OBJECTIVESystemic juvenile idiopathic arthritis (SJIA) is a chronic inflammatory disease characterized by systemic features and arthritis. Macrophage activation syndrome (MAS) is a severe complication of SJIA often involving the liver. MAS confined predominantly to the liver, causing severe hepatitis, has been increasingly recognized. When liver MAS is the primary manifestation, significant hepatic injury can occur, requiring differentiation from other forms of SJIA-related liver involvement, which may warrant distinct treatment approaches. This study examined liver pathology in SJIA-MAS patients and explored potential mechanisms.METHODSThis retrospective case series analyzed data from four SJIA-MAS patients who presented with liver dysfunction and underwent core liver biopsies at Cincinnati Children's Hospital Medical Center (2019-2024).RESULTSFour patients (age range 4 -15 years) had elevated transaminases, with one meeting MAS criteria and three diagnosed with subclinical MAS. Liver biopsies showed portal and sinusoidal inflammatory infiltrates of CD3+ CD8+ T cells and CD163+ macrophages, with extensive hepatocellular damage, including centrilobular parenchymal collapse, multifocal necrosis, and lymphocyte-mediated bile duct injury. One case revealed features of veno-occlusive disease (VOD), a novel finding. Elevated serum CXCL9 and rapid response to emapalumab (anti-IFNγ) in all patients suggested IFNγ-driven liver pathology.CONCLUSIONThis study underscores the critical roles of CD8+ T cells, macrophages, and IFNγ in SJIA-MAS hepatitis. Future research should explore whether serum biomarkers of IFNγ activity can differentiate SJIA-MAS from other liver pathologies, such as drug-induced liver injury (methotrexate or anakinra-induced) and hepatic steatosis, to guide tailored therapies.
目的全身性青少年特发性关节炎（SJIA）是一种以全身特征和关节炎为特征的慢性炎症性疾病。巨噬细胞活化综合征（MAS）是SJIA的严重并发症，常累及肝脏。MAS主要局限于肝脏，引起严重肝炎，已被越来越多地认识到。当肝脏MAS为主要表现时，可发生明显的肝损伤，需要与其他形式的sjia相关的肝脏受损伤区分开来，这可能需要不同的治疗方法。本研究检查了SJIA-MAS患者的肝脏病理，并探讨了可能的机制。方法：本回顾性病例系列分析了2019-2024年在辛辛那提儿童医院医学中心（Cincinnati Children Hospital Medical Center）接受核心肝活检的4例SJIA-MAS患者的数据。结果4例患者（年龄4 ~ 15岁）转氨酶升高，1例符合MAS标准，3例诊断为亚临床MAS。肝活检显示门静脉和窦静脉内CD3+ CD8+ T细胞和CD163+巨噬细胞炎症浸润，伴广泛肝细胞损伤，包括小叶中心实质塌陷、多灶性坏死和淋巴细胞介导的胆管损伤。1例显示静脉闭塞性疾病（VOD）的特征，这是一个新的发现。所有患者血清CXCL9升高和对emapalumab（抗ifn γ）的快速反应提示ifn γ驱动的肝脏病理。结论本研究强调CD8+ T细胞、巨噬细胞和IFNγ在SJIA-MAS肝炎中的关键作用。未来的研究应该探索IFNγ活性的血清生物标志物是否可以区分SJIA-MAS与其他肝脏病变，如药物性肝损伤（甲氨蝶呤或阿那金诱导）和肝脂肪变性，以指导定制治疗。
{"title":"Hepatic Manifestations in Systemic Juvenile Idiopathic Arthritis and Macrophage Activation Syndrome.","authors":"Esraa Eloseily,Ivanna Romankevych,Taskin Sabit,Lara Berklite,Sarangarajan Ranganathan,Paul Rosen,Michael Henrickson,Jennifer Huggins,Grant Schulert,Alexei Grom","doi":"10.3899/jrheum.2025-0699","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0699","url":null,"abstract":"OBJECTIVESystemic juvenile idiopathic arthritis (SJIA) is a chronic inflammatory disease characterized by systemic features and arthritis. Macrophage activation syndrome (MAS) is a severe complication of SJIA often involving the liver. MAS confined predominantly to the liver, causing severe hepatitis, has been increasingly recognized. When liver MAS is the primary manifestation, significant hepatic injury can occur, requiring differentiation from other forms of SJIA-related liver involvement, which may warrant distinct treatment approaches. This study