Metabolic perturbations in systemic sclerosis
Purpose of review The aim of this review is to evaluate the recent evidence of the role of metabolism in systemic sclerosis (SSc), highlighting specific aberrations and to appraise the feasibility of targeting these therapeutically. Recent findings SSc is an autoimmune disease that is characterised by three facets: vascular problems, inflammation, and fibrosis. The fibrosis primarily affects the skin and lungs and currently, no antifibrotic treatment has been found effective. In recent years a renaissance in metabolism research has begun with renewed vigour in the role of metabolism in disease, particularly in t...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: SPECIAL COMMENTARY Source Type: research

Insights into the molecular landscape of osteoarthritis in human tissues
Purpose of review To provide an overview of recent developments in the field of osteoarthritis research with a focus on insights gleaned from the application of different -omic technologies. Recent findings We searched for osteoarthritis-relevant studies focusing on transcriptomics, epigenomics, proteomics and metabolomics, published since November of 2019. Study designs showed a trend towards characterizing the genomic profile of osteoarthritis-relevant tissues with high resolution, for example either by using single-cell technologies or by considering several -omic levels and disease stages. Summary Mul...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

Bone in osteoarthritis: imaging and interventions
Purpose of review To review the recent literature on bone in osteoarthritis (OA), with a focus on imaging and intervention studies Recent findings Most studies focused on knee OA; hip and hand studies were uncommon. Bone shape studies demonstrated that shape changes precede radiographic OA, predict joint replacement, and have demonstrated high responsiveness. Novel quantitative 3D imaging markers (B-score) have better characterized OA severity, including preradiographic OA status. The addition of computerized tomography-derived 3D metrics has improved the prediction of hip joint replacement when compared to radi...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

Did COVID-19 impact osteoarthritis – clinical perspective?
Purpose of review To assess the impact of the coronavirus disease 2019 (COVID-19) pandemic on patients with osteoarthritis (OA). Recent findings The COVID-19 pandemic negatively affected patients with OA irrespective of them contracting the infection. Patients with OA had a disruption in access to the healthcare system, which resulted in delays in joint replacement surgeries from cancellations of elective surgical procedures. On the other hand, the pandemic accelerated the drive towards telemedicine and telerehabilitation, with many nonurgent services being delivered remotely whenever possible. Cross-sectional s...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

Ribosome dysfunction in osteoarthritis
Purpose of review Translation of genetic information encoded within mRNA molecules by ribosomes into proteins is a key part of the central dogma of molecular biology. Despite the central position of the ribosome in the translation of proteins, and considering the major proteomic changes that occur in the joint during osteoarthritis development and progression, the ribosome has received very limited attention as driver of osteoarthritis pathogenesis. Recent findings We provide an overview of the limited literature regarding this developing topic for the osteoarthritis field. Recent key findings that connect ribos...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

Blood and urine biomarkers in osteoarthritis – an update on cartilage associated type II collagen and aggrecan markers
Purpose of review Osteoarthritis (OA) is a painful disease for which drug development has proven difficult. One major reason for this is the heterogeneity of the disease and the current lack of operationalized means to distinguish various disease endotypes (molecular subtypes). Biomarkers measured in blood or urine, reflecting joint tissue turnover, have been developed and tested during the last decades. In this narrative review, we provide highlights on biomarkers derived from the two most studied and abundant cartilage proteins – type II collagen and aggrecan. Recent findings Multiple biomarkers assessin...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

Is osteoarthritis a mitochondrial disease? What is the evidence
Propose of review To summarize the evidence that suggests that osteoarthritis (OA) is a mitochondrial disease. Recent findings Mitochondrial dysfunction together with mtDNA damage could contribute to cartilage degradation via several processes such as: (1) increased apoptosis; (2) decreased autophagy; (3) enhanced inflammatory response; (4) telomere shortening and increased senescence chondrocytes; (5) decreased mitochondrial biogenesis and mitophagy; (6) increased cartilage catabolism; (7) increased mitochondrial fusion leading to further reactive oxygen species production; and (8) impaired metabolic flexibilit...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research

