Gut Microbiota in Lupus: a Butterfly Effect?
AbstractPurpose of ReviewSystemic lupus erythematosus (SLE) is a prototypic autoimmune disease that typically displays chronic inflammatory tissue damage and miscellaneous circulatory autoantibodies, as well as distinctive type 1 interferon signatures. The etiology of SLE is unclear and currently is attributed to genetic predisposition and environmental triggers. Gut microbiota has recently been considered a critical environmental pathogenic factor in immune-related disorders, and studies are ongoing to uncover the key pathogens and the imputative mechanisms. Fundamental advancements on the role of the microbiota in SLE pa...
Source: Current Rheumatology Reports - April 16, 2021 Category: Rheumatology Source Type: research

Persistent Joint Pain Following Arthropod Virus Infections
AbstractPurpose of ReviewPersistent joint pain is a common manifestation of arthropod-borne viral infections and can cause long-term disability. We review the epidemiology, pathophysiology, diagnosis, and management of arthritogenic alphavirus infection.Recent findingsThe global re-emergence of alphaviral outbreaks has led to an increase in virus-induced arthralgia and arthritis. Alphaviruses, including Chikungunya, O ’nyong’nyong, Sindbis, Barmah Forest, Ross River, and Mayaro viruses, are associated with acute and/or chronic rheumatic symptoms. Identification of Mxra8 as a viral entry receptor in the alphavir...
Source: Current Rheumatology Reports - April 13, 2021 Category: Rheumatology Source Type: research

Cognitive Impairment in SLE: Mechanisms and Therapeutic Approaches
AbstractA wide range of patients with systemic lupus erythematosus (SLE) suffer from cognitive dysfunction (CD) which severely impacts their quality of life. However, CD remains underdiagnosed and poorly understood. Here, we discuss current findings in patients and in animal models. Strong evidence suggests that CD pathogenesis involves known mechanisms of tissue injury in SLE. These mechanisms recruit brain resident cells, in particular microglia, into the pathological process. While systemic immune activation is critical to central nervous system injury, the current focus of therapy is the microglial cell and not the sys...
Source: Current Rheumatology Reports - March 29, 2021 Category: Rheumatology Source Type: research

Use of Rescue Therapy with IVIG or Cyclophosphamide in Juvenile Myositis
AbstractPurpose of ReviewThis review aims to present the literature available to date on the use of intravenous immunoglobulin and cyclophosphamide for juvenile patients with inflammatory myopathies, to evaluate the strength of the evidence so far for both these medications, and to reach conclusions about their efficacy.Recent FindingsJuvenile idiopathic inflammatory myopathies, mainly represented by juvenile dermatomyositis (JDM), are rare diseases but quite debilitating for the patients. JDM is an autoimmune condition with predominantly muscle and skin involvement but also systemic features affecting the cardiovascular, ...
Source: Current Rheumatology Reports - March 8, 2021 Category: Rheumatology Source Type: research

Outcome Scores in Pediatric Rheumatology
AbstractPurpose of ReviewProviding a summary of the latest research on outcome measures in juvenile idiopathic arthritis, childhood -onset systemic lupus erythematosus, and juvenile dermatomyositis.Recent FindingsA rational management of patients with pediatric rheumatic diseases requires the regular assessment of the level of disease activity and damage, as well as the evaluation of therapeutic response through validated and standardized outcome measures. Ideally, such tools should be simple, feasible, and easily applicable in routine care. Recently, there has been a great deal of effort to refine existing tools and devis...
Source: Current Rheumatology Reports - March 8, 2021 Category: Rheumatology Source Type: research

Checkpoint Molecules in Rheumatology —or the Benefits of Being Exhausted
AbstractPurpose of ReviewThis review will focus on the most common co-inhibitory molecules, emphasizing the importance of these in relation to rheumatic disease.Recent FindingsCheckpoint molecules are pivotal in determining the outcome of antigen activation. Checkpoint molecules consist of co-stimulatory and co-inhibitory molecules, where the first activates and the latter inhibits the antigen presentation process. Studies show that increased activity of co-inhibitory molecules is associated with a good prognosis in rheumatic diseases. Opposite, when cancer patients are treated with antibodies blocking the inhibitory pathw...
Source: Current Rheumatology Reports - March 2, 2021 Category: Rheumatology Source Type: research

