Review Articles in 2010

The accumulation of postapoptotic cell remnants resulting from inefficient phagocytic clearance might lead to the initiation and maintenance of systemic autoimmune reactions and chronic inflammation—hallmarks of systemic lupus erythematosus (SLE). The consequences of apoptotic cell accumulation for the etiology, pathogenesis and pathophysiology of SLE are summarized in this Review.

Antiphospholipid syndrome (APS) is characterized by recurring arterial or venous thromboses, which places patients at high risk of a variety of life-threatening conditions. This short, focused Review summarizes the prevalence and risk factors associated with death in patients with APS or its more severe variant, catastrophic APS.

Systemic sclerosis is complex disease for which effective therapies remain elusive. In this Review article, Ramos-Casals and colleagues highlight therapeutic approaches to the treatment of systemic sclerosis, and suggest that the future of systemic sclerosis therapy might be as multifaceted as the disease itself.

Surgery for painful shoulder conditions is usually only considered when conservative treatment fails. This article outlines the features of and indications for surgery in common painful conditions that affect the shoulder.

In this Review, the authors describe the emotional, cognitive and social context variables that contribute to arthritis pain, and how they have been used to develop psychological approaches to pain management.

In the absence of a safe and effective alternative treatment for chronic musculoskeletal pain, the prescription of opioid analgesics has escalated dramatically over the past decade. Their use, however, can be associated with the persistence, or even enhancement, of chronic pain, and might also induce powerful positively-reinforcing psychological effects that lead to clinical dependence, as outlined in this Review.

Individuals with chronic back pain or osteoarthritis often do not seek healthcare because of these problems, but instead make use of a range of self-care strategies. This article explores several aspects of self-management, and includes a review of the evidence for the effectiveness of various self-management programs for these two musculoskeletal conditions.

This Review discusses the role of endothelial dysfunction as a marker of the accelerated atherosclerosis associated with rheumatoid arthritis. The authors outline how the assessment of endothelial function could be useful in relation to the early identification and monitoring of cardiovascular risk in patients with the disease.

Tendons are designed to withstand considerable loads but repetitive use often results in injuries, such as tendinopathy. Concurrent with overt symptoms, a number of histological and molecular changes occur within the collagen fibril constituents of tendon. Progress in understanding how collagen, and various other components of the human tendon, respond to acute and chronic loading is outlined in this Review.

This article describes the genetic heterogeneity in rheumatoid arthritis between Asian and European populations, and how these differences might underlie the pathogenesis of the disease.

IL-1 has an important role in the pathogenesis of many hereditary and non-hereditary autoinflammatory diseases. This Review examines the biological functions of IL-1 and the use of IL-1-targeting agents in the treatment of various human diseases.

Although the link between bacterial infections and tumor necrosis factor (TNF) inhibitors is becoming increasingly established, much less is known about the risk of viral infections with these agents. The authors of this Review highlight emerging reports of viral infections in patients receiving anti-TNF therapy, and discuss treatment implications and potential strategies for preventing such infections.

By engaging innate immune receptors and inducing the production of proinflammatory cytokines, cells can sense and respond to danger signals. Defective regulation of these sensory and response mechanisms by indiscriminate recognition of self molecules or as a result of genetic mutation can result in autoimmune or autoinflammatory rheumatic diseases, as outlined in this Review.

Sciatica is a common condition for which management strategies can vary considerably. This article draws on evidence-based medicine and clinical experience to provide an overview of the diagnosis and treatment of sciatica, including a comparison of conservative and surgical interventions and the role of rehabilitation.

Rheumatoid arthritis (RA) is increasingly recognized as a risk factor for cardiovascular disease, independent of the presence of classic cardiovascular risk factors such as smoking and obesity. In this article, the authors review the pathophysiology of accelerated atherosclerosis in RA, and discuss the potential role of statins in the reduction of both inflammation and atherosclerosis in these patients.

In this Review, the author discusses therapeutic principles that guide the treatment of myositis, in the context of issues including clinical presentation, diagnostic procedures, and practical approaches to treatment. Insights into the immunopathogenesis of myositis and the emergence of new therapeutic agents are also reviewed.

Osteoporosis is a highly prevalent disease that leads to bone fragility and subsequent fracture, most commonly at the hip, spine and wrist. This article reviews the epidemiology of this potentially devastating disease, highlighting the incidence and prevalence of osteoporotic fractures, the resulting morbidity and mortality and the associated costs both to the individual and to society as a whole.

Asian researchers have been at the forefront of many topics in the field of Rheumatology, from the identification of disease entities that were first observed in the region to the establishment of the field of osteoimmunology. In this Review, Yamano and Nishioka highlight the ongoing contribution of Asian researchers to our understanding and treatment of rheumatic diseases.

Any form of treatment for patients with ankylosing spondylitis (AS) is defined as being disease-modifying on the basis of its ability to decrease inflammation, improve function and inhibit the progression of structural damage. This Review outlines clinical outcomes that are relevant to the concept of disease modification, looks at what is known about the disease-modifying properties of currently available agents and considers the challenges involved in developing future therapies for AS.

Invariant natural killer T cells have been implicated in a number of autoimmune diseases. In this Review, the authors highlight recent advances in our understanding of distinct subsets of these cells and the immunoregulatory cytokines they produce, and discuss whether inducing differential cytokine responses in these cells could be exploited to develop cell-based therapies.