Metabolic control of T cells in autoimmunity
Purpose of review
Th1, Th17, and Treg cells play distinct roles in autoimmune diseases, including systemic lupus erythematosus, multiple sclerosis, and rheumatoid arthritis. During the last 5 years we have learned that T-cell metabolism affects cell survival, differentiation and fate of T cells.
Recent findings
We highlight recent studies which have reported on T-cell metabolism in autoimmune diseases, differences in cellular metabolisms in T-cell subsets among various diseases and transcription factors which control the expression and function of central metabolic enzymes.
Summary
Distinct metabolic processes cont...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
Metabolic pathways mediate pathogenesis and offer targets for treatment in rheumatic diseases
Purpose of review
The cause of autoimmune diseases remains incompletely understood. Here, we highlight recent advances in the role of proinflammatory metabolic pathways in autoimmune disease, including treatment with antioxidants and mechanistic target of rapamycin (mTOR) inhibitors.
Recent findings
Recent studies show that mTOR pathway activation, glucose utilization, mitochondrial oxidative phosphorylation, and antioxidant defenses play critical roles in the pathogenesis of autoimmune diseases, including rheumatoid arthritis, immune thrombocytopenia, Sjögren's syndrome, large vessel vasculitis, and systemic lupus e...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
The immunopathogenesis of rheumatic immune adverse events from checkpoint inhibitors: prospects for targeted therapy
Purpose of review
The introduction of checkpoint inhibitors as well as other allied advances in cancer immunology has made immunotherapy a pillar in the treatment of cancer. At the same time, these therapies have been associated with a remarkable array of immune-mediated toxicities observed in virtually every organ system, a portion of which are rheumatic in nature or multisystem in expression making them of particular relevance for rheumatologists.
Recent findings
Most of our knowledge of these immune-related adverse events (irAEs) stems from clinical descriptive reports; we lack detailed understanding on immunopatho...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
Autoimmunity and immunodeficiency
Purpose of review
Advances in genomics and animal models of human disease have enabled the discovery of mechanisms important for host immunity and self-tolerance. Here, we summarize conceptual and clinical discoveries identified from 2018 to 2019 in the field of primary immunodeficiencies and autoimmunity.
Recent findings
Three new primary immunodeficiencies with autoimmunity were identified and the clinical phenotypes of NFKB1 haploinsufficiency and RASGRP1 deficiency were expanded. A diversity of novel mechanisms leading to autoimmunity associated with primary immunodeficiencies (PIDs) was reported, including pathwa...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
The metabolic signature of T cells in rheumatoid arthritis
Purpose of review
Rheumatoid arthritis (RA) is a prototypic autoimmune disease manifesting as chronic inflammation of the synovium and leading to acceleration of cardiovascular disease and shortening of life expectancy. The basic defect causing autoimmunity has remained elusive, but recent insights have challenged the notion that autoantigen is the core driver.
Recent findings
Emerging data have added metabolic cues involved in the proper maintenance and activation of immune cells as pathogenic regulators. Specifically, studies have unveiled metabolic pathways that enforce T cell fate decisions promoting tissue inflam...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
Advances in the diagnosis, pathogenesis and treatment of neuropsychiatric systemic lupus erythematosus
Purpose of review
Diagnosing and treating neuropsychiatric systemic lupus erythematosus (NPSLE) remains challenging as the pathogenesis is still being debated. In this review, we discuss studies evaluating recent advances in diagnostic methods, pathogenic mediators and potential treatments.
Recent findings
Screening tools used for neurodegenerative diseases were found to be both sensitive and moderately specific for cognitive dysfunction in NPSLE. Neuroimaging can be used to distinguish systemic lupus erythematosus (SLE) patients from healthy controls, but further refinement is needed to differentiate between lupus pa...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
Immune mechanisms of fibrosis and inflammation in IgG4-related disease
Purpose of review
To summarize recent advances in the understanding of the pathogenesis of IgG4-related disease.
Recent findings
Limited data exist to explain genetic susceptibility to IgG4-related disease and the underlying triggers for this disease have not yet been identified. Cytotoxic CD4+ T cells and activated B cells infiltrate affected organs and express proinflammatory and profibrotic molecules. Antigen presented by activated B cells likely reactivates cytotoxic CD4+ T cells in disease tissues and these T cells in turn induce the targeted apoptotic death of host cells in certain organs – which presumably pr...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: IMMUNOPATHOGENESIS AND TREATMENT OF AUTOIMMUNE DISEASES: Edited by George C. Tsokos Source Type: research
Progresses in the imaging of calcium pyrophosphate crystal disease
Purpose of review
Calcium pyrophosphate crystal disease (CPPD) may be considered a neglected disorder, common in clinics and wards, but not receiving enough attention since the time it was recognized as a disease entity. This review aims to highlight the advances occurred in recent years in terms of imaging of CPPD, and their potential aid in diagnosing CPPD.
