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Topic Review
Natural Products in Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disorder affecting a vast variety of the population. The onset of RA as well as the development of systematic immunization is affected by both genetic and environmental risk factors. In the antioxidant setting of natural products, RA patients may find the use of natural products beneficial. Although there is conflicting evidence of the role of antioxidants in RA, as this field remains poorly explored, the value of antioxidants in fighting inflammation is well-documented, which explains the fact that the antioxidant properties of natural products are commonly evaluated and usually represent the first step of in vitro evaluation before that of the anti-inflammatory properties.
  • 448
  • 06 May 2022
Topic Review
Response of Refractory Systemic Lupus Erythematosus to Anifrolumab
Systemic lupus erythematosus (SLE) is a clinically heterogeneous autoimmune disease, and organ manifestations, such as lupus nephritis (LN) or skin disease, may be refractory to standard treatment. Therefore, new agents are required to allow for a more personalized therapeutic approach. Several new therapies have been approved internationally, including voclosporine for LN and anifrolumab for moderately to severely active SLE. 
  • 448
  • 22 Jun 2022
Topic Review
Cytokines in Spondyloarthritis and Inflammatory Bowel Diseases
Spondyloarthritis and inflammatory bowel diseases are chronic immune disorders of the joints and the gut that often coexist in the same patient, increasing the burden of each disorder, worsening patients’ quality of life, and influencing therapeutic strategies. Genetic predisposition, environmental triggers, microbiome features, immune cell trafficking, and soluble factors such as cytokines contribute to the pathogenesis of both articular and intestinal inflammation. Cytokines have a central role in immune disorders and seem to be involved at different levels in the pathogenesis of articular and intestinal IMID, leading to the activation and perpetuation of proinflammatory pathways with consequent tissue damage.
  • 443
  • 28 Feb 2023
Topic Review
Juvenile Psoriatic Arthritis
Juvenile psoriatic arthritis (JPsA) accounts for 1–7% of all cases of juvenile idiopathic arthritis (JIA) and its definition has been a matter of controversy among pediatric rheumatologists for many years. The traditional attribution of JPsA to the spondyloarthropathy group was challenged in the early 1990s, whereas demonstrations of its heterogenous nature have led to questions about its identification as a distinct category in JIA classification.
  • 443
  • 07 Feb 2023
Topic Review
Febuxostat’s Multifaceted Therapeutic Application
Febuxostat, a xanthine oxidase inhibitor originally introduced for the management of hyperuricemia in patients with gout, has evolved into a multifaceted therapeutic agent with a spectrum of effects extending far beyond its initial scope. The diverse range of impacts exerted by febuxostat on various physiological systems are explored, offering insights into its mechanism of action, efficacy in gout management, cardiovascular implications, renal and hepatic effects, musculoskeletal applications, adverse event profiles, and emerging avenues for future research.
  • 438
  • 16 Nov 2023
Topic Review
Janus Kinase Inhibitors
Axial spondyloarthritis (axSpA) is a chronic inflammatory disease involving the spine, peripheral joints, and entheses. This condition causes stiffness, pain, and significant limitation of movement. Several effective therapies have become available based on the use of biologics that selectively block cytokines involved in the pathogenesis of the disease, such as tumor necrosis factor-α (TNFα), interleukin (IL)-17, and IL-23. However, a significant number of patients show an inadequate response to treatment. Small synthetic molecules capable of blocking the activity of Janus kinases (JAK) were introduced in the therapy of rheumatoid arthritis. Subsequently, their indication extended to the treatment of other inflammatory rheumatic diseases. 
  • 435
  • 29 Jan 2023
Topic Review
The Role of T Cells in Systemic Sclerosis
Systemic sclerosis (SSc) is a chronic disease characterized by microvasculopathy, autoantibodies (autoAbs), and fibrosis. The pathogenesis of the disease is incompletely understood. Microvasculopathy and autoAbs appear very early in the disease process. AutoAbs, such as those directed against DNA topoisomerase I (Topo I), are disease specific and associated with disease manifestations, and indicate activation of the adaptive immune system. B cells are involved in fibrosis in SSc. T cells are also involved in disease pathogenesis. T cells show signs of antigen-induced activation; T cells of TH2 type are increased and produce profibrotic cytokines interleukin (IL)-4, IL-13, and IL-31; CD4+ cytotoxic T lymphocytes are increased in skin lesions, and cause fibrosis and endothelial cell apoptosis; circulating T follicular helper (TFH) cells are increased in SSc produce IL-21 and promote plasmablast antibody production. On the other hand, regulatory T cells are impaired in SSc. These findings provide strong circumstantial evidence for T cell implication in SSc pathogenesis and encourage new T cell-directed therapeutic strategies for the disease.
