Pub Date : 2026-03-01Epub Date: 2026-01-29DOI: 10.1016/j.autrev.2026.103991
Martin Michaud , Yvan Jamilloux , Clément Delmas , Olivier Lairez , Hélène Coulier , Eric Bruguière , Grégory Pugnet
Idiopathic acute pericarditis is the most frequent form of acute pericarditis in Western countries. Although the short-term course of an uncomplicated first episode is often benign, a substantial proportion of patients progress to complicated forms with recurrences, incessant disease, or chronic constriction, leading to impaired quality of life and challenging management. In 2025, updated American and European guidelines for the diagnosis and management of pericarditis were issued, refining diagnostic criteria—particularly the role of C-reactive protein and multimodality imaging—and integrating targeted therapies such as interleukin-1 (IL-1) inhibitors. A structured assessment of risk factors for complications helps identify patients who require closer monitoring or hospitalization. Initial treatment combines non-steroidal anti-inflammatory drugs or aspirin and colchicine; in case of intolerance or resistance, second-line options include systemic corticosteroids or pharmacological blockade of IL-1. While the long-term prognosis of acute idiopathic pericarditis is generally good in terms of survival and low rates of constrictive pericarditis, recurrent and incessant forms are associated with significant morbidity. Individualized, risk-adapted management and prolonged follow-up are therefore recommended. This review summarizes contemporary data on the pathophysiology, diagnosis, management, and outcomes of idiopathic pericarditis, with a focus on autoinflammatory mechanisms and IL-1–targeted therapies.
{"title":"Idiopathic pericarditis in 2025: Advances in diagnosis and therapeutic strategies","authors":"Martin Michaud , Yvan Jamilloux , Clément Delmas , Olivier Lairez , Hélène Coulier , Eric Bruguière , Grégory Pugnet","doi":"10.1016/j.autrev.2026.103991","DOIUrl":"10.1016/j.autrev.2026.103991","url":null,"abstract":"<div><div>Idiopathic acute pericarditis is the most frequent form of acute pericarditis in Western countries. Although the short-term course of an uncomplicated first episode is often benign, a substantial proportion of patients progress to complicated forms with recurrences, incessant disease, or chronic constriction, leading to impaired quality of life and challenging management. In 2025, updated American and European guidelines for the diagnosis and management of pericarditis were issued, refining diagnostic criteria—particularly the role of C-reactive protein and multimodality imaging—and integrating targeted therapies such as interleukin-1 (IL-1) inhibitors. A structured assessment of risk factors for complications helps identify patients who require closer monitoring or hospitalization. Initial treatment combines non-steroidal anti-inflammatory drugs or aspirin and colchicine; in case of intolerance or resistance, second-line options include systemic corticosteroids or pharmacological blockade of IL-1. While the long-term prognosis of acute idiopathic pericarditis is generally good in terms of survival and low rates of constrictive pericarditis, recurrent and incessant forms are associated with significant morbidity. Individualized, risk-adapted management and prolonged follow-up are therefore recommended. This review summarizes contemporary data on the pathophysiology, diagnosis, management, and outcomes of idiopathic pericarditis, with a focus on autoinflammatory mechanisms and IL-1–targeted therapies.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 103991"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146096773","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-21DOI: 10.1016/j.autrev.2026.104009
Arriana Gkouvi , Nektarios-Marios Liapis , Efterpi Zafiriou , Dimitrios P. Bogdanos , Christina G. Katsiari , Theodora Simopoulou
Introduction
Patients with systemic sclerosis (SSc) or morphea increasingly inquire about cosmetic procedures, as these conditions often result in disfiguring cutaneous manifestations such as microstomia, thin lips, sclerotic plaques or skin atrophy. Traditionally, rheumatologists prioritize immunosuppression and disease control but often fail to address aesthetic concerns. Among available interventions, hyaluronic acid (HA) fillers offer a minimally invasive approach, yet there is not enough information regarding efficacy and safety in this population.
Objective
This systematic review aims to discuss current evidence regarding the use of HA fillers in patients with SSc or morphea.
