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Autoimmune Rheumatic Diseases and Vascular Function: The Concept of Autoimmune Atherosclerosis.

Autoimmune rheumatic diseases (AIRDs) with unknown etiology are increasing in incidence and prevalence. Up to 5% of the population is affected. AIRDs include rheumatoid arthritis, system lupus erythematosus, systemic sclerosis, and Sjögren's syndrome. In patients with autoimmune diseases, the immune system attacks structures of its own body, leading to widespread tissue and organ damage, which, in turn, is associated with increased morbidity and mortality. One third of the mortality associated with autoimmune diseases is due to cardiovascular diseases. Atherosclerosis is considered the main un…

Correlation Between Serum Tumor Marker Levels and Connective Tissue Disease-Related Interstitial Lung Disease.

OBJECTIVE: The main aims of this study were to explore the relationships between serum tumor markers and connective tissue disease-related i … 001). There was no significant difference in serum tumor marker levels in the various types of CTD (rheumatoid arthritis, systemic lupus erythematosus, Sjogren's syndrome, inflammatory myositis, systemic sclerosis, and mixed connective tissue disease). The levels of CA153 [odds ratio (OR)=1.159] and CYFRA21-1 (OR=2.269) were clearly related to the risk …

Ethnic differences in pain, function, and catastrophizing in South Florida adults with knee osteoarthritis.

ObjectiveEthnicity is associated with varying reporting of pain, coping mechanisms, and disease severity in patients with knee osteoarthritis (KOA). However, few studies have evaluated its importance in ethnicity, particularly the Hispanic population. This study compares pain intensity (VAS), function (WOMAC), and pain catastrophizing (PCS) between Hispanic (HP) and non-Hispanic White patients (NHWP) stratified by socio-economic status (SES) and osteoarthritis radiographic K-L grade.MethodsA cross-sectional study of patients from a tertiary care clinic between July 2021 and December 2022 was p

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… Rheum Dis Clin North Am. 2021;47(1):21–40. doi: 10.1016/j.rdc.2020.09.006 8. Cross M, Smith E, Hoy D, Nolte S, Ackerman I, Fransen M, et al. The global burden of hip and knee osteoarthritis: estimates from the global burden of disease 2010 study. … Ann Rheum Dis. 2014;73(7):1323–30. doi: 10.1136/annrheumdis-2013-204763 9. Hootman JM, Helmick CG, Barbour KE, Theis KA, Boring MA. Updated projected prevalence of self‐reported doctor‐diagnosed arthritis and arthritis‐attributable activity limitation among US adults, 2015–2040. …

Review: progression and heterogeneity of multiple sources of mesenchymal stromal cells for the treatment of rheumatoid arthritis.

Rheumatoid arthritis is often a neglected autoimmune disease characterized by inflammation and destruction of the joints leading to pain, swelling and restricted movement, particularly affecting specific population groups and severely reducing the quality of life of patients. Certain risk factors (smoking, diet, infections) contribute to the increased prevalence of the disease in patients, with targeted interventions to alleviate symptoms. Due to the complexity of current medications and the lack of a systematic approach to decision-making, Mesenchymal stromal cells therapy has become increasi…

Contemporary Monoclonal Antibody Utilization in Glomerular Diseases.

Therapeutic monoclonal antibodies (MAbs) have been one of the fastest growing drug classes in the past 2 decades and are indicated in the treatment of cancer, autoimmune disorders, solid organ transplantation, and glomerular diseases. The Food and Drug Administration has approved 100 MAbs between 1986 and 2021, and MAbs account for 20% of Food and Drug Administration's new drug approval every year. MAbs are preferred over traditional immunosuppressive agents because of their high specificity, reduced number of drug-drug interactions, and low toxicity, which make them a prime example of persona

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… Ann Rheum Dis. 2013;72(8):1280–1286. doi: 10.1136/annrheumdis-2012-202844. 54. Catapano F., Chaudhry A.N., Jones R.B., Smith K.G., Jayne D.W. Long-term efficacy and safety of rituximab in refractory and relapsing systemic lupus erythematosus. … Ann Rheum Dis. 2022;81(1):100–107. doi: 10.1136/annrheumdis-2021-220920. 60. Jones R.B., Tervaert J.W., Hauser T., et al. Rituximab versus cyclophosphamide in ANCA-associated renal vasculitis. N Engl J Med. 2010;363(3):211–220. doi: 10.1056/NEJMoa0909169. 61. …

Systemic Sclerosis Association with Malignancy.

