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Topic Review
Intra-Articular Administration of Therapeutics for Joint Disorders
Several acute and chronic inflammatory diseases of the joints affect individuals. Intra-articular (IA) drug delivery is often preferred when the joint disease is severe and painful since it places high concentrations of the drug directly at the desired site. Researchers have reported different strategies for increasing the local retention of the intra-articularly administered medication. 
  • 2.0K
  • 23 Nov 2022
Topic Review
Systemic Lupus Erythematosus Pathogenesis
Systemic lupus erythematosus (SLE) is a genetically predisposed, female-predominant disease, characterized by multiple organ damage, that in its most severe forms can be life-threatening. The pathogenesis of SLE is complex and involves cells of both innate and adaptive immunity. The distinguishing feature of SLE is the production of autoantibodies, with the formation of immune complexes that precipitate at the vascular level, causing organ damage. 
  • 1.7K
  • 04 Apr 2023
Topic Review
Ultrasound Examination in Nail Apparatus Assessment in Psoriasis
The assessment of psoriatic nail changes in everyday practice is based exclusively on clinical symptoms that do not reflect the entire disease process in the nail apparatus. The use of imaging methods, especially widely available and inexpensive ultrasonography, creates the possibility of additional revealing and assessing grayscale of morphological changes of the ventral nail plate, nail bed, and matrix, as well as the attachment of the finger extensor tendon to the distal phalanx. What is more, it enables the assessment of inflammation severity in the power Doppler technique. A qualitative classification of nail plate morphological changes corresponding to the severity of psoriatic nail changes has been developed so far and attempts are being made to develop a quantitative method to assess not only the presence of changes but also the severity of inflammation. 
  • 1.6K
  • 20 May 2022
Topic Review
Peripheral Neuropathy Related to Connective Tissue Diseases
Although peripheral neuropathy (PN) is a common complication in connective tissue diseases (CTD) and has been well studied, recent research has shown that PN is more diverse and frequent in different subtypes of CTD than was expected. The incidence of PN in Sjögren's syndrome and rheumatoid arthritis (RA) varies according to different disease subtypes, and the pathogenesis of neuropathic pain in different subtypes of eosinophilic granulomatosis with polyangiitis (EGPA) may also differ. Neurogenic inflammation, autoantibody-mediated changes, ischemia of the vascular wall and metabolic mechanisms have been shown to contribute to the pathogenesis of PN in CTD. Moreover, allergic inflammation has been recently identified as a possible new mechanism producing peripheral neuropathic pain associated with MPO-ANCA negative EGPA patients. Glucocorticoids are routinely used to relieve pain caused by PN. However, these steroids may cause hyperalgesia, exacerbate neuropathic pain, and activate the early phase of pain induction and produce hyperalgesia. Recently, neuroactive steroids, such as progesterone, tetrahydroprogesterone and testosterone, have been shown to exert protective effects for several PN symptoms, and in particular neuropathic pain. Neuroactive steroids will be an interesting topic for future research into PN in CTD.
  • 1.5K
  • 28 Mar 2022
Topic Review
Degenerated Intervertebral Discs
Degenerative disc disease (DDD) is one of the most common findings in CLBP patients. DDD is an inflammatory–catabolic process triggered by a long list of genetic, mechanical, and environmental factors that ultimately leads to the resorption of the IVD.
  • 1.1K
  • 22 Apr 2022
Topic Review
Urine Biomarkers of Lupus Nephritis
The kidney is one of the main organs affected by the autoimmune disease systemic lupus erythematosus (SLE). Lupus nephritis (LN) concerns 30–60% of adult SLE patients and it is significantly associated with an increase in the morbidity and mortality. The definitive diagnosis of LN can only be achieved by histological analysis of renal biopsies, but the invasiveness of this technique is an obstacle for early diagnosis of renal involvement and a proper follow-up of LN patients under treatment. The use of urine for the discovery of non-invasive biomarkers for renal disease in SLE patients is an attractive alternative to repeated renal biopsies, as several studies have described surrogate urinary cells or analytes reflecting the inflammatory state of the kidney, and/or the severity of the disease.
  • 1.0K
  • 13 Jul 2021
Topic Review
Interleukin (IL)-4 and IL-13 in Inflammatory Arthritis
Interleukin (IL)-4 and IL-13 belong to the T helper 2 (Th2) cytokine family, along with IL-3, IL-5, and IL-9. These cytokines are key mediators of allergic inflammation. 
  • 804
  • 07 Dec 2021
Topic Review
New Insight on the Pathophysiology of Osteoarthritis
Understanding the basis of osteoarthritis (OA) has seen some interesting advancements. It has been observed that cartilage degeneration is preceded by subchondral bone lesions, suggesting a key role of this mechanism within the pathogenesis and progression of OA, as well as the formation of ectopic bone and osteophytes. Moreover, low-grade, chronic inflammation of the synovial lining has gained a central role in the definition of OA physiopathology, and central immunological mechanisms, innate but also adaptive, are considered crucial in driving inflammation and tissue destruction.