Methods
A literature search was conducted in PubMed, CENTRAL and clinicaltrials.gov from inception until January 2025. Two independent reviewers examined the studies and extracted data. Data regarding the number of patients, disease type, HA filler particulars, technique, additional treatments, immunosuppression, patient reported or other outcomes and follow-up were extracted.
Results
Nineteen studies met the inclusion criteria, consisting of 8 case reports, 7 case series and 4 prospective interventional studies (including one controlled study). Most common areas were the forehead, chin and perioral region. Some studies used adjuvant treatments such as Botox or Platelet-Rich Plasma (PRP). HA fillers were consistently associated with patient satisfaction and good cosmetic results. In patients with SSc, mouth opening improved and microstomia was alleviated. However, one controlled study reported no significant improvement in mouth opening compared to autologous fat grafting. Inactive morphea lesions appeared to be more responsive compared to inflammatory ones. Adverse events were mild with no reports of disease flare.
Conclusion
HA fillers appear to be a safe and minimally invasive procedure for addressing both functional and aesthetic concerns of patients with SSc or morphea. Further randomized controlled trials are needed to clarify indications, durability and long-term safety.
{"title":"Hyaluronic acid fillers in systemic sclerosis and localized scleroderma: A systematic review","authors":"Arriana Gkouvi , Nektarios-Marios Liapis , Efterpi Zafiriou , Dimitrios P. Bogdanos , Christina G. Katsiari , Theodora Simopoulou","doi":"10.1016/j.autrev.2026.104009","DOIUrl":"10.1016/j.autrev.2026.104009","url":null,"abstract":"<div><h3>Introduction</h3><div>Patients with systemic sclerosis (SSc) or morphea increasingly inquire about cosmetic procedures, as these conditions often result in disfiguring cutaneous manifestations such as microstomia, thin lips, sclerotic plaques or skin atrophy. Traditionally, rheumatologists prioritize immunosuppression and disease control but often fail to address aesthetic concerns. Among available interventions, hyaluronic acid (HA) fillers offer a minimally invasive approach, yet there is not enough information regarding efficacy and safety in this population.</div></div><div><h3>Objective</h3><div>This systematic review aims to discuss current evidence regarding the use of HA fillers in patients with SSc or morphea.</div></div><div><h3>Methods</h3><div>A literature search was conducted in PubMed, CENTRAL and <span><span>clinicaltrials.gov</span><svg><path></path></svg></span> from inception until January 2025. Two independent reviewers examined the studies and extracted data. Data regarding the number of patients, disease type, HA filler particulars, technique, additional treatments, immunosuppression, patient reported or other outcomes and follow-up were extracted.</div></div><div><h3>Results</h3><div>Nineteen studies met the inclusion criteria, consisting of 8 case reports, 7 case series and 4 prospective interventional studies (including one controlled study). Most common areas were the forehead, chin and perioral region. Some studies used adjuvant treatments such as Botox or Platelet-Rich Plasma (PRP). HA fillers were consistently associated with patient satisfaction and good cosmetic results. In patients with SSc, mouth opening improved and microstomia was alleviated. However, one controlled study reported no significant improvement in mouth opening compared to autologous fat grafting. Inactive morphea lesions appeared to be more responsive compared to inflammatory ones. Adverse events were mild with no reports of disease flare.</div></div><div><h3>Conclusion</h3><div>HA fillers appear to be a safe and minimally invasive procedure for addressing both functional and aesthetic concerns of patients with SSc or morphea. Further randomized controlled trials are needed to clarify indications, durability and long-term safety.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104009"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147275474","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-08DOI: 10.1016/j.autrev.2026.104004
Miao Wang , Ke Wan , Han Shu , Xue Yang , Tongsheng Zhou , Qingqing Xia , Ying Chen , Lu Wang , Jun Li , Xiao-Feng Li
Rheumatoid arthritis (RA) is a chronic autoimmune disease where glycolytic metabolism plays a crucial role in its pathogenesis. This paper delves into the characteristics, key roles, and potential therapeutic applications of glycolytic metabolism in RA. In the synovial tissues and immune cells of RA patients, glycolytic metabolism is frequently observed to be enhanced, with key enzymes such as HK2, PFK-1/PFKFB3, and PKM2 showing abnormal expression and activation. Lactate, the end product of glycolysis, is increasingly recognized as an active signaling molecule that may contribute to the maintenance of inflammation and tissue destruction through multiple proposed mechanisms. Abnormal glycolytic metabolism in immune cells (macrophages, T cells, B cells, DCs) and synoviocytes (fibroblast-like synoviocytes, osteoclasts) respectively promote inflammatory responses and joint damage. Intervention strategies targeting glycolytic metabolism, such as the use of inhibitors for HK, PKM2, LDH, and PFK-1, have been proposed. However, numerous unresolved issues remain, necessitating further basic research to clarify the regulatory mechanisms and intercellular interactions of glycolytic metabolism, as well as in-depth studies on the clinical application value of related biomarkers.
