Reviews & Analysis

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  • The pathogenesis of juvenile dermatomyositis (JDM) is complex and various evidence implicate a role for type I interferons. Could the use of a bioengineered paediatric skeletal muscle model provide insight into this disease and have potential for high throughput testing of therapeutic agents?

    • Hanna Kim
    News & Views
  • The rarity of various forms of vasculitis, as well as other rheumatic diseases, presents difficulties in studying the genetics of these diseases as well as for evaluating treatments. Might new approaches, such as joint genetic analyses and drug repurposing, provide opportunities to learn more about these diseases and identify new therapies and serve as a basis for basket clinical trials?

    • Elena Carnero-Montoro
    • Marta E. Alarcón-Riquelme
    News & Views
  • Vaccines are important tools for protection against infectious diseases, particularly in patients undergoing immunosuppression (including DMARD therapy). This Review discusses the effects of DMARDs on vaccine immunogenicity, focusing on influenza and SARS-CoV-2 vaccines, and potential mechanisms underlying these effects.

    • Yannick van Sleen
    • Kornelis S. M. van der Geest
    • Elisabeth Brouwer
    Review Article
  • In this Consensus Statement, the Treatment Response Measure for Systemic Lupus Erythematosus Consortium presents the initial outcomes of a project to develop a clinical outcome assessment that can contribute to the regulatory approval process for therapeutic agents via its incorporation in end points of clinical trials in systemic lupus erythematosus.

    • Kathryn Connelly
    • Laura E. Eades
    • Yulia Pincus
    Consensus Statement
  • In this Perspective, the authors discuss molecular, cellular and imaging evidence in spondyloarthritis that supports a bone marrow rather than an entheseal origin. Focusing on immune cells and dysfunction in the bone marrow niche could redirect the therapeutic approach to spondyloarthritis.

    • Daniele Mauro
    • Saviana Gandolfo
    • Francesco Ciccia
    Perspective
  • The potential for the co-occurrence of spondyloarthritis and inflammatory bowel disease means that gastroenterologists must identify articular manifestations and rheumatologists must identify intestinal manifestations. This Review describes the progress in the treatment of patients with both spondyloarthritis and inflammatory bowel disease.

    • Giacomo Cozzi
    • Laura Scagnellato
    • Roberta Ramonda
    Review Article
  • This Review provides an overview of the complement system and its role in a range of rheumatic and autoimmune diseases, and examines the rapidly expanding landscape of complement therapeutics in these settings, as well as prospects for improving their clinical use.

    • V. Michael Holers
    Review Article
  • No drugs are yet approved for the treatment of primary Sjögren syndrome, despite a large number of clinical trials. Non-conventional approaches can help to identify novel therapeutic targets. Using a drug-repositioning transcriptomic approach, interferon has emerged once again as a major target for intervention in this disease process.

    • Gwenny M. Verstappen
    • Frans G. M. Kroese
    News & Views
  • Post-transcriptional regulation of gene expression is important in various cellular processes, and disruption of this process can lead to aberrant immune responses, including autoimmune processes. This Review discusses the role of post-transcriptional checkpoints in autoimmunity and potential therapeutic implications.

    • Rami Bechara
    • Stephan Vagner
    • Xavier Mariette
    Review Article
  • Giant cell arteritis (GCA) and polymyalgia rheumatica (PMR) are increasingly viewed as parts of a single disease spectrum. In this Review, the authors outline how stratification of patients with GCA–PMR spectrum disease using clinical, imaging and laboratory data can to help guide therapy.

    • Alessandro Tomelleri
    • Kornelis S. M. van der Geest
    • Bhaskar Dasgupta
    Review Article
  • 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.

    • Brittany N. Weber
    • Jon T. Giles
    • Katherine P. Liao
    Review Article
  • 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.

    • Rebecca T. Hansen
    • Chantal Chenu
    • Andrew A. Pitsillides
    Review Article
  • 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.

    • Charalampia Papadopoulou
    • Christine Chew
    • Lucy R. Wedderburn
    Review Article
  • 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.

    • Bernard Grillet
    • Rafaela Vaz Sousa Pereira
    • Ghislain Opdenakker
    Review Article
  • 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.

    • Giacomo Emmi
    • Alessandra Bettiol
    • Augusto Vaglio
    Evidence-based Guidelines
  • 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.

    • Bernard Khor
    • Jane H. Buckner
    News & Views
  • 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?

    • Vicky Duong
    • David J. Hunter
    News & Views
  • 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.

    • Terri H. Finkel
    • Marko Radic
    News & Views