Takayasu Arteritis: Recent Developments
AbstractPurpose of ReviewTakayasu arteritis (TA) is a granulomatous inflammatory disorder that affects large vessels, especially aorta and its proximal branches. Its diagnosis can be extremely challenging due to the non-specificity of the systemic inflammatory manifestations during the early phase of the disease and usually follows an insidious clinical course until the emergence of vascular ischemic complications.Recent FindingsIts pathogenesis has been better delineated in recent years, especially the role of HLA-B*52 allele in certain ethnic groups, as well as the use of biological therapy, and surgical revascularizatio...
Source: Current Rheumatology Reports - July 18, 2019 Category: Rheumatology Source Type: research

Towards a Better Classification and Novel Therapies Based on the Genetics of Systemic Sclerosis
AbstractPurpose of the ReviewNowadays, important advances have occurred in our understanding of the pathogenesis of systemic sclerosis (SSc), which is a rare immune-mediated inflammatory disease (IMID) characterized by vascular damage, immune imbalance, and fibrosis. Its etiology remains unknown; nevertheless, both environmental and genetic factors play a major role in the disease. This review will focus on the main advances made in the field of genetics of SSc.Recent FindingsThe assessment of how interindividual genetic variability affects disease onset and progression has enhanced our knowledge of disease biology, and th...
Source: Current Rheumatology Reports - July 15, 2019 Category: Rheumatology Source Type: research

Current Unmet Needs in Spondyloarthritis
AbstractPurpose of ReviewThere was a substantial progress in the field of spondyloarthritis (SpA) in terms of understanding disease mechanisms, early diagnosis, and improved treatment. Nonetheless, several unresolved questions and unmet needs do remain.Recent FindingsAlthough the diagnostic delay in axial SpA is decreasing, it remains one of the longest in rheumatology. Application of referral strategies, as well as correct application and interpretation of imaging finding in the clinical context, is the main key to early diagnosis of axial SpA. Tumor necrosis factor (TNF) alpha and interleukin (IL)-17 represent currently ...
Source: Current Rheumatology Reports - July 13, 2019 Category: Rheumatology Source Type: research

GI Manifestations With a Focus on the Esophagus: Recent Progress in Understanding Pathogenesis
AbstractPurpose of ReviewEsophageal dysfunction is common in systemic sclerosis (SSc) patients. Limited treatment options are available for scleroderma esophageal disease. Here, we discuss recent updates on the diagnosis, treatment, and characterization that have been made in patients with scleroderma esophageal disease.Recent FindingsIn the past few years, novel diagnostic tools have provided insight into esophageal dysmotility in SSc patients. New drugs are being tested and might improve symptoms and quality of life in SSc patients with esophageal dysfunction. Molecular stratification methods have facilitated the identif...
Source: Current Rheumatology Reports - July 3, 2019 Category: Rheumatology Source Type: research

Chondroprotective Factors in Osteoarthritis: a Joint Affair
AbstractPurpose of the ReviewOsteoarthritis is widely regarded as a spectrum of conditions that affect all joint tissues, typified by a common entity: cartilage loss. Here, we review recent progress and challenges in chondroprotection and discuss new strategies to prevent cartilage loss in osteoarthritis.Recent FindingsAdvances in clinical, molecular, and cellular characterization are enabling improved stratification of osteoarthritis subtypes. Integration of next-generation sequencing and “omics” approaches with clinically relevant readouts shows promise in delineating both subtypes of disease and meaningful t...
Source: Current Rheumatology Reports - June 21, 2019 Category: Rheumatology Source Type: research

The Role of Chondrocyte Morphology and Volume in Controlling Phenotype —Implications for Osteoarthritis, Cartilage Repair, and Cartilage Engineering
AbstractPurpose of ReviewArticular chondrocytes are exclusively responsible for the turnover of the extracellular matrix (ECM) of hyaline cartilage. However, chondrocytes are phenotypically unstable and, if they de-differentiate into hypertrophic or fibroblastic forms, will produce a defective and weak matrix. Chondrocyte volume and morphology exert a strong influence over phenotype and a full appreciation of the factors controlling chondrocyte phenotype stability is central to understanding (a) the mechanisms underlying the cartilage failure in osteoarthritis (OA), (b) the rationale for hyaline cartilage repair, and (c) t...
Source: Current Rheumatology Reports - June 15, 2019 Category: Rheumatology Source Type: research