{"title":"Regulatory mechanisms and targeted therapeutic strategies of glycolytic metabolism in rheumatoid arthritis","authors":"Miao Wang , Ke Wan , Han Shu , Xue Yang , Tongsheng Zhou , Qingqing Xia , Ying Chen , Lu Wang , Jun Li , Xiao-Feng Li","doi":"10.1016/j.autrev.2026.104004","DOIUrl":"10.1016/j.autrev.2026.104004","url":null,"abstract":"<div><div>Rheumatoid arthritis (RA) is a chronic autoimmune disease where glycolytic metabolism plays a crucial role in its pathogenesis. This paper delves into the characteristics, key roles, and potential therapeutic applications of glycolytic metabolism in RA. In the synovial tissues and immune cells of RA patients, glycolytic metabolism is frequently observed to be enhanced, with key enzymes such as HK2, PFK-1/PFKFB3, and PKM2 showing abnormal expression and activation. Lactate, the end product of glycolysis, is increasingly recognized as an active signaling molecule that may contribute to the maintenance of inflammation and tissue destruction through multiple proposed mechanisms. Abnormal glycolytic metabolism in immune cells (macrophages, T cells, B cells, DCs) and synoviocytes (fibroblast-like synoviocytes, osteoclasts) respectively promote inflammatory responses and joint damage. Intervention strategies targeting glycolytic metabolism, such as the use of inhibitors for HK, PKM2, LDH, and PFK-1, have been proposed. However, numerous unresolved issues remain, necessitating further basic research to clarify the regulatory mechanisms and intercellular interactions of glycolytic metabolism, as well as in-depth studies on the clinical application value of related biomarkers.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104004"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155787","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-05DOI: 10.1016/j.autrev.2026.104005
Sarah Turner , Eve Roberts , Natalie Hall , Christian M. Hedrich
Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease most commonly affecting children and young people. CNO can cause bone pain, hyperostosis and fractures, thereby significantly impacting on patients' wellbeing. The molecular pathophysiology of CNO is characterized by NLRP3 inflammasome activation and a pronounced imbalance between pro- and anti-inflammatory cytokines. In the absence of clinical trials, treatment of CNO remains empiric and is based on personal experience and published case series. This project systematically reviewed the available literature in pediatric CNO following ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ (PRISMA) guidance accessing Medline, Embase, NCBI PubMed, Cochrane Library Clinical Trials, ClinicalTrials.gov, and WHO ICTRP. Nonsteroidal anti-inflammatory drugs are usually used as first-line treatment. They facilitate pain control and induce early remission in some patients but also associate with later flares. Conventional disease modifying antirheumatic drugs (DMARDs) have been used with mixed success and may be helpful in patients with associated arthritis, skin inflammation, and/or inflammatory bowel disease. Biologic DMARDs, namely TNF inhibitors, are effective for the treatment of bone and associated skin and/or bowel disease. Bisphosphonates induce rapid remission in most patients but may associate with higher relapse rates when compared to TNF inhibitors. The longstanding absence of diagnostic and, until recently, classification criteria as well as defined study endpoints, the small sample size and variable therapeutic approaches challenge interpretation of studies and comparisons between treatments. Prospective randomised controlled trials are urgently needed to improve the evidence base, resulting in approval of treatments for CNO.
