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Cartilage defects often fail to heal, which can lead to degenerative changes and ultimately to osteoarthritis. This Review discusses various hypotheses for why articular cartilage fails to regenerate and accompanying potential therapeutic solutions.
Rheumatoid arthritis is associated with an excess risk of atherosclerotic cardiovascular disease. This Review summarizes shared inflammatory pathways between rheumatoid arthritis and atherosclerotic cardiovascular disease that are targeted by existing therapies, and lessons learnt from clinical trials of these drugs.
Bone marrow lesions (BMLs) are considered possible biomarkers and therapeutic targets in osteoarthritis, but human studies of BMLs have important limitations. In this Review, the authors explore the utility and potential of animal models in BML research.
This Review provides an overview of the clinical features and subtypes, pathophysiology and management of juvenile idiopathic inflammatory myopathies, including updates to our understanding of this heterogenous group of diseases that might change clinical practice in the near future.
Matrix metalloproteinases contribute to irreversible joint remodelling in the pathogenesis of joint diseases, including rheumatoid arthritis and osteoarthritis. This article reviews several aspects of matrix metalloproteinase biology related to arthritis and discusses how they relate to opportunities for precision medicine and diagnosis.
This article presents the first Evidence-Based Guideline dedicated specifically to the diagnosis and management of eosinophilic granulomatosis with polyangiitis. The 16 statements and five overarching principles cover the diagnosis and staging, treatment, outcome and follow-up of eosinophilic granulomatosis with polyangiitis.
Understanding why individuals with Down syndrome are highly predisposed to autoimmunity has broad mechanistic and therapeutic implications. New work identifies novel potential mechanistic pathways driving increased autoimmunity-relevant CD11c+ B cells and provides the broadest view to date of the repertoire of autoantibodies generated in individuals with Down syndrome.
Given that intra-articular injections for the knee of treatments such as hyaluronic acid, stem cells and platelet-rich plasma are advised against or only weakly recommended by current clinical-practice guidelines, why do people continue to seek information about these treatments?
Emerging research suggests that chimeric antigen receptor T cell therapy could be an effective treatment for a range of difficult-to-treat autoimmune diseases, and sophisticated approaches are in tests, yet initial reports also highlight several questions that remain to be answered.
Among the wide range of drugs now available for the treatment of psoriatic arthritis, the best option for an individual patient remains unclear. Emerging real-world evidence from several Nordic registries suggests that differences exist in the response rates to different classes of biologic and targeted synthetic DMARDs in psoriatic arthritis.
The full picture of post-COVID-19 autoimmune diseases and their prevalence is lacking despite numerous case reports and small series. Two studies that use large cohorts now highlight that SARS-CoV-2 infection is linked to a substantially increased risk of developing a diverse spectrum of new-onset autoimmune diseases.
Clinical heterogeneity in systemic lupus erythematosus (SLE) is a challenge to effective treatment. This Review describes advances in our understanding of genetic and epigenetic variations in SLE and the roles of immune profiling and biomarker identification in the progress towards precision medicine.
Long-term treatment with the anti-resorptive drug denosumab results in a continuous gain in bone mineral density, whereas denosumab withdrawal results in a transient overshoot in bone turnover, with rapid bone loss. This Perspective explores the potential mechanisms underlying these effects.
The onset of the destructive autoimmune joint disease rheumatoid arthritis (RA) is preceded by the development of autoantibodies to multiple citrullinated proteins. Research has now shown that citrullination modifies antigen processing, resulting in the production of cryptic epitopes, suggesting a new model for RA autoantibody development.
In this Review, Cutolo et al. provide an overview of the vitamin D endocrine system and explore the biological and clinical effects of vitamin D3 on innate and adaptive immunity in the context of autoimmune rheumatic diseases and COVID-19.
Among the limited quality and quantity of evidence on vaccination use in individuals with rheumatic and musculoskeletal diseases, a new guideline, developed with a rigorous methodology, provides useful support to clinicians and patients in making health-related decisions. Most recommendations are conditional, serving as a call to action for further research.
Osteoarthritis has many appearances and can stabilize or progress aggressively. However, there is not yet an aetiological classification of osteoarthritis subtypes. Can in silico approaches, despite difficulties in validation, help with the identification of experimentally challenging subtypes? And if they can, will these approaches translate to clinical benefits?
The involvement of citrulline-specific CD4+ T cells in anti-citrulline protein antibody-positive rheumatoid arthritis (RA) is well described, whereas less attention has been given to CD8+ T cells. New data suggest that CD8+ T cells also contribute to citrulline-specific immune responses in RA.
This Review summarizes the genetic and epigenetic basis of primary Sjögren syndrome, including genetic interactions with factors such as sex and environment. Understanding these processes provides insight into the molecular basis of this disease and might reveal new treatment targets.
In systemic lupus erythematosus, renal involvement is known as lupus nephritis and it is associated with mortality and morbidity. This Review compares and contrasts the existing management guidelines for lupus nephritis and describes emerging therapeutic approaches and the feasibility of precision medicine.