Skeletal Muscle Wasting and Its Relationship With Osteoarthritis: a Mini-Review of Mechanisms and Current Interventions
AbstractPurpose of ReviewOsteoarthritis (OA) is a subset of joint disorders resulting in degeneration of synovial joints. This leads to pain, disability and loss of independence. Knee and hip OA are extremely prevalent, and their occurrence increases with ageing. Similarly, loss of muscle mass and function, sarcopenia, occurs during ageing.Recent FindingsLittle is known about the impact of muscle wasting on OA progression; nevertheless, it has been suggested that muscle wasting directly affects the stability of the joints and loss of mobility leads to gradual degeneration of articular cartilage. The molecular mechanisms un...
Source: Current Rheumatology Reports - June 15, 2019 Category: Rheumatology Source Type: research

An Update on Diagnosis and Classification of Axial Spondyloarthritis
AbstractPurpose of ReviewTo summarize the most relevant recent progress to diagnose and classify patients with axial spondyloarthritis (axSpA).Recent FindingsA substantial proportion of new studies focused on the diagnosis and classification of patients with axSpA. Efforts have been concentrated on setting the best strategy to refer patients with suspected axSpA and evaluating the utility of different tools during the diagnostic work-up, especially of imaging techniques. On top of this, researchers have worked on addressing some concerns raised about the employment of the Assessment of SpondyloArthritis international Socie...
Source: Current Rheumatology Reports - June 15, 2019 Category: Rheumatology Source Type: research

ILC3 in Axial Spondyloarthritis: the Gut Angle
AbstractPurpose of ReviewA growing body of evidence supports the relevance of the interleukin-23/interleukin-17 (IL-23/IL-17) pathway for the pathogenesis of axial spondyloarthritis (axSpA) and its treatment. Recently, innate lymphoid cells (ILC), a heterogeneous family of immune effector cells, have been identified as a relevant contributor in tissue homeostasis, partially via IL-23/IL-17 axis. This review describes the biology and the origins of the group 3 ILCs (ILC3s) in humans, focusing on their role in the pathogenesis of axSpA.Recent FindingsClinical trials showed the effectiveness of IL23/IL-17 axis inhibition in b...
Source: Current Rheumatology Reports - June 13, 2019 Category: Rheumatology Source Type: research

Emerging Immunomodulatory Therapies and New Treatment Paradigms for Axial Spondyloarthritis
AbstractPurpose of ReviewThe purpose of this review is to educate the reader about the evolving classification of axial spondyloarthritis (AxSpA) and describe recent treatment data from clinical trials of medications with mechanisms of action other than TNF inhibition. The review will also address emerging treatment strategies for AxSpA.Recent FindingsNew and more sensitive classification schema for AxSpA find that the prevalence of the disease is more than twice that of the historic definition of ankylosing spondylitis (AS), when patients without radiographically observable damage to the sacroiliac joints are included. TN...
Source: Current Rheumatology Reports - June 6, 2019 Category: Rheumatology Source Type: research

In the Real World: Infections Associated with Biologic and Small Molecule Therapies in Psoriatic Arthritis and Psoriasis
AbstractPurpose of ReviewTo summarize our most current understanding of the real world risk of infections associated with biologic and small molecule therapies in the setting of psoriatic disease.Recent FindingsPatients with psoriasis or psoriatic arthritis are at increased risk for infection from both their disease and some of their therapies. There is little real world data for biologic and small molecule therapies; however, ustekinumab and biologics inhibiting IL-17 or IL-23 appear to have reduced risk estimates compared to anti-TNF therapies. Apremilast seems to have little infectious signal with limited real world dat...
Source: Current Rheumatology Reports - June 6, 2019 Category: Rheumatology Source Type: research

Macrophages in Systemic Sclerosis: Novel Insights and Therapeutic Implications
AbstractPurpose of ReviewMacrophages play key roles in tissue homeostasis and immune surveillance, mobilizing immune activation in response to microbial invasion and promoting wound healing to repair damaged tissue. However, failure to resolve macrophage activation can lead to chronic inflammation and fibrosis, and ultimately to pathology. Activated macrophages have been implicated in the pathogenesis of systemic sclerosis (SSc), although the triggers that induce immune activation in SSc and the signaling pathways that underlie aberrant macrophage activation remain unknown.Recent FindingsMacrophages are implicated in fibro...
Source: Current Rheumatology Reports - May 23, 2019 Category: Rheumatology Source Type: research