{"title":"Treatment of pediatric chronic nonbacterial osteomyelitis – a systematic review","authors":"Sarah Turner , Eve Roberts , Natalie Hall , Christian M. Hedrich","doi":"10.1016/j.autrev.2026.104005","DOIUrl":"10.1016/j.autrev.2026.104005","url":null,"abstract":"<div><div>Chronic nonbacterial osteomyelitis (CNO) is an autoinflammatory bone disease most commonly affecting children and young people. CNO can cause bone pain, hyperostosis and fractures, thereby significantly impacting on patients' wellbeing. The molecular pathophysiology of CNO is characterized by NLRP3 inflammasome activation and a pronounced imbalance between pro- and anti-inflammatory cytokines. In the absence of clinical trials, treatment of CNO remains empiric and is based on personal experience and published case series. This project systematically reviewed the available literature in pediatric CNO following ‘Preferred Reporting Items for Systematic Reviews and Meta-Analyses’ (PRISMA) guidance accessing <em>Medline</em>, <em>Embase</em>, <em>NCBI PubMed</em>, <em>Cochrane Library Clinical Trials</em>, <span><span><em>ClinicalTrials.gov</em></span><svg><path></path></svg></span>, and <em>WHO ICTRP</em>. Nonsteroidal anti-inflammatory drugs are usually used as first-line treatment. They facilitate pain control and induce early remission in some patients but also associate with later flares. Conventional disease modifying antirheumatic drugs (DMARDs) have been used with mixed success and may be helpful in patients with associated arthritis, skin inflammation, and/or inflammatory bowel disease. Biologic DMARDs, namely TNF inhibitors, are effective for the treatment of bone and associated skin and/or bowel disease. Bisphosphonates induce rapid remission in most patients but may associate with higher relapse rates when compared to TNF inhibitors. The longstanding absence of diagnostic and, until recently, classification criteria as well as defined study endpoints, the small sample size and variable therapeutic approaches challenge interpretation of studies and comparisons between treatments. Prospective randomised controlled trials are urgently needed to improve the evidence base, resulting in approval of treatments for CNO.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104005"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146137048","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-23DOI: 10.1016/j.autrev.2026.104010
Corrado Campochiaro , Nancy Maltez , Yossra Suliman , Alessia Alunno , Begonya Alcacer-Pitarch , Yannick Allanore , Murray Baron , Lorinda Chung , Francesco Del Galdo , Christopher P. Denton , Oliver Distler , Daniel Furst , Ilaria Galetti , Dilia Giuggioli , Dinesh Khanna , Thomas Krieg , Pia Moinzadeh , Masataka Kuwana , Marco Matucci-Cerinic , Janet Pope , Michael Hughes
Background
Digital ulcers (DUs) are among the most painful and functionally disabling complications of systemic sclerosis (SSc), affecting up to 50% of patients. Despite their clinical relevance, interventional studies on DUs are limited and vary widely in design, definitions, and outcome reporting, hindering comparability and the development of standardized treatment approaches.
Objectives
This initiative, led by an international expert group under the World Scleroderma Foundation (WSF), aims to establish points to consider for the standardized reporting of DUs in interventional studies, improving study quality, interpretability, and clinical relevance.
Methods
A steering committee of SSc experts developed these recommendations based on three systematic literature reviews on local, surgical, and systemic treatments for SSc-DUs. Consensus was achieved through iterative discussion among committee members, without external funding or third-party influence.
Results
Seven domains were identified as essential for standardization: (1) a uniform definition and classification of DUs; (2) consistent inclusion and exclusion criteria; (3) standardized primary and secondary outcome measures, including clinical and patient-reported outcomes; (4) detailed reporting of background and concomitant therapies; (5) harmonized local wound care protocols; (6) predefined timing and frequency of assessments; and (7) consideration of seasonal and environmental influences.
Conclusion
Adopting these standardized reporting principles in future DU trials will enhance the quality and comparability of data, support more robust meta-analyses, and facilitate the development of effective, patient-centered treatment strategies for SSc-related DUs.