Etiologies of Rheumatoid Arthritis: Update on Mucosal, Genetic, and Cellular Pathogenesis
AbstractPurpose of ReviewOver the last few years, the scientific community has made significant progress in understanding the etiology of rheumatoid arthritis (RA). In this review, we summarize those key findings and trends.Recent FindingsNew data strongly implicates respiratory exposures, obesity, diet and microbiome, genetics, and their interactions in the etiology of RA. Furthermore, anti-posttranslationally modified protein antibodies (AMPAs) and abnormal glycosylation may be additional biomarkers for RA. Finally, functional genomics techniques implicate loss of certain macrophage populations and proliferation of synov...
Source: Current Rheumatology Reports - March 1, 2021 Category: Rheumatology Source Type: research

Into Clinical Practice: Diagnosis and Therapy of Retroperitoneal Fibrosis
AbstractPurpose of the ReviewWe aim to review the most relevant diagnostic features and treatment options of retroperitoneal fibrosis, in order to provide a useful guide for clinical practice.Recent FindingsThe recent literature highlights the role of imaging studies such as computed tomography, magnetic resonance imaging and positron emission tomography as useful tools for the diagnosis of retroperitoneal fibrosis, with retroperitoneal biopsy being reserved to atypical cases. The treatment approach is mainly conservative and is based on the use of medical therapies plus urological interventions. Medical therapies essentia...
Source: Current Rheumatology Reports - February 10, 2021 Category: Rheumatology Source Type: research

Clinical Approach to Diagnosis and Therapy of Polyarteritis Nodosa
AbstractPurpose of the ReviewPolyarteritis nodosa is a rare disease characterized by the necrotizing inflammation of medium-sized arteries. Different etiopathogenetic and clinical variants of the disease have been recognized over the past decades. In the present paper, we review the clinical features, diagnosis, and treatment of the different subtypes of the disease.Recent FindingsThe diagnosis of polyarteritis nodosa is primarily based on clinical findings, imaging, and histopathological investigations. Microbiological and genetic investigations complement the diagnostic work-up. Idiopathic and hereditary variants of poly...
Source: Current Rheumatology Reports - February 10, 2021 Category: Rheumatology Source Type: research

Blood Biomarkers for Monitoring and Prognosis of Large Vessel Vasculitides
AbstractPurpose of ReviewLarge vessel vasculitides (LVVs) are inflammatory conditions of the wall of large-sized arteries, mainly represented by giant cell arteritis (GCA) and Takayasu arteritis (TA). The inflammatory process within the vessel wall can lead to serious consequences such as development of aneurysms, strokes and blindness; therefore, early diagnosis and follow-up of LVV are fundamental. However, the arterial wall is poorly accessible and blood biomarkers are intended to help physicians not only in disease diagnosis but also in monitoring and defining the prognosis of these conditions, thus assisting therapeut...
Source: Current Rheumatology Reports - February 10, 2021 Category: Rheumatology Source Type: research

Systemic Lupus Erythematosus in Children and Young People
AbstractPurpose of ReviewJuvenile-onset systemic lupus erythematosus ((j)SLE) is an autoimmune/inflammatory disease that results in significant damage and disability. When compared to patients with disease onset in adulthood, jSLE patients exhibit increased disease activity, damage and require more aggressive treatments. This manuscript summarises age-specific pathogenic mechanisms and underscores the need for age group –specific research, classification and treatment.Recent FindingsGenetic factors play a significant role in the pathophysiology of jSLE, as>  7% of patients develop disease as a result of sin...
Source: Current Rheumatology Reports - February 10, 2021 Category: Rheumatology Source Type: research

Update on Post-Streptococcal Reactive Arthritis: Narrative Review of a Forgotten Disease
AbstractPurpose of the ReviewThis topical review attempts to build the concepts of PSRA as an independent entity and discuss prevalent diagnostic criteria. It utilizes a search strategy to collate all clinical features of PSRA reported from across the world and also discusses laboratory and treatment options in brief.Recent FindingsThere are several immune-mediated diseases described after acute streptococcal infections. Post-streptococcal reactive arthritis (PSRA) is a sterile, self-limiting arthritis that occur as an immune sequelae to streptococcal infection. Though PSRA resembles the arthritis of acute rheumatic fever ...
Source: Current Rheumatology Reports - February 10, 2021 Category: Rheumatology Source Type: research

A Review of Complement Activation in SLE
AbstractPurpose of ReviewComplement activation is a key event in the pathogenesis of tissue inflammation and injury in systemic lupus erythematosus (SLE). This review is aimed at comparing the usefulness of measurement of complement proteins in serum/plasma (C3, C4) to complement activation (split) products in plasma and on circulating blood cells for SLE diagnosis, disease monitoring, and prognosis.Recent FindingsComplement split products, C3dg, iC3b, and C4d, are elevated in SLE, and C3dg/C3 and iC3b/C3 ratios correlate with active SLE. C4d also is higher in patients with lupus nephritis. An elevated level of the alterna...
Source: Current Rheumatology Reports - February 10, 2021 Category: Rheumatology Source Type: research

