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The vanishing touch: Unveiling the tuft erosion in scleroderma. 消失的触感揭开硬皮病簇状侵蚀的神秘面纱。
Pub Date : 2024-03-31 eCollection Date: 2024-03-01 DOI: 10.1515/rir-2024-0008
Hui Jiang, Yangzhong Zhou
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引用次数: 0
Clinical implications of seropositive and seronegative autoantibody status in rheumatoid arthritis patients: A comparative multicentre observational study. 类风湿性关节炎患者血清阳性和血清阴性自身抗体状态的临床意义:一项多中心观察比较研究。
Pub Date : 2024-03-31 eCollection Date: 2024-03-01 DOI: 10.1515/rir-2024-0007
Nevin Hammam, Passant N El-Husseiny, Suzan S Al-Adle, Nermeen Samy, Nora Y Elsaid, Dina F El-Essawi, Eman F Mohamed, Samar M Fawzy, Samah A El Bakry, Maha Nassr, Samah I Nasef, Hanan M El-Saadany, Shereen Elwan, Nada M Gamal, Abdelhfeez Moshrif, Osman Hammam, Rawhya R El Shereef, Faten Ismail, Samar Tharwat, Doaa Mosad Mosa, Mervat I Abd Elazeem, Enas A Abdelaleem, Tamer A Gheita

Background and objectives: Rheumatoid factor (RF) and anti-cyclic citrullinated protein (anti-CCP) have been used to improve the diagnosis and prognosis of rheumatoid arthritis (RA). However, their association with RA disease phenotypes, individually and in combination, is not well studied. The aim of the study was to compare patients' and disease characteristics, activity and severity in double seronegative (DNRA), single seropositive RF, single seropositive anti-CCP and double seropositive (DPRA) patients.

Methods: Adults subjects with RA from Egyptian College of Rheumatology (ECR) database who had RF and anti-CCP results available were included. Demographic, clinical features, disease activity score 28 (DAS28), Health Assessment Questionnaire (HAQ) and laboratory data were collected and compared among different RA groups.

Results: 5268 RA patients with mean age of 44.9±11.6 years, and 4477 (85%) were females. 2900 (55%) had DPRA, 892 (16.9%) had single positive RF, 597 (11.3%) had single positive anti-CCP while 879 (16.7%) had DNRA. Patients with DPRA had significantly high percentage of metabolic syndrome (19.3%, P < 0.001), and functional impairment using HAQ (P = 0.01). Older age (RRR [relative risk ratio]: 1.03, 95%CI: 1.0, 1.0, P = 0.029), greater DAS28 (RRR: 1.51, 95%CI: 1.2, 1.9, P < 0.001), higher steroid use (RRR: 2.4, 95%CI: 1.36, 4.25, P = 0.002) were at higher risk of DPRA while longer disease duration (RRR: 1.08, 95%CI: 1.01, 1.16, P = 0.017) and fibromyalgia syndrome (RRR: 2.54, 95%CI: 1.10, 5.88, P = 0.028) were associated with higher odds of single positive RF status.

Conclusion: Dual antibody-positive status has higher disease activity and severity, and higher chance of development of metabolic syndrome; highlighting the implicated role of inflammation, atherogenesis and cardiovascular disease risk in RA.