{"title":"Points to consider for reporting digital ulcers in systemic sclerosis interventional studies: An initiative from the world Scleroderma Foundation digital ulcer ad hoc committee","authors":"Corrado Campochiaro , Nancy Maltez , Yossra Suliman , Alessia Alunno , Begonya Alcacer-Pitarch , Yannick Allanore , Murray Baron , Lorinda Chung , Francesco Del Galdo , Christopher P. Denton , Oliver Distler , Daniel Furst , Ilaria Galetti , Dilia Giuggioli , Dinesh Khanna , Thomas Krieg , Pia Moinzadeh , Masataka Kuwana , Marco Matucci-Cerinic , Janet Pope , Michael Hughes","doi":"10.1016/j.autrev.2026.104010","DOIUrl":"10.1016/j.autrev.2026.104010","url":null,"abstract":"<div><h3>Background</h3><div>Digital ulcers (DUs) are among the most painful and functionally disabling complications of systemic sclerosis (SSc), affecting up to 50% of patients. Despite their clinical relevance, interventional studies on DUs are limited and vary widely in design, definitions, and outcome reporting, hindering comparability and the development of standardized treatment approaches.</div></div><div><h3>Objectives</h3><div>This initiative, led by an international expert group under the World Scleroderma Foundation (WSF), aims to establish points to consider for the standardized reporting of DUs in interventional studies, improving study quality, interpretability, and clinical relevance.</div></div><div><h3>Methods</h3><div>A steering committee of SSc experts developed these recommendations based on three systematic literature reviews on local, surgical, and systemic treatments for SSc-DUs. Consensus was achieved through iterative discussion among committee members, without external funding or third-party influence.</div></div><div><h3>Results</h3><div>Seven domains were identified as essential for standardization: (1) a uniform definition and classification of DUs; (2) consistent inclusion and exclusion criteria; (3) standardized primary and secondary outcome measures, including clinical and patient-reported outcomes; (4) detailed reporting of background and concomitant therapies; (5) harmonized local wound care protocols; (6) predefined timing and frequency of assessments; and (7) consideration of seasonal and environmental influences.</div></div><div><h3>Conclusion</h3><div>Adopting these standardized reporting principles in future DU trials will enhance the quality and comparability of data, support more robust meta-analyses, and facilitate the development of effective, patient-centered treatment strategies for SSc-related DUs.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104010"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147301400","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-11DOI: 10.1016/j.autrev.2026.104007
Jia Shi , Yiyun Pang , Li Zhang , Chanyuan Wu , Qian Wang , Mengtao Li , Shuang Zhou
{"title":"A SMURF2 p.T183M variant linking four autoimmune diseases through a fibrosis-prone immune endotype","authors":"Jia Shi , Yiyun Pang , Li Zhang , Chanyuan Wu , Qian Wang , Mengtao Li , Shuang Zhou","doi":"10.1016/j.autrev.2026.104007","DOIUrl":"10.1016/j.autrev.2026.104007","url":null,"abstract":"","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104007"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146186875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-01-31DOI: 10.1016/j.autrev.2026.103990
Ole Petter Rekvig , George C. Tsokos
Systemic lupus erythematosus (SLE) presents with diverse clinical manifestations originating from multiple contributing factors employing a complex array of pathogenetic pathways. Understanding the origin of the disease is stifled by the assumption that a set of classification criteria represent one disease. Efforts to continuously refine the SLE classification criteria over the last 50 years have been based on the assumption that they will solve core aspects of SLE. Yet, this optimism has failed to deliver, because it is not possible to conquer a complex disease through criteria which are arbitrarily selected, but not supported by causal mechanisms. We propose to reconsider the value of SLE classification criteria and contemplate the development of diagnostic criteria directed by causality to bolster research and treatment efforts. This communication proposes that SLE diagnostic criteria should replace SLE classification criteria, at which point SLE will be studied within the context of causality. Such an accomplishment will optimize SLE research and the care of patients with SLE.