A treat-to-target approach is needed for Behçet's syndrome
Purpose of review Treat-to-target (T2T) approach has improved outcomes in chronic diseases. The aim of this review is to discuss the long-term goals and review the evidence for possible targets that would predict the achievement of these goals for developing a T2T strategy for Behçet's syndrome. Recent findings There are no trials comparing a tight control strategy to standard care in Behçet's syndrome but recent studies suggest better outcomes with earlier use of biologic agents compared with sustained conventional treatment. Fluorescein angiography may be a reliable tool for assessing remission i...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Patient reported outcomes in systemic vasculitis
Purpose of review This review paper evaluates the use of patient reported outcome (PROs) in systemic vasculitis and the increasing incorporation of these measures in the evaluation of clinical outcomes and healthcare provision. Recent findings Generic PROs such as the SF-12, SF-36, EQ-5D have been used to evaluate health-related quality of life (HRQOL) across the spectrum of vasculitis; including giant cell arteritis, antineutrophil cytoplasmic antibody (ANCA)-related vasculitis and immunoglobulin A vasculitis (IgA) vasculitis. More recently disease-specific PROs have been developed including the associated vasc...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Updates in cutaneous manifestations of systemic vasculitis
Purpose of review The main purpose of this review is to present newly reported cutaneous manifestations of systemic vasculitis, updates in investigations to verify systemic involvement in cases with cutaneous vasculitis and new therapeutic guidelines. The spectrum of COVID-19-related vasculitis is also covered. Recent findings Only a few reports highlighted new cutaneous presentations or associations with some systemic vasculitic entities. For example, the association of inflammatory disorders with Takayasu arteritis, the importance of considering Kawasaki disease in febrile children with erythema nodosum, the d...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Takayasu arteritis
Purpose of review The purpose of this review is to summarize the recent advances in Takayasu arteritis (TAK), mainly focusing on pathogenesis, imaging modalities, and management. Recent findings Three novel clusters based on angiographic findings were identified in the Indian cohort and replicated in the North American cohorts. Different new imaging modalities have been tried in the assessment of arterial inflammation with promising results. There is more evidence on the long-term use of tocilizumab, but relapses are common. In light of the recent findings on the pathogenesis of TAK, Janus kinase inhibitors seem...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Animal models of vasculitis
Purpose of review Vasculitis describes a wide spectrum of rare, inflammatory, multisystem disorders. These heterogenous diseases all have inflammation of blood vessels as a central feature. However, they differ in terms of their genetic and environmental risk factors, disease pathogenesis, clinical presentations and treatment strategies. Many animal models of vasculitis exist, each resembling a different human clinical phenotype. This review provides an overview of recently published findings from experimental animal models of vasculitis. Recent findings Several new animal models have been described during the r...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

The association of Behçet's syndrome with HLA-B51 as understood in 2021
Purpose of review To discuss clinical and pathogenic roles of HLA-B∗51 in Behçet's syndrome. Recent findings HLA-B∗51 remains the most important genetic factor in Behçet's syndrome, despite the recent identification of several susceptibility genes. The prevalence of HLA-B∗51 has been shown to differ among phenotype-based clinical clusters in the same patient population. HLA-B∗51 shows epistatic interaction with the susceptible allele of endoplasmic reticulum aminopeptidase (ERAP)1 encoding the Hap10 allotype, which has the lowest trimming activity of the MHC-Class I bind...
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Editorial: Introduction, Vasculitis 2021
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: VASCULITIS SYNDROMES: Edited by Hasan Yazici and Yusuf Yazici Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - December 4, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Integrating genetic and social factors to understand health disparities in lupus
Purpose of review Both social and genetic factors are associated with health outcomes in systemic lupus erythematosus (SLE), thus playing a role in its health disparities. Despite the growing list of social and genetic factors associated with SLE outcomes, studies integrating sociocultural and individual determinants of health to understand health disparities in SLE are lacking. We review the contributions of different social and genetic factors to the disparities in SLE, and propose a socioecological model to integrate and examine the complex interactions between individual and social factors in SLE outcomes. Recen...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJOGREN SYNDROME: Edited by Amr H. Sawalha Source Type: research

