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Tissue-resident memory CD8+ T cells on the skin–joint route 组织驻留记忆CD8+ T细胞在皮肤关节途径中的作用
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-07-08 DOI: 10.1038/s41584-025-01284-z
Maria Papatriantafyllou
Skin- and joint-resident CD8+ T cells that share clonality also share phenotypic similarities in psoriatic arthritis.
共享克隆性的皮肤和关节驻留CD8+ T细胞在银屑病关节炎中也具有表型相似性。
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引用次数: 0
Nerandomilast slows progression of pulmonary fibrosis 奈兰多司特减缓肺纤维化的进展
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-07-08 DOI: 10.1038/s41584-025-01285-y
Maria Papatriantafyllou
The anti-fibrotic and anti-inflammatory agent nerandomilast has shown promise for the treatment of both idiopathic and progressive pulmonary fibrosis in phase III trials.
抗纤维化和抗炎药nerandomilast在III期试验中显示出治疗特发性和进行性肺纤维化的希望。
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引用次数: 0
Synovial fibroblast-mediated neovascularization in RA RA中滑膜成纤维细胞介导的新生血管形成
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-07-08 DOI: 10.1038/s41584-025-01283-0
Holly Webster
A study provides insights into the factors that regulate synovial fibroblast interactions with endothelial cells in RA and subsequent pathogenic neovascularization.
一项研究提供了调节RA中滑膜成纤维细胞与内皮细胞相互作用以及随后的致病性新生血管形成的因素。
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引用次数: 0
Synovial fluid as a complex molecular pool contributing to knee osteoarthritis 滑液作为一个复杂的分子池,有助于膝关节骨关节炎
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-07-07 DOI: 10.1038/s41584-025-01271-4
Hayley Peters, Jason S. Rockel, Christopher B. Little, Mohit Kapoor
The main homeostatic function of the synovial fluid is joint lubrication. However, during knee osteoarthritis (KOA), synovial fluid becomes modified with drivers of disease that contribute to symptoms (pain) and joint-related pathology. Acting as a sink of factors from both systemic circulation and local tissues, including articular cartilage, subchondral bone, synovium, and the infrapatellar fat pad, the synovial fluid enables bidirectional communication promoting KOA pathogenesis. Synovial fluid constituents might also be detected in circulation, functioning not only as accessible biomarkers but also as potential mediators of KOA-driven systemic effects. Factors deposited in synovial fluid have the ability to affect nervous system activity, acting at the neuronal projections that are integrated into joint tissues from dorsal root ganglia. Non-coding RNAs (microRNAs, long non-coding RNAs, circular RNAs), metabolites, cytokines and other secreted proteins of the synovial fluid in KOA have emerged as biomarkers of disease progression, therapeutic efficacy, and pain. These molecules might also function as molecular mediators of KOA, supporting them as candidates for therapeutic intervention. This review consolidates literature published primarily within the past 4 years, focussing on factors identified within synovial fluid as biomarkers and molecular mediators of KOA symptoms and pathology. Emerging therapeutic modalities to target synovial fluid molecular mediators are also discussed. The synovial fluid lubricates joints while also collecting molecular mediators from surrounding tissues. This Review highlights how molecular analyses of the synovial fluid might provide information on the progression of knee osteoarthritis and treatment efficacy, and identify potential therapeutic strategies targeting synovial fluid mediators in knee osteoarthritis.
