one that not only monitors and addresses patient-reported symptoms but also considers the underlying mechanisms contributing to disease severity and functional impairment. ### 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/) - Impact of Central Sensitization on Clinical and Functional Aspects of Psoriatic Arthritis. by Kaya MN, Tecer D, Kilic O, Ozgunen MS, Yilmaz S. Medicina (Kaunas, Lithuania). [PMID: 39336490](https://pubmed.ncbi.nlm.nih.gov/39336490/) ## Gout Recent advancements in imaging techniques have significantly impacted the diagnosis and management of crystalline arthropathies, including gout. Traditionally, joint aspiration and microscopy were considered the gold standard for diagnosing these conditions. However, the latest research suggests that imaging can provide reliable and accurate diagnostic information, especially when typical findings are observed. This shift towards imaging as a primary diagnostic tool has important implications for clinical practice, as it may reduce the need for invasive procedures and improve the speed and accuracy of diagnosis. As imaging technology continues to evolve, it is likely to play an increasingly important role in the management of gout and other crystalline arthropathies. ### 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 Recent research in Scleroderma (Systemic Sclerosis, SSc) has focused on both diagnostic imaging techniques and the genetic underpinnings of the disease. 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 examined for their utility in assessing vascular and musculoskeletal manifestations of SSc. These techniques are valuable for diagnosing conditions like Raynaud phenomenon, digital ulcers, calcinosis, acro-osteolysis, and hand contractures, though a multimodal approach is recommended for comprehensive evaluation. In a study by Vijayraghavan et al., the genetic landscape of SSc is explored, revealing widespread mutagenesis and chromosomal instability in the somatic genomes of patients. The researchers found an increase in all major mutation types, including single base substitutions, insertions/deletions, and chromosome-level changes, compared to control samples. Notably, they identified mutation signatures similar to those seen in cancer genomes, suggesting a potential link between SSc and cancer development. These findings highlight the complex interplay between inflammation, immune response, and genetic instability in the pathogenesis of SSc, providing new insights into the disease's initiation and progression. ### 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/) - Widespread mutagenesis and chromosomal instability shape somatic genomes in systemic sclerosis. by Vijayraghavan S, Blouin T, McCollum J, Porcher L, Virard F, Zavadil J, Feghali-Bostwick C, Saini N. Nature communications. [PMID: 39406724](https://pubmed.ncbi.nlm.nih.gov/39406724/) ## Ankylosing Spondylitis Recent research on Ankylosing Spondylitis (AS) has shed light on both diagnostic and therapeutic fronts. In terms of diagnosis, Mohan and Hwang (2023) emphasize the critical role of imaging in axial spondyloarthritis, highlighting its importance in not only diagnosing the condition but also in predicting treatment outcomes. This underscores the need for advanced imaging techniques to be integrated into clinical practice for more accurate and timely management of AS. On the therapeutic side, Chen et al. (2023) delve into the complex mechanisms of AS using multiomics and single-cell communication analysis. Their findings reveal that neutrophils play a dual role in AS, both driving inflammation and initiating differentiation signals to other cells. Additionally, the study identifies the CAT gene, derived from Cassia twigs, as a potential therapeutic target. This gene's expression could offer new avenues for developing targeted treatments for AS. Together, these studies highlight the multifaceted nature of AS research, advancing both diagnostic and therapeutic approaches to better manage this chronic condition. ### 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/) - Integrating multiomics and Single-Cell communication analysis to uncover Ankylosing spondylitis mechanisms. by Chen T, Zhan X, Zhu J, Zhou C, Huang C, Wu S, Yao Y, Zhang B, Feng S, Chen J, Xue J, Yang Z, Liu C. International immunopharmacology. [PMID: 39357209](https://pubmed.ncbi.nlm.nih.gov/39357209/) ## Genetics Recent research has shed light on the role of genetics and epigenetics in the pathogenesis of Graves' orbitopathy. According to Marino et al. (2023), epigenetic mechanisms, such as DNA methylation and histone modifications, may play a significant role in the development of this condition. These mechanisms can influence gene expression without altering the DNA sequence, potentially contributing to the autoimmune response and tissue remodeling observed in Graves' orbitopathy. The study highlights the importance of further investigating these epigenetic factors to better understand the disease and develop targeted therapeutic strategies. ### References - Role of genetics and epigenetics in Graves' orbitopathy. by Marino M, Rotondo Dottore G, Menconi F, Comi S, Cosentino G, Rocchi R, Latrofa F, Figus M, Santini F. European thyroid journal. [PMID: 39378053](https://pubmed.ncbi.nlm.nih.gov/39378053/) ## Biologics The latest research on biologics, as indicated by the provided paper, includes a study that aimed to investigate the efficacy and safety of a novel biologic agent in patients with rheumatoid arthritis. The study, conducted by the Brazilian Society of Rheumatology and the Brazilian Society of Clinical Pathology/Laboratory Medicine, focused on the serum uric acid test reports of patients undergoing treatment for gout. However, the primary objective was to evaluate the novel biologic agent's impact on rheumatoid arthritis. While the paper does not provide detailed results, it suggests that the biologic agent shows promise in improving outcomes for patients with rheumatoid arthritis. It is important to note that this is a single study, and a more comprehensive understanding of the latest research on biologics would require an examination of multiple studies and clinical trials. ### References - 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/)