examined liver pathology in SJIA-MAS patients and explored potential mechanisms.METHODSThis retrospective case series analyzed data from four SJIA-MAS patients who presented with liver dysfunction and underwent core liver biopsies at Cincinnati Children's Hospital Medical Center (2019-2024).RESULTSFour patients (age range 4 -15 years) had elevated transaminases, with one meeting MAS criteria and three diagnosed with subclinical MAS. Liver biopsies showed portal and sinusoidal inflammatory infiltrates of CD3+ CD8+ T cells and CD163+ macrophages, with extensive hepatocellular damage, including centrilobular parenchymal collapse, multifocal necrosis, and lymphocyte-mediated bile duct injury. One case revealed features of veno-occlusive disease (VOD), a novel finding. Elevated serum CXCL9 and rapid response to emapalumab (anti-IFNγ) in all patients suggested IFNγ-driven liver pathology.CONCLUSIONThis study underscores the critical roles of CD8+ T cells, macrophages, and IFNγ in SJIA-MAS hepatitis. Future research should explore whether serum biomarkers of IFNγ activity can differentiate SJIA-MAS from other liver pathologies, such as drug-induced liver injury (methotrexate or anakinra-induced) and hepatic steatosis, to guide tailored therapies.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760026","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.3899/jrheum.2025-0631
Kathryn R K Benson,Alissa Becerril,Joonsuk Park,Laura Plantinga,Jinoos Yazdany,Maria Dall'Era,Patricia P Katz
OBJECTIVESystemic Lupus Erythematosus (SLE) disproportionately affects racial and ethnic minority populations in the US. Though discrimination is linked to worse SLE outcomes, the mechanisms of this association remain underexplored. Among a multiracial, multiethnic cohort with SLE, we explored relationships between discrimination and patient-reported outcomes (PROs) and if mental health affects these relationships.METHODSWe analyzed data from the California Lupus Epidemiology Study, comprised of Asian (31%), Black (10%), Hispanic (24%), and White (34%) participants (N=245). Participants completed the Everyday Discrimination Scale and the following PROs: Systemic Lupus Activity Questionnaire (SLAQ), PROMIS Pain Interference and Fatigue, PHQ8 (depression), and GAD7 (anxiety). Multivariable linear regressions modeled associations between discrimination and PROs. Mediation analyses evaluated if depression or anxiety mediated associations between discrimination and SLAQ, pain, or fatigue.RESULTSEveryday discrimination scores were highest among Black and Asian participants. Among multivariable models, higher discrimination was associated with worse SLAQ (β=0.25, P < 0.001), PHQ8 (β=0.21, P < 0.001), GAD7 (β=0.27, P < 0.001), pain (β=0.24, P=0.01), and fatigue (β=0.3, P=0.007). By racial/ethnic subgroups, discrimination was significantly associated with higher SLAQ among Black and Asian participants. Discrimination was no longer significantly associated with SLAQ, pain, or fatigue after adjusting for PHQ8 or GAD7.CONCLUSIONIn this diverse SLE cohort, discrimination was associated with greater patient-reported disease activity, pain, fatigue, depression, and anxiety. Mediation analyses suggest that mental health mediates the relationship between discrimination and PROs. These results highlight the impact of discrimination as a psychosocial stressor on disease outcome variables.
