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Current Opinion in Rheumatology

Ryuta Kamekura, Hiroki Takahashi, Shingo Ichimiya
PURPOSE OF REVIEW: New insights into IgG4-related disease (IgG4-RD) have recently been obtained. A better understanding of the mechanisms underlying this disease is important for identification of therapeutic targets, which will lead to the development of specific strategies for treatment. RECENT FINDINGS: Infiltration of activated T follicular helper (Tfh) cells is observed in affected tissues of IgG4-RD. Such Tfh cells have a greater capacity than tonsillar Tfh cells to help B cells produce IgG4...
November 12, 2018: Current Opinion in Rheumatology
Hasan Yazici, Yusuf Yazici
No abstract text is available yet for this article.
November 6, 2018: Current Opinion in Rheumatology
Uğur Uygunoğlu, Aksel Siva
PURPOSE OF REVIEW: Neurological involvement in Behçet's syndrome is defined as 'the occurrence of neurological symptoms and signs in a patient who meets the International Diagnostic Criteria for BS not otherwise explained by any other known systemic or neurological disease or treatment, and in whom objective abnormalities consistent with neuro-Behçet's syndrome (NBS) are detected either on neurological examination, neuroimaging studies (magnetic resonance imaging [MRI]), and/or on cerebrospinal fluid (CSF) examination'...
November 6, 2018: Current Opinion in Rheumatology
Sophie I Mavrogeni, Theodoros Dimitroulas, George D Kitas
PURPOSE OF REVIEW: Cardiac manifestations in systemic vasculitides, either primary or secondary due to infection, malignancy or autoimmune rheumatic diseases may be life-threatening. Cardiovascular (CVD) magnetic resonance (CMR) has been recently proposed as an ideal noninvasive tool to evaluate systemic vasculitides. In the present article, we present an overview of CMR in the diagnosis and follow-up of cardiac involvement in systemic vasculitides. RECENT FINDINGS: CMR is a noninvasive, nonradiating modality, capable to assess cardiac function, perfusion and tissue characterization that can be of great diagnostic value in both primary and secondary systemic vasculitides...
November 6, 2018: Current Opinion in Rheumatology
Eric Gracey, Emilie Dumas, Meital Yerushalmi, Zoya Qaiyum, Robert D Inman, Dirk Elewaut
PURPOSE OF REVIEW: This article aims to review recent literature linking epithelial barrier inflammation and arthritis in spondyloarthritis (SpA), with a critical view on how they are bound by genetic, immunological and environmental ties. RECENT FINDINGS: The epithelia-joint axis has become an intense area of both basic and clinical SpA research. The penultimate goal is to understand the immunopathologic links between epithelial inflammation and arthritis in SpA...
November 6, 2018: Current Opinion in Rheumatology
Allison C Billi, J Michelle Kahlenberg, Johann E Gudjonsson
PURPOSE OF REVIEW: To give an overview of recently published articles addressing the mechanisms underlying sex bias in autoimmune disease. RECENT FINDINGS: Recent studies investigating the origins of sex bias in autoimmune disease have revealed an extensive and interconnected network of genetic, hormonal, microbial, and environmental influences. Investigation of sex hormones has moved beyond profiling the effects of hormones on activity and prevalence of immune cell types to defining the specific immunity-related genes driving these changes...
November 1, 2018: Current Opinion in Rheumatology
Marzia Caproni, Alice Verdelli
PURPOSE OF REVIEW: Cutaneous vasculitis reflects a spectrum ranging from skin limited to severe systemic forms. To date, there is still no generally acknowledged nomenclature for cutaneous vasculitis. This review aims to summarize the recent advances in the nomenclature of cutaneous vasculitis. RECENT FINDINGS: The most widely adopted vasculitis classification system is the one of 2012 Revised Chapel Hill Consensus Conference (CHCC) which represent not such a classification but a nomenclature system that name vasculitis on the basis of the size of the vessel affected...