Immune checkpoints and the multiple faces of B cells in systemic lupus erythematosus
Purpose of review B-lymphocytes are crucial in the pathogenesis of systemic lupus erythematosus (SLE), including autoantibody production, antigen presentation, co-stimulation, and cytokine secretion. Co-stimulatory and co-inhibitory molecules control interactions between B and T cells during an inflammatory response, which is essential for an appropriate host protection and maintenance of self-tolerance. Here, we review recent findings about checkpoint molecules and SLE B cells including their potential therapeutic implications and experiences from clinical trials. Recent findings Most prominent checkpoint molec...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJOGREN SYNDROME: Edited by Amr H. Sawalha Source Type: research

The role of CD8+ T-cell systemic lupus erythematosus pathogenesis: an update
Purpose of review Systemic lupus erythematosus (SLE) is a serious autoimmune disease with a wide range of organ involvement. In addition to aberrant B-cell responses leading to autoantibody production, T-cell abnormalities are important in the induction of autoimmunity and the ensuing downstream organ damage. In this article, we present an update on how subsets of CD8+ T cells contribute to SLE pathogenesis. Recent findings Reduced cytolytic function of CD8+ T cells not only promotes systemic autoimmunity but also accounts for the increased risk of infections. Additional information suggests that effector functi...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJOGREN SYNDROME: Edited by Amr H. Sawalha Source Type: research

Transcriptomics data: pointing the way to subclassification and personalized medicine in systemic lupus erythematosus
Purpose of review To summarize recent studies stratifying SLE patients into subgroups based on gene expression profiling and suggest future improvements for employing transcriptomic data to foster precision medicine. Recent findings Bioinformatic & machine learning pipelines have been employed to dissect the transcriptomic heterogeneity of lupus patients and identify more homogenous subgroups. Some examples include the use of unsupervised random forest and k-means clustering to separate adult SLE patients into seven clusters and hierarchical clustering of single-cell RNA-sequencing (scRNA-seq) of immune cell...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJOGREN SYNDROME: Edited by Amr H. Sawalha Source Type: research

Optimizing reproductive health management in lupus and Sjogren's syndrome
Purpose of review People with childbearing capacity who are diagnosed with systemic lupus erythematosus (SLE) and Sjogren's syndrome (SS) have specific and important reproductive health considerations. Recent findings Recommendations from the European League Against Rheumatism (EULAR) and the American College of Rheumatology (ACR) provide rheumatologists and other clinicians with guidance for reproductive health management of patients with rheumatic diseases. Patient-centered reproductive health counseling can help clinicians to operationalize the EULAR and ACR guidelines and enhance patient care. Summary ...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJOGREN SYNDROME: Edited by Amr H. Sawalha Source Type: research

Physical exercise for the management of systemic autoimmune myopathies: recent findings, and future perspectives
Purpose of review The aim of this review is to present the main pieces of evidence, recent literature and to present future perspectives on the use of exercise/physical training in the treatment and improvement of the quality of life of patients with systemic autoimmune myopathies. Recent findings In the last decades, knowledge about the relevance of physical exercise training in preventing and treating chronic diseases and improving quality of life has grown. Following the global trend exemplified by the expression ‘exercise is medicine’, the importance of exercise/physical training has also grown i...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello and Mariele Gatto Source Type: research

Anti-HMGCR myopathy: clinical and histopathological features, and prognosis
Purpose of review This review aims to describe clinical and pathological features, prognosis and treatment in patients with anti-HMGCR antibody positive immune-mediated necrotizing myopathy (HMGCR-IMNM) based on recent findings. Recent findings Using advances in diagnostic modalities that can confirm the presence of anti-HMGCR antibody, the clinical and pathological manifestations of HMGCR-IMNM were found to be broader than previously reported. Although only a small percentage of HMGCR-IMNM patients present with atypical manifestations, some of these patients show slow disease progression and clinical symptoms, ...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello and Mariele Gatto Source Type: research