在美国，系统性红斑狼疮（SLE）不成比例地影响着种族和少数民族人群。尽管歧视与更糟糕的SLE结果有关，但这种关联的机制仍未得到充分探讨。在一个多种族、多民族的SLE患者队列中，我们探讨了歧视与患者报告结果（PROs）之间的关系，以及心理健康是否影响这些关系。方法我们分析来自加州狼疮流行病学研究的数据，包括亚洲（31%）、黑人（10%）、西班牙裔（24%）和白人（34%）参与者（N=245）。参与者完成了日常歧视量表和以下PROs：系统性狼疮活动问卷（SLAQ）， PROMIS疼痛干扰和疲劳，PHQ8（抑郁）和GAD7（焦虑）。多变量线性回归模拟了歧视与PROs之间的关系。中介分析评估了抑郁或焦虑是否介导了歧视与SLAQ、疼痛或疲劳之间的关联。结果黑人和亚裔参与者的日常歧视得分最高。在多变量模型中，高分辨力与较差的SLAQ （β=0.25, P < 0.001）、PHQ8 （β=0.21, P < 0.001）、GAD7 （β=0.27, P < 0.001）、疼痛（β=0.24， P=0.01）和疲劳（β=0.3， P=0.007）相关。在种族/民族亚组中，黑人和亚洲参与者的歧视与较高的SLAQ显著相关。在调整PHQ8或GAD7后，歧视不再与SLAQ、疼痛或疲劳显著相关。结论：在这个多样化的SLE队列中，歧视与更大的患者报告的疾病活动、疼痛、疲劳、抑郁和焦虑相关。中介分析表明，心理健康在歧视与职业倾向之间起中介作用。这些结果突出了歧视作为一种社会心理压力源对疾病结局变量的影响。
{"title":"The Impact of Everyday Discrimination on Systemic Lupus Erythematous Disease Activity and Mental Health Outcomes.","authors":"Kathryn R K Benson,Alissa Becerril,Joonsuk Park,Laura Plantinga,Jinoos Yazdany,Maria Dall'Era,Patricia P Katz","doi":"10.3899/jrheum.2025-0631","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0631","url":null,"abstract":"OBJECTIVESystemic Lupus Erythematosus (SLE) disproportionately affects racial and ethnic minority populations in the US. Though discrimination is linked to worse SLE outcomes, the mechanisms of this association remain underexplored. Among a multiracial, multiethnic cohort with SLE, we explored relationships between discrimination and patient-reported outcomes (PROs) and if mental health affects these relationships.METHODSWe analyzed data from the California Lupus Epidemiology Study, comprised of Asian (31%), Black (10%), Hispanic (24%), and White (34%) participants (N=245). Participants completed the Everyday Discrimination Scale and the following PROs: Systemic Lupus Activity Questionnaire (SLAQ), PROMIS Pain Interference and Fatigue, PHQ8 (depression), and GAD7 (anxiety). Multivariable linear regressions modeled associations between discrimination and PROs. Mediation analyses evaluated if depression or anxiety mediated associations between discrimination and SLAQ, pain, or fatigue.RESULTSEveryday discrimination scores were highest among Black and Asian participants. Among multivariable models, higher discrimination was associated with worse SLAQ (β=0.25, P < 0.001), PHQ8 (β=0.21, P < 0.001), GAD7 (β=0.27, P < 0.001), pain (β=0.24, P=0.01), and fatigue (β=0.3, P=0.007). By racial/ethnic subgroups, discrimination was significantly associated with higher SLAQ among Black and Asian participants. Discrimination was no longer significantly associated with SLAQ, pain, or fatigue after adjusting for PHQ8 or GAD7.CONCLUSIONIn this diverse SLE cohort, discrimination was associated with greater patient-reported disease activity, pain, fatigue, depression, and anxiety. Mediation analyses suggest that mental health mediates the relationship between discrimination and PROs. These results highlight the impact of discrimination as a psychosocial stressor on disease outcome variables.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"111 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.3899/jrheum.2025-1181
Ruby J Mckenna,Stephanie J W Shoop-Worrall
{"title":"Changes in Modern Care for Juvenile Idiopathic Arthritis: How Much Does This Affect Health-Related Quality of Life?","authors":"Ruby J Mckenna,Stephanie J W Shoop-Worrall","doi":"10.3899/jrheum.2025-1181","DOIUrl":"https://doi.org/10.3899/jrheum.2025-1181","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
OBJECTIVESystemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects approximately 15%-20% of patients during childhood at initial onset. For childhood-onset SLE (cSLE), clinical manifestations are not typical at early stages, thus cSLE classification criteria are lacking, which makes diagnoses difficult. To evaluate suitable classification criteria for these children, we conducted a multicenter cohort study to compare the practicability of EULAR/ACR-2019, SLICC-2012, and ACR-1997 Classification Criteria for SLE.METHODSPatients from three different regions participated, including children with cSLE (n=348), a children's control group (n=59), adults with SLE (n=80), and an adult control group (n=76). Sensitivity, specificity, and Area Under the Curve (AUC) values for EULAR/ACR-2019, SLICC-2012, and ACR-1997 Classification Criteria were calculated. Serial and parallel tests were conducted, and data when adjusting for EULAR/ACR-2019 classification criteria score thresholds, were compared.RESULTSIn our study, 348 cases with a firmly established clinical cSLE diagnosis (83.62% female) were collected. For children with SLE, ACR-1997 criteria showed the highest specificity (98.31%, 95% confidence interval (CI): 90.9%-100.0%), while SLICC-2012 criteria had the highest sensitivity (94.54%, 95% CI: 91.6%-96.7%). In comprehensive comparisons, EULAR/ACR-2019 criteria had the best AUC (0.944) and Youden Index (0.889) values. Parallel tests using SLICC-2012 or EULAR/ACR-2019 criteria for cSLE achieved the highest AUC (0.962) value and increased sensitivity to 99.14%. Finally, a EULAR/ACR-2019 score = 10 (cutoff for cSLE) generated the highest AUC value (0.953, 95% CI: 0.928-0.971).CONCLUSIONEULAR/ACR-2019 criteria were the most appropriate criteria for patients with cSLE. Moreover, in parallel tests using SLICC-2012 or EULAR/ACR-2019 criteria, diagnostic sensitivity was enhanced. Also, a total EULAR/ACR-2019 score ≥ 10 was appropriate for classifying cSLE. Our findings provide a basis for determining the most appropriate diagnostic strategy for children with SLE.
{"title":"Evaluating the Applicability of the EULAR/ACR-2019, SLICC-2012, and ACR-1997 Classification Criteria for Systemic Lupus Erythematosus in Children: a multicenter study.","authors":"Jingyi Qiao,Yanan Ma,Xinyue Zhang,Guohao Zhu,Yaoyao Shangguan,Yangqi Yin,Hong Chang,Jiakai Wang,Gang Luo,Sana Qureshi,Dahai Wang,Wenjie Zheng,Xiaoxue Ma","doi":"10.3899/jrheum.2025-0559","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0559","url":null,"abstract":"OBJECTIVESystemic lupus erythematosus (SLE) is a chronic autoimmune disease that affects approximately 15%-20% of patients during childhood at initial onset. For childhood-onset SLE (cSLE), clinical manifestations are not typical at early stages, thus cSLE classification criteria are lacking, which makes diagnoses difficult. To evaluate suitable classification criteria for these children, we conducted a multicenter cohort study to compare the practicability of EULAR/ACR-2019, SLICC-2012, and ACR-1997 Classification Criteria for SLE.METHODSPatients from three different regions participated, including children with cSLE (n=348), a children's control group (n=59), adults with SLE (n=80), and an adult control group (n=76). Sensitivity, specificity, and Area Under the Curve (AUC) values for EULAR/ACR-2019, SLICC-2012, and ACR-1997 Classification Criteria were calculated. Serial and parallel tests were conducted, and data when adjusting for EULAR/ACR-2019 classification criteria score thresholds, were compared.RESULTSIn our study, 348 cases with a firmly established clinical cSLE diagnosis (83.62% female) were collected. For children with SLE, ACR-1997 criteria showed the highest specificity (98.31%, 95% confidence interval (CI): 90.9%-100.0%), while SLICC-2012 criteria had the highest sensitivity (94.54%, 95% CI: 91.6%-96.7%). In comprehensive comparisons, EULAR/ACR-2019 criteria had the best AUC (0.944) and Youden Index (0.889) values. Parallel tests using SLICC-2012 or EULAR/ACR-2019 criteria for cSLE achieved the highest AUC (0.962) value and increased sensitivity to 99.14%. Finally, a EULAR/ACR-2019 score = 10 (cutoff for cSLE) generated the highest AUC value (0.953, 95% CI: 0.928-0.971).CONCLUSIONEULAR/ACR-2019 criteria were the most appropriate criteria for patients with cSLE. Moreover, in parallel tests using SLICC-2012 or EULAR/ACR-2019 criteria, diagnostic sensitivity was enhanced. Also, a total EULAR/ACR-2019 score ≥ 10 was appropriate for classifying cSLE. Our findings provide a basis for determining the most appropriate diagnostic strategy for children with SLE.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.3899/jrheum.2025-0127
