Emerging Concepts in Precision Medicine in Axial Spondyloarthritis
AbstractPurpose of ReviewAxial spondyloarthritis (AxSpA) is among the rheumatology ’s most heritable complex diseases, yet precision medicine at clinics still needs to be explored. We reviewed the emerging concepts and recent developments in polygenic risk scores, Mendelian randomization, pharmacogenomics, single-cell sequencing, and spatial transcriptomics.Recent FindingsPolygenic risk score has resulted in encouraging results with potential diagnostic utility as it appears to outperform current diagnostic tools. Its performance and generalizability vary with ethnicity. Mendelian randomization has elucidated multiple ca...
Source: Current Rheumatology Reports - July 28, 2023 Category: Rheumatology Source Type: research
Systemic Lupus Erythematosus and COVID-19
AbstractPurpose of ReviewTo describe the current state of knowledge regarding COVID-19 in patients with systemic lupus erythematosus (SLE). We focus on (i) SARS-CoV-2 vaccination uptake, immunogenicity and safety, and (ii) outcomes of COVID-19 in patients with SLE and pertinent risk factors for adverse sequelae.Recent FindingsNotwithstanding the potential concern of patients about possible post-vaccination side-effects, the safety of anti-SARS-CoV-2 vaccines in patients with SLE has been undisputedly confirmed in numerous studies. Humoral immunogenicity is generally attained in SLE, although affected by the use of backgrou...
Source: Current Rheumatology Reports - July 21, 2023 Category: Rheumatology Source Type: research
Flares in Lupus Nephritis: Risk Factors and Strategies for Their Prevention
AbstractPurpose of ReviewDiscuss the prognostic significance of kidney flares in patients with lupus nephritis, associated risk factors, and possible preventative strategies.Recent FindingsRecently performed clinical trials and observational cohort studies underscore the high frequency of relapses of kidney disease, following initial response, in patients with proliferative and/or membranous lupus nephritis. Analysis of hard disease outcomes such as progression to chronic kidney disease or end-stage kidney disease, coupled with histological findings from repeat kidney biopsy studies, have drawn attention to the importance ...
Source: Current Rheumatology Reports - July 15, 2023 Category: Rheumatology Source Type: research
Neuroimmune Mechanisms Underlying Post-acute Sequelae of SARS-CoV-2 (PASC) Pain, Predictions from a Ligand-Receptor Interactome
AbstractPurpose of ReviewIndividuals with post-acute sequelae of SARS-CoV-2 (PASC) complain of persistent musculoskeletal pain. Determining how COVID-19 infection produces persistent pain would be valuable for the development of therapeutics aimed at alleviating these symptoms.Recent FindingsTo generate hypotheses regarding neuroimmune interactions in PASC, we used a ligand-receptor interactome to make predictions about how ligands from PBMCs in individuals with COVID-19 communicate with dorsal root ganglia (DRG) neurons to induce persistent pain. In a structured literature review of -omics COVID-19 studies, we identified ...
Source: Current Rheumatology Reports - June 10, 2023 Category: Rheumatology Source Type: research
Intravenous Immunoglobulin in Idiopathic Inflammatory Myopathies: a Practical Guide for Clinical Use
AbstractPurpose of ReviewIdiopathic inflammatory myopathies (IIM) are a complex family of autoimmune systemic disorders which often affect muscle and/or skin. IIM cause significant morbidity and mortality, but optimal treatment is uncertain. This review provides a practical guide for using intravenous immunoglobulin (IVIG) and subcutaneous immunoglobulin (SCIG) in the management of IIM, including dermatomyositis (DM), polymyositis (PM), immune-mediated necrotizing myositis (IMNM), and spontaneous inclusion body myositis (IBM), based on relevant recent literature and experience. We summarize pertinent considerations when us...
Source: Current Rheumatology Reports - June 1, 2023 Category: Rheumatology Source Type: research
An Update on the Diagnosis and Management of Calcium Crystal Disease
This article aims to review the challenges to diagnosis and management of calcium crystal deposition diseases and evaluate the literature published over the past 3 years.Recent FindingsThe awaited development of classification criteria is an essential step in the progression of calcium crystal deposition disease clinical research. There have been recent improvements in the accuracy of imaging for the diagnosis of crystal deposition diseases with published definitions of characteristic features. Factors associated with acute flares of disease have been identified and an association with increased cardiovascular risk has b...
Source: Current Rheumatology Reports - May 30, 2023 Category: Rheumatology Source Type: research
Has the COVID 19 Pandemic Impacted the Management of Chronic Musculoskeletal Pain?
We examined 30 studies (n = 18,810) from 36 countries investigating the impact of the COVID-19 pandemic on chronic musculoskeletal pain outcomes. The available evidence suggests that the pandemic significantly impacted pain levels, mental health, quality of life and healthcare accessibility in patients with chronic musc uloskeletal pain. Of 30 studies, 25 (83%) reported symptom worsening, and 20 (67%) reported reduced healthcare accessibility. Patients were unable to access necessary care services during the pandemic, including orthopedic surgeries, medications, and complementary therapies, leading to worsened pain , p...
Source: Current Rheumatology Reports - May 3, 2023 Category: Rheumatology Source Type: research
Syndesmophyte Growth in Ankylosing Spondylitis: from Laboratory to Bedside
This study aims to review recent studies on risk factors for syndesmophyte growth in ankylosing spondylitis (AS) and on treatment effects.Recent FindingsNew genetic studies, including a genome-wide association study, provided only limited evidence of specific genetic associations with radiographic severity. Measures of inflammation, including vertebral osteitis and C-reactive protein level, were strongly associated with radiographic progression, while studies of adipokines had mixed results. Mesenchymal stem cells from HLA-B27 positive AS patients were found to promote vertebral ossification via a pathway of B27 misfolding...
Source: Current Rheumatology Reports - May 1, 2023 Category: Rheumatology Source Type: research
