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Current Rheumatology Reports

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https://www.readbyqxmd.com/read/27832442/cannabinoids-in-the-management-of-musculoskeletal-or-rheumatic-diseases
#1
REVIEW
Mary-Ann Fitzcharles, Winfried Häuser
The endocannabinoid system impacts pain and inflammation with potential for therapeutic effect on patients with rheumatic diseases. The current treatment options include the herbal product derived from the plant Cannabis sativa, as well as pharmaceutical preparations. The legalization of medicinal cannabis (marijuana) in many jurisdictions and widespread public advocacy has propelled an interest in use either by prescription or self-medication. In this review, we examine current evidence for efficacy and adverse effects of any cannabinoid product in rheumatic conditions...
December 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27822769/imaging-in-juvenile-spondyloarthritis
#2
REVIEW
Pamela F Weiss, Nancy A Chauvin, Johannes Roth
PURPOSE OF REVIEW: This review aims to provide an update on the use of imaging in the assessment of juvenile spondyloarthritis (JSpA) disease manifestations. RECENT FINDINGS: Recent studies have demonstrated superior reliability and specificity of MRI for assessment of sacroiliac joint inflammation compared with radiography. The use of gadolinium contrast may not add incremental value to the assessment of inflammatory sacroiliitis. Sacroiliitis is common at diagnosis of spondyloarthritis...
December 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27812956/direct-oral-anticoagulants-use-in-antiphospholipid-syndrome-are-these-drugs-an-effective-and-safe-alternative-to-warfarin-a-systematic-review-of-the-literature
#3
REVIEW
Virginie Dufrost, Jessie Risse, Stéphane Zuily, Denis Wahl
BACKGROUND: The cornerstone of thrombotic antiphospholipid syndrome (APS) patients' management is to prevent recurrent thrombosis by long-term anticoagulation. PURPOSE OF REVIEW: The purpose of the review is to summarize available literature on direct oral anticoagulants (DOACs) use in APS patients through a systematic review and to determine factors associated with thrombosis recurrence. RECENT FINDINGS: The recent RAPS trial demonstrated that APS patients treated with rivaroxaban had a significant twofold-increased thrombin potential, suggesting a higher thrombotic risk, in comparison with warfarin users...
December 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27812955/differential-effects-of-inflammation-on-bone-and-response-to-biologics-in-rheumatoid-arthritis-and-spondyloarthritis
#4
REVIEW
Zheni Stavre, Katherine Upchurch, Jonathan Kay, Ellen M Gravallese
PURPOSE OF REVIEW: We review the pathways, cytokines, and concepts important to the pathogenesis of bone resorption and formation in rheumatoid arthritis (RA) and spondyloarthritis (SpA). RECENT FINDINGS: Research in bone biology has shed light on the pathogenesis of the joint destruction that occurs in RA and in peripheral SpA. However, understanding the mechanisms behind the bone formation seen in peripheral and axial SpA has been challenging. Mouse models have been used to gain an understanding of key signaling pathways, cytokines and cells regulating inflammation in these diseases...
December 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27812954/activation-of-the-mechanistic-target-of-rapamycin-in-sle-explosion-of-evidence-in-the-last-five-years
#5
REVIEW
Zachary Oaks, Thomas Winans, Nick Huang, Katalin Banki, Andras Perl
The mechanistic target of rapamycin (mTOR) is a central regulator in cell growth, activation, proliferation, and survival. Activation of the mTOR pathway underlies the pathogenesis of systemic lupus erythematosus (SLE). While mTOR activation and its therapeutic reversal were originally discovered in T cells, recent investigations have also uncovered roles in other cell subsets including B cells, macrophages, and "non-immune" organs such as the liver and the kidney. Activation of mTOR complex 1 (mTORC1) precedes the onset of SLE and associated co-morbidities, such as anti-phospholipid syndrome (APS), and may act as an early marker of disease pathogenesis...
December 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27812953/monogenic-lupus
#6
REVIEW
Mindy S Lo
PURPOSE OF REVIEW: Systemic lupus erythematosus (SLE) is a multisystem autoimmune disease known for its clinical heterogeneity. Over time, new insights into the complex genetic origin of SLE have started to explain some of this clinical variability. These findings, reviewed here, have also yielded important understanding in the immune mechanisms behind SLE pathogenesis. RECENT FINDINGS: Several new monogenic disorders with lupus-like phenotype have been described...
December 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27812952/predictors-of-poor-outcome-in-anca-associated-vasculitis-aav
#7
REVIEW
Luis E Vega, Luis R Espinoza
It is important to recognize factors that might predict poor outcome and prognosis in patients with AAV. The predictors reported in the literature encompass genetic, histopathological, and clinical ones. Genetic studies (genetic predictors) have found genes that are associated with prediction of poor response to treatment, deterioration of renal function, and risk of mortality. Histopathological studies (histopathological predictors) have shown that sclerotic renal lesions are associated with increased risk of progression to end-stage renal disease and death...
