Update on lupus epidemiology: advancing health disparities research through the study of minority populations
Purpose of review
The current review focuses on recent population-based studies that have examined the burden of lupus, disease outcomes, and gaps in quality of care, with an emphasis in research addressing health disparities.
Recent findings
The Centers for Disease Control and Prevention National Lupus Registries underscored higher susceptibility of both systemic lupus erythematosus (SLE) and primary cutaneous lupus among people of color, compared with whites. Not only does SLE disproportionately strike people from racial and ethnic minorities, those individuals are also at increased risk of developing severe manifes...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana Kaplan Source Type: research
Lupus nephritis: challenges and progress
Purpose of review
The management of lupus nephritis remains unsatisfactory due to insufficiently effective treatment regimens and the dearth of reliable predictors of disease onset or progression to guide individualized therapeutic decisions. This review summarizes new findings related to lupus nephritis over the last 18 months and discusses clinical needs that should be considered to advance trials of mechanism-based therapeutic strategies.
Recent findings
Collaborative teams are addressing how to improve disease definitions and are developing predictive models for disease onset, disease response and risk of flare in...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana Kaplan Source Type: research
Malignancies in systemic lupus erythematosus: an update
Purpose of review
Patients with systemic lupus erythematosus (SLE) have altered incidences of certain malignancies as compared with the general population. This review summarizes the recent literature on risk of malignancy in SLE and proposed mechanisms for these altered susceptibilities.
Recent findings
Recent studies have confirmed previous data showing an increased risk of hematological, lung, thyroid, liver, cervical and vulvovaginal cancers, while demonstrating a decreased risk of breast and prostate cancer. Lymphomagenesis in SLE has been linked to increased activity of multiple inflammatory cytokines as well as...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana Kaplan Source Type: research
Update on the pathogenesis of central nervous system lupus
Propose of review
Neuropsychiatric systemic lupus erythematosus (NPSLE) is an emerging frontier in lupus care encompassing a wide spectrum of clinical manifestations. Its pathogenesis remains poorly understood because of the complexity of pathophysiologic mechanisms involved and limited access to tissue. We highlight recent advances in the pathophysiology of neuropsychiatric lupus.
Recent findings
Disruption of blood–brain barrier (BBB) facilitating entrance of neurotoxic antibodies into the central nervous system (CNS), neuroinflammation and cerebral ischemia are the key mechanisms. Disruption of the BBB may occur ...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana Kaplan Source Type: research
An update on the genetics of systemic lupus erythematosus
Purpose of review
The aim of this study is to update on the most recent findings on the genetics of systemic lupus erythematosus.
Recent findings
Our overview focuses particularly on results from expression quantitative trait loci, exome sequencing, and rare variants and their impact on disease.
Summary
Systemic lupus erythematosus is a systemic autoimmune disease for which a significant number of susceptibility genes have been identified. Several genome-wide association studies were recently published in different populations that provide a better picture of the molecular mechanisms. It is becoming clear that the ...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana Kaplan Source Type: research
Update on pregnancy complications in systemic lupus erythematosus
Purpose of review
This review summarizes recent research in the field of systemic lupus erythematosus (SLE) and pregnancy with focus on clinical and biochemical predictors of adverse pregnancy outcomes (APOs), accumulating evidence for the safety and efficacy of hydroxychloroquine (HCQ) in pregnancy, and the importance of preconception counseling.
Recent findings
Ongoing research from PROMISSE investigators (Predictors of Pregnancy Outcome: Biomarkers in Antiphospholipid Antibody Syndrome and Systemic Lupus Erythematosus) adds to the understanding of risk factors for APOs in SLE pregnancies, including aberrant complem...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: SYSTEMIC LUPUS ERYTHEMATOSUS AND SJÖGREN SYNDROME: Edited by Mariana Kaplan Source Type: research
The role of cancer-associated autoantibodies as biomarkers in paraneoplastic myositis syndrome
Purpose of review
The aim of this study is to provide a comprehensive overview of the current insight about the clinical utility of cancer-associated autoantibodies (CAAs) as biomarkers in paraneoplastic myositis syndrome (PMS). In addition, the possible mechanisms of the relationship between malignancy and myositis onset are discussed.
Recent findings
It has become increasingly clear that a subgroup of the myositis-specific autoantibodies could be considered as CAAs because they are closely related to the PMS. Increased risk of cancer was found in patients with antitranscriptional intermediary factor 1-γ (TIF1-γ), ...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello, and Mariele Gatto Source Type: research
Interferon-signature in idiopathic inflammatory myopathies
Purpose of review
The present review describes the interferon (IFN)-signature currently emerging as a tool for the diagnosis of idiopathic inflammatory myopathies (IIMs), and aims at presenting the interests and limitations of this recent tool for the clinics and the research.
