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Current Opinion in Rheumatology

Lazaros I Sakkas, Dimitrios P Bogdanos
PURPOSE OF REVIEW: This review highlights the most recent data obtained in this field and provides clues toward the better understanding of the close interplay between microbiota and host, leading to autoimmune diseases. RECENT FINDINGS: A well-described model of microbiota/host interaction of relevance to autoimmunity is that linking anti-citrullinated peptide antibody positive rheumatoid arthritis and alterations of microbiota largely concentrating on Porphyromonas gingivalis and more recently of Aggregatibacter actinomycetemcomitans and Prevotella copri...
March 13, 2018: Current Opinion in Rheumatology
Sovira Tan, Michael M Ward
PURPOSE OF REVIEW: Computed tomography (CT) is increasingly being used in ankylosing spondylitis (AS) for imaging the spine and sacroiliac joint (SIJ). We review new insights to diagnosis and evaluation revealed by the use of CT. RECENT FINDINGS: Studies using low-dose CT in AS to detect syndesmophytes can image the entire spine, but semiquantitative scoring of the scans by human readers decreases the reliability and validity of this method. The thoracic spine is the segment most involved with syndesmophytes...
March 13, 2018: Current Opinion in Rheumatology
Rene Y Choi, Mark Asquith, James T Rosenbaum
PURPOSE OF REVIEW: The intestinal microbiome is thought to play a role in the pathogenesis of inflammatory bowel disease (IBD). There are many shared clinical manifestations between IBD and spondyloarthritis (SpA), of which the most common are peripheral arthritis and uveitis. Clinical overlap along with similar genetics between these diseases suggests a possible shared pathogenetic mechanism, which might center on the intestinal microbiota. In this review, we discuss the available evidence that SpA is a microbiome-driven disease and indicate how SpA-associated uveitis could be tied to gut dysbiosis...
March 13, 2018: Current Opinion in Rheumatology
William Joseph McCune, Mousa Al Abbas
No abstract text is available yet for this article.
March 13, 2018: Current Opinion in Rheumatology
Patrick Martineau, William D Leslie
PURPOSE OF REVIEW: Trabecular bone score (TBS) is a texture index derived from the lumbar spine dual-energy X-ray absorptiometry which can assess skeletal quality and provide information about fracture risk independent of bone mineral density (BMD). TBS is useful in assessing osteoporotic fracture risk, with lower TBS values associated with increased fracture risk. In this article, we review the current state of TBS, including its utility and limitations in the assessment and management of osteoporosis, with particular emphasis on the recent literature...
March 9, 2018: Current Opinion in Rheumatology
Luis J Jara, Gabriela Medina, Miguel A Saavedra
PURPOSE OF REVIEW: To provide an update about the interactions between infections and autoimmune diseases (AIDs), from the molecular perspective to the clinical spectrum and the differentiation between infection and disease activity. RECENT FINDINGS: Any kind of infection may modify the innate and adaptive immune response through the following mechanisms: molecular mimicry, superantigens, epitope spreading and B-cell activation. The consequence is the overproduction of antibodies shared with those found in AIDs...
March 9, 2018: Current Opinion in Rheumatology
Nada Abdulaziz, Anjali R Shah, William J McCune
PURPOSE OF REVIEW: Antimalarial drugs including chloroquine, its less toxic quinolone-derivative hydroxychloroquine (HCQ), and quinacrine have become cornerstones in the treatment of autoimmune diseases including systemic lupus, rheumatoid arthritis, sarcoidosis, and Sjogren syndrome; cutaneous disorders, antiphospholipid syndrome, and have recently been employed at higher dioses in oncology. Benefits include anti-inflammatory effects, protection against thrombosis, and improved control of hyperglycemia and hyperlipidemia...
March 6, 2018: Current Opinion in Rheumatology
Jon T Giles
No abstract text is available yet for this article.
February 19, 2018: Current Opinion in Rheumatology
Tina D Mahajan, Ted R Mikuls
PURPOSE OF REVIEW: Therapies for rheumatoid arthritis (RA) continue to expand rapidly. The purpose of this review is to discuss novel treatment options, including biosimilars, that are available, as well as to highlight promising agents in development. The purpose is also to discuss new emerging safety signals associated with these drugs and to discuss strategies in tapering therapy. RECENT FINDINGS: There are several novel RA therapies. These include the interleukin-6 (IL-6) receptor blocker sarilumab, which was approved in 2017...
February 15, 2018: Current Opinion in Rheumatology
Juan-Manuel Anaya, Paula Restrepo-Jiménez, Carolina Ramírez-Santana
PURPOSE OF REVIEW: The autoimmune ecology refers to the interactions between individuals and their environment leading to a breakdown in immune tolerance and, therefore, to the development of one or more autoimmune diseases in such an individual. Herein, an update is offered on four specific factors associated with autoimmune diseases, namely, vitamin D, smoking, alcohol and coffee consumption from the perspective of exposome and metabolomics. RECENT FINDINGS: Smoking is associated with an increased risk for most of the autoimmune diseases...
February 12, 2018: Current Opinion in Rheumatology
Gustavo Guimarães Moreira Balbi, Francinne Machado-Ribeiro, Cláudia D L Marques, Flávio Signorelli, Roger Abramino Levy
PURPOSE OF REVIEW: Tuberculosis (TB) is a millenarian chronic infection and, yet, remains a major global health problem. The interaction between systemic lupus erythematosus (SLE) and TB is complex, as one seems to be a risk factor for the development of the other. SLE patients are more likely to develop TB, that is more frequently extrapulmonary, with more extensive pulmonary involvement, and with a higher relapse rate. RECENT FINDINGS: Different studies suggest that TB is more prevalent in SLE patients and that TB may actually be a risk factor for the development of the disease...