{"title":"Causation-based SLE diagnostic criteria should replace advance-repressing SLE classification criteria","authors":"Ole Petter Rekvig , George C. Tsokos","doi":"10.1016/j.autrev.2026.103990","DOIUrl":"10.1016/j.autrev.2026.103990","url":null,"abstract":"<div><div>Systemic lupus erythematosus (SLE) presents with diverse clinical manifestations originating from multiple contributing factors employing a complex array of pathogenetic pathways. Understanding the origin of the disease is stifled by the assumption that a set of classification criteria represent one disease. Efforts to continuously refine the SLE classification criteria over the last 50 years have been based on the assumption that they will solve core aspects of SLE. Yet, this optimism has failed to deliver, because it is not possible to conquer a complex disease through criteria which are arbitrarily selected, but not supported by causal mechanisms. We propose to reconsider the value of SLE classification criteria and contemplate the development of diagnostic criteria directed by causality to bolster research and treatment efforts. This communication proposes that SLE diagnostic criteria should replace SLE classification criteria, at which point SLE will be studied within the context of causality. Such an accomplishment will optimize SLE research and the care of patients with SLE.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 103990"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146103535","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-08DOI: 10.1016/j.autrev.2026.104001
Antonio Daniel Corlatescu , Horia Petre Costin , Gabriel González-Escamilla , Sergiu Groppa , Vinzenz Fleischer
The choroid plexus (CP), one key regulator of cerebrospinal fluid (CSF) production and immune surveillance at the blood–CSF barrier, has recently emerged as a relevant structure in multiple sclerosis (MS) pathophysiology. This review synthesizes current evidence highlighting CP enlargement as measured with magnetic resonance imaging (MRI) as a potential biomarker of neuroinflammation and neurodegeneration in MS. We first outline the basic immunological roles of the CP, emphasizing its function as a dynamic interface facilitating immune cell trafficking and cytokine production within the CNS. Advances in MRI and PET (positron emission tomography) imaging have enabled the quantification of CP volume, revealing enlargement across different MS stages, including radiologically isolated syndrome and pediatric MS. CP volume correlates with lesion load, chronic lesion expansion, microglial activation, and inflammatory CSF profiles, suggesting its responsiveness to neuroinflammatory activity. Notably, CP enlargement is also associated with neurodegenerative processes, including gray matter atrophy, cognitive decline, and disability progression, indicating its potential role also as a surrogate marker of MS-related neurodegeneration. However, methodological variability, confounding factors and a lack of longitudinal standardization challenge the interpretation of CP metrics. We highlight the need for multimodal approaches to unravel the temporal and mechanistic significance of CP enlargement. Future research should also explore CP-targeted interventions and their relevance for MS progression. Overall, CP imaging, in particular its enlargement, offers a novel, biologically meaningful perspective into MS pathogenesis, bridging inflammatory and degenerative pathways, and holds promise for improved disease monitoring.
{"title":"Imaging the hidden player: Choroid plexus enlargement in multiple sclerosis","authors":"Antonio Daniel Corlatescu , Horia Petre Costin , Gabriel González-Escamilla , Sergiu Groppa , Vinzenz Fleischer","doi":"10.1016/j.autrev.2026.104001","DOIUrl":"10.1016/j.autrev.2026.104001","url":null,"abstract":"<div><div>The choroid plexus (CP), one key regulator of cerebrospinal fluid (CSF) production and immune surveillance at the blood–CSF barrier, has recently emerged as a relevant structure in multiple sclerosis (MS) pathophysiology. This review synthesizes current evidence highlighting CP enlargement as measured with magnetic resonance imaging (MRI) as a potential biomarker of neuroinflammation and neurodegeneration in MS. We first outline the basic immunological roles of the CP, emphasizing its function as a dynamic interface facilitating immune cell trafficking and cytokine production within the CNS. Advances in MRI and PET (positron emission tomography) imaging have enabled the quantification of CP volume, revealing enlargement across different MS stages, including radiologically isolated syndrome and pediatric MS. CP volume correlates with lesion load, chronic lesion expansion, microglial activation, and inflammatory CSF profiles, suggesting its responsiveness to neuroinflammatory activity. Notably, CP enlargement is also associated with neurodegenerative processes, including gray matter atrophy, cognitive decline, and disability progression, indicating its potential role also as a surrogate marker of MS-related neurodegeneration. However, methodological variability, confounding factors and a lack of longitudinal standardization challenge the interpretation of CP metrics. We highlight the need for multimodal approaches to unravel the temporal and mechanistic significance of CP enlargement. Future research should also explore CP-targeted interventions and their relevance for MS progression. Overall, CP imaging, in particular its enlargement, offers a novel, biologically meaningful perspective into MS pathogenesis, bridging inflammatory and degenerative pathways, and holds promise for improved disease monitoring.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104001"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146155736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2026-03-01Epub Date: 2026-02-26DOI: 10.1016/j.autrev.2026.104013
Shumin Wang , Huimin Liu , Wanrong Huang , Xun Zeng , Lang Qin , Rui Gao
The publication of the 2023 ACR-EULAR classification criteria for antiphospholipid syndrome (APS) has shifted the understanding of APS from a “one-size-fits-all” approach to a more nuanced, subphenotype-based research and management paradigm. Obstetric APS (OAPS), characterized by obstetric clinical manifestations, represents a distinct subtype with unique underlying pathophysiology. OAPS is now recognized as a multifactorial autoimmune disorder, extending beyond the previously held view that it is solely caused by placental vascular thrombosis or micro-thrombosis. Recent evidence has confirmed that trophoblast dysfunction, inflammation and decidual microenvironmental dysfunction are also critical in the pathogenesis of OAPS. Looking forward, a comprehensive summary of the pathogenesis of OAPS will facilitate progress in both research and clinical management of this condition.
