T and B lymphocytes in fibrosis and systemic sclerosis
Purpose of review
To summarize recent advances in the understanding of the pathogenesis of autoimmune fibrotic diseases. These diseases include IgG4-related disease, systemic sclerosis and lupus nephritis.
Recent findings
Recent studies indicate that a poorly studied subset of helper T cells, cytotoxic CD4+ T cells and sub-populations of disease-specific activated B cells infiltrate inflamed tissues and collaborate to induce tissue fibrosis in autoimmune fibrotic diseases. Cycles of apoptosis induced by antigen-specific cytotoxic CD4+ T cells followed by macrophage-mediated clearing of apoptotic cells and finally tiss...
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
Role of type I interferons and innate immunity in systemic sclerosis: unbalanced activities on distinct cell types?
Purpose of review
The role of type I IFNs (IFN-I) in the promotion of autoimmunity has been well established. However, its role in the skin fibrosis of systemic sclerosis (SSc) is less clear. IFN-I can participate to tissue repair, and, here, we will consider the extent to which IFN-I's role in SSc skin fibrosis may reflect in part IFN-I functions during wound healing.
Recent findings
Studies are beginning to delineate whether IFN-I has a protective or pathogenic role and how IFN-I affects tissue biology. Recent support for a pathogenic role came from a study depleting plasmacytoid dendritic cells during bleomycin-ind...
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
Gastrointestinal involvement in systemic sclerosis: an update
Purpose of review
This review provides important updates in systemic sclerosis (SSc)-related gastrointestinal disease, specifically focusing on the most recent literature.
Recent findings
In the past year, several studies were published that present interesting insights into SSc and gastrointestinal disease. Studies focusing on newly identified risk factors, novel approaches to diagnosis and assessment of disease activity, survival and quality of life demonstrate progress in our understanding of this challenging area. Additional data on specific SSc gastrointestinal-related topics, such as the link between gastrointes...
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
Detection and classification of systemic sclerosis-related interstitial lung disease: a review
Purpose of review
Systemic sclerosis (SSc) is a heterogeneous disease with a variable disease course. Interstitial lung disease (ILD) is one of the leading causes of morbidity and mortality in patients with SSc. The present review highlights recent advances in the classification, diagnosis, and early detection of SSc-associated ILD (SSc-ILD).
Recent findings
Risk stratification through measurement of disease extent on high-resolution computed tomography (HRCT) of the chest, longitudinal declines in pulmonary function tests (PFTs), and mortality prediction models have formed the basis for classifying clinically signifi...
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
Editorial introductions
No abstract available (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - September 25, 2019 Category: Rheumatology Tags: EDITORIAL INTRODUCTIONS Source Type: research
Impact of infections in autoimmune rheumatic diseases and pregnancy
Purpose of review
To provide an update about the impact of infections in autoimmune rheumatic diseases (ARDs), from the analysis of the role of infections in pregnant women without ARDs, to the identification of maternal–fetal infections and their role in the maternal–fetal outcome of women with ARDs.
Recent findings
Recent studies indicate that patients with ARDs and pregnancy are also susceptible to presenting infections of varying degrees, including serious infections, which contribute to the morbidity and mortality observed in pregnancy and postpartum of these patients.
Any type of infectious agent will inter...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
Periodontal bacteria and the rheumatoid arthritis-related antigen RA-A47: the cross-reactivity potential
Purpose of review
The purpose of this review is to evaluate the mechanisms that underlie the association between periodontal pathogens and rheumatoid arthritis (RA).
Recent findings
This review focuses on the cross-reactivity hypothesis as a mechanism that might contribute to explain the pathologic evolution of periodontal infections from periodontitis to RA. The scientific rationale is that immune reactions following infection by periodontal bacteria might cross-react with RA autoantigens, in this way eventually leading to autoimmunity.
Summary
Using the rheumatoid antigen associated with RA-A47 arthritis as an an...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
Complement, infection, and autoimmunity
Purpose of review
Complement system dysfunction in terms of upregulation, downregulation, or dysregulation can create an imbalance of both host defense and inflammatory response leading to autoimmunity. In this review, we aimed at describing the role of complement system in host defense to inflection and in autoimmunity starting from the evidence from primary and secondary complement system deficiencies.
Recent findings
Complement system has a determinant role in defense against infections: deficiencies of complement components are associated with increased susceptibility to infections. Primary complement system defic...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
Infections as triggers of flares in systemic autoimmune diseases: novel innate immunity mechanisms
This article reviews the recent scientific literature in this regard and highlights the key issues needing investigation.
