Review Articles

This Review discusses how best to manage the reproductive health of patients with vasculitis, including the safety of contraception, the use of assisted reproductive technology, preservation of fertility during therapy, disease management in pregnancy and the use of medications compatible with pregnancy and lactation.

The mitochondrion has multiple functions, including energy production, regulation of apoptosis and reactive oxygen species generation. Disruption of these mitochondrial processes can lead to pro-inflammatory immune responses. This Review discussions the role of mitochondria and mitochondrial dysfunction in rheumatic diseases.

In this Review, the authors discuss the roles of sex and gender in relation to axial spondyloarthritis. Although evidence now suggests that the disease has equal prevalence in men and women, important differences occur in phenotypes, response to therapy and outcomes.

In this Review, the authors summarize the genetic factors associated with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). They describe the findings from genetic association studies, their pathogenic significance and their implications for the classification, management and prognosis of AAV.

In this Review, Psarras, Wittmann and Vital discuss evidence of the production of type I interferons by cells and tissues other than haematopoietic cells. These interferons can have local effects, and their roles in the pathogenesis of systemic lupus erythematosus suggest the value of interferon-blocking therapies for treatment of this condition.

In this Review, the authors summarize and discuss regional differences in the prevalence and incidence of rheumatoid arthritis (RA), and describe temporal trends associated with the disease as well as evidence related to risk factors.

Gout can be effectively treated with long-term urate-lowering therapy. Current guidelines advocate the use of a treat-to-target serum urate strategy, with a target serum urate concentration of <5 mg/dl (<0.30 mmol/l) or <6 mg/dl (<0.36 mmol/l), but specific targets are under debate. In this Review, the authors consider the rationale and evidence for the recommendations.

In this Review, the authors discuss age-related arthropathy and the similarities and differences between childhood loss of immune tolerance and adult development of immune-mediated arthritis, and develop three hypotheses describing age-related mechanisms that contribute to the onset of arthritis.

This Review summarizes our understanding of sex- and gender-related differences in psoriatic arthritis, with a focus on disease progression and outcomes, underlying mechanisms and response to therapies.

Assessing systemic sclerosis (SSc) disease activity is challenging, and improved outcome measures are needed. This Review describes clinical and biochemical outcome measures of distinct features of SSc, with an emphasis on the dermatological manifestations and interstitial lung disease, including insights into biomarkers gained from single-cell RNA sequencing.

In this Review, the authors summarize the pathophysiological mechanisms of IL-1-mediated autoinflammation. They describe the epidemiological and clinical features of autoinflammatory diseases, challenges associated with diagnostics and disease management, and current and future therapies for targeting the IL-1 pathway.

In this Review, the authors provide an overview of the mechanisms contributing to joint damage in rheumatoid arthritis, particularly the interactions among immune cells, fibroblasts and bone, and discuss how this knowledge could inform the development of novel therapies.

In this Review, the authors discuss the characterization of distinct synovial tissue macrophage (STM) populations and their functions in the context of the healthy and arthritic joint. They also describe how distinct STMs are specified, how they respond to danger signals and the clinical implications of understanding STM heterogeneity.

In this Review, the authors discuss the latest insights into how autoantibodies and autoreactive B cells relate to the disease process in rheumatoid arthritis, from the development of pre-disease seropositivity to the onset of overt symptoms and the maintenance of disease chronicity.

Intervertebral disc calcification is an often overlooked phenotype that can have considerable clinical consequences. In this article, the authors aim to raise awareness of intervertebral disc calcification and discuss its implications for the management and prognosis of degenerative spinal changes.

Ubiquitylation is involved in the regulation of most cellular systems, including the innate immune system. Here, the authors describe the molecular pathogenesis of disorders of ubiquitylation that result in innate immune overactivation and systemic autoinflammatory disease.

In this Review, the authors discuss a comprehensive mechanistic concept of psoriatic arthritis, including discussion of the genetic, biomechanical, metabolic and microbial factors that contribute to the development of the disease as well as its manifestations and consequences.

Sphingosine 1-phosphate has essential roles in vascular barrier function, lymphocyte trafficking and differentiation, and inflammatory response in autoimmune rheumatic diseases; modulation of sphingosine 1-phosphate signalling is a potential therapeutic approach in systemic lupus erythematosus, rheumatoid arthritis and systemic sclerosis.

In this Review, the authors discuss how the inflammatory, hypoxic environment of joints in rheumatoid arthritis affects metabolism in fibroblasts, endothelial cells and immune cells. Understanding the competing requirements of these cells can enable effective therapeutic targeting of synovial metabolism.

Endothelial progenitor cells are essential for the maintenance of endothelial function, which in turn is crucial for cardiovascular physiology. The reduced function and numbers of endothelial progenitor cells in individuals with systemic lupus erythematosus could contribute to the excessive cardiovascular disease mortality in this patient population.