Osteoporosis Pathophysiology, Epidemiology, and Screening in Rheumatoid Arthritis
AbstractPurpose of ReviewTo review the burden of osteoporosis (OP) in rheumatoid arthritis (RA) and to describe the OP screening strategies applied in RA.Recent FindingsRA is an inflammatory condition that predisposes patients to development of OP. OP in RA has a multifactorial pathogenesis with systemic inflammation and glucocorticoid use playing major roles. Newer studies have reported an intriguing association between RA autoantibodies and the development of OP. OP screening strategies in RA patients include clinical and vitamin D assessment, biochemical markers of bone remodeling, and bone imaging evaluations, particul...
Source: Current Rheumatology Reports - May 23, 2019 Category: Rheumatology Source Type: research

Treatment Strategies in ANCA-Associated Vasculitis
AbstractPurpose of ReviewThe long-term survival of patients with antineutrophil cytoplasmic antibody-associated vasculitis (AAV) has improved dramatically as a direct result of evolving therapy. This review summarizes evidence-based treatment strategies with currently approved immunosuppressive medications to serve as a guide for practitioners in the management of patients with AAV.Recent FindingsTargeted therapy aimed at minimizing treatment-related adverse effects while optimizing effectiveness is a propagated approach. Such tailored therapy considers disease severity and is especially warranted in those at high risk for...
Source: Current Rheumatology Reports - May 23, 2019 Category: Rheumatology Source Type: research

Correction to: Cell Senescence in Lupus
The original version of this article unfortunately contained mistakes. (Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - May 23, 2019 Category: Rheumatology Source Type: research

Emotional Awareness and Expression Therapy for Chronic Pain: Rationale, Principles and Techniques, Evidence, and Critical Review
This article presents the rationale for EAET, describes its principles and techniques, reviews its development and early testing as well as recent clinical trials, and critically analyzes the evidence base.Recent FindingsFour initial trials (between 2006 and 2011) demonstrated the efficacy of earlier versions of EAET. Four recent randomized, controlled trials of different EAET durations (1 to 8 sessions) and formats (individual or group) in patients with fibromyalgia, irritable bowel syndrome, pelvic pain, or medically unexplained symptoms support the earlier findings. EAET reliably reduces pain and interference, although ...
Source: Current Rheumatology Reports - May 23, 2019 Category: Rheumatology Source Type: research

Systemic Vasculitis Associated With Immune Check Point Inhibition: Analysis and Review
AbstractPurpose of ReviewImmunotherapy with immune checkpoint inhibitors (ICIs) has become a well-established modality to treat a number of different malignancies, especially in cases with advanced stages and/or recurrent diseases. These agents have been associated with development of a variety of autoimmune disorders as immune-related adverse events (IRAEs or irAEs). This review focuses on development of vasculitis with use of ICI.Recent FindingsAvailable information on vasculitis associated with immune checkpoint inhibition is limited primarily to case reports at this time. Most immune-related adverse events will not pre...
Source: Current Rheumatology Reports - May 21, 2019 Category: Rheumatology Source Type: research

The Primary Cilium: Emerging Role as a Key Player in Fibrosis
This article summarizes recent studies evaluating the association between primary cilia and morphogen signaling driving myofibroblast transition and subsequent fibrosis.Recent FindingsEmerging observations implicate dysfunctional primary cilia in fibrosis in many different tissues and organs. Primary cilia seem to be necessary for the initiation of the transition and sustained activation of myofibroblasts.SummaryWe summarize recent progress in this field and propose the primary cilium as a potential mediator of fibrosis pathogenesis in SSc. Understanding the contributions of primary cilia in fibrosis may ultimately inform ...
Source: Current Rheumatology Reports - May 21, 2019 Category: Rheumatology Source Type: research