Recent findings
The main advances in CPPD imaging have occurred with ultrasound and computed tomography. Ultrasound has been shown as more sensitive than conventional radiography in detecting chondrocalcinosis. OMERACT definitions of ultrasound signs of CPPD have...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research
Debates in gout management
Purpose of review
This review discusses the findings of recently published translational research studies that have the potential to directly impact on the management of gout patients.
Recent findings
Recent research suggests that treat-to-target urate-lowering treatment (ULT) alongside individualized education about gout, and shared decision making results in excellent adherence with ULT and prevents gout flares in the long term. Such interventions should preferentially be delivered face-to-face rather than remotely. The recently published CARES study raises the possibility that febuxostat increases the risk of death...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: CRYSTAL DEPOSITION DISEASES: Edited by Sara K. Tedeschi Source Type: research
Comorbidities in gout and hyperuricemia: causality or epiphenomena?
Purpose of review
To review advances in the understanding of potentially causal relationships between gout, hyperuricemia and comorbidities.
Recent findings
Observational studies reveal 4–5 comorbidity clusters in gout patients. There tend to be gout alone, gout with chronic kidney disease and gout with other metabolic comorbidities. However, heterogeneous study populations and confounding make inference difficult for causal relationships. Mendelian randomization leverages genetic information as an instrumental variable to indicate putatively causal relationships between traits of epidemiological interest. Thus far,...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: EPIDEMIOLOGY AND HEALTH-RELATED SERVICES: Edited by Kenneth G. Saag Source Type: research
Rural health issues in rheumatology: a review
Purpose of review
Early access to rheumatology is imperative to achieve appropriate outcomes in rheumatologic diseases. But there seems to be a significant gap and disparity in the access to rheumatology care between urban and rural areas. This review was undertaken to analyze this issue.
Recent findings
A significant delay in diagnosis of rheumatic disorder has been correlated to the travel distance to rheumatologist. It is also clear that currently, a significant rheumatology workforce shortage exists and is projected to worsen significantly, thereby making this gap and disparity much bigger.
Summary
The scope of...
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: EPIDEMIOLOGY AND HEALTH-RELATED SERVICES: Edited by Kenneth G. Saag Source Type: research
Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - January 29, 2020 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Unpicking observational relationships between hip shape and osteoarthritis: hype or hope?
Purpose of review
To review recent findings concerning the observational relationship between hip shape and hip osteoarthritis (HOA) and their shared genetic influences, and the potential for clinical application.
Recent findings
Recent observational studies have strengthened the evidence that specific shape deformities, such as cam and acetabular dysplasia, are related to HOA. Statistical shape modelling has emerged as a method to measure hip shape holistically, with the added advantage that this can be applied to dual X-ray absorptiometry scan images. This has led to several additional aspects of hip shape variation...
Source: Current Opinion in Rheumatology - November 29, 2019 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research
Current status of functional MRI of osteoarthritis for diagnosis and prognosis
Purpose of review
Osteoarthritis is a major source of disability, pain and socioeconomic cost worldwide. The epidemiology of the disorder is multifactorial including genetic, biological and biomechanical components, some of them detectable by MRI. This review provides the most recent update on MRI biomarkers which can provide functional information of the joint structures for diagnosis, prognosis and treatment response monitoring in osteoarthritis trials.
Recent findings
Compositional or functional MRI can provide clinicians with valuable information on glycosaminoglycan content (chemical exchange saturation transfer,...
Source: Current Opinion in Rheumatology - November 29, 2019 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research
The gut microbiome-joint connection: implications in osteoarthritis
Purpose of review
Osteoarthritis is a debilitating disease leading to joint degeneration, inflammation, pain, and disability. Despite efforts to develop a disease modifying treatment, the only accepted and available clinical approaches involve palliation. Although many factors contribute to the development of osteoarthritis, the gut microbiome has recently emerged as an important pathogenic factor in osteoarthritis initiation and progression. This review examines the literature to date regarding the link between the gut microbiome and osteoarthritis.
Recent findings
Studies showing correlations between serum levels of...
Source: Current Opinion in Rheumatology - November 29, 2019 Category: Rheumatology Tags: OSTEOARTHRITIS: Edited by Mukundan Attur Source Type: research
