Inflammasomes are multiprotein complexes that play a crucial role in the innate immune response by detecting cellular stress and initiating inflammatory signaling through the release of cytokines. When inflammation is dysregulated, it can contribute significantly to the development of autoinflammatory diseases, a group of disorders characterized by inappropriate inflammation in the absence of infection or autoimmunity. This review examines the current understanding of inflammasome dysfunction in various autoinflammatory diseases, highlighting recent advances that connect genetic mutations and environmental triggers to the hyperactivation of inflammasomes. We focus on key inflammasomes, including NLRP1, NLRP3, NLRC4, and Pyrin, and their involvement in disorders such as Cryopyrin-Associated Periodic Syndromes and Familial Mediterranean Fever. Furthermore, we discuss the molecular mechanisms that lead to inflammasome dysregulation, such as gain-of-function mutations. We also review therapeutic approaches targeting these pathways, which show promise in alleviating disease symptoms and improving patient outcomes.
{"title":"Dysregulation of inflammasomes in autoinflammatory diseases","authors":"Cyrielle Hou, Zhuo Wang, Valentin Eichenberger, Fabio Martinon","doi":"10.1016/j.jbspin.2025.105903","DOIUrl":"10.1016/j.jbspin.2025.105903","url":null,"abstract":"<div><div>Inflammasomes are multiprotein complexes that play a crucial role in the innate immune response by detecting cellular stress and initiating inflammatory signaling through the release of cytokines. When inflammation is dysregulated, it can contribute significantly to the development of autoinflammatory diseases, a group of disorders characterized by inappropriate inflammation in the absence of infection or autoimmunity. This review examines the current understanding of inflammasome dysfunction in various autoinflammatory diseases, highlighting recent advances that connect genetic mutations and environmental triggers to the hyperactivation of inflammasomes. We focus on key inflammasomes, including NLRP1, NLRP3, NLRC4, and Pyrin, and their involvement in disorders such as Cryopyrin-Associated Periodic Syndromes and Familial Mediterranean Fever. Furthermore, we discuss the molecular mechanisms that lead to inflammasome dysregulation, such as gain-of-function mutations. We also review therapeutic approaches targeting these pathways, which show promise in alleviating disease symptoms and improving patient outcomes.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105903"},"PeriodicalIF":3.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-05DOI: 10.1016/j.jbspin.2025.105902
Mrinalini Dey , Elena Nikiphorou
Health disparities remain a critical challenge in rheumatological management, contributing to inequities in aspects such as disease outcomes, access to care, and treatment adherence. Evidence suggests that racial and ethnic minorities, as well as individuals from lower socioeconomic backgrounds, experience delayed and reduced access to specialist care, and lower utilisation of advanced therapies. Structural barriers, including limitations in insurance coverage and geographic disparities in rheumatology workforce distribution, further exacerbate these inequities. Additionally, differences in health literacy, treatment adherence, and cultural perceptions of disease significantly impact patient outcomes. Understanding the social determinants of health and integrating patient-centered approaches into rheumatology practice are essential for mitigating disparities and improving outcomes for underserved populations. This review synthesises the current evidence on the multiple aspects of health disparities in rheumatological management, identifies key gaps in research, and proposes strategies to enhance equitable healthcare delivery. Addressing these issues is imperative for achieving better disease control, enhancing quality of life, and reducing the overall burden of rheumatic diseases across diverse populations.
{"title":"Health equity and causes of disparities in rheumatological management","authors":"Mrinalini Dey , Elena Nikiphorou","doi":"10.1016/j.jbspin.2025.105902","DOIUrl":"10.1016/j.jbspin.2025.105902","url":null,"abstract":"<div><div>Health disparities remain a critical challenge in rheumatological management, contributing to inequities in aspects such as disease outcomes, access to care, and treatment adherence. Evidence suggests that racial and ethnic minorities, as well as individuals from lower socioeconomic backgrounds, experience delayed and reduced access to specialist care, and lower utilisation of advanced therapies. Structural barriers, including limitations in insurance coverage and geographic disparities in rheumatology workforce distribution, further exacerbate these inequities. Additionally, differences in health literacy, treatment adherence, and cultural perceptions of disease significantly impact patient outcomes. Understanding the social determinants of health and integrating patient-centered approaches into rheumatology practice are essential for mitigating disparities and improving outcomes for underserved populations. This review synthesises the current evidence on the multiple aspects of health disparities in rheumatological management, identifies key gaps in research, and proposes strategies to enhance equitable healthcare delivery. Addressing these issues is imperative for achieving better disease control, enhancing quality of life, and reducing the overall burden of rheumatic diseases across diverse populations.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105902"},"PeriodicalIF":3.8,"publicationDate":"2025-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143804892","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-04DOI: 10.1016/j.jbspin.2025.105900
Jacques Morel , Amélie Wetzman , Daniel Wendling , Martin Soubrier , Sylvie Hoang , Daniel Briançon , Olivier Roth , Philippe Goupille , Jacques-Eric Gottenberg , Xavier Mariette , Cédric Lukas , On behalf of the French Society of Rheumatology, the investigators participating in REGATE registry
Objective
Our study aimed to estimate the incidence and risk factors of cancer among rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ) and followed for five years in the French registry (REGATE).
Method
The REGATE registry is a French prospective cohort study investigating the safety of TCZ in RA (registration no: 910346). Data were collected using an e-CRF between 2011 and 2016 and with a questionnaire specifically distributed to participating centers that reported malignancies in REGATE. We mainly focused on solid cancers, hematological malignancies, and non-melanoma skin cancers (NMSC). To identify potential risk factors associated with cancer, we performed a univariate analysis and a multivariate analysis using Cox proportional hazards models.