Myalgic Encephalomyelitis, Chronic Fatigue Syndrome, and Chronic Fatigue: Three Distinct Entities Requiring Complete Different Approaches
AbstractPurpose of ReviewA recent review implicates that myalgic encephalomyelitis (ME), chronic fatigue syndrome (CFS), and chronic fatigue are part of the “fatigue spectrum” and recommends “longitudinal studies integrating biopsychosocial approaches to inform early management and targeted rehabilitation strategies.”Recent FindingsME is a neuromuscular disease distinguished by muscle fatigability (prolonged muscle weakness after minor exertion) and specific signs of neurological dysfunction. ME is not equivalent to CFS, as proposed by the authors. CFS is defined as unexplained chronic fatigue accom...
Source: Current Rheumatology Reports - May 9, 2019 Category: Rheumatology Source Type: research

Application of Metabolomics to Osteoarthritis: from Basic Science to the Clinical Approach
AbstractPurpose of the ReviewOsteoarthritis (OA) is a multifactorial and progressive disease affecting whole synovial joint. The extract pathogenic mechanisms and diagnostic biomarkers of OA remain unclear. In this article, we review the studies related to metabolomics of OA, discuss the biomarkers as a tool for early OA diagnosis. Furthermore, we examine the major studies on the application of metabolomics methodology in the complex context of OA and create a bridge from findings in basic science to their clinical utility.Recent FindingsRecently, the tissue metabolomics signature permits a view into transitional phases be...
Source: Current Rheumatology Reports - May 6, 2019 Category: Rheumatology Source Type: research

Novel Imaging Approaches in Systemic Sclerosis-Associated Interstitial Lung Disease
AbstractPurpose of the ReviewNovel imaging approaches, such as quantitative computed tomography (CT), magnetic resonance imaging (MRI), and molecular imaging, are being applied to interstitial lung diseases to provide prognostic, functional, and molecular information. Here, we review such imaging approaches and their applicability to systemic sclerosis-associated interstitial lung disease (SSc-ILD).Recent FindingsQuantitative CT can be used to quantify the radiographic response to SSc-ILD therapy. Due to advances in MRI sequence development, MRI can detect the presence of SSc-ILD with high accuracy. MRI can also be utilize...
Source: Current Rheumatology Reports - April 25, 2019 Category: Rheumatology Source Type: research

Effectiveness of Remission Induction Strategies for Early Rheumatoid Arthritis: a Systematic Literature Review
AbstractPurpose of ReviewTo review the effectiveness of remission induction strategies compared to single csDMARD-initiating strategies according to current guidelines in early RA.Recent FindingsTwenty-nine studies, heterogeneous on, e.g., specific treatment strategy and remission outcome used, were identified. Using DAS28-remission over 12  months, 13 (76%) of 17 remission induction strategies showed significantly more patients achieving remission. Pooled relative “risk” was 1.73 [95%CI 1.59–1.88] for bDMARD-based remission induction strategies and 1.20 [95%CI 1.03–1.40] for combination csDMAR...
Source: Current Rheumatology Reports - April 23, 2019 Category: Rheumatology Source Type: research

Ephrins and Eph Receptor Signaling in Tissue Repair and Fibrosis
AbstractPurpose of ReviewFibrosis is a pathological feature of many human diseases that affect multiple organs. The development of anti-fibrotic therapies has been a difficult endeavor due to the complexity of signaling pathways associated with fibrogenic processes, complicating the identification and modulation of specific targets. Evidence suggests that ephrin ligands and Eph receptors are crucial signaling molecules that contribute to physiological wound repair and the development of tissue fibrosis. Here, we discuss recent advances in the understanding of ephrin and Eph signaling in tissue repair and fibrosis.Recent Fi...
Source: Current Rheumatology Reports - April 12, 2019 Category: Rheumatology Source Type: research

Response to Commentary: ‘Myalgic Encephalomyelitis, Chronic Fatigue Syndrome, and Chronic Fatigue: Three Distinct Entities Requiring Complete Different Approaches’
(Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - April 6, 2019 Category: Rheumatology Source Type: research