Metabolic Regulation of Tendon Inflammation and Healing Following Injury
AbstractPurpose of ReviewThis review seeks to provide an overview of the role of inflammation and metabolism in tendon cell function, tendinopathy, and tendon healing. We have summarized the state of knowledge in both tendon and enthesis.Recent FindingsRecent advances in the field include a substantial improvement in our understanding of tendon cell biology, including the heterogeneity of the tenocyte environment during homeostasis, the diversity of the cellular milieu during in vivo tendon healing, and the effects of inflammation and altered metabolism on tendon cell function in vitro. In addition, the mechanisms by which...
Source: Current Rheumatology Reports - February 10, 2021 Category: Rheumatology Source Type: research

Treatment of Calcinosis in Juvenile Dermatomyositis
AbstractPurpose of ReviewJuvenile dermatomyositis (JDM) is a rare autoimmune disease characterised by muscle and skin involvement. Calcinosis is a debilitating complication of JDM which is difficult to treat and may cause long-term morbidity. The purpose of this review is to provide an update for the treatment of JDM-associated calcinosis based on previously published studies.Recent FindingsEvidence-based studies are lacking for the management of calcinosis, and current treatment modalities have been largely based on case reports, case series, cohort studies, limited controlled studies and anecdotal clinical experience. Th...
Source: Current Rheumatology Reports - February 8, 2021 Category: Rheumatology Source Type: research

T Cell Abnormalities in the Pathogenesis of Systemic Lupus Erythematosus: an Update
AbstractPurpose of ReviewSystemic lupus erythematosus is a complex disease with broad spectrum of clinical manifestations. In addition to abnormal B cell responsive leading to autoantibody production, various T cells also play different roles in promoting systemic autoimmunity and end organ damage. We aim to provide a review on recent developments in how abnormalities in different T cells subsets contribute to systemic lupus erythematosus pathogenesis and how they inform the consideration of new promising therapeutics.Recent FindingsDistinct subsets of T cells known as T follicular helper cells enable the production of pat...
Source: Current Rheumatology Reports - January 29, 2021 Category: Rheumatology Source Type: research

SARS-CoV-2 and Systemic Lupus Erythematosus
AbstractPurpose of ReviewTo summarize current knowledge of the impact of coronavirus disease 19 (COVID-19) on patients with systemic lupus erythematosus (SLE).Recent FindingsSeveral observational studies, including case series, patient surveys, and patient registries, have examined the incidence and severity of COVID-19 in patients with SLE. Due to methodologic limitations (focus on sicker patients, exclusion of asymptomatic or mild cases, limited or inaccurate viral testing), it is difficult to determine the risk and outcomes of COVID-19 in SLE patients. Corticosteroids might be associated with increased hospitalizations ...
Source: Current Rheumatology Reports - January 28, 2021 Category: Rheumatology Source Type: research

Efficacy and Safety of Turmeric Extracts for the Treatment of Knee Osteoarthritis: a Systematic Review and Meta-analysis of Randomised Controlled Trials
AbstractPurpose of the ReviewFinding appropriate pharmacological options to treat osteoarthritis (OA) remain challenging. We aimed to determine the efficacy and safety of all types of turmeric extracts for the management of knee OA.Recent FindingsSixteen RCTs of up to 16  weeks duration including 1810 adults with knee OA were included. Eleven RCTs compared the efficacy of turmeric extracts with placebo and five with active comparators (NSAIDs). The overall risk bias of included RCTs was moderate. Turmeric extracts significantly reduced knee pain (SMD − 0.82, 95 % CI − 1.17 to − 0...
Source: Current Rheumatology Reports - January 28, 2021 Category: Rheumatology Source Type: research

NETosis in Rheumatic Diseases
AbstractPurpose of ReviewNeutrophils are the most numerous and the first responder cells of the innate immune system. Evidence suggests that neutrophils may play an essential role in the pathogenesis of multiple systemic diseases. A novel mechanism of neutrophil extracellular traps (NETs) leading to breaking of self-tolerance and generation of autoimmune responses in predisposed individuals has been described in various autoimmune conditions. The purpose of the review is to identify these important mechanisms of NETs leading to autoimmunity in various rheumatic diseases.Recent FindingsNETs contain histone and chromatin, wh...
Source: Current Rheumatology Reports - January 28, 2021 Category: Rheumatology Source Type: research