背景和目的:类风湿因子(RF)和抗环瓜氨酸蛋白(anti-CCP)已被用于改善类风湿性关节炎(RA)的诊断和预后。然而,对它们单独或联合使用与 RA 疾病表型的关系研究不多。本研究旨在比较双血清阴性(DNRA)、单血清阳性 RF、单血清阳性抗CCP 和双血清阳性(DPRA)患者的病情特征、活动性和严重程度:方法:纳入埃及风湿病学会(ECR)数据库中具有RF和抗CCP结果的成人RA患者。收集人口统计学、临床特征、疾病活动度评分 28(DAS28)、健康评估问卷(HAQ)和实验室数据,并对不同 RA 组别进行比较:结果:5268 名 RA 患者,平均年龄为(44.9±11.6)岁,其中 4477 名(85%)为女性。2900例(55%)为DPRA,892例(16.9%)为RF单项阳性,597例(11.3%)为抗CCP单项阳性,879例(16.7%)为DNRA。DPRA 患者患有代谢综合征(19.3%,P < 0.001)和 HAQ 功能障碍(P = 0.01)的比例明显较高。年龄越大(RRR [相对风险比]:1.03,95%CI:1.0,1.0,P = 0.029)、DAS28 越高(RRR:1.51,95%CI:1.2,1.9,P < 0.001)、使用类固醇越多(RRR:2.4,95%CI:1.36,4.25,P = 0.002)患 DPRA 的风险较高,而病程较长(RRR:1.08,95%CI:1.01,1.16,P = 0.017)和纤维肌痛综合征(RRR:2.54,95%CI:1.10,5.88,P = 0.028)与 RF 单项阳性状态的几率较高相关:结论:双重抗体阳性者的疾病活动度和严重程度较高,患代谢综合征的几率也较高;这突出表明了炎症、动脉粥样硬化和心血管疾病风险在RA中的作用。
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引用次数: 0
Chinese guideline for the diagnosis and treatment of Takayasu's arteritis (2023). 中国高安氏动脉炎诊断与治疗指南(2023 年)》。
Pub Date : 2024-03-31 eCollection Date: 2024-03-01 DOI: 10.1515/rir-2024-0002
Xinping Tian, Xiaofeng Zeng

Takayasu's arteritis (TAK) is a chronic granulomatous inflammatory disease that involves aorta and its primary branches. It is characterized by wall thickening, stenosis/obliteration or aneurysm formation of the involved arteries. In order to standardize the diagnosis and treatment of TAK in China, a clinical practice guideline with an evidence-based approach is developed under the leadership of National Clinical Medical Research Center for Dermatologic and Immunologic Diseases (NCRC-DID). Eleven recommendations for 11 clinical questions that are important to the diagnosis and treatment of TAK are developed based on the latest evidence and expert opinions combined with real clinical practice in China.

高安氏动脉炎(TAK)是一种累及主动脉及其主要分支的慢性肉芽肿性炎症性疾病。其特征是受累动脉的管壁增厚、狭窄/闭塞或动脉瘤形成。为了规范中国 TAK 的诊断和治疗,国家皮肤性病与免疫性疾病临床医学研究中心(NCRC-DID)牵头制定了循证医学临床实践指南。该指南根据最新证据和专家意见,结合中国的实际临床实践,针对TAK诊断和治疗中的11个重要临床问题提出了11条建议。
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引用次数: 0
What can patients tell us in Sjögren's syndrome? 对于斯约恩综合征,患者能告诉我们什么?
Pub Date : 2024-03-31 eCollection Date: 2024-03-01 DOI: 10.1515/rir-2024-0004
Joe Berry, Jessica Tarn, Dennis Lendrem, John Casement, Wan-Fai Ng

In Sjögren's Syndrome (SS), clinical heterogeneity and discordance between disease activity measures and patient experience are key obstacles to effective therapeutic development. Patient reported outcome measures (PROMs) are useful tools for understanding the unmet needs from the patients' perspective and therefore they are key for the development of patient centric healthcare systems. Initial concern about the subjectivity of PROMs has given way to methodological rigour and clear guidance for the development of PROMs. To date, several studies of patient stratification using PROMs have identified similar symptom-based subgroups. There is evidence to suggest that these subgroups may represent different disease endotypes with differing responses to therapeutic interventions. Stratified medicine approaches, alongside sensitive outcome measures, have the potential to improve our understanding of SS pathobiology and therapeutic development. The inclusion of PROMs is important for the success of such approaches. In this review we discuss the opportunities of using PROMs in understanding the pathogenesis of and therapeutic development for SS.