Recent findings
Thanks to its high specificity mediated by pattern recognition receptors, the IIR is not called unspecific anymore. The discovery of these increasingly accurate recognizing molecular mechanisms has also evidenced their involvement in breaking self-immune tolerance and to maintain chronic inflammation in autoimmune responses. Neutrophil extracellular traps (NETS) as the main source of antinuclear antibodies; the ‘neutrophils-pDC activation loop’ theory; and the Th1/Th2/Th17 misbala...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
Porphyromonas gingivalis and rheumatoid arthritis
Purpose of review
To explore the pathogenic association between periodontal disease and rheumatoid arthritis focusing on the role of Porphyromonas gingivalis.
Recent findings
In the last decades our knowledge about the pathogenesis of rheumatoid arthritis substantially changed. Several evidences demonstrated that the initial production of autoantibodies is not localized in the joint, rather in other immunological-active sites. A central role seems to be played by periodontal disease, in particular because of the ability of P. gingivalis to induce citrullination, the posttranslational modification leading to the produc...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
Osteoarticular manifestations of Mayaro virus infection
Purpose of review
To carry out an update on the state of the art of the Mayaro virus (MAYV) infection and its osteoarticular implications.
Recent findings
There is a wide distribution of MAYV in Latin America and documented exported cases to the United States and Europe. Although osteoarticular involvement is not the most frequent, it is one the most associated with disability. The main mechanisms related to arthropathy involves cellular infiltrates (i.e. macrophages, natural killer cells, lymphocytes) together with production of cytokines, such as IL-6, IL-7, IL8, IL-12p70.
Summary
MAYV infection is an emerging di...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
The dark side of Sjögren's syndrome: the possible pathogenic role of infections
Purpose of review
To highlight recent findings on pathogenic mechanisms and clinical associations which characterize the role of infectious agents as triggers for Sjögren's syndrome development.
Recent findings
Several candidate infectious agents have been identified to induce the autoimmune and inflammatory pathways leading to Sjögren's syndrome clinical appearance in the setting of a genetic background. This is reinforced by the demonstration that Sjögren's syndrome patients are characterized by higher prevalence of seropositivity to virus and bacterial agents in comparison with general population. Moreover, thes...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
The dilemma of treating hepatitis C virus-associated cryoglobulinemia
Purpose of review
The present review focuses on the new therapeutic opportunities offered by the combination of biological drugs, mainly Rituximab, with direct-acting antiviral agents (DAAs).
Recent findings
Hepatitis C virus (HCV) is known to be the etiologic agent in the majority of patients with mixed cryoglobulinemia syndrome. Clinical research has been focused on antiviral drugs and, more recently, on the new, highly potent DAAs. New DAAs assure sustained virologic response (SVR) rates greater than 90% with relief of mild-to-moderate symptoms.
Summary
Mixed cryoglobulinemia may present with multiorgan vasculit...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
The association between hepatitis B, hepatitis C and systemic sclerosis: a cross-sectional study
Purpose of review
To investigate the association between systemic sclerosis (SSc) to chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) carriage. We utilized the database of Clalit Health Services, the largest healthcare organization in Israel and performed a cross-sectional study.
Recent findings
The study included 2431 SSc patients and 12 710 age-and-sex matched controls, HBV was found in 38 SSc patients (1.56%) and 64 controls (0.5%). HCV was found in 30 SSc patients (1.23%) and 83 controls (0.65%). In multivariable logistic regression model, HBV was found to be associated with smoking, dialysis treatmen...
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
From hepatitis C virus immunoproteomics to rheumatology via cross-reactivity in one table
Purpose of review
To give an overview of molecular and immunologic data that link hepatitis C virus (HCV) infection to rheumatic diseases in the human host.
Recent findings
A high level of peptide sharing exists between immunopositive HCV epitopes and human proteins that, when altered, associate with rheumatic manifestations.
Summary
The findings suggest the involvement of HCV infection in the induction of most rheumatic diseases via a mechanism of autoimmune cross-reactivity. (Source: Current Opinion in Rheumatology)
Source: Current Opinion in Rheumatology - July 30, 2019 Category: Rheumatology Tags: INFECTIONS AND ENVIRONMENTAL ASPECTS OF AUTOIMMUNITY: Edited by Yehuda Shoenfeld Source Type: research