The association of systemic sclerosis (SSc) and cancer is well known from several decades suggesting common genetic and environmental risk factors involved in the development of both diseases. Immunosuppressive drugs widely used in SSc may increase the risk of cancer occurrence and different SSc clinical and serological features identify patients at major risk to develop malignancy. In this context, among serological features, presence of anti-RNA polymerase III and anti-topoisomerase I autoantibodies seems to increase cancer frequency in SSc patients (particularly lung and breast cancers). Lu

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… Ann Rheum Dis 76(11):1897–1905 10.1136/annrheumdis-2017-211448 28835464 8. Rubio-Rivas M Royo C Simeón CP Corbella X Fonollosa V Mortality and survival in systemic sclerosis: systematic review and meta-analysis Semin Arthritis Rheum 2014 44 2 208 219 24931517 10.1016/j.semarthrit.2014.05.010 9. … Abu-Shakra M Guillemin F Lee P Cancer in systemic sclerosis Arthritis Rheum 1993 36 460 464 8457221 10.1002/art.1780360405 11. Roumm AD Medsger TA Jr Cancer and systemic sclerosis An epidemiologic study Arthritis Rheum 1985 28 1336 1340 4084328 10.1002/art.1780281204 12. …

Immunotherapeutic approaches for systemic lupus erythematosus: early overview and future potential.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease. Current SLE therapies include immunosuppressants, antimalarial drugs, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids, but these treatments can cause substantial toxicities to organs and may not be effective for all patients. In recent years, significant progress has been made in the treatment of SLE using immunotherapy, including Benlysta and Saphnelo. These advances in immunotherapy hold promise for SLE patients, providing new therapeutic options that may offer better clinical benefit and effectiveness. S

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… Bernatsky S Boivin JF Joseph L Manzi S Ginzler E Gladman DD Mortality in systemic lupus erythematosus Arthritis Rheum 2006 54 2550 7 10.1002/art.21955 16868977 3. … Aringer M EULAR/ACR classification criteria for SLE Semin Arthritis Rheum 2019 49 S14 17 10.1016/j.semarthrit.2019.09.009 31779843 98. …

From Sjögren syndrome to Sjögren disease: rethinking classification and diagnostic complexity.

Sjögren syndrome (SS), traditionally regarded as a sicca-predominant condition, is now recognized as a systemic autoimmune disease characterized by type I interferon activation, B-cell hyperactivity, and periepithelial lymphocytic infiltration. This conceptual shift has prompted changes in terminology, with "SS" increasingly replaced by "Sjögren disease (SjD)" and "secondary SS" by "associated SjD," reflecting the concept of polyautoimmunity and ensuring equal clinical standing. In this review, we trace the historical evolution of SS classification criteria and examine their limitations in rea

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… Ann Rheum Dis 2000 59 54 60 10627428 10.1136/ard.59.1.54 PMC1752994 86 Daniels TE Labial salivary gland biopsy in Sjögren’s syndrome. … Int J Rheum Dis 2020 23 1388 1395 32918388 10.1111/1756-185X.13940 97 Pomorska A Świętoń D Lieberman SM Recurrent or persistent salivary gland enlargement in children: when is it Sjögren’s? …

Postmenopausal women with osteoarthritis and osteoporosis show different ultrastructural characteristics of trabecular bone of the femoral head.