在斯琼格伦综合症(SS)中,临床异质性以及疾病活动测量和患者体验之间的不一致是有效开发疗法的主要障碍。患者报告结果测量(PROMs)是从患者角度了解未满足需求的有用工具,因此是发展以患者为中心的医疗保健系统的关键。最初人们对 PROMs 的主观性感到担忧,但现在,人们对 PROMs 的开发方法和明确指导有了严格的认识。迄今为止,一些使用 PROMs 对患者进行分层的研究已经确定了类似的基于症状的亚组。有证据表明,这些亚组可能代表不同的疾病内型,对治疗干预措施的反应也不尽相同。分层医学方法与敏感的结果测量相结合,有可能提高我们对 SS 病理生物学和治疗发展的认识。纳入 PROMs 对此类方法的成功非常重要。在本综述中,我们将讨论使用 PROMs 了解 SS 发病机制和治疗发展的机会。
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引用次数: 0
Lupus hands mimicking psoriatic arthritis. 狼疮手模仿银屑病关节炎。
Pub Date : 2023-12-19 eCollection Date: 2023-12-01 DOI: 10.2478/rir-2023-0031
Lidan Zhao, Fengchun Zhang

We report a case of a 68-year-old woman with chronic and severely destructive arthritis for 8 years with imaging features mimicking psoriatic arthritis (PsA) but serological evidence of systemic lupus erythematosus. Both the lupus panniculitis-like rash and the presence of interstitial lung disease were considered manifestations of systemic involvement of SLE.

我们报告了一例68岁女性患者的病例,她患有慢性严重破坏性关节炎8年,影像学特征类似银屑病关节炎(PsA),但血清学证据显示她患有系统性红斑狼疮。狼疮泛发性皮疹和间质性肺病都被认为是系统性红斑狼疮全身受累的表现。
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引用次数: 0
Advances and challenges in management of large vessel vasculitis. 大血管炎治疗的进展与挑战。
Pub Date : 2023-12-19 eCollection Date: 2023-12-01 DOI: 10.2478/rir-2023-0028
Cong-Qiu Chu

Glucocorticoids (GC) remains the mainstay for management of large vessel vasculitis (LVV). Recent introduction of interleukin-6 signaling blocker, tocilizumab has substantially changed the practice in management of patients with LVV, in particular, giant cell arteritis (GCA). Benefit of tocilizumab to patients with Takayasu arteritis (TAK) is supported by observational studies, but randomized clinical trials are lacking. Addition of tocilizumab enables reduction of the total amount of GC in patients with GCA, but GC burden remains high and to be further reduced. Ongoing studies aim at minimal use of GC or even GC-free. Tumor necrosis factor inhibitors appear to be beneficial to TAK despite their ineffectiveness to GCA. Randomized clinical trials are undergoing to target other inflammatory cytokines in both GCA and TAK. Janus kinase inhibitors alone or in combination with conventional disease modifying anti-rheumatic drugs showed promising results in treatment of TAK.

糖皮质激素(GC)仍是治疗大血管炎(LVV)的主要药物。最近白细胞介素-6信号传导阻断剂托西珠单抗的问世大大改变了大血管炎患者的治疗方法,尤其是巨细胞动脉炎(GCA)患者。观察性研究证实了托珠单抗对高安动脉炎(TAK)患者的益处,但缺乏随机临床试验。添加替西利珠单抗可减少 GCA 患者的 GC 总量,但 GC 负担仍然很高,有待进一步减少。正在进行的研究旨在尽量少用 GC,甚至不用 GC。肿瘤坏死因子抑制剂似乎对 TAK 有益,尽管对 GCA 无效。针对 GCA 和 TAK 的其他炎症细胞因子的随机临床试验正在进行中。Janus 激酶抑制剂单独使用或与传统的疾病调整抗风湿药物联合使用在治疗 TAK 方面显示出良好的效果。
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引用次数: 0
Role of ultrasound in guiding the biopsy site in eosinophilic fasciitis. 超声波在引导嗜酸性粒细胞筋膜炎活检部位中的作用。
Pub Date : 2023-12-19 eCollection Date: 2023-12-01 DOI: 10.2478/rir-2023-0032
Felice Galluccio, Angelo Cassisa, Marco Matucci-Cerinic
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引用次数: 0
Understanding the roles of the microbiome in autoimmune rheumatic diseases. 了解微生物组在自身免疫性风湿病中的作用。
Pub Date : 2023-12-19 eCollection Date: 2023-12-01 DOI: 10.2478/rir-2023-0027
Abhimanyu Amarnani, Gregg J Silverman

