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Topic Review
B Cell Tolerance and Targeted Therapies in SLE
Systemic Lupus Erythematosus (SLE) is a chronic systemic autoimmune disease of high clinical and molecular heterogeneity, and a relapsing-remitting pattern. The disease is currently without cure and more prevalent in women. B cell tolerance and production of autoantibodies are critical mechanisms that drive SLE pathophysiology. However, how the balance of the immune system is broken and how the innate and adaptive immune systems are interacting during lupus- specific autoimmune responses are still largely unknown.
  • 707
  • 19 Oct 2023
Topic Review
Antinuclear Antibodies
The discovery of antinuclear antibodies (ANAs) in the mid-20th century during studies on systemic lupus erythematosus (SLE) marked a significant breakthrough.
  • 700
  • 05 Feb 2024
Topic Review
Polyarteritis Nodosa
Polyarteritis nodosa (PAN), also known as panarteritis nodosa, represents a form of necrotizing vasculitis that predominantly affects medium-sized vessels, although it is not restricted to them and can also involve smaller vessels. The clinical presentation is heterogeneous and characterized by a significant number of patients exhibiting general symptoms, including asthenia, fever, and unintended weight loss. Although PAN can involve virtually any organ, it preferentially affects the skin, nervous system, and the gastrointestinal tract. Orchitis is a rare but specific manifestation of PAN. The absence of granulomas, glomerulonephritis, and anti-neutrophil cytoplasmic antibodies serves to distinguish PAN from other types of vasculitis. Major complications consist of hemorrhagic and thrombotic events occurring in mesenteric, cardiac, cerebral, and renal systems. Historically, PAN was frequently linked to hepatitis B virus (HBV) infection, but this association has dramatically changed in recent years due to declining HBV prevalence.
  • 690
  • 18 Dec 2023
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.
  • 689
  • 23 Feb 2023
Topic Review
Cardiovascular Risk Prediction Parameters in Rheumatic Diseases
Multiple imaging techniques, such as ECG, ultrasound, and cIMT, as well as biomarkers like osteoprotegerin cytokine receptor and angiopoietin-2, can be beneficial in both CV risk prediction and in early subclinical diagnosis. Physical exercise is an essential non-pharmacological intervention that can maintain the health of the cardiovascular system and, additionally, influence the underlying disease. Lipid-lowering drugs (methotrexate from the non-biologic DMARDs family as well as biologic DMARDs such as anti-TNF) were all associated with a lower CV risk; however, anti-TNF medication can decrease cardiac compliance and promote heart failure in patients with previously diagnosed chronic HF. Although they achieved success rates in reducing inflammation, glucocorticoids, NSAIDs, and COX-2 inhibitors were correlated with an increased risk of CVD. When taking all of the aforementioned points into consideration, there appears to be a dire need to establish and implement CVD risk stratification models in rheumatic patients. 
  • 681
  • 07 Mar 2022
Topic Review
Giant Cell Arteritis
Giant cell arteritis (GCA) is a noninfectious granulomatous vasculitis of unknown etiology affecting individuals older than 50 years. Two forms of GCA have been identified: a cranial form involving the medium-caliber temporal artery causing temporal arteritis (TA) and an extracranial form involving the large vessels, mainly the thoracic aorta and its branches. GCA generally affects individuals with a genetic predisposition, but several epigenetic (micro)environmental factors are often critical for the onset of this vasculitis.
  • 681
  • 05 Feb 2024
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.
  • 680
  • 14 Feb 2023
Topic Review
The Treatment of Enthesitis-Related Arthritis
Enthesitis-related arthritis (ERA) represents 5–30% of all cases of juvenile idiopathic arthritis (JIA) and belongs to the spectrum of the disorders included in the group of juvenile spondyloarthritis. In the last decade, there have been considerable advances in the classification, diagnosis, monitoring, and treatment of ERA. New provisional criteria for ERA have been recently proposed by the Paediatric Rheumatology INternational Trials Organisation, as part of a wider revision of the International League of Associations for Rheumatology criteria for JIA. The therapeutic recommendations for ERA are comparable to those applied to other non-systemic JIA categories, unless axial disease and/or enthesitis are present. In such cases, the early use of a TNF-alpha inhibitor is recommended. Novel treatment agents are promising, including IL-17/IL-23 or JAK/STAT pathways blockers.
  • 679
  • 24 Oct 2023
Topic Review
Molecular Mechanisms Involved in Systemic Sclerosis-Related Lung Fibrosis
Systemic sclerosis (SSc), or scleroderma, is an autoimmune connective tissue disease with one of the highest mortality rates among the rheumatic diseases. Fibrosis is recognized to be a defining feature of SSc, affecting the skin and multiple visceral organs. As a result, SSc is considered the prototypic fibrosing disease. 