Patient Reported Outcomes in Large Vessel Vasculitides
AbstractPurpose of ReviewThe goal of this paper is to review current and future uses of patient-reported outcomes in large vessel vasculitis. The large vessel vasculitides comprise Giant Cell Arteritis and Takayasu arteritis; both are types of systemic vasculitis which affect the larger blood vessels. Patient-reported outcomes (PROs) capture the impact of these diseases on health-related quality of life.Recent FindingsGeneric PROs such as the SF-36 are currently used to compare HRQOL of people with GCA and TAK within clinical trials and observational studies and to make comparisons with the general population and HRQoL in ...
Source: Current Rheumatology Reports - January 28, 2021 Category: Rheumatology Source Type: research

Pediatric Antiphospholipid Syndrome: from Pathogenesis to Clinical Management
AbstractPurpose of ReviewElucidating the pathogenic mechanisms mediated by antiphospholipid antibodies (aPL) might exert important clinical implications in pediatric antiphospholipid syndrome (APS).Recent FindingsaPL are traditionally regarded as the main pathogenic players in APS, inducing thrombosis via the interaction with fluid-phase and cellular components of coagulation. Recent APS research has focused on the role of β2 glycoprotein I, which bridges innate immunity and coagulation. In pediatric populations, aPL should be screened in appropriate clinical settings, such as thrombosis, multiple-organ dysfunction, o...
Source: Current Rheumatology Reports - January 28, 2021 Category: Rheumatology Source Type: research

Diffuse Idiopathic Skeletal Hyperostosis (DISH) and a Possible Inflammatory Component
AbstractPurpose of ReviewDiffuse Idiopathic Skeletal Hyperostosis (DISH) is considered a metabolic condition, characterized by new bone formation affecting mainly at entheseal sites. Enthesitis and enthesopathies occur not only in the axial skeleton but also at some peripheral sites, and they resemble to some extent the enthesitis that is a cardinal feature in spondyloarthritis (SpA), which is an inflammatory disease.Recent FindingsWe review the possible non-metabolic mechanism such as inflammation that may also be involved at some stage and help promote new bone formation in DISH. We discuss supporting pathogenic mechanis...
Source: Current Rheumatology Reports - January 26, 2021 Category: Rheumatology Source Type: research

COVID-19: What Do Rheumatologists Need to Know?
AbstractPurpose of ReviewSevere acute respiratory syndrome-related coronavirus 2 (SARS-CoV-2) emerged in December 2019, rapidly reaching global pandemic proportions. Coronavirus disease 2019 (COVID-19) has presented unique challenges to the rheumatology community. It is known that many individuals with rheumatic disease are at increased risk of severe disease from other infections, sparking a similar fear for COVID-19. In addition, medications routinely used in rheumatology practice are being trialled as treatments, with the potential for drug shortages for rheumatology patients.Recent FindingsUnderlying comorbidities and ...
Source: Current Rheumatology Reports - January 5, 2021 Category: Rheumatology Source Type: research

Something Old, Something New: the ACR Gout Treatment Guideline and Its Evolution from 2012 to 2020
AbstractPurpose of ReviewGout is the most common inflammatory arthritis in the USA, affecting about 4% of all adults. The American College of Rheumatology (ACR) released a new guideline in 2020 to help with the management of gout. This guideline serves as an update to the previous set of guidelines which the ACR published in 2012. The purpose of this review is to compare the 2012 ACR gout guidelines to the newly released 2020 ACR gout guidelines.Recent FindingsThere are many similarities between the two guidelines, and also several key differences. The 2020 guidelines assist in the clinical management of gout by healthcare...
Source: Current Rheumatology Reports - November 27, 2020 Category: Rheumatology Source Type: research

Skin Histology in Systemic Sclerosis: a Relevant Clinical Biomarker
AbstractPurpose of ReviewSystemic sclerosis (SSc) is a life-threatening autoimmune disease that causes debilitating skin fibrosis. The skin in SSc is easily accessible, and skin biopsies may provide rich biological data regarding underlying disease pathophysiology. Here, we review literature relevant to the potential for skin histology to serve as a diagnostic, pharmacokinetic/response, and predictive biomarker in SSc.Recent FindingsMultiple histologic parameters correlate with SSc severity, including alpha smooth muscle actin (aSMA), CD34, collagen density, thickness, and inflammatory cell infiltration. Recent clinical tr...
Source: Current Rheumatology Reports - November 26, 2020 Category: Rheumatology Source Type: research