Differential diagnosis of necrotizing myopathy
Purpose of review Necrotizing myopathy is a broad term. It includes patients with the recently described immune-mediated necrotizing myopathies (IMNM) who have specific antibodies, such as anti-hydroxy-3-methylglutaryl-CoA reductase or anti-signal recognition particle, seronegative phenotypes that can be associated with cancer, and other types of myositis and connective tissue diseases involving necrotic muscle fibers as a characteristic pathologic feature. Necrotizing myopathies that are not immune-mediated, such as those caused by drugs, dystrophies, infections, or even hypothyroidism are also included. The purpose o...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello and Mariele Gatto Source Type: research

Polymyositis: does it really exist as a distinct clinical subset?
Purpose of review To summarize information on polymyositis; diagnosis, definitions, published data and opinions. Recent findings Polymyositis originally referred to inflammatory muscle diseases presenting with muscle weakness and inflammatory cell infiltrates on muscle tissue visible by microscopy. Over time and with improved technology to immunophenotype infiltrating inflammatory cells and characterize muscle fibres, the meaning of polymyositis changed and became more specific. There is ongoing controversy over the term polymyositis, with proponents for a strict definition based on histopathological and immunoh...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello and Mariele Gatto Source Type: research

Skeletal muscle immunohistochemistry of acquired and hereditary myopathies
Purpose of review The continued development in the field of immunohistochemistry (IHC) has improved the ability to diagnose muscle diseases. Many hereditary diseases are diagnosed by the absence or abnormal localization of proteins. Detection of secondary pathological protein expression is also used in diagnostics, and to study disease processes. We relate and discuss recent reports, where IHC has been an important tool in the investigation of muscle diseases. Recent findings In idiopathic inflammatory myopathies, IHC has extended its role to diagnose subgroups. This is most evident concerning immune-mediated ne...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello and Mariele Gatto Source Type: research

Lymphocyte immunophenotyping in inflammatory myositis: a review
Purpose of review This is a comprehensive review of the current knowledge on predominant immune cell phenotypes involved in idiopathic inflammatory myopathies (IIM). Recent findings Major circulating immune cell subpopulations described in IIM encompass the lymphocyte compartment. An unbalance in T cell subsets seems to consistently affect the peripheral and muscle compartment, with a predominance of CD4+ T and B cells in dermatomyositis, CD8+ T cells in polymyositis/inclusion body myositis (IBM) and novel findings highlighting novel proinflammatory T subsets, that is, CD8+Tbet+ and CD28− T cells across di...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello and Mariele Gatto Source Type: research

Environmental triggers for connective tissue disease: the case of COVID-19 associated with dermatomyositis-specific autoantibodies
Purpose of review The aim of the present review is to analyze the link between autoimmune diseases and environmental factors, in particular severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection (COVID-19) as it shares numerous features with the interstitial lung disease associated with connective tissue diseases positive for rare autoantibodies directed at highly specific autoantigens (i.e., MDA5 and RIG1) among the intracellular sensors of SARS-CoV-2 in the innate response against viruses. Recent findings As shown in recent publications and in our original data, specific autoantibodies may be f...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello and Mariele Gatto Source Type: research

Adipose tissue and adipose secretome in systemic sclerosis
Purpose of review Adipose tissue is closely associated with systemic sclerosis (SSc)-pathology, both anatomically and functionally. This review focuses on local effects of adipocytes in the context of adipose to mesenchymal transdifferentiation (AMT), effects of the adipose stromal vascular fraction on SSc pathogenesis and systemic effects of adipose tissue secretome. Recent findings Novel populations of fibroblasts evolving from adipose tissue were identified– for example COL11+ cancer-associated fibroblasts differentiated from adipose-derived stromal cells. Lipofibroblasts in human lungs were described u...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research