BackgroundOsteoporosis (OP) and osteoarthritis (OA) are public health diseases affecting the quality of life of the elderly, and bring about a heavy burden to the society and family of patients. It has been debated whether or not there is an inverse relationship between these two disorders.MethodsTo compare the exact difference in bone tissue structure between osteoporosis and osteoarthritis, we observed the ultrastructure of trabecular bone from the femoral heads using scanning electron microscopy (SEM) and transmission electron microscopy (TEM). A total of 15 femoral head specimens from post

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… Arthritis Rheum. 1970;13:139–144. doi: 10.1002/art.1780130206. Li B, Aspden RM. Composition and mechanical properties of cancellous bone from the femoral head of patients with osteoporosis or osteoarthritis. J Bone Mine Res. 1997;12:641–651. doi: 10.1359/jbmr.1997.12.4.641. … Ann Rheum Dis. 1972;31:259–264. doi: 10.1136/ard.31.4.259. Dequeker J, Burssens A, Creytens G, Bouillon R. Ageing of bone: its relation to osteoporosis and osteoarthrosis in postmenopausal women. Front Horm Res. 1975;3:116–130. doi: 10.1159/000398271. Dequeker J, Johnell O. …

Comorbidities in Black South Africans with established rheumatoid arthritis.

OBJECTIVE: Comorbidities contribute both to morbidity and mortality in rheumatoid arthritis (RA). The aim of the current study was to investigate the prevalence and spectrum of comorbidities in South Africans with established RA. METHODS: A retrospective, consecutive case record review of 500 Black South African patients with established disease of ≥5 years attending a tertiary rheumatology service was performed. Common comorbidities including those listed in the Charlson Comorbidity Score (CCS) were documented. RESULTS: Most patients, 463 known alive (AG) and 37 known deceased (DG), were fe…

Sex and age do not modify the association between glucocorticoids and bone mineral density in patients with rheumatoid arthritis: a cross-sectional study.

BackgroundIt is unclear whether sex or age modify the association of glucocorticoid (GC) use with reduced bone mineral density (BMD) in patients with rheumatoid arthritis (RA).MethodsWe studied cross-sectional data of RA patients with current or previous GC treatment in a single center cohort study (Rh-GIOP cohort). Our primary outcome was the minimum T-score (measured by DXA) of either lumbar spine, total femur, or femoral neck. Current GC dose was the main exposure; cumulative GC dose and cumulative duration of GC use were also assessed. Following a predefined statistical analysis plan, line…

Использование эластографии шейных волн для оценки окулярного участия в системном склерозе

Справочная информация: Ряд исследований, проведенных с целью получения изображений, подтвердили окулярное участие в системном склерозе (SSc). Однако эталограмма пока не используется для этой цели в литературе. Таким образом, данное исследование было направлено на оценку окулярного участия в SSc с использованием эластографии волн шеи (SWE). Методы: Это исследование включало в себя 29 SSc пациенты и 30 :: контроль за состоянием здоровья в зависимости от возраста и пола. Все участники прошли независимую офтальмологическую оценку two Офтальмологи. Впоследствии SWE использовалась для оценки сетчатк

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… Arthritis Rheum. 2019;49:119–125. doi: 10.1016/j.semarthrit.2018.12.007. 11. Zemanova M. Shear wave elastography in ophthalmic diagnosis. J. Fr. Ophtalmol. 2019;42:73–80. doi: 10.1016/j.jfo.2018.05.006. 12. Cui X.W., Li K.N., Yi A.J., Wang B., Wei Q., Wu G.G., Dietrich C.F. … Arthritis Rheum. 2013;65:2737–2747. doi: 10.1002/art.38098. 20. Cappelli L., Wigley F.M. Management of Raynaud Phenomenon and Digital Ulcers in scleroderma. Rheum. Dis. Clin. N. Am. 2015;41:419–438. doi: 10.1016/j.rdc.2015.04.005. 21. …

From the nephrologist's point of view: diversity of causes and clinical features of acute kidney injury.