Self-Management of Rheumatoid Arthritis: Mobile Applications
AbstractPurpose of ReviewTo review the self-management of rheumatoid arthritis (RA) using mobile applications.Recent FindingsRecent research supports that self-management not only can be an empowering behavior for an individual but also has been shown to improve health outcomes in RA. Mobile health applications are growing in popularity and adoption. Emerging evidence supports that using a mobile application for RA self-management may reduce disease activity and improve health outcomes.SummaryThis review discusses mobile applications designed to improve self-management of RA as well as applications not specific to RA that ...
Source: Current Rheumatology Reports - November 26, 2020 Category: Rheumatology Source Type: research

Beyond Medical Treatment: Surgical Treatment of Gout
AbstractPurpose of ReviewMedical treatment with urate-lowering therapy (ULT) is efficacious. A recent publication suggested that surgery in gout is more prevalent than previously reported. This revelation led us to review what is known about surgical treatment of gout.Recent FindingsThe Google Scholar database (January 1, 2014 –January 1, 2020) found 104 publications with a total of 169 gout patients, with an average disease duration of 6.7 years. Most (68%) were not on ULT. The mean pre-operative serum urate levels were 9.19 mg/dL. One hundred thirteen patients underwent tophi excision, while in 33 patient...
Source: Current Rheumatology Reports - November 24, 2020 Category: Rheumatology Source Type: research

Beyond Giant Cell Arteritis and Takayasu ’s Arteritis: Secondary Large Vessel Vasculitis and Vasculitis Mimickers
AbstractPurpose of ReviewTo provide an overview of mimickers of large vessel vasculitis (LVV), by the main presenting manifestation, i.e., systemic, vascular, and cranial manifestations.Recent FindingsThe main differential diagnoses in patients with giant cell arteritis (GCA) and Takayasu arteritis (TAK) presenting with systemic manifestations (i.e., fever, anorexia, weight loss, night sweats, arthralgia/myalgia, and/or increased inflammatory indexes) are neoplastic, infectious, or other inflammatory conditions. In patients with vascular manifestations (such as peripheral ischemia, vascular stenoses, or aneurysms), atheros...
Source: Current Rheumatology Reports - November 7, 2020 Category: Rheumatology Source Type: research

Micronutrients: Essential Treatment for Inflammatory Arthritis?
AbstractPurpose of ReviewSynovial inflammation is characteristic of inflammatory chronic arthropathies and can cause progressive articular damage, chronic pain, and functional loss. Scientific research has increasingly focused on investigating anti-inflammatory micronutrients present in fruits, vegetables, spices, seeds, tea, and wine. This review aims to examine the anti-inflammatory effect of polyphenols (phytonutrients present in plants) and other micronutrients described in randomized clinical trials conducted in patients with chronic inflammatory arthropathies.Recent FindingsThere is an increasing evidence that differ...
Source: Current Rheumatology Reports - October 26, 2020 Category: Rheumatology Source Type: research

Morbidity and Mortality of Large-Vessel Vasculitides
AbstractPurpose of ReviewGiant cell arteritis (GCA) and Takayasu arteritis (TAK) comprise the primary systemic large-vessel vasculitides. In these conditions, arterial stenosis, occlusion, aneurysm, and dissection can lead to severe disease-related consequences. This review focuses on disease-related manifestations of GCA and TAK, emphasizing the impact of these findings on long-term morbidity and mortality.Recent FindingsVision loss remains a main contributor of morbidity in GCA. Non-invasive imaging allows for recognition of aortic disease in GCA but monitoring and intervention guidelines require further development. TAK...
Source: Current Rheumatology Reports - October 16, 2020 Category: Rheumatology Source Type: research

Treatment of Giant Cell Arteritis and Takayasu Arteritis —Current and Future
AbstractPurpose of ReviewGuidelines for the management of large vessel vasculitides have been recently updated by several scientific societies. We have evaluated the current recommendations for treatment of giant cell arteritis (GCA) and Takayasu arteritis (TA) and addressed potential future therapeutic strategies.Recent FindingsWhile glucocorticoids (GCs) remain the gold standard for induction of remission, many patients relapse and acquire high cumulative GC exposure. Thus, GC-sparing therapies such as methotrexate are recommended for selected patients with GCA and all patients with TA. Recent high-quality evidence shows...
Source: Current Rheumatology Reports - October 12, 2020 Category: Rheumatology Source Type: research