November 1, 2018: Current Opinion in Rheumatology
Muhammad Farooq Rai, Robert H Brophy, Linda J Sandell
PURPOSE OF REVIEW: The interaction between joint injuries and posttraumatic osteoarthritis (PTOA) is generally thought to be mechanical in nature, however, surgical intervention has little effect on the development of PTOA. Little is known about the biological underpinning of how meniscus and anterior cruciate ligament (ACL) tears lead to cartilage degeneration. This review summarizes the latest findings regarding biological factors that influence how the knee responds to meniscus and ligament injuries, how meniscus and/or ACL tears turn the joint in the direction of PTOA and whether patient risk for PTOA after meniscus/ACL injury can be predicted...
November 1, 2018: Current Opinion in Rheumatology
Renea Jablonski, Jane Dematte, Sangeeta Bhorade
PURPOSE OF REVIEW: The purpose of this review is to highlight recent data regarding feasibility and outcomes following lung transplantation for patients with systemic sclerosis related pulmonary disease as well as to emphasize areas of uncertainly in need of further study. We include a description of our centre's approach to lung transplant evaluation and posttransplant management in this complex patient population. RECENT FINDINGS: Historical data have demonstrated that patients with scleroderma have an increased risk of complications following lung transplantation owing to the multisystem nature of disease, particularly concurrent gastrointestinal, cardiac and renal involvement...
November 2018: Current Opinion in Rheumatology
Laure Gallay, Catherine Gayed, Baptiste Hervier
PURPOSE OF REVIEW: Antisynthetase syndrome (ASyS) is an acquired myopathy characterized by the presence of myositis-specific autoantibodies directed against tRNA-synthetases. ASyS is potentially life threatening due to lung involvement and treatment remains a challenge to date. With symptoms not limited to muscles but also involving lung, skin and joints, ASyS appears specific and has a particular pathogenesis, different from the other inflammatory myopathies. This review is intended to discuss the current understanding of ASyS pathogenesis, pointing its current knowledge and also the crucial prospects that may lead to critical improvement of ASyS care...
November 2018: Current Opinion in Rheumatology
Yves Allenbach, Olivier Benveniste
PURPOSE OF REVIEW: In the past decade, immune-mediated necrotizing myopathies have emerged as a separate entity in the heterogenous group of autoimmune myopathies. This group is characterized by clinical manifestations restricted to the muscle tissue, and until recently, the definition was based on muscular pathological features. RECENT FINDINGS: It was shown that they are the most severe autoimmune myopathies in term of muscle damages. They have been associated with two myositis-specific antibodies: either anti-signal recognition particle (anti-SRP) or anti-hydroxy-3-methylglutaryl-CoA reductase (anti-HMGCR) antibodies...
November 2018: Current Opinion in Rheumatology
Zsuzsanna H McMahan, Laura K Hummers
PURPOSE OF REVIEW: This review provides important updates in systemic sclerosis (SSc)-related gastrointestinal disease, with a particular focus on the diagnosis and management of dysmotility. RECENT FINDINGS: In the past 2 years, several studies were published that present interesting diagnostic insights into SSc and gastrointestinal dysmotility. Studies focusing on new therapies and the novel application of existing therapies, both in SSc and non-SSc-associated gastrointestinal dysmotility syndromes, demonstrate progress in the management of these challenging complications...
November 2018: Current Opinion in Rheumatology
Flavia V Castelino, Paul F Dellaripa
PURPOSE OF REVIEW: Systemic sclerosis is a systemic autoimmune disorder wherein interstitial lung disease (ILD) is the major source or morbidity and mortality. Research into mechanisms of fibrosis and its intersection with autoimmunity, specifically lung fibrosis, has accelerated and been applied to autoimmune disorders such as scleroderma. This review highlights important emerging insights and treatment trials. RECENT FINDINGS: The important elements of this review focus on the challenges faced in identifying patients not only who develop lung disease but who are at a higher risk for progression given the heterogeneous natural history of ILD in scleroderma...