Acute kidney injury (AKI) is a clinical syndrome with multiple entities. Although AKI implies renal damage, functional impairment or both, diagnosis is solely based on the functional parameters of serum creatinine and urine output. The latest definition was provided by the Kidney Disease Improving Global Outcomes (KDIGO) working group in 2012. Independent of the underlying disease, and even in the case of full recovery, AKI is associated with an increased morbidity and mortality. Awareness of the patient's individual risk profile and the diversity of causes and clinical features of AKI is pivo

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… Ann Rheum Dis 2007; 66: 605–617 58. Flossmann O, Berden A, de Groot K, et al. Long-term patient survival in ANCA-associated vasculitis. Ann Rheum Dis 2011; 70: 488–494 59. Kemna M, Damoiseaux J, Austen J, et al. … Arthritis Rheum 2004; 51: 269–273 61. George J, Nester C. Syndromes of thrombotic microangiopathy. N Engl J Med 2014; 371: 654–666 62. Ståhl A, Vaziri-Sani F, Heinen S, et al. …

Juvenile-onset Systemic Lupus Erythematosus: Recent Advances in Pathogenesis and Treatment.

PURPOSE OF REVIEW: This review summarizes recent advances in understanding the pathogenesis and therapeutic landscape of juvenile-onset systemic lupus erythematosus (jSLE), with a focus on how emerging genetic and immunologic insights inform patient stratification, targeted treatments, and Treat-to-Target (T2T) approaches in pediatric care. RECENT FINDINGS: Studies of (ultra-)rare gene variants (e.g., affecting TLR7, UNC93B1, PLD4, PTPN2, BACH2) aided in understanding key pathogenic pathways, and allowed linking these to associated clinical phenotypes. Multi-ancestral genomic studies and cumu

Panniculitis and pancreatitis: Inflammation and necrotic mechanisms in a patient with alcohol use disorder and alarming suspicion for malignant process.

Panniculitis is an inflammatory process localized to subcutaneous tissue, with etiologies including infection, malignancy, external insults, enzymatic destructive processes, and inflammatory disorders. The incidence of panniculitis manifesting as necrosis of subcutaneous fat tissue associated with pancreatic diseases is low, which may encompass associated periarthritis with bone necrosis and panniculitis (Pancreatitis, panniculitis and polyarthritis syndrome). Pancreatitis, panniculitis and polyarthritis syndrome is considered to derive from the systemic activity of enzymes within the pancreas

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… Evidence for the pathogenicity of lipolytic enzymes Arthritis Rheum 26 2 1983 121 126 10.1002/art.1780260201 6337595 4 Langenhan R Reimers N Probst A. … Nakahara N Intraosseous fat necrosis associated with alcoholic pancreatitis Clin J Gastroenterol 2 6 2009 425 430 10.1007/s12328-009-0113-9 Epub 2009 Oct 3 26192800 9 Narváez J Bianchi MM Santo P de la Fuente D Ríos-Rodriguez V Bolao F Pancreatitis, panniculitis, and polyarthritis Semin Arthritis Rheum …

Ongoing clinical trials and treatment options for patients with systemic sclerosis-associated interstitial lung disease.

SSc is a rare CTD that affects multiple organ systems, resulting in substantial morbidity and mortality. Evidence of interstitial lung disease (ILD) is seen in ∼80% of patients with SSc. Currently there is no approved disease-modifying treatment for ILD and few effective treatment options are available. CYC is included in treatment guidelines, but it has limited efficacy and is associated with toxicity. MMF is becoming the most commonly used medication in clinical practice in North America and the UK, but its use is not universal. Newer agents targeting the pathogenic mechanisms underlying SSc

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… Arthritis Rheum 2006;54:3962–70. 26. Kowal-Bielecka O, Fransen J, Avouac J. et al. Update of EULAR recommendations for the treatment of systemic sclerosis. Ann Rheum Dis 2017;76:1327–39. 27. Tashkin DP, Roth MD, Clements PJ. et al. … Arthritis Rheum 1989;32:1128–34. 32. DeMarco PJ, Weisman MH, Seibold JR. et al. Predictors and outcomes of scleroderma renal crisis: the high-dose versus low-dose D-penicillamine in early diffuse systemic sclerosis trial. Arthritis Rheum 2002;46:2983–9. 33. …

Risk of malignancy in ankylosing spondylitis: a systematic review and meta-analysis.