Reducing the Toxicity of Long-Term Glucocorticoid Treatment in Large Vessel Vasculitis
AbstractPurposeWhile glucocorticoids (GCs) are effective in large vessel vasculitis (LVV), they may cause serious adverse events (AEs), especially if taken for longer durations and at higher doses. Unfortunately, patients suffering from LVV often need long-term treatment with GCs; therefore, toxicity needs to be expected and countered.Recent FindingsGCs remain the mainstay of therapy for both giant cell arteritis and Takayasu arteritis. In order to minimize their toxicity, the following strategies should be considered: GC tapering, administration of conventional synthetic (e.g., methotrexate) or biologic (e.g., tocilizumab...
Source: Current Rheumatology Reports - October 12, 2020 Category: Rheumatology Source Type: research

Microbial Influences of Mucosal Immunity in Rheumatoid Arthritis
AbstractPurpose of ReviewThis review will summarize recent data defining the relationship between rheumatoid arthritis (RA) and the microbiome at mucosal sites throughout the body. It will highlight what is known, what is speculated, and current knowledge gaps regarding the microbiome in RA.Recent FindingsAn extensive relationship between the microbiome and immune cell function can influence RA-related inflammation and T cell and B cell biology. Studies are beginning to characterize microbial changes in individuals who are at risk for RA, which is a critical element needed to understand the influence of the microbiome on R...
Source: Current Rheumatology Reports - October 5, 2020 Category: Rheumatology Source Type: research

Diagnostic Value of Muscle Ultrasound for Myopathies and Myositis
AbstractPurpose of ReviewThe purpose of this review is to critically discuss the use of ultrasound in the evaluation of muscle disorders with a particular focus on the emerging use in inflammatory myopathies.Recent FindingsIn myopathies, pathologic muscle shows an increase in echogenicity. Muscle echogenicity can be assessed visually, semi-quantitatively, or quantitatively using grayscale analysis. The involvement of specific muscle groups and the pattern of increase in echogenicity can further point to specific diseases. In pediatric neuromuscular disorders, the value of muscle ultrasound for screening and diagnosis is we...
Source: Current Rheumatology Reports - September 27, 2020 Category: Rheumatology Source Type: research

Complementary and Alternative Medicine Use in Psoriatic Arthritis Patients: a Review
AbstractPurpose of ReviewWhile complementary and alternative medicine (CAM) use is prevalent in the general population and is known to be used in systemic rheumatic disease such as rheumatoid arthritis and systemic lupus erythematosus, its use in psoriatic arthritis (PsA) is less well-studied. The purpose of this review was to identify published data describing the use of CAM in patients with PsA.Recent FindingsPsA patients report frequent use of CAM. Diet is believed to affect disease activity, and dietary approaches are used by patients to mitigate symptoms. Dietary supplements have been studied, especially fatty acids, ...
Source: Current Rheumatology Reports - September 27, 2020 Category: Rheumatology Source Type: research

Adipocytic Progenitor Cells Give Rise to Pathogenic Myofibroblasts: Adipocyte-to-Mesenchymal Transition and Its Emerging Role in Fibrosis in Multiple Organs
AbstractPurpose of ReviewAdipocytes have recently been shown to be able to reprogram to a myofibroblastic phenotype in a process termed adipocyte mesenchymal transition (AMT). This review seeks to discuss the relevance of this process to disease and explore its mechanisms.Recent FindingsAMT occurs in multiple organs and diseases, transdifferentiation goes through a precursor cell and there is a reversible process that can be influenced by metabolic stress, myeloid cells, immune dysregulation, and pharmacological intervention.SummaryAMT is a newly appreciated and highly relevant process in multiple forms of fibrosis. Target...
Source: Current Rheumatology Reports - September 24, 2020 Category: Rheumatology Source Type: research

Acupuncture and Chronic Musculoskeletal Pain
We examined 16 review articles and 11 randomized controlled trials published in the last 5  years on the clinical efficacy of acupuncture in adults with CMP conditions. The available evidence suggests that acupuncture does have short-term pain relief benefits for patients with symptomatic knee osteoarthritis and chronic low back pain and is a safe and reasonable referral option. Acupunct ure may also have a beneficial role for fibromyalgia. However, the available evidence does not support the use of acupuncture for treating hip osteoarthritis and rheumatoid arthritis.SummaryThe majority of studies concluded the superi...
Source: Current Rheumatology Reports - September 24, 2020 Category: Rheumatology Source Type: research