Optimal Biologic Selection for Treatment of Psoriatic Arthritis: the Approach to Precision Medicine
AbstractPurpose of ReviewThis review describes previously reported findings on optimal biologic agent selection for psoriatic arthritis (PsA) treatment and outlines our approach to developing precision medicine techniques for targeted treatment of this disease.Recent FindingsClinical trials have reported the effectiveness of numerous biologics with different targets, such as tumor necrosis factor- α, interleukin (IL)-17A, IL-17 receptor, IL-12/23(p40), and IL-23(p19) for the treatment of PsA. Although several studies have suggested specific predictors of treatment responses to each biologic, how biologics are differe...
Source: Current Rheumatology Reports - March 20, 2019 Category: Rheumatology Source Type: research

The European Map of Axial Spondyloarthritis: Capturing the Patient Perspective —an Analysis of 2846 Patients Across 13 Countries
AbstractPurpose of ReviewScientific research in axial spondyloarthritis (axSpA) has grown significantly. Nevertheless, the patient perspective remains insufficiently explored. Using a cross-sectional survey, the European Map of Axial Spondyloarthritis (EMAS) describes how patients living with self-reported axSpA experience their disease physically, psychologically, and socially.Recent Findings2846 patients participated: mean age 43.9  ± 12.3 years, 61.3% female, mean disease duration was 17.2 ± 12.4 years, and 71.3% were HLA-B27 positive. Mean diagnostic delay was 7.4&thi...
Source: Current Rheumatology Reports - March 12, 2019 Category: Rheumatology Source Type: research

The Effect of TNF Inhibition on Bone Density and Fracture Risk and of IL17 Inhibition on Radiographic Progression and Bone Density in Patients with Axial Spondyloarthritis: a Systematic Literature Review
AbstractPurpose of ReviewOsteoporosis in axial spondyloarthritis may be modified by therapy. The purpose of this systematic review is to describe (i) the effect of TNFi on BMD, (ii) the effect of secukinumab on BMD, and (iii) the effect of secukinumab on radiographic disease progression in axSpA.Recent FindingsWe searched PubMed, Embase, and Cochrane using the following retrieval languages: spondyloarthritis, ankylosing spondylitis, TNF, IL-17, x-rays, and osteoporosis. Twenty-nine studies were included; 27 re: TNFi and BMD, and 2 re: IL-17 blockers and x-ray progression. TNFi over 2 –4 years increased BMD of th...
Source: Current Rheumatology Reports - March 12, 2019 Category: Rheumatology Source Type: research

Idiopathic Pericarditis —an Autoinflammatory Disease?
AbstractPurpose of the ReviewIdiopathic acute and recurrent pericarditis are rare diseases of unknown origin. Here, we review trigger factors, pathomechanism, and treatment options for acute and recurrent pericarditis.Recent FindingsAcute pericarditis can be triggered by viral infections, myocardial ischemia, heart catheter interventions, cardiac surgery or seem to occur without any trigger. Earlier reports about viral nucleic acids in the effusion or myocardial autoantibodies in serum were detected only in a minority of patients. The current pathomechanistic concept focuses on the innate immune system. Clinical trials rev...
Source: Current Rheumatology Reports - March 9, 2019 Category: Rheumatology Source Type: research

Prevention of Infection in the Perioperative Setting in Patients with Rheumatic Disease Treated with Immunosuppression
AbstractPurpose of ReviewPatients with autoimmune rheumatic disease are at increased risk of infection after surgery. The goal of this manuscript is to review current evidence on important contributors to infection risk in these patients and the optimal management of immunosuppression in the perioperative setting.Recent FindingsRecent studies have confirmed that patients with autoimmune rheumatic disease, including rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE), are at increased risk of infection after surgery, with most evidence coming from studies of joint replacement surgery. Immunosuppression, disease...
Source: Current Rheumatology Reports - March 8, 2019 Category: Rheumatology Source Type: research

Family Planning and Rheumatoid Arthritis
We describe some of these considerations herein and focus on strategies to help providers to clarify and support their patients ’ reproductive goals. (Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - March 6, 2019 Category: Rheumatology Source Type: research

Platelets in Systemic Sclerosis: the Missing Link Connecting Vasculopathy, Autoimmunity, and Fibrosis?
AbstractPurpose of ReviewPlatelets are no longer recognized solely as cell fragments regulating hemostasis. They have pleiotropic functions and they are linked directly or indirectly with the three cornerstones of systemic sclerosis (SSc): vasculopathy, autoimmunity, and fibrosis. In this review, we summarize the current knowledge on the potential role of platelets in the pathogenesis of SSc.Recent FindingsExperimental evidence suggests that vasculopathy, a universal and early finding in SSc, may activate platelets which subsequently release several profibrotic mediators such as serotonin and transforming growth factor &be...
Source: Current Rheumatology Reports - March 4, 2019 Category: Rheumatology Source Type: research

