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Catastrophic antiphospholipid syndrome, a severe form of antiphospholipid syndrome, is associated with a high mortality rate; approximately 50% of patients die from thrombotic diathesis. As discussed in this Review, efforts to facilitate early diagnosis, institute effective treatments in a timely manner, and to better understand the causes of this extreme condition are needed to improve patient outcome.
The pathogenesis of pain in patients with fibromyalgia syndrome is complex and incompletely understood. In this Review, Roland Staud and Miguel E Rodriguez discuss the abnormalities of pain processing that occur in these patients, focusing on the role of deep-tissue nociception, peripheral and central pain processing, temporal summation of pain (or wind-up) and central sensitization.
Given the central role that B cells have in the pathogenesis of rheumatoid arthritis and systemic lupus erythematosus, interest in approaches that therapeutically target B cells is considerable. This review provides an update on B-cell-depleting therapies for these diseases, as well as other approaches that target co-stimulatory signals, cytokines and other B-cell surface molecules.
Medical treatment for children with severe systemic juvenile idiopathic arthritis is unsatisfactory at present, and affected patients suffer from significant morbidity throughout their lives. Research into the pathogenesis of this disease should allow for the identification of new molecular targets and the development of improved therapies for this serious form of childhood arthritis.
Autoimmune responses are an inherent consequence of the wide repertoires of T-cell and B-cell receptors, which are needed in order for these cells to recognize a broad range of pathogens. This review explains the strategies used by the immune system to prevent and regulate the generation of autoreactive receptors and maintain immunologic tolerance.
Osteoporosis results from decreased osteoblast function, increased osteoclast function and increased adiposity of the bone marrow with age. Regulation of the balance between fat and bone in the bone marrow is complex and involves genetic, hormonal and environmental influences. Here, Clifford Rosen outlines a hypothesis that skeletal fragility has its pathogenic roots in pleuripotent marrow stromal cells and their fate as either fat or bone cells.
