Review Articles in 2020

Various core and adjunctive therapies are available for osteoarthritis (OA) that can have beneficial effects on the well-being of the individual; however, challenges remain in implementing best-evidence, high-value care.

Various types of programmed cell death, including necroptosis, pyroptosis, NETosis and apoptosis, contribute to acute and chronic inflammation, and dysregulation of these pathways is implicated in rheumatic diseases. Understanding the mechanisms and overlap between cell death pathways might lead to new therapies.

Biomarkers help in the diagnosis and monitoring of disease, but robust biomarkers can be difficult to discover and validate. This Review explores the state of biomarker discovery for axial spondyloarthritis and suggests future developments to advance this field.

Gout is a chronic crystal deposition disorder in which sustained hyperuricaemia leads to formation and deposition of monosodium urate crystals in the joints. The prevalence and incidence of gout are increasing globally, which may be related to changes in the prevalence of gout risk factors (such as obesity) and comorbidities.

Atherosclerotic cardiovascular disease is a major cause of morbidity and mortality in patients with rheumatoid arthritis. In this Review, Semb and colleagues outline atherosclerotic cardiovascular disease risk management and prevention for patients with rheumatoid arthritis.

This Review outlines the pathophysiology of Kawasaki disease and discusses the progress gained from experimental mouse models and their potential therapeutic translation to human disease.

Fibroblast-like synoviocytes in rheumatoid arthritis have an aggressive phenotype caused, in part, by epigenetic imprinting, which contributes to various pathological processes. Understanding the mechanisms underlying the cell abnormalities and phenotypes, including their spatial and temporal differences, could lead to new therapies.

Peptidylarginine deiminases (PADs) citrullinate proteins, thereby creating the targets of the autoimmune response in rheumatoid arthritis; yet, in some individuals, PADs themselves can be the targets of immune responses. The mechanisms behind this complex relationship are unravelled in this Review.

Emerging data on the interactions between epigenetic mechanisms and genetic risk loci are providing insights into the underlying mechanisms of osteoarthritis that could identify novel and exploitable therapeutic targets

Lupus nephritis is a serious and currently irreversible complication of systemic lupus erythematosus that is a leading cause of mortality. New biomarkers and therapies are being developed to improve the monitoring and treatment of this disease.

Pharmacomicrobiomics studies investigating the effect of variations within the human gut microbiome on drugs have provided insights into therapeutics used for inflammatory arthritis, which could facilitate microbiome-based precision medicine approaches in rheumatology.

The concept of autoinflammation has evolved to include multifactorial conditions and disorders with autoimmune and immunodeficiency components. An appreciation of the contributions of various molecular mechanisms and systems could improve our understanding and treatment of the systemic autoinflammatory diseases.

Raynaud phenomenon and digital ulcers are some of the most common and difficult to treat manifestations of systemic sclerosis. In this Review, the authors outline how to assess and treat these conditions, and also discuss unmet clinical needs.

Mechanical loading is an important factor in the development of tendon and ligament disorders. In this Review, the authors discuss the evidence for the known role of mechanical loading in tendinopathy and its potential role in inflammatory arthritis.

Methotrexate can suppress inflammation via multiple mechanisms that can differ across different cell types. Understanding these mechanisms might enable better understanding of the disease and prediction of treatment responses.

Mycophenolate mofetil, azathioprine and tacrolimus are conventional DMARDs that originate in the field of transplantation medicine. This Review discusses the history, mechanisms, current indications and future prospects of these drugs in the field of rheumatology.

Hydroxychloroquine and chloroquine are antimalarial drugs commonly used for the treatment of rheumatic diseases. Multiple mechanisms might explain the efficacy and adverse effects of these drugs, but further investigation could lead to the development of more specific and potent drugs.

Glucocorticoids are anti-inflammatory therapies commonly used in rheumatology, but have wide-ranging adverse effects. Understanding the pharmacokinetic properties and mechanisms of action of glucocorticoids could inform in the development of novel therapies with fewer adverse effects.

The activity of various metabolic pathways can influence the function and differentiation of T cells. T cell metabolism is dysfunctional in systemic lupus erythematosus (SLE) and targeting metabolic pathways in SLE could be a promising therapeutic avenue.

Successful pregnancy requires changes to the immune system to enable tolerance of the growing fetus. In this Review, the authors discuss how these immunomodulatory mechanisms contribute to the phenomenon of pregnancy-related improvement of rheumatoid arthritis.