  • 785
  • 15 Dec 2022
Topic Review
Antinuclear Antibodies in Systemic Sclerosis
Systemic sclerosis is a systemic autoimmune rheumatic disease characterized by immune abnormalities, leading to vasculopathy and fibrosis. Autoantibody testing has become an increasingly important part of diagnosis and prognostication. Clinicians have been limited to antinuclear antibody (ANA), antitopoisomerase I (also known as anti-Scl-70) antibody, and anticentromere antibody testing. ANA are common in the general population, occurring in up to 20% of women. The presence of an ANA is not necessarily suggestive of a pathologic process, particularly at low titers.
  • 774
  • 06 Mar 2023
Topic Review
Fine Wine and Gout
From ancient times to the present day, gout has been associated in the popular and scientific literature with wealthy men who overindulge in fancy foods, fine wine, and debauchery. Curiously, amongst diseases, gout was thought to be good, a malady to be accepted because of otherwise beneficial effects on health, and longevity. 
  • 755
  • 13 Jun 2022
Topic Review
Probiotics in Rheumatoid Arthritis and Spondyloarthritis
The World Health Organization in 2002 defined probiotics as “living organisms in food and dietary supplements that upon ingestion can improve the health of the host beyond their inherent basic nutritional content”. Naturally presents in fruits, raw vegetables, dairy products (in particular fermented ones), they are an integral part of the gut microbiota as a component of commensal flora. The main probiotic microorganisms used in human nutrition are lactic acid bacteria such as Lactobacillus and Bifidobacterium.
  • 748
  • 21 Jan 2022
Topic Review
Vitamin D and Rheumatic Diseases
Vitamin D plays an important role in maintaining a healthy mineralized skeleton. It is also considered an immunomodulatory agent that regulates innate and adaptive immune systems. The aim of this narrative review is to provide general concepts of vitamin D for the skeletal and immune health, and to summarize the mechanistic, epidemiological, and clinical evidence on the relationship between vitamin D and rheumatic diseases. Multiple observational studies have demonstrated the association between a low level of serum 25-hydroxyvitamin D [25(OH)D] and the presence and severity of several rheumatic diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), spondyloarthropathies, and osteoarthritis (OA). Nevertheless, the specific benefits of vitamin D supplements for the treatment and prevention of rheumatic diseases are less accepted as the results from randomized clinical trials are inconsistent, although some conceivable benefits of vitamin D for the improvement of disease activity of RA, SLE, and OA have been demonstrated in meta-analyses. It is also possible that some individuals might benefit from vitamin D differently than others, as inter-individual difference in responsiveness to vitamin D supplementation has been observed in genomic studies. Although the optimal level of serum 25(OH)D is still debatable, it is advisable it is advisable that patients with rheumatic diseases should maintain a serum 25(OH)D level of at least 30 ng/mL (75 nmol/L) to prevent osteomalacia, secondary osteoporosis, and fracture, and possibly 40–60 ng/mL (100–150 nmol/L) to achieve maximal benefit from vitamin D for immune health and overall health.
  • 731
  • 22 Nov 2021
Topic Review
Affective Disturbance in Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a chronic, inflammatory synovitis-based systemic immune disease of unknown etiology. In addition to joint pathological damage, RA has been linked to neuropsychiatric comorbidities, including depression, schizophrenia, and anxiety, increasing the risk of neurodegenerative diseases in life.
  • 730
  • 04 Aug 2022
Topic Review
Paradoxical Duel Role of Collagen in Rheumatoid Arthritis
In biology, collagen-biomaterial regulates several signaling mechanisms of bone and immune cells involved in tissue repair and any imbalance in collagen turnover may affect the homeostasis of cells, becoming a major cause of several complications. The administration of oral collagen may play a potential role in returning cells to their normal function. For several decades, the beneficial effects of collagen have been explored widely, and thus many commercial products are available in cosmetics, food, and biomedical fields. For instance, collagen-based-products have been widely used to treat the complications of cartilage-related-disorders. Many researchers are reporting the anti-arthritogenic properties of collagen-based materials. In contrast, collagen, especially type-II collagen (CII), has been widely used to induce arthritis by immunization in an animal-model with or without adjuvants, and the potentially immunogenic-properties of collagen have been continuously reported for a long time. Additionally, the immune tolerance of collagen is mainly regulated by the T-lymphocytes and B-cells. This controversial hypothesis is getting more and more evidence nowadays from both sides to support its mechanism. 