滑液的主要自稳态功能是关节润滑。然而,在膝骨关节炎(KOA)期间,滑液会随着疾病的驱动因素而改变,从而导致症状(疼痛)和关节相关病理。作为来自体循环和局部组织(包括关节软骨、软骨下骨、滑膜和髌下脂肪垫)的因子汇,滑膜液能够双向交流,促进KOA的发病。滑液成分也可能在循环中检测到,不仅作为可获得的生物标志物,而且作为koa驱动的全身效应的潜在介质。沉积在滑液中的因子有影响神经系统活动的能力,作用于从背根神经节进入关节组织的神经元突起。KOA滑膜液的非编码rna (microrna、长链非编码rna、环状rna)、代谢物、细胞因子和其他分泌蛋白已成为疾病进展、治疗效果和疼痛的生物标志物。这些分子也可能作为KOA的分子介质,支持它们作为治疗干预的候选物。本综述整合了过去4年发表的文献,重点关注滑液中确定的作为KOA症状和病理的生物标志物和分子介质的因素。新兴的治疗方式,以靶滑液分子介质也进行了讨论。
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引用次数: 0
Platelets as drivers of immunothrombosis in rheumatic diseases 血小板作为风湿病免疫血栓形成的驱动因素
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-07-07 DOI: 10.1038/s41584-025-01276-z
Norma Maugeri, Angelo A. Manfredi
Platelets are central players in inflammatory and thrombotic responses that drive the onset and progression of rheumatic diseases. In particular, they regulate immunothrombosis, a defence mechanism in which the immune and blood-clotting systems cooperate to contain infections or vascular damage. Although immunothrombosis can help to preserve blood-vessel integrity and promote healing, it becomes harmful when exaggerated or chronic. In rheumatic diseases, such as systemic lupus erythematosus, systemic sclerosis and antiphospholipid syndrome, immunothrombosis contributes to persistent inflammation, abnormal blood-clot formation and long-term damage to the small blood vessels. It has also been implicated in maintaining autoimmune responses to autoantigens released by neutrophils. Platelets are among the first responders to vascular injury and influence the activity of immune cells, particularly neutrophils, by promoting the formation of neutrophil extracellular traps. Platelets express proteins such as P-selectin and the damage-associated molecule high-mobility group box 1 (HMGB1), which have distinct and non-redundant roles, both via direct interactions locally at sites of vascular damage and systemically via the release of extracellular vesicles. Understanding how platelets contribute to vascular inflammation and clotting in autoimmune settings elucidates disease mechanisms and might lead to the identification of new therapeutic targets. This Review provides an overview of how platelets promote immunothrombosis in rheumatic disease. The authors discuss the different ways in which platelets and immunothrombosis can be targeted for therapeutic intervention.
血小板是炎症和血栓形成反应的核心参与者,这些反应驱动风湿病的发生和进展。特别是,它们调节免疫血栓形成,这是一种免疫和凝血系统合作抑制感染或血管损伤的防御机制。虽然免疫血栓可以帮助保持血管的完整性和促进愈合,但当它被夸大或慢性时就会变得有害。在风湿性疾病中,如系统性红斑狼疮、系统性硬化症和抗磷脂综合征,免疫血栓形成导致持续炎症、异常血凝块形成和对小血管的长期损害。它还涉及维持对中性粒细胞释放的自身抗原的自身免疫反应。血小板是血管损伤的第一反应者之一,通过促进中性粒细胞胞外陷阱的形成,影响免疫细胞,特别是中性粒细胞的活性。血小板表达p -选择素和损伤相关分子高迁移率组盒1 (HMGB1)等蛋白,它们通过血管损伤部位的局部直接相互作用和通过细胞外囊泡的系统性释放,发挥着独特而非冗余的作用。了解血小板如何在自身免疫环境下促进血管炎症和凝血,阐明疾病机制,并可能导致新的治疗靶点的确定。
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引用次数: 0
CAR T cell therapy for children with rheumatic disease: the time is now CAR - T细胞疗法治疗儿童风湿性疾病:时机已到
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-07-02 DOI: 10.1038/s41584-025-01272-3
Holly Wobma, Stacy P. Ardoin, Challice L. Bonifant, Jennifer C. Cooper, Hanna Kim, Rebecca E. Sadun, Laura Lewandowski, Michael Keller, Robert A. Colbert, Cuoghi Edens, Kimberly DeQuattro, Kyla Driest, Julia Shalen, Ivana Stojkic, Andrea Knight, Colleen Annesley, Kathryn S. Torok, Caitlin W. Elgarten, Toshihiro Onishi, Shaun W. Jackson, Susan Prockop, Nirali N. Shah, Kaveh Ardalan, Margaret Lamb, on behalf of the Integrated Multidisciplinary Paediatric Autoimmunity and Cell Therapy (IMPACT) working group*
Initial success with B cell-targeted chimeric antigen receptor (CAR) T cells for the treatment of systemic lupus erythematosus and other rheumatic diseases has generated enthusiasm for the broad application of this technology outside of the field of oncology. Paediatric patients with severe rheumatic diseases require lifelong therapy with a substantial toxicity burden and a high cost of care. Paradigm-shifting treatments, including CAR T cells, are desperately needed. Although CAR T cell therapy shows promise for paediatric rheumatic diseases, there are unique aspects of care compared with adults, which require careful consideration and expertise. In response, we established the Integrated Multidisciplinary Paediatric Autoimmunity and Cell Therapy (IMPACT) working group, comprising international experts in the fields of paediatric rheumatology, oncology and cellular therapy, immunology and nephrology, to address the challenges of introducing cell therapies to patients with paediatric-onset autoimmune diseases. Given the possible benefits, we advocate for the study of CAR T cells in paediatric patients with rheumatic diseases who carry a lifelong risk of morbidity and mortality from chronic illness and medication toxicity. As this patient population is relatively small, consensus around definitions of success, robust study of predictors of response and uniform assessment and reporting of toxicities are critical to advancing the field. In this Perspective, the authors and the members of the Integrated Multidisciplinary Paediatric Autoimmunity and Cell Therapy (IMPACT) working group discuss specific considerations for the use of chimeric antigen receptor (CAR) T cell therapies in paediatric patients with rheumatic diseases.
