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RMD Open Feb 2024It is known that metabolic shifts and tissue remodelling precede the development of visible inflammation and structural organ damage in inflammatory rheumatic diseases... (Review)
Review
It is known that metabolic shifts and tissue remodelling precede the development of visible inflammation and structural organ damage in inflammatory rheumatic diseases such as the inflammatory arthritides. As such, visualising and measuring metabolic tissue activity could be useful to identify biomarkers of disease activity already in a very early phase. Recent advances in imaging have led to the development of so-called 'metabolic imaging' tools that can detect these changes in metabolism in an increasingly accurate manner and non-invasively.Nuclear imaging techniques such as F-D-glucose and fibroblast activation protein inhibitor-labelled positron emission tomography are increasingly used and have yielded impressing results in the visualisation (including whole-body staging) of inflammatory changes in both early and established arthritis. Furthermore, optical imaging-based bedside techniques such as multispectral optoacoustic tomography and fluorescence optical imaging are advancing our understanding of arthritis by identifying intra-articular metabolic changes that correlate with the onset of inflammation with high precision and without the need of ionising radiation.Metabolic imaging holds great potential for improving the management of patients with inflammatory arthritis by contributing to early disease interception and improving diagnostic accuracy, thereby paving the way for a more personalised approach to therapy strategies including preventive strategies. In this narrative review, we discuss state-of-the-art metabolic imaging methods used in the assessment of arthritis and inflammation, and we advocate for more extensive research endeavours to elucidate their full field of application in rheumatology.
Topics: Humans; Arthritis; Inflammation; Tomography, X-Ray Computed; Positron-Emission Tomography; Molecular Imaging
PubMed: 38341194
DOI: 10.1136/rmdopen-2023-003880 -
Aging Clinical and Experimental Research Jul 2023Normal bone remodeling depends of a balance between bone forming cells, osteoblasts and bone resorbing cells, the osteoclasts. In chronic arthritides and some... (Review)
Review
Normal bone remodeling depends of a balance between bone forming cells, osteoblasts and bone resorbing cells, the osteoclasts. In chronic arthritides and some inflammatory and autoimmune diseases such as rheumatoid arthritis, there is a great constellation of cytokines produced by pannus that impair bone formation and stimulate bone resorption by inducing osteoclast differentiation and inhibiting osteoblast maturation. Patients with chronic inflammation have multiple causes that lead to low bone mineral density, osteoporosis and a high risk of fracture including circulating cytokines, impaired mobility, chronic administration of glucocorticoids, low vitamin D levels and post-menopausal status in women, among others. Biologic agents and other therapeutic measures to reach prompt remission might ameliorate these deleterious effects. In many cases, bone acting agents need to be added to conventional treatment to reduce the risk of fractures and to preserve articular integrity and independency for daily living activities. A limited number of studies related to fractures in chronic arthritides were published, and future investigation is needed to determine the risk of fractures and the protective effects of different treatments to reduce this risk.
Topics: Humans; Female; Arthritis, Rheumatoid; Osteoclasts; Bone Resorption; Bone and Bones; Osteoblasts; Cytokines; Fractures, Bone
PubMed: 37222927
DOI: 10.1007/s40520-023-02432-9 -
Zhejiang Da Xue Xue Bao. Yi Xue Ban =... Apr 2023Interleukin (IL)-36 is a family of cytokines that belongs to the larger IL-1 superfamily. IL-36 agonist/antagonist binds to the interleukin-36 receptor involving in... (Review)
Review
Interleukin (IL)-36 is a family of cytokines that belongs to the larger IL-1 superfamily. IL-36 agonist/antagonist binds to the interleukin-36 receptor involving in physiological inflammation regulation and pathogenesis of many inflammatory diseases. In inflammatory joint diseases, the expression of IL-36 changes, and some studies have initially explored the role of IL-36 in these diseases. In psoriatic arthritis, IL-36 signal mediates plasma cell and fibroblast-like synoviocyte crosstalk presenting IL-36 agonist/antagonist imbalance. In rheumatoid arthritis, IL-36 agonists induce fibroblast-like synoviocyte to produce pro-inflammatory factors, while IL-36 antagonist deficiency leads to lesion progression. In osteoarthritis, IL-36 agonists induce chondrocytes to produce catabolic enzymes and pro-inflammatory factors. This article reviews the expression and function of IL-36 in different inflammatory joint diseases to provide a reference for revealing their pathogenic mechanisms and discovering therapeutic targets.