Aiming for Cure and Preventive Initiatives in Psoriatic Disease: Building Synergy at NPF, GRAPPA, and PPACMAN
AbstractPurpose of ReviewTo provide a general overview of the organizations dedicated to advance clinical and translational research in the field of psoriatic disease and to describe the current and future opportunities for team science approaches to overcome unmet needs in the field. Descriptions of initiatives from the NPF, PPACMAN, and GRAPPA are summarized.Recent FindingsProgram projects have recently identified areas of knowledge gaps in diagnosis, treatment, and prevention of psoriasis and psoriatic arthritis (PsA). NPF ’s Psoriasis Prevention Initiative aims to identify interventions that can prevent the onset...
Source: Current Rheumatology Reports - September 20, 2020 Category: Rheumatology Source Type: research

Understanding Fibrosis in Systemic Sclerosis: Novel and Emerging Treatment Approaches
AbstractPurpose of the ReviewOver the years, our perceptions of fibrogenesis in systemic sclerosis (SSc) have advanced a lot. Herein, we review potential targets for SSc discovered in the past 3  years.Recent FindingsIn recent years, metabolites have come into the limelight of SSc research. Anti-oxidants, promotor of adipogenesis, modulator of fatty acid metabolism, regulator of glucose homeostasis, and adenosine deaminase open a new door for SSc treatment. A mosaic of biolipids, especially cannabinoid receptor 2 agonist, represents a rational therapeutic approach in fibrosis. In terms of immune aspects, targeting che...
Source: Current Rheumatology Reports - September 20, 2020 Category: Rheumatology Source Type: research

Imaging for Diagnosis, Monitoring, and Outcome Prediction of Large Vessel Vasculitides
AbstractPurpose of ReviewTo discuss and summarize the latest evidence on imaging techniques in giant cell arteritis (GCA) and Takayasu arteritis (TAK). This is a report on the performance of ultrasound (US), magnetic resonance imaging (MRI), computed tomography (CT), 18F-fluorodeoxyglucose positron emission tomography (18-FDG-PET), and other emerging imaging techniques in diagnosis, outcome prediction, and monitoring of disease activity.Recent FindingsImaging techniques have gained an important role for diagnosis of large vessel vasculitides (LVV). As signs of vasculitis, US, MRI, and CT show a homogeneous arterial wall th...
Source: Current Rheumatology Reports - September 20, 2020 Category: Rheumatology Source Type: research

Kawasaki Disease: an Update
AbstractPurpose of ReviewProvide the most recent updates on the epidemiology, pathogenesis, and treatment advances in Kawasaki disease.Recent FindingsTreatment advances in complex, IVIG-refractory cases of Kawasaki disease. Multisystem inflammatory syndrome, a newly reported inflammatory condition with Kawasaki-like features and an association with the 2019 Coronavirus (COVID-19).SummaryKawasaki disease (KD) is a rare systemic inflammatory disease that predominately affects children less than 5  years of age. Pathogenesis of KD remains unknown; the leading theory is that an unknown stimulus triggers an immune-mediated...
Source: Current Rheumatology Reports - September 12, 2020 Category: Rheumatology Source Type: research

Impact and Management of Dysphagia in Inflammatory Myopathies
AbstractPurpose of ReviewDysphagia is a common symptom in inflammatory myopathies. This review provides an overview on the epidemiology, clinical impact, and management of dysphagia in myositis. Relevant diagnostic tools and treatment strategies are discussed.Recent FindingsDysphagia can occur in any inflammatory myopathy, particularly in inclusion body myositis (IBM). It can lead to malnutrition or aspiration with subsequent pneumonia or even death. Dysphagia can be explored and monitored by patient-reported outcome scales for swallowing. New diagnostic tools such as real-time MRI and oro-pharyngo-esophageal scintigraphy ...
Source: Current Rheumatology Reports - August 27, 2020 Category: Rheumatology Source Type: research

Cardiovascular Manifestations of Systemic Vasculitides
AbstractPurpose of ReviewVasculitis can cause heart disease and are associated with premature atherosclerosis, causing increased morbidity and mortality. Consequently, it is important to know how they can affect the cardiovascular system in order to detect and treat the abnormalities in earlier phases.Recent FindingsA clear increasing trend of inpatient burden of myocardial infarction and thromboembolic events in granulomatosis with polyangiitis has been observed lately. Beh çet’s disease has been linked to an increased risk of atrial fibrillation. Studies showing increased atherosclerosis and thromboembolic p...
Source: Current Rheumatology Reports - August 26, 2020 Category: Rheumatology Source Type: research

