Reviews & Analysis

Immunopathology in autoimmune diseases is promoted by complex interactions between many types of immune cells, and adequate disease inhibition relies on targeting molecules that orchestrate these interactions. One such molecule, IL-7, has well-known effects on lymphoid cells, but could this cytokine also affect innate immune cells to induce immunopathology?

Early diagnosis of primary Sjögren Syndrome (pSS) is difficult but important for long-term disease management. Emerging data support the usefulness of salivary gland ultrasonography in the diagnosis of pSS. But is this imaging tool relevant to clinical practice and should it be added to current classification criteria?

Cytokines from the IL-1 family perform important functions in innate immune reactions, but can also be involved in chronic inflammatory diseases. This Review highlights the roles of IL-1 family members in rheumatic diseases and potential therapeutic approaches to targeting them.

Data from clinical trials of novel targeted therapies for psoriatic arthritis and other autoimmune diseases, which have produced sometimes surprising results, can inform our understanding of the immunopathogenesis of these diseases and help to identify the most relevant therapeutic targets.

Chikungunya can be a mild and self-limiting disease, but can also involve a complex spectrum of atypical, severe and/or chronic rheumatic manifestations that place a considerable burden on individuals. New strategies are under development to help treat and prevent this disease.

In patients with chronic inflammatory rheumatic diseases, non-adherence to methotrexate therapy could lead to lower drug efficacy, unnecessary adjustments of medication, and avoidable health-care costs. Use of a novel blood assay to measure methotrexate could help prevent or reduce non-adherence in clinical practice.

Rheumatoid arthritis (RA)-associated lung disease is difficult to treat and is associated with increased morbidity and mortality. A better understanding of the pathogenic pathways involved in lung disease in patients with RA should aid the development of specific therapies.

EULAR has published points to consider for the use of big data in rheumatology research that open up discussions and debates that are necessary and important, but are they missing the opportunities presented by cross-discipline collaboration to expand our perspective of disease beyond what is clinically visible?

Gout diagnostic criteria help focus attention on the accurate and early diagnosis of gout. New recommendations reinforce that joint aspiration and demonstration of monosodium urate crystals remains the gold standard for a diagnosis of gout and should be attempted in every patient with suspected gout.

Cutaneous lupus erythematosus encompasses a broad spectrum of skin lesions that can occur in isolation or as a manifestation of systemic lupus erythematosus. Insights into the cellular and molecular pathogenesis of cutaneous lupus erythematosus have triggered the development of new therapeutic strategies.

Advanced X-ray-based, magnetic resonance and optical imaging technologies are capable of visualizing the complex architecture of bone and its blood supply. Clinical and experimental applications of these technologies and novel analytical methods are providing new insights into the structure and function of bone in health and disease.

Criteria to define remission in gout could be valuable in clinical trials and practice. But do the available preliminary criteria truly predict the long-term absence of gout signs and symptoms?

Epidemiological data on the prevalence and severity of specific manifestations of systemic lupus erythematosus (SLE) among different ethnic groups are now emerging. The use of rigorous epidemiological methods should enable a better understanding of these features of SLE in different ethnic groups, which could influence disease management.

Tissue engineering strategies to repair articular cartilage and menisci are advancing rapidly. This Review provides an overview of surgical and tissue engineering approaches in current use and outlines exciting developments in the field.

The relationship between inflammation, cardiovascular disease and metabolic comorbidities in rheumatoid arthritis and psoriatic arthritis is complex. Understanding these relationships is important for the management of both diseases, as cardiometabolic comorbidities place a considerable burden on these patients.

T follicular helper cells and T follicular regulatory cells tightly control the production of (auto)antibodies by B cells. Understanding their phenotypes and how the function of these cells is dysregulated in rheumatic diseases will aid future therapeutic development.

In this Perspectives article, the authors present how various types of anti-citrullinated protein antibodies (ACPAs) differ based on the structural interactions of these antibodies with their citrullinated antigens, and examine the potential consequences for ACPA-mediated effector functions.

New data highlight the contribution of IL-6 to vascular calcification in chronic inflammation. Given that increased vascular calcification and accelerated atherosclerosis occur in patients with chronic inflammatory diseases, new therapies that block the IL-6 pathway might reduce the risk of cardiovascular events in these patients.

The effects of IL-17 on the joints in inflammatory arthritis are well-documented, but less is known about its systemic effects. In this Review, Beringer and Miossec discuss the effects of IL-17 on muscle, the cardiovascular system and the liver.

Analysis of data from the European Scleroderma Trials and Research (EUSTAR) cohort has initially identified six subsets of systemic sclerosis (SSc), as opposed to the binary classification of limited and diffuse cutaneous SSc. We now move closer to a more actionable SSc classification for improved clinical care and trial design.