The gut microbiome represents a potential promising therapeutic target for autoimmune diseases. This review summarizes the current knowledge on the links between the gut microbiome and several autoimmune rheumatic diseases including rheumatoid arthritis (RA), systemic lupus erythematosus (SLE) spondyloarthropathies (SpA), Sjogren's syndrome (SS), and systemic sclerosis (SSc). Evidence from studies of RA and SLE patients suggests that alterations in the gut microbiome composition and function contribute to disease development and progression through increased gut permeability, with microbes and microbial metabolites driving an excessive systemic activation of the immune system. Also, there is growing evidence that gut dysbiosis and subsequent immune cell activation may contribute to disease pathogenesis in SpA and SS. For SSc, there are fewer, but these are still informative, reports on alterations in the gut microbiome. In general, the complex interplay between the microbiome and the immune system is still not fully understood. Here we discuss the current knowledge of the link between the gut microbiome and autoimmune rheumatic diseases, highlighting potentially fertile areas for future research and make considerations on the potential benefits of strategies that restore gut microbiome homeostasis.

肠道微生物组是治疗自身免疫性疾病的潜在靶点。本综述总结了目前有关肠道微生物组与几种自身免疫性风湿病之间联系的知识,包括类风湿性关节炎(RA)、系统性红斑狼疮(SLE)、脊柱关节病(SpA)、斯约格伦综合征(SS)和系统性硬化症(SSc)。对风湿性关节炎和系统性红斑狼疮患者的研究证据表明,肠道微生物组组成和功能的改变通过增加肠道的通透性来促进疾病的发生和发展,微生物和微生物代谢产物推动了免疫系统的过度全身性激活。此外,越来越多的证据表明,肠道菌群失调和随后的免疫细胞激活可能会导致 SpA 和 SS 的发病机制。对于 SSc,有关肠道微生物组改变的报道较少,但仍具有参考价值。总的来说,微生物组与免疫系统之间复杂的相互作用仍未被完全理解。在此,我们讨论了目前有关肠道微生物组与自身免疫性风湿病之间联系的知识,强调了未来研究的潜在肥沃领域,并对恢复肠道微生物组平衡的策略的潜在益处进行了思考。
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引用次数: 0
Correlations of baseline neutrophil-lymphocyte ratio with prognosis of patients with lupus nephritis: A single-center experience. 狼疮性肾炎患者基线中性粒细胞-淋巴细胞比值与预后的相关性:单中心经验。
Pub Date : 2023-12-19 eCollection Date: 2023-12-01 DOI: 10.2478/rir-2023-0029
Yi Chen, Xue Wu, Xiaomei Chen, Mengmeng Li, Cainan Luo, Yamei Shi, Jing Li, Lijun Wu

Objective: We aimed to evaluate the correlations among the neutrophil-to-lymphocyte ratio (NLR), lupus nephritis (LN) clinical characteristics, and renal prognosis of patients with LN.

Methods: We enrolled 122 patients who were diagnosed with LN at the Rheumatology Department of the People's Hospital, Xinjiang Uygur Autonomous Region from January 2013 to April 2022. We determined the occurrence of renal adverse events in patients with LN by reviewing medical records and follow-up data. Correlations were analyzed using the Spearman test, and the quartile method was applied to classify all of the 122 patients who had completed follow-up into low, medium, and high NLR groups. The Kaplan-Meier survival curve was used to conduct survival analysis, and Cox regression analyses were used to explore possible potential risk factors.

Results: The baseline NLR of patients with LN was positively correlated with C-reactive protein (CRP), serum creatinine, blood urea nitrogen, and systemic lupus erythematosus disease activity index scores (P < 0.05) and negatively correlated with estimated glomerular filtration rate (eGFR) and serum albumin (P < 0.05). Patients who completed follow-up were divided into three NLR groups based on their NLR values: 30 in the low (NLR ≤ 2.21), 62 in the medium (NLR > 2.21 and NLR ≤ 6.17), and 30 in the high NLR group (NLR > 6.17). The patient survival time before developing poor renal prognosis was significantly different among the three groups (P < 0.05). High NLR (hazard ratio [HR] = 3.453, 95% confidence interval [CI]: 1.260-9.464), CRP (HR = 1.009, 95% CI: 1.002-1.017), eGFR (HR = 0.979, 95% CI: 0.963-0.995), and 24-h proteinuria values (HR = 1.237, 95% CI: 1.025-1.491) as well as anti-double stranded DNA antibody positivity (HR = 3.056, 95% CI:1.069-8.736) were independent risk factors associated with a poor renal prognosis for patients with LN.