  • 677
  • 21 Feb 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.
  • 675
  • 22 Jul 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.
  • 675
  • 14 Dec 2022
Topic Review
Systemic Lupus Erythematosus Disease Activity Score
Systemic lupus erythematosus (SLE) is a chronic systemic autoimmune disease that affects multiple organ systems and manifests in a relapsing–remitting pattern. Consequently, it is paramount for rheumatologists to assess disease activity, identify flare-ups, and establish treatment goals for patients with SLE. In 2019, the Systemic Lupus Erythematosus Disease Activity Score (SLE-DAS) was introduced as a novel tool for measuring disease activity. This tool refines the parameters of the established SLE Disease Activity Index 2000 (SLEDAI-2K) to enhance the assessment process.
  • 673
  • 25 Dec 2023
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. 
  • 658
  • 22 Jun 2022
Topic Review
Tumor Necrosis Factor-α Inhibitors
Immune-mediated inflammatory diseases, such as rheumatoid arthritis, psoriatic arthritis, peripheral and/or axial spondyloarthritis, Crohn’s disease, and ulcerative colitis, are characterized by molecular and cellular changes in the immune system. Due to the systemic nature of these diseases, organs such as the liver or cardiovascular system are often affected by the inflammatory process. Tumor necrosis factor-α inhibitor therapy reduces the activation of pro-inflammatory signaling cascades, mitigates the chronic inflammatory process by restoring cellular balance, and alleviates clinical consequences, such as pain and tissue damage.
  • 655
  • 14 Aug 2023
Topic Review
Extracellular Vesicles in Renal Disease
Autoimmune diseases are rare conditions with high mortality and morbidity, particularly when the kidney is involved. Extracellular vesicles (EV) act as regulators of the inter-cellular signals and modulate the immune system. This review focus on the potential contribute of EV on the pathophysiology of Systemic Lupus Erythematosus (SLE), Antiphospholipid syndrome (APS), Thrombotic Microangiopathy, and ANCA-vasculitis. Of interest, EV were recognized as novel biomarkers of disease activity in APS and ANCA-vasculitis. EV are also involved in the pathogenesis of SLE, and particularly in the renal injury associated with the lupus nephritis. This implies that to explore EV for disease biomarker discovery and to investigate their potential as therapeutic targets in autoimmune diseases should be the future challenge.
  • 654
  • 27 Apr 2021
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. 
  • 648
  • 11 May 2022
Topic Review
Metabolome in Rheumatoid Arthritis
Rheumatoid arthritis (RA) is a systemic autoimmune disease, clinically characterized by poly-articular involvement with chronic synovial inflammation culminating in bone erosions and disability. Metabolomics is an emerging science that is part of the omics group (e.g., proteomic, transcriptomics, etc.). It allows the identification of small molecules, known as metabolites, in a biologic system, catching the alteration of the metabolic status of different tissues and fluids that mirror the cellular perturbation occurring during disease.
  • 640
  • 03 Apr 2023
Topic Review
Hypertrophic and Senescent Chondrocyte Phenotypes Associated with Osteoarthritis
Osteoarthritis (OA) is a complex disease of whole joints with progressive cartilage matrix degradation and chondrocyte transformation. The inflammatory features of OA are reflected in increased synovial levels of IL-1β, IL-6 and VEGF, higher levels of TLR-4 binding plasma proteins and increased expression of IL-15, IL-18, IL-10 and Cox2, in cartilage. Chondrocytes in OA undergo hypertrophic and senescent transition; in these states, the expression of Sox-9, Acan and Col2a1 is suppressed, whereas the expression of RunX2, HIF-2α and MMP-13 is significantly increased.
  • 640
  • 22 Nov 2023
Topic Review
Pathophysiological Role of Hyaluronic Acid in Rheumatic Diseases
Hyaluronic acid (HA) is as naturally occurring glycosaminoglycan composed of repeating disaccharide units consisting of glucuronic acids and N-acetylglucosamine, resulting in different molecular weights. HA plays a crucial pathophysiological role in rheumatic diseases, especially concerning joint health and function.
  • 627
  • 06 Sep 2023
Topic Review
MDA-5 Dermatomyositis and Associated Interstitial Lung Disease
Anti-melanoma differentiation-associated gene 5 (MDA-5) dermatomyositis (DM) is noteworthy for its association with rapidly progressive interstitial lung disease (RP-ILD), vasculopathy, and distinctive cutaneous features. First identified in a Japanese cohort in 2005, MDA-5 DM carries a significant mortality risk, emphasizing the crucial need for early diagnosis. 
  • 622
  • 08 Mar 2024
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