B细胞靶向嵌合抗原受体(CAR) T细胞治疗系统性红斑狼疮和其他风湿性疾病的初步成功,使人们对该技术在肿瘤领域之外的广泛应用产生了热情。患有严重风湿病的儿科患者需要终生治疗,毒性负担很大,护理费用很高。现在迫切需要包括CAR - T细胞在内的范式转换疗法。尽管CAR - T细胞疗法显示出治疗儿科风湿病的希望,但与成人相比,治疗有其独特的方面,需要仔细考虑和专业知识。作为回应,我们建立了综合多学科儿科自身免疫和细胞治疗(IMPACT)工作组,由儿科风湿病学、肿瘤学和细胞治疗、免疫学和肾脏病学领域的国际专家组成,以应对向儿科发病的自身免疫性疾病患者引入细胞治疗的挑战。考虑到可能的益处,我们提倡在患有风湿性疾病的儿童患者中研究CAR - T细胞,这些患者终生都有因慢性疾病和药物毒性而发病和死亡的风险。由于该患者群体相对较小,因此就成功的定义达成共识,对反应预测因素进行强有力的研究,以及对毒性进行统一的评估和报告,对于推进该领域至关重要。
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引用次数: 0
Location-specific treatment of chronic inflammatory joint disease 慢性炎性关节病的部位特异性治疗
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-06-25 DOI: 10.1038/s41584-025-01278-x
Adrian Ciurea, Caroline Ospelt
Over the past decades, considerable progress has been made in the pharmacological treatment of immune-mediated joint diseases such as rheumatoid arthritis and psoriatic arthritis; however, treatment-resistant arthritis remains a major clinical challenge. To tackle insufficient treatment outcomes, further research into the underlying mechanisms and patterns of non-responsiveness is needed.
在过去的几十年里,免疫介导的关节疾病如类风湿关节炎和银屑病关节炎的药理治疗取得了相当大的进展;然而,治疗抵抗性关节炎仍然是一个主要的临床挑战。为了解决治疗效果不足的问题,需要进一步研究无反应性的潜在机制和模式。
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引用次数: 0
Immunometabolism in systemic lupus erythematosus 系统性红斑狼疮的免疫代谢
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-06-16 DOI: 10.1038/s41584-025-01267-0
Eduardo Patiño-Martinez, Mariana J. Kaplan
Systemic lupus erythematosus (SLE) is a multifaceted autoimmune disorder characterized by chronic inflammation, tissue damage, accelerated cardiovascular disease and the synthesis of autoantibodies that target nucleic acids and nuclear protein complexes. Emerging evidence underscores the key role of immune metabolic dysregulation in SLE, revealing how metabolic reprogramming during immune cell activation influences disease development and progression. Alterations in key metabolic pathways such as glycolysis and oxidative phosphorylation profoundly affect the activation, differentiation and function of B and T cells, monocytes, neutrophils and other immune cells, driving inflammation and tissue injury. This Review synthesizes current findings on immune cell metabolism in animal models of lupus and in patients with SLE, highlighting the interplay of metabolic disturbances, mitochondrial dysfunction and disease pathogenesis. Furthermore, it explores the potential of targeting metabolic pathways as therapeutic strategies to mitigate organ damage and improve outcomes in SLE. Systemic lupus erythematosus is characterized by altered metabolic profiles and changes in immune cell metabolism. The authors review these changes and discuss how interventions that target metabolic processes might provide treatment options in systemic lupus erythematosus.