Marisa Sit,Ryan H Mason,Alexander J Kaplan
Hydroxychloroquine is a pharmacological agent in the management of various rheumatological disorders, including systemic lupus erythematosus and rheumatoid arthritis. Its therapeutic effects are attributed to its immunomodulatory and antimicrobial properties, and it is widely used due to its efficacy, relatively low cost, and generally favorable safety profile. Despite its well-established clinical utility, chronic use of hydroxychloroquine is associated with serious ocular side effects. This review covers hydroxychloroquine's history, pharmacokinetics and ocular safety profile, with a focus on the risk, diagnosis and screening for ocular toxicity. Retinopathy, the most significant adverse ocular side effect, may lead to irreversible vision loss if not promptly detected.
{"title":"Hydroxychloroquine Ocular Toxicity - A Comprehensive Review.","authors":"Marisa Sit,Ryan H Mason,Alexander J Kaplan","doi":"10.3899/jrheum.2025-0127","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0127","url":null,"abstract":"Hydroxychloroquine is a pharmacological agent in the management of various rheumatological disorders, including systemic lupus erythematosus and rheumatoid arthritis. Its therapeutic effects are attributed to its immunomodulatory and antimicrobial properties, and it is widely used due to its efficacy, relatively low cost, and generally favorable safety profile. Despite its well-established clinical utility, chronic use of hydroxychloroquine is associated with serious ocular side effects. This review covers hydroxychloroquine's history, pharmacokinetics and ocular safety profile, with a focus on the risk, diagnosis and screening for ocular toxicity. Retinopathy, the most significant adverse ocular side effect, may lead to irreversible vision loss if not promptly detected.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.3899/jrheum.2025-1042
Arjun Mahajan,Maureen Whittelsey,Nikki Zangenah,Maria Vazquez-Machado,Jeffrey S Smith,Jeffrey A Sparks,Avery H LaChance
{"title":"Rituximab Versus Mycophenolate Mofetil for Infection Risk in Systemic Sclerosis.","authors":"Arjun Mahajan,Maureen Whittelsey,Nikki Zangenah,Maria Vazquez-Machado,Jeffrey S Smith,Jeffrey A Sparks,Avery H LaChance","doi":"10.3899/jrheum.2025-1042","DOIUrl":"https://doi.org/10.3899/jrheum.2025-1042","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"156 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.3899/jrheum.2025-0693
Samar Aboulenain,Sahil Koppikar,Heather McDonald-Blumer,Maria F Powell,Pooneh Akhavan,Alan Liang Zhou,Ahmed Omar,Shirley Lake
{"title":"Developing and Implementing an Entrustable Professional Activity for Musculoskeletal Ultrasound in an Adult Rheumatology Residency: A Pilot Study.","authors":"Samar Aboulenain,Sahil Koppikar,Heather McDonald-Blumer,Maria F Powell,Pooneh Akhavan,Alan Liang Zhou,Ahmed Omar,Shirley Lake","doi":"10.3899/jrheum.2025-0693","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0693","url":null,"abstract":"","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"35 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760027","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.3899/jrheum.2025-0830
Shike Xu,Jeffrey B Driban,Priya S Prakash,Timothy E McAlindon,Charles B Eaton,Bing Lu