Calcinosis in Systemic Sclerosis: Updates in Pathophysiology, Evaluation, and Treatment
AbstractPurpose of ReviewCalcinosis is a common complication of systemic sclerosis with no known effective pharmacologic therapy. We reviewed the literature regarding systemic sclerosis-related calcinosis as well as other disorders of biomineralization in order to identify targets of future study for calcinosis.Recent FindingsPatients with systemic sclerosis-related calcinosis demonstrate systemic abnormalities in mineralization pathways, including decreased levels of the mineralization inhibitor inorganic pyrophosphate. Insights from other mineralization disorders suggest that local and systemic phosphate metabolism pathw...
Source: Current Rheumatology Reports - August 26, 2020 Category: Rheumatology Source Type: research

NETs in APS: Current Knowledge and Future Perspectives
AbstractPurpose of ReviewAntiphospholipid syndrome (APS) is a thrombo-inflammatory disease that is primarily treated with anticoagulation. Better understanding the inflammatory aspects of APS could lead to safer, more effective, and more personalized therapeutic options. To this end, we sought to understand recent literature related to the role of neutrophils and, in particular, neutrophil extracellular traps (NETs) in APS.Recent FindingsExpression of genes associated with type I interferons, endothelial adhesion, and pregnancy regulation are increased in APS neutrophils. APS neutrophils have a reduced threshold for NET re...
Source: Current Rheumatology Reports - August 25, 2020 Category: Rheumatology Source Type: research

Pregnancy Outcomes in Systemic Vasculitides
AbstractPurpose of ReviewIn recent years, improvements in the recognition of primary vasculitides and increased treatment options have led to greater survival rates and a better quality of life for patients. Therefore, pregnancy in women with vasculitis has become a more frequent consideration or event. Literature on pregnancy outcomes in this population has grown and allowed us, in this article, to review the effects of pregnancy on disease activity, as well as maternal and fetal outcomes for each type of vasculitides.Recent FindingsSuccessful pregnancies in patients with vasculitides are possible, especially when concept...
Source: Current Rheumatology Reports - August 25, 2020 Category: Rheumatology Source Type: research

Complementary and Alternative Medicine Use in Rheumatoid Arthritis
AbstractPurpose of ReviewDespite advances in pharmacologic management of rheumatoid arthritis (RA), complementary and alternative medicine (CAM) remains popular adjuncts to therapy among patients for ongoing symptomatology.Recent FindingsMind-body interventions are becoming increasingly popular, including yoga and meditation. Randomized controlled trials have found these interventions to be helpful regarding pain, mood, and energy in RA patients. Other CAM modalities, such as natural products, special diets, acupuncture, and body-based therapies, also continue to be used by RA patients with limited evidence for efficacy an...
Source: Current Rheumatology Reports - August 25, 2020 Category: Rheumatology Source Type: research

Vasculitides in HIV Infection
AbstractPurpose of ReviewTo review the spectrum of vasculitides in HIV-infected patients and to identify the clinical features that characterize vasculitis in sero-positive HIV.Recent FindingsEpidemiological studies conducted in the post-HAART era described the rarity of vasculitis in the setting of HIV-infected patients. A study identified histopathological features such as leukocytoclastic vasculitis of the vasa vasorum and adventitial inflammation in the large artery pathology of HIV-positive patients compared with HIV-negative patients with critical lower limb ischemia. A recent retrospective cohort study reported that...
Source: Current Rheumatology Reports - August 25, 2020 Category: Rheumatology Source Type: research

Lipid-lowering Therapies in Myositis
AbstractPurpose of ReviewThe use of lipid-lowering therapies in patients with idiopathic inflammatory myopathies (IIM) is complicated and there are no guidelines for diagnosing, monitoring, or treating atherosclerotic cardiovascular disease (ASCVD) in this group of patients.Recent FindingsThe use of lipid-lowering therapies, especially statins, is recommended in patients with increased risk for ASCVD, which includes patients with inflammatory diseases, based on recent American College of Cardiology/American Heart Association (ACC/AHA) guidelines for ASCVD management.SummaryThere is accumulating evidence that patients with ...
Source: Current Rheumatology Reports - August 25, 2020 Category: Rheumatology Source Type: research

Turning the Page in Osteoarthritis Assessment with the Use of Ultrasound
AbstractPurpose of ReviewThis narrative review summarizes the last 5  years of published, peer-reviewed research on the use of musculoskeletal ultrasound (US) in osteoarthritis (OA).Recent FindingsMultiple features relevant to OA can be visualized on US, including synovitis, erosion, enthesitis, osteophytes, cartilage damage, meniscal extrusion, and popliteal cysts. US can be used to confirm a diagnosis of OA or make an alternate diagnosis in the clinical setting. When a standardized protocol is used, US is a reliable modality for assessment of the features of OA. Findings on US can predict progression and response to...
Source: Current Rheumatology Reports - August 25, 2020 Category: Rheumatology Source Type: research