February 12, 2018: Current Opinion in Rheumatology
Dimitri Poddighe
PURPOSE OF REVIEW: Providing an overview on Mycoplasma pneumoniae-related extra-pulmonary diseases (MpEPDs) in children, who represent the preferred target population by those complications, and discussing the main pathogenic mechanisms implicated or potentially involved. RECENT FINDINGS: Recent evidences supported the fact that M. pneumoniae is more than an extra-cellular pathogen colonizing epithelial cells of the respiratory tract. It is able to penetrate the cell membrane of host cells and to invade the respiratory mucosa, leading to pronounced inflammatory responses and also spreading outside the respiratory system, to some extent...
February 9, 2018: Current Opinion in Rheumatology
Fatma Alibaz-Oner, Amr H Sawalha, Haner Direskeneli
PURPOSE OF REVIEW: Current treatment modalities in Behçet's disease will be summarized in light of new studies published within the last 2 years. RECENT FINDINGS: There is an increasing interest in the treatment of refractory mucocutaneous symptoms of Behçet's disease, and results were quite promising with apremilast, anakinra, and ustekinumab. Data from large case series confirmed both the efficacy and safety of tumor necrosis factor-α inhibitors for the treatment of refractory major organ manifestations such as ocular, neurologic, vascular, and gastrointestinal involvement...
February 9, 2018: Current Opinion in Rheumatology
Dolores Pérez, Danielle Azoulay
PURPOSE OF REVIEW: The aim of this review is to summarize the recent studies regarding the relationship between anti-DFS70 antibodies and HIV-1 infection. Examining the interaction between HIV-1 integrate (HIV-IN) and DFS70 and its role in the integration into the host's chromatin. Then, summarizing the importance of anti-DFS70 autoantibodies binding the DFS70 in the same region as the HIV-IN. RECENT FINDINGS: The interaction between HIV-IN and DFS70 protein could be a proficient target in the treatment against HIV-1 infection...
February 3, 2018: Current Opinion in Rheumatology
Michael Bonelli, Clemens Scheinecker
PURPOSE OF REVIEW: The purpose of this review is to summarize the current knowledge concerning the mechanisms of action of Abatacept in patients with rheumatoid arthritis. RECENT FINDINGS: Abatacept (CTLA-4Ig) represents a soluble, recombinant, fully humanized fusion protein, comprising the extracellular domain of CTLA-4 and the Fc portion of IgG1. Abatacept binds to the costimulatory molecules CD80 and CD86 on antigen-presenting cells (APC), thereby blocking interaction with CD28 on T cells...
February 3, 2018: Current Opinion in Rheumatology
Anne C Regierer, Anja Strangfeld
PURPOSE OF REVIEW: What is the best treatment option in patients with active rheumatoid arthritis who have a history of malignant disease? Rheumatologists are increasingly faced with this question in their daily practice. As uncontrolled high disease activity is an important risk factor for further comorbidities and shortened life expectancy, the treatment has to be effective, without bearing a higher risk for cancer recurrence. What data is available today to guide treatment decisions and how robust is its evidence? RECENT FINDINGS: As patients with prior cancer are usually not included in randomized controlled trials, all data we have to elucidate this topic stems from observational cohort studies, mainly biologics registers established in several European countries...
January 31, 2018: Current Opinion in Rheumatology
Ravi B Sutaria, Jose K Amaral, Robert T Schoen
PURPOSE OF REVIEW: To review the emergence, clinical features, pathogenesis, and treatment of acute chikungunya (CHIK) fever and chronic CHIK arthritis. RECENT FINDINGS: Since 2004, CHIK, an arboviral infection, has spread throughout the world, infecting millions of people. The illness occurs in two phases: an acute viremic infection followed by chronic arthritis. In less developed countries, there are limited resources and effective treatment. For acutely ill CHIK fever patients, management is symptomatic...
January 31, 2018: Current Opinion in Rheumatology
Alfons A den Broeder, Noortje van Herwaarden, Bart J F van den Bemt
PURPOSE OF REVIEW: To give an overview of recently published articles covering therapeutic drug monitoring (TDM) of biological DMARDs (bDMARDs) in rheumatoid arthritis. RECENT FINDINGS: In the last 18 months, two clinical studies and nine reviews were found after a systematic literature search. Most (narrative) reviews conclude that TDM should be used to improve biological treatment in rheumatoid arthritis patients, whereas most of the clinical studies (including 13 studies identified earlier) whenever scrutinized do not support this conclusion...
January 31, 2018: Current Opinion in Rheumatology
Sterling G West
PURPOSE OF REVIEW: Sarcoidosis is a systemic disease characterized by noncaseating granulomatous inflammation of multiple organ systems. Pulmonary, cardiac, and neurologic involvements have the worst prognosis. Current recommendations for the therapeutic management and follow-up of sarcoidosis involving these critical organs will be reviewed. RECENT FINDINGS: In those sarcoidosis patients requiring immunosuppressive therapy, corticosteroids are used first at varying doses depending on the presenting manifestation...
January 31, 2018: Current Opinion in Rheumatology
William G Dixon, Kaleb Michaud
PURPOSE OF REVIEW: As digital technology becomes more ubiquitous, understanding the current state-of-the-art in digital information use for clinical care and research for patients with rheumatoid arthritis (RA) is timely and relevant. RECENT FINDINGS: The opportunities for recording and utilizing high-quality data from rheumatologists are reviewed, as well as opportunities from collecting, integrating and analysing patient-generated data to deliver a step-change in the support and management of RA...
January 23, 2018: Current Opinion in Rheumatology
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