Conclusion: The baseline NLR in peripheral blood can be used as a reference index for evaluating renal function and disease activity in patients with LN, and a high NLR has predictive value for the prognosis of patients with LN.

目的我们旨在评估中性粒细胞与淋巴细胞比值(NLR)、狼疮性肾炎(LN)临床特征和LN患者肾脏预后之间的相关性:我们选取了2013年1月至2022年4月期间在新疆维吾尔自治区人民医院风湿免疫科确诊的122例LN患者。我们通过查阅病历和随访数据,确定了LN患者肾脏不良事件的发生情况。采用斯皮尔曼检验分析相关性,并采用四分位法将所有完成随访的122例患者分为低、中、高NLR组。采用 Kaplan-Meier 生存曲线进行生存分析,并采用 Cox 回归分析探讨可能的潜在风险因素:LN患者的基线NLR与C反应蛋白(CRP)、血清肌酐、血尿素氮和系统性红斑狼疮疾病活动指数评分呈正相关(P<0.05),与估计肾小球滤过率(eGFR)和血清白蛋白呈负相关(P<0.05)。根据患者的 NLR 值,将完成随访的患者分为三个 NLR 组:低 NLR 组(NLR ≤ 2.21)30 人,中 NLR 组(NLR > 2.21 和 NLR ≤ 6.17)62 人,高 NLR 组(NLR > 6.17)30 人。三组患者在肾脏预后不良前的存活时间有显著差异(P < 0.05)。高 NLR(危险比 [HR] = 3.453,95% 置信区间 [CI]:1.260-9.464)、CRP(HR = 1.009,95% CI:1.002-1.017)、eGFR(HR = 0.979,95% CI:0.963-0.995)和 24 小时蛋白尿值(HR = 1.237,95% CI:1.025-1.491)以及抗双链 DNA 抗体阳性(HR = 3.056,95% CI:1.069-8.736)是与 LN 患者肾脏预后不良相关的独立危险因素:结论:外周血中的基线 NLR 可作为评估 LN 患者肾功能和疾病活动性的参考指标,高 NLR 对 LN 患者的预后具有预测价值。
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引用次数: 0
Identification and functional prediction of long non-coding RNA and mRNA related to connective tissue disease-associated interstitial lung diseases. 与结缔组织病相关的间质性肺疾病相关的长非编码 RNA 和 mRNA 的鉴定和功能预测。
Pub Date : 2023-12-19 eCollection Date: 2023-12-01 DOI: 10.2478/rir-2023-0030
Fei Dai, Yixi He, Tianyi Lei, Yi Jiang, Quanbo Zhang, Yufeng Qing

Objective: Recently, the role of long non-coding RNA (lncRNA) in rheumatic immune diseases has attracted widespread attention. However, knowledge of lncRNA in connective tissue disease-associated interstitial lung disease (CTD-ILD) is limited. This study explored the expression profile and possible mechanisms of lncRNA and mRNA in peripheral blood mononuclear cells (PBMCs) of CTD-ILD patients, especially systemic sclerosis (SSc)-ILD and rheumatoid arthritis (RA)-ILD.

Methods: LncRNA microarray analysis identified 240 diferentially expressed lncRNAs and 218 diferentially expressed mRNA in the CTD-ILD group and the connective tissue disease without associated interstitial lung disease (CTD-NILD) group. The bioinformatics analysis of diferential genes has identified several important biological processes and signal pathways, including nuclear factor kappa B (NF-kappa B) signaling pathway, interleukin 17 (IL-17) signaling pathway, B cell receptor signaling pathway. Relative expression levels of five diferentially expressed lncRNAs and one mRNA in 120 SSc and RA patients with or without ILD were detected by quantitative reverse-transcription (PCR).