Topics: Humans; Interleukins; Arthritis, Rheumatoid; Osteoarthritis; Arthritis, Psoriatic; Cytokines
PubMed: 37283111
DOI: 10.3724/zdxbyxb-2023-0034 -
Translational Research : the Journal of... Jun 2021Patients with inflammatory arthritis represent a possible high-risk group to COVID-19 due to their immunosuppressive regimen designed to maintain low disease activity.... (Review)
Review
Patients with inflammatory arthritis represent a possible high-risk group to COVID-19 due to their immunosuppressive regimen designed to maintain low disease activity. Thus, substantial effort has been put forth to understand the impact of COVID-19 on these patients. Patients with rheumatic diseases as a whole do not appear to be more susceptible to acquiring COVID-19. Furthermore, immunosuppression generally did not increase the likelihood of developing severe COVID-19, with the important exception of medium and high-dose glucocorticoid use. In addition, a small number of COVID-19 patients have developed new inflammatory arthritis; whether this represents an unmasking of previous subclinical disease or a bone fide virus-induced arthritis is unclear. Nevertheless, it appears that inflammatory arthritis patients currently on immunosuppression should continue their medication to prevent future flares and limit glucocorticoid usage. While this continues to be a rapidly evolving field, these data are reassuring to both patients with and providers treating inflammatory arthritides.
Topics: Arthritis; COVID-19; Humans; Immunosuppressive Agents; Rheumatic Diseases; SARS-CoV-2; Severity of Illness Index
PubMed: 33626415
DOI: 10.1016/j.trsl.2021.02.010 -
Frontiers in Immunology 2023The NLRP3 inflammasome, which belongs to the pyrin domain containing 3 family of NOD-like receptors, has a significant impact on both the innate and adaptive immune... (Review)
Review
The NLRP3 inflammasome, which belongs to the pyrin domain containing 3 family of NOD-like receptors, has a significant impact on both the innate and adaptive immune responses. Regulating host immune function and protecting against microbial invasion and cell damage, the NLRP3 inflammasome plays a crucial role. By triggering caspase-1, it facilitates the development of the inflammatory cytokines IL-1β and IL-18, and triggers cell pyroptosis, resulting in cell lysis and demise. Common sterile arthritis includes osteoarthritis (OA), rheumatoid arthritis (RA) and gouty arthritis (GA), all of which manifest as bone destruction and synovial inflammation in a complex inflammatory state, placing a significant medical burden on the families of patients and government agencies. In the past few years, there has been a growing interest in investigating the impact of cell pyroptosis on arthritis development, particularly the widespread occurrence of pyroptosis mediated by the NLRP3 inflammasome. The NLRP3 inflammasome's biological properties are briefly described in this review, along with the presentation of the fundamental processes of pyroptosis resulting from its activation. Furthermore, we provide a summary of the advancements made in studying the NLRP3 inflammasome in various forms of arthritis and enumerate the intervention approaches that target the NLRP3-mediated pyroptosis, either directly or indirectly. These discoveries lay the groundwork for future investigations on medications for arthritis, offering fresh approaches for the clinical identification and treatment of this condition.
Topics: Humans; Inflammasomes; NLR Family, Pyrin Domain-Containing 3 Protein; Arthritis, Rheumatoid; Osteoarthritis; Arthritis, Gouty
PubMed: 37954594
DOI: 10.3389/fimmu.2023.1273174 -
MMWR. Morbidity and Mortality Weekly... Oct 2021Arthritis has been the most frequently reported main cause of disability among U.S. adults for >15 years (1), was responsible for >$300 billion in arthritis-attributable...
Arthritis has been the most frequently reported main cause of disability among U.S. adults for >15 years (1), was responsible for >$300 billion in arthritis-attributable direct and indirect annual costs in the U.S. during 2013 (2), is linked to disproportionately high levels of anxiety and depression (3), and is projected to increase 49% in prevalence from 2010-2012 to 2040 (4). To update national prevalence estimates for arthritis and arthritis-attributable activity limitation (AAAL) among U.S. adults, CDC analyzed combined National Health Interview Survey (NHIS) data from 2016-2018. An estimated 58.5 million adults aged ≥18 years (23.7%) reported arthritis; 25.7 million (10.4% overall; 43.9% among those with arthritis) reported AAAL. Prevalence of both arthritis and AAAL was highest among adults with physical limitations, few economic opportunities, and poor overall health. Arthritis was reported by more than one half of respondents aged ≥65 years (50.4%), adults who were unable to work or disabled* (52.3%), or adults with fair/poor self-rated health (51.2%), joint symptoms in the past 30 days (52.2%), activities of daily living (ADL) disability (54.8%), or instrumental activities of daily living (IADL) disability (55.9%). More widespread dissemination of existing, evidence-based, community-delivered interventions, along with clinical coordination and attention to social determinants of health (e.g., improved social, economic, and mental health opportunities), can help reduce widespread arthritis prevalence and its adverse effects.