December 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27796844/the-complex-role-of-the-lung-in-the-pathogenesis-and-clinical-outcomes-of-rheumatoid-arthritis
#8
REVIEW
Lindsay B Kelmenson, M Kristen Demoruelle, Kevin D Deane
While the primary manifestation of rheumatoid arthritis (RA) is articular disease, extra-articular disease may also occur. In particular, pulmonary disease is a frequent extra-articular manifestation of seropositive RA and a leading cause of morbidity and mortality in this population. This review will highlight studies published in the last several years and will, in particular, discuss the relationship of antibodies to citrullinated protein/peptide antigens (ACPA) and lung disease in patients with RA. We will also review the data regarding the potential role of the lung and generation of RA-related autoantibodies in a period of disease development termed "preclinical RA...
November 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27734211/low-dose-il-2-in-the-treatment-of-lupus
#9
Masayuki Mizui, George C Tsokos
Recent extensive research on interleukin-2 (IL-2)/IL-2 receptor (IL-2R) biology has revealed its critical role in the regulation of immune tolerance by influencing regulatory T (Treg) cell functions and survival. Since in vivo low-dose IL-2 administration in humans has been confirmed to be safe and effective in expanding Treg, it is likely that it may be considered for the treatment of several autoimmune diseases including systemic lupus erythematousus (SLE). A recent clinical trial demonstrated the safety and efficacy of low-dose IL-2 treatment on SLE...
November 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27709413/immune-cell-metabolism-in-systemic-lupus-erythematosus
#10
Seung-Chul Choi, Anton A Titov, Ramya Sivakumar, Wei Li, Laurence Morel
Cellular metabolism represents a newly identified checkpoint of effector functions in the immune system. A solid body of work has characterized the metabolic requirements of normal T cells during activation and differentiation into polarized effector subsets. Similar studies have been initiated to characterize the metabolic requirements for B cells and myeloid cells. Only a few studies though have characterized the metabolism of immune cells in the context of autoimmune diseases. Here, we review what is known on the altered metabolic patterns of CD4(+) T cells, B cells, and myeloid cells in lupus patients and lupus-prone mice and how they contribute to lupus pathogenesis...
November 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27704250/regulatory-t-cells-in-sle-biology-and-use-in-treatment
#11
Sophia Giang, Antonio La Cava
T regulatory cells (Tregs) represent a phenotypically and functionally heterogeneous group of lymphocytes that exert immunosuppressive activities on effector immune responses. Tregs play a key role in maintaining immune tolerance and homeostasis through diverse mechanisms which involve interactions with components of both the innate and adaptive immune systems. As in many autoimmune diseases, Tregs have been proposed to play a relevant role in the pathogenesis of systemic lupus erythematosus (SLE), an autoimmune disease characterized by a progressive breakdown of tolerance to self-antigens and the presence of concomitant hyperactive immune responses...
November 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27686950/gout-and-osteoarthritis-associations-pathophysiology-and-therapeutic-implications
#12
Chio Yokose, Meng Chen, Adey Berhanu, Michael H Pillinger, Svetlana Krasnokutsky
Osteoarthritis (OA), the most common type of arthritis worldwide, is a degenerative disease of diarthrodial joints resulting in pain, reduced quality of life, and socioeconomic burden. Gout, the most common form of inflammatory arthritis, is a consequence of persistently elevated levels of urate and the formation of proinflammatory monosodium urate crystals in joints. Clinicians have long noted a predilection for both diseases to occur in the same joints. In this review, we provide an overview into research elucidating possible biochemical, mechanical, and immunological relationships between gout and OA...
October 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27646150/antiphospholipid-syndrome-alliance-for-clinical-trials-and-international-networking-aps-action-5-year-update
#13
REVIEW
Medha Barbhaiya, Danieli Andrade, Doruk Erkan
Antiphospholipid Syndrome Alliance for Clinical Trials and International Networking (APS ACTION) is the first-ever international network created to design and conduct large-scale, multicenter clinical trials and research in persistently antiphospholipid antibody (aPL)-positive patients. Since its inception in 2010, the APS ACTION has made important strides toward our goal of international research collaboration and data sharing. Through the dedication and hard work of 50 APS ACTION members, collaborative international projects are currently underway including a multicenter web-based registry and repository of aPL-positive patients, a randomized controlled clinical trial assessing the efficacy of hydroxychloroquine for primary thrombosis prevention in persistently aPL-positive but thrombosis-free patients, standardization of aPL testing through the use of core laboratories worldwide, identification of the limitations in the existing aPL/APS literature, and conducting observational research studies to further our understanding of the disease...