The dynamic organelle primary cilia: emerging roles in organ fibrosis
This article aims to provide a critical overview of recent developments and insights in primary cilia biology relevant to fibrosis. Recent findings Several studies have highlighted the association of altered primary cilia with various forms of fibrosis. In a rather complex manner, the presence of primary cilia seems to be required for initiation of myofibroblast transition, whereas its loss promotes myofibroblast transition at a later stage. Recent evidence also suggested that noncanonical functions of ciliary transport proteins may influence, such cellular transitions independently of primary cilia. The possibility...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research

Insights into origins and specificities of autoantibodies in systemic sclerosis
Purpose of review Autoantibodies are hallmark findings in systemic sclerosis (SSc), often present prior to disease onset. Clinical diagnosis and prognosis of SSc have long relied on the antitopoisomerase – anticentromere – anti-RNA polymerase antibody trichotomy. However, many more autoantibodies found in SSc are being actively investigated for insights into triggering events, mechanisms of tolerance break, and connections to tissue damage. This review examines recent studies on SSc autoantibodies and the early events that lead to their development. Recent findings Recent work has elucidated potentia...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research

Biomarkers in systemic sclerosis: mechanistic insights into pathogenesis and treatment
Purpose of review Systemic sclerosis (SSc) is heterogenous on molecular, cellular, tissue, and clinical levels. Although many biomarkers have been described in clinical studies, few have been rigorously mapped to specific molecular pathways, tissue pathologies, and clinical manifestations. A focused assessment of peripheral blood levels of C–C Motif Chemokine Ligand-18 (CCL18) and periostin illustrates how biomarkers can link molecular mediators to clinical outcomes. Recent findings CCL18 is produced by pulmonary macrophages in response to type 2 cytokines and IL6. Elevated serum CCL18 is associated with i...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research

New mechanism-based approaches to treating and evaluating the vasculopathy of scleroderma
Purpose of review Utilizing recent insight into the vasculopathy of scleroderma (SSc), the review will highlight new opportunities for evaluating and treating the disease by promoting stabilization and protection of the microvasculature. Recent findings Endothelial junctional signaling initiated by vascular endothelial-cadherin (VE-cadherin) and Tie2 receptors, which are fundamental to promoting vascular health and stability, are disrupted in SSc. This would be expected to not only diminish their protective activity, but also increase pathological processes that are normally restrained by these signaling mediato...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research

Contribution of monocytes and macrophages to the pathogenesis of systemic sclerosis: recent insights and therapeutic implications
Purpose of review To discuss recent studies addressing the role of monocytes and macrophages in the pathogenesis of systemic sclerosis (SSc) based on human and mouse models. Recent findings Studies indicate that monocyte adhesion could be increased in SSc secondary to an interferon-dependent loss of CD52, and chemotaxis up-regulated through the CCR3/CCL24 pathway. Beyond the conventional M1/M2 paradigm of macrophage subpopulations, new subpopulations of macrophages have been recently described in skin and lung biopsies from SSc patients. Notably, single-cell ribonucleic acid sequencing has provided evidence for ...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research

Raynaud's phenomenon and digital ulcers: advances in evaluation and management
Purpose of review The aim of this review is to give an update on advances in evaluation and management of systemic sclerosis (SSc)-related Raynaud's phenomenon and digital ulceration, focusing on reports from the last 18 months. The increasing recognition of the huge impact of Raynaud's phenomenon and of digital ulceration on the everyday lives of patients with SSc has sparked enthusiasm internationally to develop better outcome measures and better treatments, and so a review is timely. Recent findings There have been recent advances in the development of patient reported outcome instruments [e.g. the Hand Disab...
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - October 9, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research

The impact of the COVID-19 pandemic on the field of pediatric rheumatology
Purpose of review The purpose of this review is to discuss the clinical management of children with pediatric rheumatic disease (PRD) during the Coronavirus disease of 2019 (COVID-19) pandemic, as well as the unique role of the pediatric rheumatologist during a time of emerging post-COVID inflammatory sequelae including, multisystem inflammatory syndrome in children (MIS-C). Recent findings To date, there has been little evidence to suggest that children with PRD, including those on immunomodulatory therapies, are at increased risk for severe COVID-19. Clinical guidance statements have been created to support cl...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research