Recent findings
Recent in-vivo and in-vitro transcriptomic studies have evidenced the involvement of IFNs in the pathogenesis of IIMs. A correlation between the IFN-signature and the clinical severity of IIMs has been established. Moreover, studies pointed out differences in the IFN-signature regarding the IIM subgroup (dermatomyositis, polymyos...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello, and Mariele Gatto Source Type: research
Diagnosis and treatment of myasthenia gravis
This article provides an update on the most recent advances in diagnostic procedures and therapeutic approaches for myasthenia gravis, spanning from autoantibody and neuroelectrophysiological tests as diagnostic tools, to innovative and promising treatments based on biological drugs.
Recent findings
Novel studies performed by cell-based assays (CBAs) indicate an improvement in the chance of identifying serum autoantibodies in myasthenic patients. Clinical trials on the use of biological drugs were recently concluded, providing important data on safety and efficacy of eculizumab, efgartigimod and amifampridine phosphate:...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello, and Mariele Gatto Source Type: research
Using the tools of proteomics to understand the pathogenesis of idiopathic inflammatory myopathies
Purpose of review
One of the most important advances in medical research over the past 20 years has been the emergence of technologies to assess complex biological processes on a global scale. Although a great deal of attention has been given to genome-scale genetics and genomics technologies, the utility of studying the proteome in a comprehensive way is sometimes under-appreciated. In this review, we discuss recent advances in proteomics as applied to dermatomyositis/polymyositis as well as findings from other inflammatory diseases that may enlighten our understanding of dermatomyositis/polymyositis.
Recent findings
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Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello, and Mariele Gatto Source Type: research
Genetics of idiopathic inflammatory myopathies: insights into disease pathogenesis
Purpose of review
To review the advances that have been made in our understanding of the genetics of idiopathic inflammatory myopathies (IIM) in the past 2 years, with a particular focus on dermatomyositis and polymyositis.
Recent findings
Fine-mapping studies in the major histocompatibility complex region in Caucasian and Korean populations have identified novel human leukocyte antigen (HLA) variants that are associated with autoantibody subgroups in IIM. Differences in HLA associations have been identified between Caucasian adult-onset and juvenile-onset patients with anti-TIF1 autoantibodies, suggesting distinct ae...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello, and Mariele Gatto Source Type: research
Pulmonary involvement in antisynthetase syndrome
Purpose of review
Lung involvement is a distinctive feature of antisynthetase syndrome (ASS) and it is considered a basic disease-classifying criterion. In this review, we go over clinical features, radiological patterns, prognostic factors, pathogenesis and treatment of lung involvement in ASS patients, focusing on the clinical differences linked to the different antibody specificities known so far.
Recent findings
The lung is the most common extramuscular organ involved in ASS and has the greatest impact on patient prognosis. The pulmonary disease-defining manifestation in ASS is interstitial lung disease (ILD), yet...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: MYOSITIS AND MYOPATHIES: Edited by Andrea Doria, Anna Ghirardello, and Mariele Gatto Source Type: research
Biomarkers in systemic sclerosis
Purpose of review
To discuss recent advances in identification of biomarkers in systemic sclerosis for disease severity, prognosis, and treatment response.
Recent findings
Recent reports describe novel circulating markers of disease severity, autoantibody associations with specific manifestations including cancer, and skin gene expression-based predictors of modified Rodnan skin score progression and treatment response. Moreover, there is converging evidence that C-reactive protein and pneumoproteins such as Krebs von den Lungen-6 and chemokine ligand 18 could serve as prognostic biomarkers in systemic sclerosis-assoc...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research
Calcinosis in scleroderma made crystal clear
Purpose of review
Review the current state of knowledge and recent developments in the field of scleroderma-related calcinosis [systemic sclerosis (SSc)-calcinosis], focusing on emerging information related to pathophysiology.
Recent findings
Recent studies have begun to characterize that factors that regulate ectopic mineralization, and those that underlie the imbalance of promoters and inhibitors of this process in SSc.
Summary
Calcinosis cutis due to ectopic mineralization is a common and highly troublesome complication of SSc. Despite its significant prevalence and clinical impact, the pathogenesis is poorly un...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research
Macrophages and cadherins in fibrosis and systemic sclerosis
Purpose of review
Macrophages are key players in systemic sclerosis (SSc) and fibrosis. The mechanism by which macrophages regulate fibrogenesis is unclear and understanding the origin and function of macrophages is critical to developing effective therapeutics. Novel targets on macrophages are under investigation and recently, cadherins have emerged as a potential therapeutic target on macrophages. The current review will discuss the importance of macrophages in SSc and fibrosis and summarize recent studies on the role of cadherin-11 (Cdh11) on macrophages and fibrosis.
Recent findings
Genome-wide expression studies ...
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: RAYNAUD PHENOMENON, SCLERODERMA, OVERLAP SYNDROMES AND OTHER FIBROSING SYNDROMES: Edited by John Varga Source Type: research