October 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27641916/functional-genomics-and-its-bench-to-bedside-translation-pertaining-to-the-identified-susceptibility-alleles-and-loci-in-ankylosing-spondylitis
#14
REVIEW
Tony J Kenna, Aimee Hanson, Mary-Ellen Costello, Matthew A Brown
Ankylosing spondylitis (AS) is a highly heritable disease for which there is a great unmet need for improved therapies. Genetics research has identified several major pathways involved in the disease, from which treatments have either now entered clinical practice or are in development. In particular, therapies targeting the IL-23 pathway were repositioned for use in AS following the discovery of multiple genes in the pathway as determinants of AS risk. Discovery of the association of aminopeptidase genes with AS, and subsequently with psoriasis, inflammatory bowel disease and other conditions, has triggered research into therapies targeting this pathway...
October 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27641915/the-microbiome-a-revolution-in-treatment-for-rheumatic-diseases
#15
REVIEW
James T Rosenbaum, Mark J Asquith
PURPOSE OF REVIEW: The microbiome is the term that describes the microbial ecosystem that cohabits an organism such as humans. The microbiome has been implicated in a long list of immune-mediated diseases which include rheumatoid arthritis, ankylosing spondylitis, and even gout. The mechanisms to account for this effect are multiple. The clinical implications from observations on the microbiome and disease are broad. RECENT FINDINGS: A growing number of microbiota constituents such as Prevotella copri, Porphyromonas gingivalis, and Collinsella have been correlated or causally related to rheumatic disease...
October 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27613285/infections-with-biologics-in-rheumatoid-arthritis-and-related-conditions-a-scoping-review-of-serious-or-hospitalized-infections-in-observational-studies
#16
REVIEW
Jasvinder A Singh
Biologic use is a major advance in the treatment of several autoimmune conditions, including rheumatoid arthritis. In this review, we summarize key studies of serious/hospitalized infections in rheumatoid arthritis (RA). RA is a risk factor for infections. High RA disease activity is associated with higher risk of serious infection. The risk of serious infections with tumor necrosis factor inhibitor (TNFi) biologics is increased in the first 6 months of initiating therapy, and this risk was higher compared to the use of traditional disease-modifying anti-rheumatic drugs (DMARDs)...
October 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27475948/neonatal-lupus-what-we-have-learned-and-current-approaches-to-care
#17
REVIEW
Marisa S Klein-Gitelman
Neonatal lupus results from the passive transfer of autoantibodies; however, this transfer is not sufficient to cause disease. This article reviews clinical presentation with a focus on autoimmune-mediated congenital heart disease. Recent data looking for additional disease mechanisms and biomarkers as well as latest information on interventions will be reviewed. Our understanding of this rare disease is often dependent on patient participation in disease registries and biorepositories. Future participation in registries including descriptive as well as biophysical data is critical to our knowledge...
September 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27443850/current-perspectives-on-arthroplasty-in-systemic-lupus-erythematosus-rates-outcomes-and-adverse-events
#18
REVIEW
Shanthini Kasturi, Susan Goodman
Systemic lupus erythematosus (SLE) is a chronic debilitating condition with significant impact on the musculoskeletal system. Arthroplasty may be indicated for damage related to active lupus or its treatment. As therapies for SLE have advanced, morbidity and mortality have declined, while the rate of joint replacement has increased. The age of SLE patients undergoing arthroplasty is increasing, and the indication for surgery is evolving-while avascular necrosis was previously the predominant indication for arthroplasty, osteoarthritis now accounts for a larger proportion of surgeries...
September 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27435070/imaging-in-spondyloarthritis-controversies-in-recognition-of-early-disease
#19
REVIEW
Ulrich Weber, Anne Grethe Jurik, Robert G W Lambert, Walter P Maksymowych
Advanced imaging has become essential for recognition of clinically suspected early spondyloarthritis. This report summarizes recent progress towards a data-driven comprehensive definition of a positive sacroiliac joint MRI in axial spondyloarthritis, which incorporates contextual information provided by structural lesions alongside with active changes. A focus is on emerging limitations and challenges with increasing use of imaging in spondyloarthritis. We discuss the ongoing controversy as to whether sacroiliac joint MRI due to its superior reliability and ability to depict both structural and active lesions should be the preferred imaging modality in early disease over the traditional approach with pelvic radiographs...
September 2016: Current Rheumatology Reports
https://www.readbyqxmd.com/read/27422277/is-synovial-macrophage-activation-the-inflammatory-link-between-obesity-and-osteoarthritis
#20
REVIEW
Antonia RuJia Sun, Thor Friis, Sunderajhan Sekar, Ross Crawford, Yin Xiao, Indira Prasadam
Osteoarthritis (OA) is the most common musculoskeletal disease, affecting nearly 25 % of the world population (WHO reports), leading to pain and disability. There are as yet no clinically proven therapies to halt OA onset or progression; the development of such therapies is, therefore, a national as well as international research priority. Obesity-related metabolic syndrome has been identified as the most significant, but also an entirely preventable risk factor for OA; however, the mechanisms underlying this link remain unclear...
September 2016: Current Rheumatology Reports
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