The role of immunomodulatory medications in the treatment of COVID-19
Purpose of review Given the role of inflammation in severe forms of COVID-19, glucocorticoids and disease-modifying antirheumatic drugs (DMARDs) have been assessed as potential COVID-19 therapies. Recent findings Randomized controlled trials (RCTs) have shown that glucocorticoids reduce mortality in severe COVID-19. RCTs of DMARDs have shown mixed results varying on intervention and inclusion criteria. DMARDs, including colchicine or biologic agents, may improve COVID-19 outcomes in specific patient populations. Summary Glucocorticoids are an effective treatment for the management of severe COVID-19. Furt...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research

Is severe COVID-19 a cytokine storm syndrome: a hyperinflammatory debate
Purpose of review The COVID-19 pandemic is a global public health crisis with considerable mortality and morbidity. A role for cytokine storm and therapeutic immunomodulation in a subgroup of patients with severe COVID-19 was proposed early in the pandemic. The concept of cytokine storm in COVID-19 has been criticised, given the lack of clear definition and relatively modest cytokinaemia (which may be necessary for viral clearance) compared with acute respiratory distress syndrome and bacterial sepsis. Here we consider the arguments for and against the concept of cytokine storm in COVID-19. Recent findings Sever...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research

Coronavirus disease 2019: update on coronavirus disease 2019 outcomes and vaccine efficacy in patients with immune-mediated inflammatory disease
Purpose of review Although the literature to date on COVID-19 outcomes in those with immune-mediated inflammatory disease has been largely reassuring there remain many unanswered questions. These include the impact of specific medications on outcomes and the antibody response after COVID-19 vaccination. Recent findings We summarized the current literature related to COVID-19 outcomes in immune-mediated inflammatory diseases in rheumatology, gastroenterology, dermatology, and neurology. Overall, we found either no difference or modest differences in risk for severe COVID-19 for people with immune-mediated disease...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research

Editorial: Rheumatology at the center of coronavirus disease 2019: pathogenesis, treatment, and clinical care
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: RHEUMATOLOGICAL ASPECTS AND TREATMENTS OF COVID-19: Edited by Rebecca H. Haberman Source Type: research

Safety updates in novel therapeutics for pediatric rheumatic disease
Purpose of review Biologics and novel targeted therapeutics have transformed the management of pediatric rheumatic diseases over the past two decades; however, questions about short-term and long-term safety remain. Safety data gathered from recent clinical trials, long-term extensions of prior trials, registries, and other real-world evidence are summarized here for biologics and novel therapeutics commonly prescribed for pediatric rheumatic diseases. Recent findings With nearly 20 years of therapeutic experience, tumor necrosis inhibitors (TNFi) are generally well tolerated, although infections, malignancy, ...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research

Update in familial Mediterranean fever
Purpose of review Familial Mediterranean fever (FMF) is the prototypic autoinflammatory disease. Although the gene associated with the disease was identified 24 years ago, we still have to learn about the pathogenesis of its inflammation and the variation in the phenotype. In this review, we discuss some recent findings in FMF, such as changes in our understanding of the genetics, aims to define new criteria, and factors contributing to the disease presentation. Recent findings We finally have learned why a mutation causing this disease was selected in ancient times; MEFV gene mutations confer resistance to th...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research

Haematopoietic stem cell transplantation in paediatric rheumatic disease
Purpose of review A small proportion of children affected by rheumatic diseases suffer from severe, progressive disease, resistant to conventional antirheumatic therapies and to biologic agents interfering with inflammatory cytokines, costimulatory molecules expressed on immune system cells and intracellular signalling pathways. Adding to the poor prognosis is a high risk from significant morbidity and mortality associated with long-term treatment with multiple, often combined anti-inflammatory and immunosuppressive agents. Carefully selected patients from this unfortunate group may benefit from treatment with haematop...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research