Current knowledge about the overall and site-specific risk of malignancy associated with ankylosing spondylitis (AS) is inconsistent. We conducted a systematic review and meta-analysis to address this knowledge gap. Five databases (PubMed, EMBASE, Web of Science, the Cochrane library and the virtual health library) were systematically searched. A manual search of publications within the last 2 years in key journals in the field (Annals of the Rheumatic Diseases, Rheumatology and Arthritis &rheumatology) was also performed. STATA 11.2 software was used to conduct the meta-analysis. After screen…

A Pilot Clinical Study of Hyperacute Serum Treatment in Osteoarthritic Knee Joint: Cytokine Changes and Clinical Effects.

The serum fraction of platelet-rich fibrin (hyperacute serum) has been shown to improve cartilage cell proliferation in in vitro osteoarthritic knee joint models. We hypothesize that hyperacute serum may be a potential regenerative therapeutic for osteoarthritic knees. In this study, the cytokine milieu at the synovial fluid of osteoarthritic knee joints exposed to hyperacute serum intraarticular injections was investigated. Patients with knee osteoarthritis received three injections of autologous hyperacute serum; synovial fluid was harvested before each injection and clinical monitoring was

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… Rheum. Dis. 2019;78:413–420. doi: 10.1136/annrheumdis-2018-213336. 81. Fleischmann R.M., Bliddal H., Blanco F.J., Schnitzer T.J., Peterfy C., Wang S.C.L., Feng S., Conaghan P.G., Berenbaum F., Pelletier J.-P., et al. … Arthritis Rheum. 2019;71:1056–1069. doi: 10.1002/art.40840. 82. Zupan J., Vrtačnik P., Cör A., Haring G., Weryha G., Visvikis-Siest S., Marc J. VEGF-A is associated with early degenerative changes in cartilage and subchondral bone. …

Pure red cell aplasia in a patient with rheumatoid arthritis after JAK inhibitor exposure-diagnostic challenges.

We describe a patient with long-standing rheumatoid arthritis (RA) who developed severe refractory transfusion-dependent anaemia lasting several months following treatment with a JAK1 inhibitor (Filgotinib). The patient proceeded with extensive investigations, including bone marrow assessment, and was initially diagnosed with Filgotinib-associated anaemia. However, despite stopping this agent, the anaemia persisted with fluctuating reticulocyte count resulting in multiple hospital admissions. Although the anaemia was initially attributed to Filgotinib, its persistence alongside delayed reticul…

Immune mediated inflammatory diseases: moving from targeted biologic therapy, stem cell therapy to targeted cell therapy.

Despite the advancements in targeted biologic therapy for immune-mediated inflammatory diseases (IMIDs), significant challenges persist, including challenges in drug maintenance, primary and secondary non-responses, and adverse effects. Recent data have strengthened the evidence supporting stem cell therapy as an experimental salvage therapy into a standard treatment option. Recent preclinical and clinical studies suggested that chimeric antigen receptor T cell (CAR-T) therapy, which depleting tissue and bone marrow B cells, may lead to improvement, even inducing long-lasting remissions for pa

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… Ann Rheum Dis . ( 2011 ) 70 ( 2 ): 284–8 . doi: 10.1136/ard.2010.135111 21068090 20 Paramarta JE Baeten DL . … Ann Rheum Dis . ( 2024 ) 83 ( 4 ): 409–16 . doi: 10.1136/ard-2023-224916 38123338 35 Zeng L Liu C Wu Y Liu S Zheng Y Hao W . …