Topics: Adolescent; Adult; Aged; Arthritis; Female; Health Surveys; Humans; Male; Middle Aged; Mobility Limitation; Prevalence; United States; Young Adult
PubMed: 34618800
DOI: 10.15585/mmwr.mm7040a2 -
The Bone & Joint Journal Oct 2015Arthritis of the wrist is a painful disabling condition that has various causes and presentations. The traditional treatment has been a total wrist fusion at a price of... (Review)
Review
Arthritis of the wrist is a painful disabling condition that has various causes and presentations. The traditional treatment has been a total wrist fusion at a price of the elimination of movement. However, forms of treatment which allow the preservation of movement are now preferred. Modern arthroplasties of the wrist are still not sufficiently robust to meet the demands of many patients, nor do they restore normal kinematics of the wrist. A preferable compromise may be selective excision and partial fusion of the wrist using knowledge of the aetiology and pattern of degenerative change to identify which joints can be sacrificed and which can be preserved. This article provides an overview of the treatment options available for patients with arthritis of the wrist and an algorithm for selecting an appropriate surgical strategy.
Topics: Algorithms; Arthritis; Humans; Wrist Joint
PubMed: 26430002
DOI: 10.1302/0301-620X.97B10.35717 -
JBJS Reviews Aug 2021Orthopaedics pioneered the expansion of gene therapy beyond its traditional scope of diseases that are caused by rare single-gene defects. Orthopaedic applications of...
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Orthopaedics pioneered the expansion of gene therapy beyond its traditional scope of diseases that are caused by rare single-gene defects. Orthopaedic applications of gene therapy are most developed in the areas of arthritis and regenerative medicine, but several additional possibilities exist.
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Invossa, an ex vivo gene therapeutic for osteoarthritis, was approved in South Korea in 2017, but its approval was retracted in 2019 and remains under appeal; a Phase-III clinical trial of Invossa has restarted in the U.S.
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There are several additional clinical trials for osteoarthritis and rheumatoid arthritis that could lead to approved gene therapeutics for arthritis.
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Bone-healing and cartilage repair are additional areas that are attracting considerable research; intervertebral disc degeneration and the healing of ligaments, tendons, and menisci are other applications of interest. Orthopaedic tumors, genetic diseases, and aseptic loosening are additional potential targets.
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If successful, these endeavors will expand the scope of gene therapy from providing expensive medicines for a few patients to providing affordable medicines for many.
Topics: Arthritis, Rheumatoid; Genetic Therapy; Humans; Intervertebral Disc Degeneration; Orthopedics; Osteoarthritis
PubMed: 34437305
DOI: 10.2106/JBJS.RVW.20.00220 -
Clinical Medicine (London, England) Aug 2016
Topics: Arthritis; Arthritis, Infectious; Humans
PubMed: 27481394
DOI: 10.7861/clinmedicine.16-4-399a -
American Family Physician Jul 2015Polyarticular arthritis is commonly encountered in clinical settings and has multiple etiologies. The first step is to distinguish between true articular pain and... (Review)
Review
Polyarticular arthritis is commonly encountered in clinical settings and has multiple etiologies. The first step is to distinguish between true articular pain and nonarticular or periarticular conditions by recognizing clinical patterns through the history and physical examination. Once pain within a joint or joints is confirmed, the next step is to classify the pain as noninflammatory or inflammatory in origin. Noninflammatory arthritis, which is mostly related to osteoarthritis, has a variable onset and severity and does not have inflammatory features, such as warm or swollen joints. Osteoarthritis usually presents with less than one hour of morning stiffness and pain that is aggravated by activity and improves with rest. A review of systems is usually negative for rashes, oral ulcers, or other internal organ involvement. In contrast, inflammatory arthritis generally causes warm, swollen joints; prolonged morning stiffness; and positive findings on a review of systems. Once inflammatory arthritis is suspected, possible diagnoses are sorted by the pattern of joint involvement, which includes number and type of joints involved, symmetry, and onset. The suspicion for inflammatory arthritis should be confirmed by the appropriate serologic/tissue and/or imaging studies in the clinical setting or in consultation with a subspecialist.
Topics: Arthritis; Diagnosis, Differential; Humans; Immunologic Tests; Inflammation; Medical History Taking; Physical Examination; Serologic Tests; Symptom Assessment
PubMed: 26132125
DOI: No ID Found