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Topic Review
Post-Translational Modifications in Rheumatic Diseases
Post-translational modifications (PTMs) are reversible or irreversible chemical reactions that occur in specific amino acids (aas) of some proteins after their translation. In fact, more than 140 different aa-based structures can constitute the proteins when considering the PTMs that could modify the 20 natural aas. Several factors, such as the location of the aa within the protein’s primary sequence, will determine whether PTMs occur as well as their type and frequency. PTMs are not encoded by the cellular genome and can significantly modify protein structure and modulate functions such as folding, degradation, signaling, localization, stability, enzymatic activity and protein-protein interactions. More than 400 different types of PTMs have been described in humans occurring in several cellular organelles (nucleus, cytoplasm, endoplasmic reticulum and Golgi apparatus). They are involved in a large number of cellular events and are considered a key mechanism for the regulation of the biological activity of proteins. The latest findings about the role of PTMs in the generation of autoimmunity is discussed. Meanwhile, the most relevant PTMs in rheumatic diseases that occur in synovial tissue are discussed.
  • 527
  • 22 Dec 2022
Topic Review
Medicinal and Aromatic Plants against Obesity and Arthritis
Obesity is a significant health concern, as it causes a massive cascade of chronic inflammations and multiple morbidities. Rheumatoid arthritis and osteoarthritis are chronic inflammatory conditions and often manifest as comorbidities of obesity. Adipose tissues serve as a reservoir of energy as well as releasing several inflammatory cytokines (including IL-6, IFN-γ, and TNF-α) that stimulate low-grade chronic inflammatory conditions such as rheumatoid arthritis, osteoarthritis, diabetes, hypertension, cardiovascular disorders, fatty liver disease, oxidative stress, and chronic kidney diseases. Dietary intake, low physical activity, unhealthy lifestyle, smoking, alcohol consumption, and genetic and environmental factors can influence obesity and arthritis. Current arthritis management using modern medicines produces various adverse reactions. Medicinal plants have been a significant part of traditional medicine, and various plants and phytochemicals have shown effectiveness against arthritis and obesity; however, scientifically, this traditional plant-based treatment option needs validation through proper clinical trials and toxicity tests. In addition, essential oils obtained from aromatic plants are being widely used for complementary therapy (e.g., aromatherapy, smelling, spicing, and consumption with food) against arthritis and obesity; scientific evidence is necessary to support their effectiveness.
  • 523
  • 08 Mar 2022
Topic Review
Copper Toxicosis
Copper, manganese, and iron are vital elements required for the appropriate development and the general preservation of good health. Additionally, these essential metals play key roles in ensuring proper brain development and function.
  • 522
  • 11 Aug 2021
Topic Review
Comorbidities in Rheumatoid Arthritis
Comorbidities in patients with rheumatoid arthritis (RA) are often associated with poor health outcomes and increased mortality. Treatment decisions should consider these comorbidities due to known or suspected associations with certain drug classes. In clinical practice, it is critical to balance potential treatment benefit against the possible risks for comorbidities as well as the articular manifestations of RA. This entry summarises the current literature relating to prevalence and risk factors for the important comorbidities of cardiovascular disease, infections, lymphomas and nonmelanoma skin cancers in patients with RA. The impact on patient outcomes and the interplay between these comorbidities and the therapeutic options currently available, including tumour necrosis factor inhibitors and newer biological therapies, are also explored. As newer RA therapies are developed, and patients gain wider and earlier access to advanced therapies, in part due to the emergence of biosimilars, it is important to consider the prevention or treatment of comorbidities as part of the overall management of RA.
  • 517
  • 25 Apr 2021
Topic Review
Vitamin D and Infectious Diseases
It is now 2 years since we have seen the impact of the CoronaVirus Disease-19 (COVID-19) caused by Syndrome-Coronavirus-2 worldwide, affecting millions of people and rates of mortality close to 6 million. Although we are beginning to see the real benefit of vaccines, in terms of reduced mortality rates, many individuals still remain to be vaccinated or do not respond to them leaving a large number of patients still experiencing severe respiratory symptoms associated with COVID-19. In recent months, we have seen another surge in individuals infected with COVID-19 and mortality rates are also increasing. In the absence of effective therapies or vaccines, the medical and scientific community have extensively explored a range of current available therapeutic agents, mainly focused on targeting viral replication as well as managing severe respiratory symptoms associated with COVID-19.  Vitamin D has emerged as one such candidate due to its recognized immunomodulatory effects. In this regard, the activation of the vitamin D receptor (VDR) signaling pathway may generate beneficial effects in acute respiratory distress syndrome by decreasing the cytokine/chemokine storm, thus having an important immunomodulatory and anti-inflammatory role.
  • 494
  • 07 Feb 2022
Topic Review
Adult-Onset Still’s Disease
Adult-onset Still’s disease (AoSD) is a rare systemic autoinflammatory disease characterized by arthritis, spiking fever, skin rash and elevated ferritin levels. 
  • 491
  • 12 Jul 2021
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.
  • 490
  • 10 Feb 2023
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.
  • 489
  • 11 Jan 2023
Topic Review
SARS-CoV-2 Infection in Systemic Juvenile Idiopathic Arthritis
Systemic juvenile idiopathic arthritis (sJIA) is a serious multifactorial autoinflammatory disease with a significant mortality rate due to macrophage activation syndrome (MAS). Recent research has deepened the knowledge about the pathophysiological mechanisms of sJIA-MAS, facilitating new targeted treatments, and biological disease-modifying antirheumatic drugs (bDMARDs), which significantly changed the course of the disease and prognosis. From the data analyzed so far, there have been no exacerbations of both COVID-19 and sJIA under bDMARDs treatment, but multicenter international studies are still needed to highlight all risk factors for a possible severe course of COVID-19 among sJIA patients. Children with sJIA and COVID-19 should be monitored to identify eventual long-run exacerbations after infection.
  • 481
  • 24 Apr 2022
Topic Review
Dietary Intervention in Connective Tissue Diseases
Dietary intervention and nutritional counseling might have an important role as adjuvant therapy in patients with connective tissue diseases, particularly in the light of the comorbidities which characterize these conditions. 
  • 481
  • 15 Dec 2021
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