November 2018: Current Opinion in Rheumatology
Patrizia Fuschiotti
PURPOSE OF REVIEW: Dysregulation of both the innate and the adaptive immune systems has been identified in systemic sclerosis (SSc). However, the mechanisms underlying aberrant immune cell function remain poorly understood. T cells represent a predominant cell type in the affected tissues of patients, particularly in the early inflammatory stage of the disease. Antigen specificity of infiltrating T cells has not been identified; however, recent studies implicate specific T-cell subsets and the cytokines they produce in SSc pathogenesis by modulating the development of autoimmunity, inflammation and fibrosis...
November 2018: Current Opinion in Rheumatology
Anna Ghirardello, Andrea Doria
PURPOSE OF REVIEW: The aim of this study was to provide the most recent evidence on clinical utility of myositis-specific autoantibodies (MSAs) in the management of patients with myositis. RECENT FINDINGS: In the last few years, several evidences have emerged on the clinical and pathogenetic role of established and novel MSA. Antisynthetase antibodies represent a reliable biomarker for pulmonary involvement also in patients with connective tissue diseases other than myositis...
November 2018: Current Opinion in Rheumatology
Max Brown, Steven O'Reilly
PURPOSE OF REVIEW: Systemic sclerosis (SSc) is an autoimmune connective tissue disease in which inflammation and cytokine dysregulation leads to skin fibrosis. Toll-like receptors (TLRs) are conserved pattern recognition receptors, recognizing pathogens danger-associated molecular patterns (DAMPs) that elicit a cascade of proinflammatory signaling. Recently, TLRs have been found to be critically important in SSc pathogenesis, with increased levels of the TLRs and their ligands present in the disease...
November 2018: Current Opinion in Rheumatology
Iago Pinal-Fernandez, Andrew L Mammen
PURPOSE OF REVIEW: The purpose of this article is to review the etiopathogenesis of dermatomyositis, including the predisposing factors, triggers, inflammatory cells, pathways and target antigens associated with dermatomyositis. RECENT FINDINGS: During the last few years, we have made considerable progress in unveiling the etiopathogenesis of dermatomyositis. In the first place, we have defined genes within the major histocompatibility complex locus as the greatest genetic risk factor for the disease...
November 2018: Current Opinion in Rheumatology
Dilli R Poudel, Chris T Derk
PURPOSE OF REVIEW: Systemic sclerosis is a debilitating rheumatic disease with high morbidity and mortality. This review attempts to provide the most recent update on mortality and survival and their determinants in systemic sclerosis (SSc). RECENT FINDINGS: SSc remains an uncommon rheumatic disease with high mortality. There have been attempts to devise more comprehensive but simpler scoring systems to prognosticate survival in SSc, which will influence triaging of patients and guide the utilization of aggressive treatment strategies...
November 2018: Current Opinion in Rheumatology
Julie J Paik
PURPOSE OF REVIEW: This review discusses the most updated literature of muscle disease in scleroderma in the past year. RECENT FINDINGS: In the past year, two studies have highlighted that fibrosis is a prevalent histopathologic feature in muscle biopsies of patients with scleroderma muscle disease. In addition, microangiopathy was a common co-feature on muscle biopsies. A fibrosing myopathy, or fibrosis predominance on muscle histopathology, is associated with a unique clinical phenotype in patients with scleroderma...
November 2018: Current Opinion in Rheumatology
Christopher A Mecoli, Livia Casciola-Rosen
PURPOSE OF REVIEW: New research continues to provide important insights into the utility of antibody specificities. This review provides an update of recent findings, and the important insights they provide into disease mechanism. RECENT FINDINGS: A growing number of autoantibodies have been discovered in scleroderma patients with unique clinical associations. A subgroup of these antibodies may have functional consequences and contribute to disease pathogenesis, driving the vascular and fibrotic phenotype...
November 2018: Current Opinion in Rheumatology
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