  • 432
  • 26 Sep 2022
Topic Review
Glucocorticoid-Induced Osteoporosis
Glucocorticoid-induced osteogenic dysfunction is the main pathologyical mechanism underlying the development of glucocorticoid-induced osteoporosis. Glucocorticoids promote adipogenic differentiation and osteoblast apoptosis through various pathways. Various ongoing studies are exploring the potential of natural products in preventing glucocorticoid-induced osteoporosis. Preclinical studies have consistently shown the bone protective effects of tocotrienol through its antioxidant and anabolic effects.
  • 427
  • 08 Feb 2023
Topic Review
Nitric Oxide Synthases in Rheumatoid Arthritis
Rheumatoid arthritis (RA) is an autoimmune disease characterized by severe joint damage and disability. However, the specific mechanism of RA has not been thoroughly clarified over the past decade. Nitric oxide (NO), a kind of gas messenger molecule with many molecular targets, is demonstrated to have significant roles in histopathology and homeostasis. Three nitric oxide synthases (NOS) are related to producing NO and regulating the generation of NO. Based on the latest studies, NOS/NO signaling pathways play a key role in the pathogenesis of RA. Overproduction of NO can induce the generation and release of inflammatory cytokines and act as free radical gas to accumulate and trigger oxidative stress, which can involve in the pathogenesis of RA. Therefore, targeting NOS and its upstream and downstream signaling pathways may be an effective approach to managing RA.
  • 412
  • 21 Jul 2023
Topic Review
Visualization Methods of Diagnostics in Juvenile Idiopathic Arthritis
Juvenile idiopathic arthritis (JIA) is a disease with unknown causes in all forms of arthritis in children under 16 years of age. It is diagnosed when other joint pathologies are excluded. Difficulties in early and differential diagnoses lead to rapid disability and an unfavorable life prognosis. Therefore, a timely diagnosis is necessary to prevent irreversible damage to joints and preserve their function. Due to the widespread use of new technologies, modern multimodal imaging has gained recognition, including radiography, ultrasound, and MRI. The combination of methods plays a key role in confirming the diagnosis, monitoring the disease activity, the prognosis during the disease course, and the outcome in children with JIA. Each method has its advantages and disadvantages.
  • 409
  • 22 Jul 2022
Topic Review
Pathophysiological Role of IL-33 in Systemic Lupus Erythematosus
IL-33 is a newly discovered cytokine displaying pleiotropic localizations and functions. More specifically, it also functions as an alarmin, following its release from cells undergoing cell death or necrosis, to alert the innate immune system. The role of IL-33 has been underlined in several inflammatory and autoimmune diseases including systemic lupus erythematosus (SLE). The expressions of IL-33 as well as its receptor, ST2, are significantly upregulated in SLE patients and in patients with lupus nephritis. 
  • 405
  • 17 Jun 2022
Topic Review
Characteristics and Treatment of Elderly-Onset Rheumatoid Arthritis
Elderly-onset rheumatoid arthritis (EORA) is a distinct clinical entity defined as the onset of rheumatoid arthritis (RA) in individuals aged over 60 years. EORA presents unique clinical features, including a more equitable distribution of sexes, a potential predilection for male involvement, a higher incidence of acute onset characterized by constitutional symptoms, a propensity for systemic manifestations, elevated sedimentation rates at disease onset, a reduced occurrence of rheumatoid factor positivity, increased titers of anti-citrullinated protein antibodies, a preference for involvement of large joints, elevated disease activity, the presence of bone erosions, and heightened patient disability.
  • 404
  • 21 Jan 2024
Topic Review
Autophagy in Rheumatic Diseases
Autophagy is a lysosomal pathway for the degradation of damaged proteins and intracellular components that promotes cell survival under specific conditions. Apoptosis is, in contrast, a critical programmed cell death mechanism, and the relationship between these two processes influences cell fate. Recent evidence suggests that autophagy and apoptosis are involved in the self-tolerance promotion and in the regulatory mechanisms contributing to disease susceptibility and immune regulation in rheumatic diseases. 