OBJECTIVEDietary factors related to inflammation, obesity, and metabolism may contribute to OA development. This study examines the relationship between metabolomic signatures of dietary patterns and radiographic knee OA incidence.METHODSThis case-cohort study included 603 participants from the Osteoarthritis Initiative, comprising 237 incident radiographic knee OA cases and 366 non-cases during a 6-year followup. Plasma metabolomes were analyzed using liquid chromatography-tandem mass spectrometry. We averaged metabolite levels at baseline and year 1 as the exposure and identified incident cases with those who had a Kellgren and Lawrence grade ≥2 in follow-ups. We selected 46 metabolites significantly associated with major food groups based on previous studies. Principal component analysis identified four metabolomic signatures related to specific food groups. Weighted logistic regression was used to examine associations between metabolomic signature scores and knee OA incidence.RESULTSAmong the 603 participants, after adjusting for age, sex and other covariates the highest quartiles of two metabolomic signatures associated with healthy food groups were linked to a reduced OA risk compared to the lowest quartile [Odds ratio (95% CI): 0.69 (0.44, 1.08) and 0.61 (0.40, 0.92)]. However, after further adjustment for BMI, these associations weakened. The proportions of the associations mediated through BMI for these two signatures were 43.7% and 81.4%, respectively. The other signatures were null.CONCLUSIONMetabolomic signatures of healthy dietary patterns may be linked to a lower risk of radiographic knee OA, with BMI potentially playing an intermediary role. Further studies are needed to explore causality.
{"title":"Metabolomic Signatures of Dietary Patterns and Incident Radiographic Knee Osteoarthritis: A Case-Cohort Study from Osteoarthritis Initiative.","authors":"Shike Xu,Jeffrey B Driban,Priya S Prakash,Timothy E McAlindon,Charles B Eaton,Bing Lu","doi":"10.3899/jrheum.2025-0830","DOIUrl":"https://doi.org/10.3899/jrheum.2025-0830","url":null,"abstract":"OBJECTIVEDietary factors related to inflammation, obesity, and metabolism may contribute to OA development. This study examines the relationship between metabolomic signatures of dietary patterns and radiographic knee OA incidence.METHODSThis case-cohort study included 603 participants from the Osteoarthritis Initiative, comprising 237 incident radiographic knee OA cases and 366 non-cases during a 6-year followup. Plasma metabolomes were analyzed using liquid chromatography-tandem mass spectrometry. We averaged metabolite levels at baseline and year 1 as the exposure and identified incident cases with those who had a Kellgren and Lawrence grade ≥2 in follow-ups. We selected 46 metabolites significantly associated with major food groups based on previous studies. Principal component analysis identified four metabolomic signatures related to specific food groups. Weighted logistic regression was used to examine associations between metabolomic signature scores and knee OA incidence.RESULTSAmong the 603 participants, after adjusting for age, sex and other covariates the highest quartiles of two metabolomic signatures associated with healthy food groups were linked to a reduced OA risk compared to the lowest quartile [Odds ratio (95% CI): 0.69 (0.44, 1.08) and 0.61 (0.40, 0.92)]. However, after further adjustment for BMI, these associations weakened. The proportions of the associations mediated through BMI for these two signatures were 43.7% and 81.4%, respectively. The other signatures were null.CONCLUSIONMetabolomic signatures of healthy dietary patterns may be linked to a lower risk of radiographic knee OA, with BMI potentially playing an intermediary role. Further studies are needed to explore causality.","PeriodicalId":501812,"journal":{"name":"The Journal of Rheumatology","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145760022","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.3899/jrheum.2025-1216
Patrick H Dessein,Mpoti Seboka,Ahmed Solomon
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