Descending Control Mechanisms and Chronic Pain
AbstractPurpose of ReviewThe goal of the review was to highlight recent advances in our understanding of descending pain-modulating systems and how these contribute to persistent pain states, with an emphasis on the current state of knowledge around “bottom-up” (sensory) and “top-down” (higher structures mediating cognitive and emotional processing) influences on pain-modulating circuits.Recent FindingsThe connectivity, physiology, and function of these systems have been characterized extensively over the last 30  years. The field is now beginning to ask how and when these systems are engaged t...
Source: Current Rheumatology Reports - March 4, 2019 Category: Rheumatology Source Type: research

The Role of Complementary and Alternative Medicine Treatments in Fibromyalgia: a Comprehensive Review
AbstractPurpose of ReviewFibromyalgia is a complex chronic pain syndrome that can have debilitating consequences for affected patients. When compared to the general population, patients with fibromyalgia experience lowered mechanical and thermal pain thresholds, altered temporal summation of painful stimuli, and higher than normal pain ratings for known noxious stimuli.Recent FindingsThere is no definitive cure for fibromyalgia and treatment primarily focuses on both symptom management and improving patient quality of life. This treatment strategy involves a comprehensive multidisciplinary approach consisting of lifestyle ...
Source: Current Rheumatology Reports - March 4, 2019 Category: Rheumatology Source Type: research

Commentary on the Current Guidelines for the Diagnosis of Lupus Nephritis Flare
AbstractPurpose of ReviewLupus nephritis flare is a frequent complication in patients with systemic lupus erythematosus. Recognizing disease activity is crucial in lupus nephritis management. Proteinuria magnitude and urine sediment change are major clinical indicators of lupus nephritis activity. This work updates these insights in light of recent findings regarding proteinuria quantification and urine sediment analyses.Recent FindingsCurrently, BILAG and SLEDAI estimate proteinuria magnitude based on the protein/creatinine ratio of “spot” (single void collections) or “intended” 24-h urine collecti...
Source: Current Rheumatology Reports - February 27, 2019 Category: Rheumatology Source Type: research

New Attempts to Define and Clarify Lupus
AbstractPurpose of ReviewThe purpose is to discuss the advances that genetics and genomics have provided to better understand the molecular mechanisms behind SLE and how to solve its heterogeneity. I propose new ideas that can help us stratify lupus in order to find the best therapies for each patient, and the idea of substituting clinical diagnosis with molecular diagnosis according to their molecular patterns, an idea that may not only include lupus but also other diseases.Recent FindingsThe study of rare mutations may provide insight into groups of lupus patients where type I interferon signature is important and help u...
Source: Current Rheumatology Reports - February 26, 2019 Category: Rheumatology Source Type: research

Immune Checkpoint Inhibitor-Induced Myositis: a Case Report and Literature Review
AbstractPurpose of the ReviewWe clarify clinical characteristics of patients with immune checkpoint inhibitor (ICI)-induced myositis.Recent FindingsIn 13 of 15 cases with ICI-induced myositis, the type of malignancy was melanoma. Eight, 4, and 3 patients received anti-PD-1 alone, anti-CTLA4 alone, and a combination of those, respectively. The mean period to the onset of ICI-induced myositis from the initiation of ICI was 4  weeks. Myocarditis was a complication in five patients. Seven of the patients died. The causes of death were myocarditis in three patients, respiratory muscle paralysis in two patients, and cancer ...
Source: Current Rheumatology Reports - February 21, 2019 Category: Rheumatology Source Type: research

Support Groups in Scleroderma
AbstractPurpose of ReviewThis review presents evidence on support group effectiveness in common diseases, research on support groups in systemic sclerosis (SSc), and work underway by the Scleroderma Patient-centered Intervention Network in collaboration with patient organizations to train SSc support group leaders in order to improve support group access and the experiences of support groups for members and leaders.Recent FindingsGiving and receiving emotional and practical support from others with SSc is an important reason that individuals with SSc attend support groups, but many patients cannot access support groups. SS...
Source: Current Rheumatology Reports - February 21, 2019 Category: Rheumatology Source Type: research