  • 402
  • 11 May 2022
Topic Review
Nutritional Factors for Etiology and Course of RA
A possible association of lifestyle factors with rheumatoid arthritis (RA) has attracted increasing public interest. Nutritional habits determine the composition of our microbiome, which is increasingly recognized as a major player in the etiology of inflammatory rheumatic diseases (IRDs). In a non-RA cohort, a diet with high fiber content resulted in a reduced level of inflammatory cytokines. In addition, polyunsaturated fatty acids may exert anti-inflammatory and immunomodulatory effects, as illustrated by the inverse correlation between n-3-fatty acids and autoantibodies in individuals at high risk for RA.
  • 398
  • 14 Dec 2022
Topic Review
Microwave Radiometry in Arthritis Assessment
The ability of microwave radiometry (MWR) to detect with high accuracy in-depth temperature changes in human tissues is under investigation in various medical fields. The need for non-invasive, easily accessible imaging biomarkers for the diagnosis and monitoring of inflammatory arthritis provides the background for this application in order to detect the local temperature increase due to the inflammatory process by placing the appropriate MWR sensor on the skin over the joint.
  • 397
  • 23 Feb 2023
Topic Review
Different Interventions for Osteoarthritis Rehabilitation
Osteoarthritis (OA) is a common disease among the human population worldwide. OA causes functional impairment, leads to disability and poses serious socioeconomic burden. The rehabilitation offers a function-oriented method to reduce the disability using diverse interventions (kinesiotherapy, physical therapy, occupational therapy, education, and pharmacotherapy). 
  • 396
  • 29 May 2023
Topic Review
Epidemiology, Pathogenesis, and Risk Factors of Knee Osteoarthritis
The knee is the joint most frequently involved in osteoarthritis and represents a significant contributor to patient morbidity and impaired functional status. Major risk factors include genetics, age, sex, mechanical load and obesity/metabolic syndrome. Some studies highlighted the role of obesity and metabolic syndrome in the pathogenesis of knee osteoarthritis not simply through increased mechanical loading but the systemic effects of obesity-induced inflammation. The current concept of knee osteoarthritis is that of a ‘whole joint disease’, which highlights the involvement not only of articular cartilage but also the synovium, subchondral bone, ligaments and muscles. 
  • 394
  • 08 Aug 2023
Topic Review
Outcome in Systemic Lupus Erythematosus
Systemic Lupus Erythematosus (SLE) is a rare systemic and chronic disease often referred to as the prototype of autoimmune rheumatic diseases because of the varied spectrum of clinical manifestations and diversity of phenotypes. The etiology of SLE is believed to be multifactorial, and both genetic predisposition and environmental triggers are most likely involved. The incidence, severity and phenotypic expression of the disease differ between ethnic groups, gender and age at disease onset.
  • 391
  • 14 Feb 2023
Topic Review
ML in Achieving Precision Medicine in Systemic Sclerosis
Systemic sclerosis (SSc) is a rare connective tissue disease that can affect different organs and has extremely heterogenous presentations. This complexity makes it difficult to perform an early diagnosis and a subsequent subclassification of the disease. This hinders a personalized approach in clinical practice. In this context, machine learning (ML), a branch of artificial intelligence (AI), is able to recognize relationships in data and predict outcomes. ML has been used to stratify SSc patients and identify those at high risk of severe complications. Additionally, ML may be useful in the early detection of organ involvement. Furthermore, ML might have a role in target therapy approach and in predicting drug response.
  • 389
  • 08 Oct 2022
Topic Review
Treat-to-Target in Systemic Lupus Erythematosus
Treat-to-target is a therapeutic approach based on adjustments to treatment at set intervals in order to achieve well-defined, clinically relevant targets. This approach has been successfully applied to many chronic conditions, and in rheumatology promising results have emerged for rheumatoid arthritis. For systemic lupus erythematosus (SLE), defining the most meaningful treatment targets has been challenging, due to disease complexity and heterogeneity. Control of disease activity, the reduction of damage accrual and the patient’s quality of life should be considered as the main targets in SLE, and several new drugs are emerging to achieve these targets. 
  • 379
  • 13 Jun 2023
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