系统性红斑狼疮(SLE)是一种以慢性炎症、组织损伤、心血管疾病加速和靶向核酸和核蛋白复合物的自身抗体合成为特征的多层面自身免疫性疾病。新出现的证据强调了免疫代谢失调在SLE中的关键作用,揭示了免疫细胞激活过程中的代谢重编程如何影响疾病的发生和进展。糖酵解和氧化磷酸化等关键代谢途径的改变深刻影响B细胞和T细胞、单核细胞、中性粒细胞等免疫细胞的活化、分化和功能,从而引发炎症和组织损伤。这篇综述综合了狼疮动物模型和SLE患者免疫细胞代谢的最新发现,强调了代谢紊乱、线粒体功能障碍和疾病发病机制的相互作用。此外,它还探讨了靶向代谢途径作为缓解器官损伤和改善SLE预后的治疗策略的潜力。
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引用次数: 0
2023 International Rome consensus for the nomenclature of Sjögren disease 2023年Sjögren疾病命名法国际罗马共识
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-06-10 DOI: 10.1038/s41584-025-01268-z
Manuel Ramos-Casals, Alan N. Baer, María del Pilar Brito-Zerón, Katherine M. Hammitt, Coralie Bouillot, Soledad Retamozo, Alison Mackey, David Yarowsky, Breck Turner, Jaime Blanck, Benjamin A. Fisher, Esen K. Akpek, Chiara Baldini, Hendrika Bootsma, Simon J. Bowman, Thomas Dörner, Leslie Laing, Scott M. Lieberman, Xavier Mariette, Stephen C. Pflugfelder, Vidya Sankar, Antoni Sisó-Almirall, Athanasios G. Tzioufas, Juan-Manuel Anaya, Berkan Armağan, Michele Bombardieri, Steven Carsons, Salvatore de Vita, Robert I. Fox, Roberto Gerli, Roberto Giacomelli, Jacques Eric Gottenberg, Gabriela Hernández-Molina, Roland Jonsson, Aike Kruize, Seung-Ki Kwok, Xiaomei Li, Sara S. McCoy, Wan-Fai Ng, Peter Olsson, Maureen Rischmueller, Alain Saraux, R. Hal Scofield, Valéria Valim, Claudio Vitali, Frederick Vivino, Marie Wahren-Herlenius, Haralampos M. Moutsopoulos, on behalf of the International Task Force on Nomenclature of Sjögren Disease
Nomenclature for the disease widely known as Sjögren syndrome has proven unsatisfactory. Patients have perceived ‘syndrome’ as indicative of a vague collection of symptoms, prompting the Sjögren’s Foundation to abandon the term. Furthermore, the traditional distinction between ‘primary’ and ‘secondary’ forms fails to account for the complex interplay between overlapping autoimmune diseases. Following a bibliometric analysis, systematic literature review and a Delphi consensus process with equal involvement of professional and patient representatives, five recommendations are now issued. First, the term ‘Sjögren disease’ should replace ‘Sjögren syndrome’. Second, the acronym ‘SjD’ should be used as an abbreviation for ‘Sjögren disease’. Third, the descriptor ‘associated’ should be used in lieu of ‘secondary’ for Sjögren disease occurring in association with a second systemic autoimmune disease for which classification criteria are fulfilled. Fourth, Sjögren disease is the preferred terminology in common parlance and in clinical diagnosis, without differentiation as to primary and associated forms. Fifth, the differentiation between primary and associated Sjögren is recommended for scientific studies to define a homogeneous population. In conclusion, the consensus endorses ‘Sjögren disease’ as the official nomenclature to acknowledge the distinct pathogenesis of this disorder and to improve clarity in both clinical practice and research. In this Consensus Statement, an international group of experts and patient representatives validates and endorses the transition from the term ‘Sjögren syndrome’ to ‘Sjögren disease’, and issue several additional recommendations regarding the nomenclature of this disorder.
这种被广泛称为Sjögren综合征的疾病的命名法已被证明不令人满意。患者认为“综合征”是一种模糊的症状集合,这促使Sjögren基金会放弃了这个术语。此外,“原发性”和“继发性”形式之间的传统区分未能解释重叠自身免疫性疾病之间复杂的相互作用。经过文献计量学分析、系统文献回顾和专家和患者代表平等参与的德尔菲共识过程,现在发布了五项建议。首先,术语“Sjögren疾病”应该取代“Sjögren综合症”。其次,缩写“SjD”应该用作“Sjögren disease”的缩写。第三,对于Sjögren与第二种系统性自身免疫性疾病相关且符合分类标准的疾病,应使用描述词“相关”代替“继发性”。第四,Sjögren疾病在日常用语和临床诊断中是首选术语,不区分原发形式和相关形式。第五,建议在科学研究中区分原生和相关Sjögren,以定义同质人群。总之,共识赞同“Sjögren疾病”作为官方命名,以承认这种疾病的独特发病机制,并提高临床实践和研究的清晰度。
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引用次数: 0
Methotrexate does not improve knee OA 甲氨蝶呤不能改善膝关节OA
IF 32.7 1区 医学 Q1 RHEUMATOLOGY Pub Date : 2025-06-10 DOI: 10.1038/s41584-025-01274-1
Sarah Onuora
In the MESKO clinical trial, treatment with low-dose methotrexate did not improve pain or joint inflammation in individuals with inflammatory knee osteoarthritis.
在MESKO临床试验中,低剂量甲氨蝶呤治疗并没有改善炎症性膝骨关节炎患者的疼痛或关节炎症。
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引用次数: 0
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Nature Reviews Rheumatology
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