Diagnostic Imaging of Inflammatory Myopathies: New Concepts and a Radiological Approach
AbstractPurpose of ReviewThe purpose of this review article is to highlight the current role of diagnostic imaging in the assessment of inflammatory myopathies.Recent FindingsRecent research demonstrates that imaging plays an important role in evaluating patients with symptoms of an inflammatory myopathy. In general, MRI is the pivotal imaging modality for assessing inflammatory myopathies, revealing precise anatomic details because of changes in the signal intensity of the muscles. Whole-body MR imaging has become increasingly important over the last several years. US is also a valuable imaging modality for scanning muscl...
Source: Current Rheumatology Reports - February 14, 2019 Category: Rheumatology Source Type: research

Radiologic Manifestations of Musculoskeletal Sarcoidosis
AbstractPurpose of ReviewThe purpose of this review article is to present the spectrum of abnormalities and multi-modality imaging evaluations in patients with musculoskeletal sarcoidosis.Recent FindingsThe articular manifestations of sarcoidosis are difficult to distinguish from those of the other inflammatory and degenerative arthropathies, and the muscular lesions in sarcoidosis are generally clinically silent and therefore often missed. Magnetic resonance imaging has shown these manifestations to be very common in active sarcoidosis, and should thus be included in the screening if musculoskeletal sarcoidosis is suspect...
Source: Current Rheumatology Reports - February 14, 2019 Category: Rheumatology Source Type: research

Brief Report on the 11th Meeting of the European Forum on Antiphospholipid Antibodies
(Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - February 11, 2019 Category: Rheumatology Source Type: research

The Invisible Burden of Chronic Fatigue in the Community: a Narrative Review
AbstractPurpose of ReviewUnexplained fatigue is commonly reported in the general population, with varying severity. Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) sits at the extreme of the fatigue continuum, yet more individuals experience unexplained prolonged fatigue (1 –6-month duration) or chronic fatigue (>  6 months) that, although debilitating, does not fulfil ME/CFS criteria. This review examines the empirical literature comparing symptoms for those with prolonged fatigue, chronic fatigue and ME/CFS.Recent FindingsSubstantial overlap of self-reported psychological, physical and fu...
Source: Current Rheumatology Reports - February 11, 2019 Category: Rheumatology Source Type: research

SLE-associated risk factors affect DC function
This report updates functional implications or pathways in dendritic cells which are putatively important for the development or propagation of SLE based on genetic and functional studies performed in both human and animal models. (Source: Current Rheumatology Reports)
Source: Current Rheumatology Reports - February 2, 2019 Category: Rheumatology Source Type: research

The Post-GWAS Era: How to Validate the Contribution of Gene Variants in Lupus
AbstractPurpose of ReviewSystemic lupus erythematosus (SLE) is a complex autoimmune disease with strong genetic associations. Here, we provide an update on recent advancements in validating SLE candidate genes and risk variants identified in genome-wide association studies (GWAS).Recent FindingsA pairing of computational biology with new and emerging techniques has significantly increased our understanding of SLE associated variants. Specifically, generation of mutations within mice and examination of patient samples has been the dominant mechanisms for variant validation.SummaryWhile progress has been made in validating s...
Source: Current Rheumatology Reports - January 23, 2019 Category: Rheumatology Source Type: research

Genetic Versus Non-genetic Drivers of SLE: Implications of IRF5 Dysregulation in Both Roads Leading to SLE
AbstractPurpose of ReviewSystemic lupus erythematosus (SLE) is characterized by a breakdown of immune tolerance, resulting in inflammation and tissue destruction. While the primary causes of SLE are still obscure, the disorder is highly heritable. Genetic risk variants, on their own, are rarely causal or fully explain disease pathogenesis. We discuss the possibility thatIRF5, a SLE susceptibility gene, has both genetic and non-genetic contributions to disease pathogenesis.Recent FindingsGenetic variants within and aroundIRF5 robustly associate with SLE risk. In SLE blood cells,IRF5 risk variants associate with elevatedIRF5...
Source: Current Rheumatology Reports - January 15, 2019 Category: Rheumatology Source Type: research