Clinical features of multisystem inflammatory syndrome in children
Purpose of review To review diagnosis, clinical characteristics and treatment of multisystem inflammatory syndrome in children (MIS-C) associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Recent findings MIS-C emerged in spring 2020 as a hyperinflammatory syndrome following SARS-CoV-2 exposure in children. Despite growing awareness of MIS-C, diagnosis remains challenging due to the range of phenotypes and severity. Fever accompanied by shock, cardiac dysfunction, gastrointestinal symptoms, or mucocutaneous signs suggestive of Kawasaki disease, especially in the presence of known or suspe...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research

Updates on interferon in juvenile dermatomyositis: pathogenesis and therapy
Purpose of review This review provides updates regarding the role of interferon (IFN) in juvenile dermatomyositis (JDM), including comparison to interferonopathies and therapeutic implications. Recent findings Transcriptomic and protein-based studies in different tissues and peripheral IFN-α assessment have demonstrated the importance of the dysregulated IFN pathway in JDM. Additional studies have validated IFN-regulated gene and protein expression correlation with disease activity in blood and muscle, with potential to predict flares. Type I and II IFN both are dysregulated in peripheral blood and muscle,...
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: PEDIATRIC AND HERITABLE DISORDERS: Edited by Polly J. Ferguson Source Type: research

Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - August 6, 2021 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research

Twenty years of clinical trials in axial spondyloarthritis: what can we learn for the future?
Purpose of review We have now about 20 years of experience with the treatment of axial spondyloarthritis with biologics, which raises the question what we can learn from past experience, and which open questions should be addressed in future investigations. Recent findings Many studies have shown that axSpA patients – both patients in their nonradiological and radiological stage – respond similarly well to biologic treatment and these patients should be seen as having the same disease at different stages. AxSpA respond best to TNF-blocker – and probably also to other biologics – if the ...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Patient educational needs and challenges in psoriatic arthritis
Purpose of review To provide an overview of the recent research publications on educational needs of patients with psoriatic arthritis (PsA) and the associated challenges. Recent findings The rate of good treatment adherence in PsA can be as low as 57.7% and successful patient education can help improve treatment adherence. Also, 78.7% of patients who stopped their disease modifying anti-rheumatic drugs during the first wave of the COVID-19 pandemic did so without the advice of their clinician. In delivering educational needs, the aspects of disease process, treatment, self-help measures, managing pain, movement...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Janus kinase–signal transducers and activators of transcription cell signaling in Spondyloarthritis: rationale and evidence for JAK inhibition
Purpose of review The Janus kinase–signal transducers and activators of transcription (JAK–STAT) signaling proteins represent a group of intracellular kinase molecules that play a central role in the signaling pathways induced by cytokines, chemokines, and certain growth factors associated with systemic and local inflammation of autoimmune diseases including in Spondyloarthritis (SpA). Here, we will discuss (i) the functional significance of the JAK–STAT kinase cascades in the inflammatory-proliferative processes of SpA and its cellular/molecular mechanisms (ii) progress in the development of oral syn...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research

Intestinal dysbiosis in spondyloarthritis – chicken or egg?
Purpose of review The well-established link between intestinal inflammation and spondyloarthritis (SpA) remains largely unexplained. Recent sequencing technologies have given access to a thorough characterization of the gut microbiota in healthy and disease conditions. This showed that inflammatory bowel disease (IBD) is associated with dysbiosis – i.e., disturbed gut microbiota composition – which may contribute to disease pathogenesis. Whether gut dysbiosis exists in SpA and could contribute to disease development or be a bystander consequence of chronic inflammation is a question of major interest. Re...
Source: Current Opinion in Rheumatology - June 3, 2021 Category: Rheumatology Tags: SPONDYLOARTHROPATHIES INCLUDING PSORIATIC ARTHRITIS: Edited by Joerg Ermann Source Type: research