Results: The ENST00000604692 expression level was significantly higher in the ILD than the without interstitial lung disease (NILD) group; T311354 and arginase-1 were significantly higher in SSc than RA group.

Conclusion: These data suggest that the specific profile of lncRNA in PBMCs of CTD-ILD patients and the potential signal pathways related to the pathogenesis of CTD-ILD, which may provide newfound insights for the diagnosis and treatment of CTD-ILD patients.

目的:最近,长非编码 RNA(lncRNA)在风湿免疫疾病中的作用引起了广泛关注。然而,人们对结缔组织病相关性间质性肺病(CTD-ILD)中的lncRNA了解有限。本研究探讨了lncRNA和mRNA在CTD-ILD患者外周血单核细胞(PBMCs)中的表达谱和可能的机制,尤其是系统性硬化症(SSc)-ILD和类风湿性关节炎(RA)-ILD:LncRNA微阵列分析在CTD-ILD组和无伴有间质性肺病的结缔组织病(CTD-NILD)组中发现了240个差异表达的lncRNA和218个差异表达的mRNA。通过对差异基因进行生物信息学分析,发现了几个重要的生物学过程和信号通路,包括核因子卡巴B(NF-kappa B)信号通路、白细胞介素17(IL-17)信号通路、B细胞受体信号通路。通过定量反转录(PCR)方法检测了120名患有或不患有ILD的SSc和RA患者中5种不同表达的lncRNA和1种mRNA的相对表达水平:结果:ENST00000604692在ILD组的表达水平明显高于无间质性肺病(NILD)组;T311354和精氨酸酶-1在SSc组的表达水平明显高于RA组:这些数据表明,CTD-ILD患者PBMCs中lncRNA的特异性谱以及与CTD-ILD发病机制相关的潜在信号通路,可能为CTD-ILD患者的诊断和治疗提供新的发现。
{"title":"Identification and functional prediction of long non-coding RNA and mRNA related to connective tissue disease-associated interstitial lung diseases.","authors":"Fei Dai, Yixi He, Tianyi Lei, Yi Jiang, Quanbo Zhang, Yufeng Qing","doi":"10.2478/rir-2023-0030","DOIUrl":"https://doi.org/10.2478/rir-2023-0030","url":null,"abstract":"<p><strong>Objective: </strong>Recently, the role of long non-coding RNA (lncRNA) in rheumatic immune diseases has attracted widespread attention. However, knowledge of lncRNA in connective tissue disease-associated interstitial lung disease (CTD-ILD) is limited. This study explored the expression profile and possible mechanisms of lncRNA and mRNA in peripheral blood mononuclear cells (PBMCs) of CTD-ILD patients, especially systemic sclerosis (SSc)-ILD and rheumatoid arthritis (RA)-ILD.</p><p><strong>Methods: </strong>LncRNA microarray analysis identified 240 diferentially expressed lncRNAs and 218 diferentially expressed mRNA in the CTD-ILD group and the connective tissue disease without associated interstitial lung disease (CTD-NILD) group. The bioinformatics analysis of diferential genes has identified several important biological processes and signal pathways, including nuclear factor kappa B (NF-kappa B) signaling pathway, interleukin 17 (IL-17) signaling pathway, B cell receptor signaling pathway. Relative expression levels of five diferentially expressed lncRNAs and one mRNA in 120 SSc and RA patients with or without ILD were detected by quantitative reverse-transcription (PCR).</p><p><strong>Results: </strong>The <i>ENST00000604692</i> expression level was significantly higher in the ILD than the without interstitial lung disease (NILD) group; <i>T311354</i> and arginase-1 were significantly higher in SSc than RA group.</p><p><strong>Conclusion: </strong>These data suggest that the specific profile of lncRNA in PBMCs of CTD-ILD patients and the potential signal pathways related to the pathogenesis of CTD-ILD, which may provide newfound insights for the diagnosis and treatment of CTD-ILD patients.</p>","PeriodicalId":74736,"journal":{"name":"Rheumatology and immunology research","volume":"4 4","pages":"204-215"},"PeriodicalIF":0.0,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10729597/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138833427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Rheumatology and immunology research
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