{"title":"Obstetric antiphospholipid syndrome: Advances in pathogenesis","authors":"Shumin Wang , Huimin Liu , Wanrong Huang , Xun Zeng , Lang Qin , Rui Gao","doi":"10.1016/j.autrev.2026.104013","DOIUrl":"10.1016/j.autrev.2026.104013","url":null,"abstract":"<div><div>The publication of the 2023 ACR-EULAR classification criteria for antiphospholipid syndrome (APS) has shifted the understanding of APS from a “one-size-fits-all” approach to a more nuanced, subphenotype-based research and management paradigm. Obstetric APS (OAPS), characterized by obstetric clinical manifestations, represents a distinct subtype with unique underlying pathophysiology. OAPS is now recognized as a multifactorial autoimmune disorder, extending beyond the previously held view that it is solely caused by placental vascular thrombosis or micro-thrombosis. Recent evidence has confirmed that trophoblast dysfunction, inflammation and decidual microenvironmental dysfunction are also critical in the pathogenesis of OAPS. Looking forward, a comprehensive summary of the pathogenesis of OAPS will facilitate progress in both research and clinical management of this condition.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104013"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147321257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mitochondria exhibit tissue-specific physiological functions and are central to the maintenance of cellular homeostasis. Emerging evidence indicates that intercellular mitochondrial transfer is regulated by multiple determinants and exerts a profound influence on the function of both innate and adaptive immune cells. The underlying mechanisms are highly heterogeneous, involving distinct cellular contexts, microenvironmental cues, and modes of intercellular communication. This review summarizes the major triggers and mechanistic pathways governing mitochondrial transfer in immune cells and immune-related diseases, and discusses the therapeutic potential of this process while highlighting key challenges that currently limit its clinical translation. By integrating recent mechanistic insights and translational perspectives, this review aims to provide a conceptual framework for the development of mitochondrial transfer–based strategies in the treatment of immune-mediated disorders.
{"title":"Mitochondrial transfer and transplantation in the immune cells: Mechanistic foundations, medical applications, and future prospects","authors":"Xiaofeng Liu , Xinyu Feng , Deping Zhan , Heng Yin","doi":"10.1016/j.autrev.2026.104011","DOIUrl":"10.1016/j.autrev.2026.104011","url":null,"abstract":"<div><div>Mitochondria exhibit tissue-specific physiological functions and are central to the maintenance of cellular homeostasis. Emerging evidence indicates that intercellular mitochondrial transfer is regulated by multiple determinants and exerts a profound influence on the function of both innate and adaptive immune cells. The underlying mechanisms are highly heterogeneous, involving distinct cellular contexts, microenvironmental cues, and modes of intercellular communication. This review summarizes the major triggers and mechanistic pathways governing mitochondrial transfer in immune cells and immune-related diseases, and discusses the therapeutic potential of this process while highlighting key challenges that currently limit its clinical translation. By integrating recent mechanistic insights and translational perspectives, this review aims to provide a conceptual framework for the development of mitochondrial transfer–based strategies in the treatment of immune-mediated disorders.</div></div>","PeriodicalId":8664,"journal":{"name":"Autoimmunity reviews","volume":"25 3","pages":"Article 104011"},"PeriodicalIF":8.3,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147324595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"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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