Cell Senescence in Lupus
AbstractPurpose of ReviewThe concept of cellular senescence has been evolving. Although originally proposed based on studies of serum-driven replication of cell lines in vitro, it is now clear that cellular senescence occurs in vivo. It has also become clear that cellular senescence can be triggered by a number of stimuli such as radiation, chemotherapy, activation of oncogenes, metabolic derangements, and chronic inflammation.Recent FindingsAs we learn more about the mechanisms of cellular aging, it has become important to ask whether accelerated cellular senescence occurs in lupus and other systemic rheumatologic disease...
Source: Current Rheumatology Reports - January 14, 2019 Category: Rheumatology Source Type: research

Pharmacological Treatment of Pain in Osteoarthritis: A Descriptive Review
AbstractPurpose of ReviewOsteoarthritis (OA) is the most common form of arthritis that is characterized by loss of articular cartilage and new formation of bone. Pain and functional disability are common features that lead to disability and poor quality of life. This review discusses the current state of knowledge concerning the treatment of pain in OA, with a focus on pharmacological treatments. This includes the use of non-steroidal anti-inflammatory drugs, acetaminophen, and other disease-modifying agents.Recent FindingsAn updated review of the role of anti-nerve growth factor monoclonal antibodies and other novel agent...
Source: Current Rheumatology Reports - November 21, 2018 Category: Rheumatology Source Type: research

Bone Microdamage in Acute Knee Injury
AbstractPurpose of ReviewThis review summarizes what is known about how bone tissue responds to microdamage, and how this applies to the subchondral region. This has significant relevance to acute joint injury, and is related to the occurrence of bone marrow lesions (BMLs) which are seen by MRI in 80% of acute knee joint injuries. Here, we review what is known about these phenomena (microcracks and BMLs) in the literature and discuss potential mechanisms by which they may be linked.Recent FindingsThe recent findings in this field have shown that microcracks in bone initiate targeted remodeling via RANKL expression in osteo...
Source: Current Rheumatology Reports - November 21, 2018 Category: Rheumatology Source Type: research

Autoinflammatory Disease-Associated Vasculitis/Vasculopathy
AbstractPurpose of ReviewAutoinflammatory diseases (AIDs) constitute several disorders that share similar characteristics, clinical features, disease course, and prognosis. They are characterized by the presence of recurrent episodes of unprovoked inflammation due to dysregulated innate immune system in the absence of autoantibodies or infections. AIDs include periodic fever syndromes and other less commonly growing list of syndromes. In this review, vasculitis associated with different AIDs will be highlighted.Recent FindingsVasculitis is inflammation and necrosis of the blood vessels causing impaired blood flow, ischemia...
Source: Current Rheumatology Reports - November 17, 2018 Category: Rheumatology Source Type: research

Gout: Update on Dual-Energy Computed Tomography with Emphasis on Artifact Identification
AbstractPurpose of ReviewGout is the most common inflammatory arthritis and is increasing in prevalence and incidence in many countries worldwide. Accurate diagnosis is important to direct treatment that may include chronic medication. Burden quantification and treatment monitoring are key in the effective care of patients with gout. This review highlights the positive impact of dual-energy computed tomography (DECT) on the evaluation of gout patients and discusses common imaging artifacts that limit this imaging modality.Recent FindingsDECT has become the most accurate imaging method for confirming or excluding gout. Of n...
Source: Current Rheumatology Reports - November 13, 2018 Category: Rheumatology Source Type: research

Anxiety and Mood Disorders in Systemic Lupus Erythematosus: Current Insights and Future Directions
AbstractPurpose of ReviewOptimal management of anxiety and mood disorders in patients with systemic lupus erythematosus (SLE) is limited by an incomplete understanding of their pathophysiology and a lack of treatment guidelines. This review aims to critically synthesize recent literature on these conditions in adults with SLE, focusing on their etiology, assessment, and management.Recent FindingsAlong with psychosocial factors, there is growing evidence for a bidirectional interaction between inflammatory pathways and SLE-associated anxiety and mood disorders. Direct immune-mediated mechanisms via autoantibodies may also p...
Source: Current Rheumatology Reports - November 12, 2018 Category: Rheumatology Source Type: research