Results
Our study included 1496 patients with RA who were treated with TCZ for a mean duration of 32.0 (±22.0) months and followed for an average of 47 (±15.2) months, resulting in a total exposure of 3990.9 patient-years (PY). Of these patients, 63 (4.2%) were diagnosed with a total of 75 cancers during the follow-up period (35 solid neoplasms, 11 hematological malignancies, 3 melanomas, and 26 NMSC). The overall incidence of cancer excluding NMSC was 7.5/1000 PY (exposure time). Our multivariate analysis revealed that high age (HR = 1.05 [1.02–1.08]), current smoker (HR = 2.65 [1.27–5.53]) and male 2.38 [1,18–4,80]) were independent risk factors for solid cancers. Age and active smoking were associated with higher risk of hematological malignancies.
Conclusion
We found no additional risk factors of cancer for RA patients under TCZ, beyond those already known in the general population.
{"title":"Risk of cancer in patients with rheumatoid arthritis under tocilizumab: Data from the French national registry REGATE","authors":"Jacques Morel , Amélie Wetzman , Daniel Wendling , Martin Soubrier , Sylvie Hoang , Daniel Briançon , Olivier Roth , Philippe Goupille , Jacques-Eric Gottenberg , Xavier Mariette , Cédric Lukas , On behalf of the French Society of Rheumatology, the investigators participating in REGATE registry","doi":"10.1016/j.jbspin.2025.105900","DOIUrl":"10.1016/j.jbspin.2025.105900","url":null,"abstract":"<div><h3>Objective</h3><div>Our study aimed to estimate the incidence and risk factors of cancer among rheumatoid arthritis (RA) patients treated with tocilizumab (TCZ) and followed for five years in the French registry (REGATE).</div></div><div><h3>Method</h3><div>The REGATE registry is a French prospective cohort study investigating the safety of TCZ in RA (registration n<sup>o</sup>: 910346). Data were collected using an e-CRF between 2011 and 2016 and with a questionnaire specifically distributed to participating centers that reported malignancies in REGATE. We mainly focused on solid cancers, hematological malignancies, and non-melanoma skin cancers (NMSC). To identify potential risk factors associated with cancer, we performed a univariate analysis and a multivariate analysis using Cox proportional hazards models.</div></div><div><h3>Results</h3><div>Our study included 1496 patients with RA who were treated with TCZ for a mean duration of 32.0 (±22.0) months and followed for an average of 47 (±15.2) months, resulting in a total exposure of 3990.9 patient-years (PY). Of these patients, 63 (4.2%) were diagnosed with a total of 75 cancers during the follow-up period (35 solid neoplasms, 11 hematological malignancies, 3 melanomas, and 26 NMSC). The overall incidence of cancer excluding NMSC was 7.5/1000 PY (exposure time). Our multivariate analysis revealed that high age (HR<!--> <!-->=<!--> <!-->1.05 [1.02–1.08]), current smoker (HR<!--> <!-->=<!--> <!-->2.65 [1.27–5.53]) and male 2.38 [1,18–4,80]) were independent risk factors for solid cancers. Age and active smoking were associated with higher risk of hematological malignancies.</div></div><div><h3>Conclusion</h3><div>We found no additional risk factors of cancer for RA patients under TCZ, beyond those already known in the general population.</div></div>","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 5","pages":"Article 105900"},"PeriodicalIF":3.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-04DOI: 10.1016/j.jbspin.2025.105901
Mustafa Kemal Demir , Zeynep Erdogan Iyigun
{"title":"Acute herpes zoster lumbar radiculitis","authors":"Mustafa Kemal Demir , Zeynep Erdogan Iyigun","doi":"10.1016/j.jbspin.2025.105901","DOIUrl":"10.1016/j.jbspin.2025.105901","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 4","pages":"Article 105901"},"PeriodicalIF":3.8,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143797208","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-02DOI: 10.1016/j.jbspin.2025.105898
Florence A Trémollieres, Anna Gosset
{"title":"Back to hormonal replacement therapy.","authors":"Florence A Trémollieres, Anna Gosset","doi":"10.1016/j.jbspin.2025.105898","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105898","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105898"},"PeriodicalIF":3.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789351","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-02DOI: 10.1016/j.jbspin.2025.105897
Tristan Pascart
{"title":"Imaging in the assessment of deposits in gout: From research to daily clinical implementation","authors":"Tristan Pascart","doi":"10.1016/j.jbspin.2025.105897","DOIUrl":"10.1016/j.jbspin.2025.105897","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105897"},"PeriodicalIF":3.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789352","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-04-02DOI: 10.1016/j.jbspin.2025.105899
Daniel Wendling, Frank Verhoeven, Clément Prati
{"title":"Muscle in axial spondyloarthritis: Culprit or victim?","authors":"Daniel Wendling, Frank Verhoeven, Clément Prati","doi":"10.1016/j.jbspin.2025.105899","DOIUrl":"10.1016/j.jbspin.2025.105899","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":"92 6","pages":"Article 105899"},"PeriodicalIF":3.8,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-03-25DOI: 10.1016/j.jbspin.2025.105894
M Nassafi, L Taihi, F A Houssiau
{"title":"Bilateral Diaphyseal Tibial Idiopathic Hyperostosis: A Rare Cause of Chronic Tibial Pain.","authors":"M Nassafi, L Taihi, F A Houssiau","doi":"10.1016/j.jbspin.2025.105894","DOIUrl":"https://doi.org/10.1016/j.jbspin.2025.105894","url":null,"abstract":"","PeriodicalId":54902,"journal":{"name":"Joint Bone Spine","volume":" ","pages":"105894"},"PeriodicalIF":3.8,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143733266","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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