  • 714
  • 22 Jul 2022
Topic Review
Role of Glycosylation in Systemic Lupus Erythematosus
Glycosylation is a post-translational modification that affects the stability, structure, antigenicity and charge of proteins. In the immune system, glycosylation is involved in the regulation of ligand–receptor interactions, such as in B-cell and T-cell activating receptors. Alterations in glycosylation have been described in several autoimmune diseases, such as systemic lupus erythematosus (SLE), in which alterations have been found mainly in the glycosylation of B lymphocytes, T lymphocytes and immunoglobulins. In immunoglobulin G of lupus patients, a decrease in galactosylation, sialylation, and nucleotide fucose, as well as an increase in the N-acetylglucosamine bisector, are observed. These changes in glycoisolation affect the interactions of immunoglobulins with Fc receptors and are associated with pericarditis, proteinuria, nephritis, and the presence of antinuclear antibodies. In T cells, alterations have been described in the glycosylation of receptors involved in activation, such as the T cell receptor; these changes affect the affinity with their ligands and modulate the binding to endogenous lectins such as galectins. In T cells from lupus patients, a decrease in galectin 1 binding is observed, which could favor activation and reduce apoptosis. Furthermore, these alterations in glycosylation correlate with disease activity and clinical manifestations, and thus have potential use as biomarkers.
  • 713
  • 11 Jan 2023
Topic Review
Tendinopathies
Tendinopathy is an umbrella term used to identify a complex clinical condition characterized by molecular, cellular, and histological changes occurring in affected tendons that leads to persistent pain, swelling, and impaired physical performance. Several pathogenic mechanisms are involved in the occurrence of this condition. High load demands and repetitive mechanical exposure during exercise act as primum movens of tendinopathy.
  • 708
  • 08 Nov 2021
Topic Review
Pathogenesis and Treatment of Neuropsychiatric Lupus Erythematosus
Neuropsychiatric systemic lupus erythematosus (NPSLE) has a broad spectrum of sub-types with diverse severities and prognoses. Ischemic and inflammatory mechanisms, including autoantibodies and cytokine-mediated pathological processes, are key components of the pathogenesis of NPSLE. Additional brain-intrinsic elements (such as the brain barrier and resident microglia) are also important facilitators of NPSLE. An improved understanding of NPSLE may provide further options for managing this disease. The attenuation of neuropsychiatric disease in mouse models demonstrates the potential for novel targeted therapies. Conventional therapeutic algorithms include symptomatic, anti-thrombotic, and immunosuppressive agents that are only supported by observational cohort studies, therefore performing controlled clinical trials to guide further management is essential and urgent. The latest pathogenetic mechanisms of NPSLE are presented, and the progress in its management is discussed.
  • 702
  • 09 Sep 2022
Topic Review
Therapy of the Rheumatic Knee
In rheumatoid arthritis, the joints of the lower extremities are almost always affected. This is most conspicuous in the knee joint. In rheumatics, inflammatory osteoarthritis manifests itself comparably earlier than in patients with osteoarthritis. The focus of attention was primarily on the synovia with its destruction process and secondary changes. Now, driven by experimental research, dendritic cells and fibroblasts and molecular features are moving into the clinician’s field of vision. Even in joints that appear to be in remission with no swelling or pain, the activity of these cells leads to changes in the capsule-ligaments. The complex deformities and instabilities caused by this, in conjunction with atrophy of the inter-articular musculature, have an impact on the activities of daily life (ADL). If these biomechanical aspects of the knee joint are not taken into account early on in therapy, the frequency of primary and secondary surgical treatment increases. The timely recognition of biomechanical pathologies and consistent treatment can contribute to improving the patient situation in addition to adequate medication therapy. 
  • 693
  • 07 Apr 2021
Topic Review
Specialized Pro-Resolving Mediators Biomarkers
The application of precision medicine paradigm in the daily treatment of patients has been greatly hampered by the lack of robust biomarkers. Lipid mediators are central in the regulation of host immune responses during both the initiation and resolution of inflammation. Amongst lipid mediators, the specialized pro-resolving mediators (SPM) govern immune cells to promote the resolution of inflammation. These autacoids are produced via the stereoselective conversion of essential fatty acids to yield molecules that are dynamically regulated during inflammation and exert potent immunoregulatory activities. Furthermore, there is an increasing appreciation for the role that these mediators play in conveying the biological actions of several anti-inflammatory therapeutics. Identification and quantitation of these mediators has traditionally been achieved using hyphenated mass spectrometric techniques, primarily liquid-chromatography tandem mass spectrometry. 
  • 684
  • 03 Mar 2022
Topic Review
Advanced Drug Delivery for Treating Sjögren’s Dry Eye
Sjögren’s syndrome is a chronic and insidious autoimmune disease characterized by lymphocyte infiltration of exocrine glands. Patients typically present with dry eye (keratoconjunctivitis sicca), dry mouth (xerostomia), and other systemic manifestations. The current management for Sjögren's syndrome dry eye (SSDE) has been ineffective as it only targets ocular surface inflammation and dryness without addressing the specific disease process. Ophthalmologists often adopt a trial-and-error approach, which allows the cycle of dry eye disease (DED) to progress and potentially cause permanent damage to the lacrimal functional unit. Topical treatments also depend on patients' ability to administer eye drops and their compliance. These limitations emphasize the need for personalized, targeted treatments that address the underlying pathophysiology of SSDE. This article aims to present new advances in ocular drug delivery for more effective treatment.
  • 684
  • 10 Feb 2023
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