Archives of rheumatology最新文献

Background/Aims: This study aimed to investigate the association between lung function and imaging parameters with health-related quality of life (HRQoL), as measured by the St. George's Respiratory Questionnaire (SGRQ), in patients with rheumatoid arthritis-associated interstitial lung disease (RA-ILD), systemic sclerosis-associated ILD (SSc-ILD), and idiopathic pulmonary fibrosis (IPF). Materials and Methods: In this cross-sectional study, a total of 120 patients (37 RA-ILD, 42 SSc-ILD, and 41 IPF) were included. Demographic, clinical, functional (forced vital capacity [FVC], lung diffusion capacity for carbon monoxide [DLCO], 6 minute walk test), and radiological (Warrick scores) data were collected. The associations between SGRQ scores and these parameters, as well as other patient-reported outcome measures (PROMs), were analyzed. Results: St. George's Respiratory Questionnaire scores showed significant correlations with functional measures and PROMs across all groups. However, no correlation was found between SGRQ and FVC only in RA-ILD. In SSc-ILD and IPF, SGRQ scores were also significantly associated with high-resolution computed tomography-based Warrick scores. However, no correlation was found between SGRQ and radiological parameters in RA-ILD. Receiver operating characteristic (ROC) analysis demonstrated that SGRQ could help identify patients with impaired lung function (FVC <70%) in IPF and SSc-ILD groups. Conclusion: St. George's Respiratory Questionnaire may be a valuable tool for evaluating HRQoL in patients with SSc-ILD and IPF, with moderate associations with functional and radiological outcomes. Its utility in RA-ILD appears to be more limited and requires further investigation.

Background/Aims: Individuals increasingly turn to artificial intelligence (AI) chatbots for health-related information; however, the accuracy and usability of their responses remain uncertain. This study assessed the quality, comprehensiveness, and readability of responses from 6 AI chatbots-ChatGPT-3.5, ChatGPT-4o (OpenAI), Copilot AI (Microsoft), Perplexity AI (Perplexity.AI), Gemini AI (Google), and ChatSonic AI (Writesonic)-to the most commonly searched fibromyalgia-related queries. Materials and Methods: The top 10 most frequently searched fibromyalgia-related questions from the past 2 years were retrieved from the Google Trends database. Each chatbot was queried separately, and a total of 60 responses (10 per chatbot) were assessed both qualitatively and quantitatively by 2 reviewers, focusing on content quality, accuracy, readability, and alignment with evidence-based guidelines. Results: ChatGPT-3.5 had the lowest Ensuring Quality Information for Patients score (20.6 ± 4.5), indicating very low quality information, while Gemini achieved the highest (40.5 ± 5), which was still classified as low quality. Understandability was moderate for Copilot, Gemini, and Perplexity (67.2) but lowest for ChatGPT-3.5 (43.2 ± 10.2). Actionability was weak and the misinformation assessment revealed a moderate level across all chatbots. Readability scores indicated university-level complexity, with ChatGPT-4o having the lowest Reading Ease score (11.3 ± 11.2) and Copilot the highest (30.3 ± 13.2). Conclusion: While AI chatbots provide accessible health information, their accuracy and depth vary. Gemini, Copilot, and Perplexity AI showed better quality, but citation inconsistencies, readability challenges, and misinformation risks highlight the need for refinement beyond the hype. Clinicians should guide fibromyalgia patients in critically assessing AI-generated health content. Future research should explore improvements in AI chatbot applicability for medical inquiries.

Background/Aims: Autoimmune diseases (ADs) are a group of disorders characterized by the dysfunction of the immune system, leading to selfdirected attacks on organs or tissues. The global burden of ADs in older adolescents and young adults is still lacking and requires updates.This study described the global, regional, and country-specific disease burden and temporal trends of ADs in older adolescents and young adults (aged 15-29 years) from 1990 to 2019. Materials and Methods: Data from the 2019 Global Burden of Disease, Injury, and Risk Factors study were utilized to report age-standardized incidence rate (ASIR), age-standardized prevalence rate (ASPR), age-standardized mortality rate (ASMR), and age-standardized disability-adjusted life years (ASDR) rates of ADs at global, regional, and national levels. The average annual percent change was determined by Joinpoint regression analysis. Results: In 2019, the burden of alopecia areata (AA) and rheumatic heart disease (RHD) in older adolescents and young adults was particularly notable. Specifically, the ASIR for AA was 493.84 per 100 000 (95% uncertainty interval (UI): 444.13, 544.49), while the ASPR, ASMR, and ASDR for RHD were 771.43 per 100 000 (95% UI: 529.38, 1074.04), 1.08 per 100 000 (95% UI: 0.94, 1.23), and 108.36 per 100 000 (95% UI: 88.63, 133.67), respectively. From 1990 to 2019, the heavy disease burden of ADs was more pronounced in the European region and region of the Americas, where Italy and El Salvador were particularly affected. Although the burden of ADs was generally more severe in females than in males across most regions, males consistently had higher ASIR (10.19 per 100 000; 95% UI: 4.68, 18.22), ASPR (249.77 per 100 000; 95% UI: 186.89, 325.98), ASMR (0.53 per 100 000; 95% UI: 0.47, 0.60), and ASDR (47.59 per 100 000; 95% UI: 40.97, 56.34) for type 1 diabetes mellitus (T1DM) compared to females. Conclusion: Globally, there is an increasing burden of AA, T1DM, and RHD in older adolescents and young adults. The American and European regions and females endure a severe burden of ADs. Healthcare providers should be aware of the heavy burden of ADs and develop age-appropriate prevention, diagnosis, and intervention strategies to achieve health equity.

Background/Aims: Primary Sjögren's syndrome (pSS) is an autoimmune disease that can affect several systems. The purpose of this study was to examine the connection between primary Sjögren's disease activity and the CRP-albumin-lymphocyte index (CALLY) and the HALP (hemoglobin, albumin, lymphocyte, and platelet) score, 2 novel immunonutritional indicators that have not yet been applied to rheumatological disease activation. Materials and Methods: This cross-sectional study included 89 patients with pSS and 113 age- and sex-matched individuals. The relationship between haematological, inflammatory, immunonutritional biomarkers, and disease activation was investigated, as were the differences between the groups. Results: Eighty-nine patients (96.6% female, mean age 53.4 ± 15.0 years) and 113 control subjects (97.3% female, mean age 50.8 ± 14.9 years) were included in the study. The levels of C-reactive protein (CRP), erythrocyte sedimentation rate, red cell distribution width, neutrophil lymphocyte ratio, monocyte lymphocyte ratio, platelet lymphocyte ratio, and C-reactive protein albumin ratio were significantly higher in the group of patients with pSS compared to the control group (all; P < .001). Systemic immuneinflammation index and systemic inflammatory response index were significantly elevated in the patient cohort compared to the control group (P = .002 and P = .048, respectively). The CALLY index and HALP score were negatively correlated with EULAR Sjögren's syndrome disease activity index (P < .001 for both). Conclusion: The CALLY index and HALP score represent a novel approach to assessing disease activity and prognosis in a number of conditions, including stroke, myocardial infarction, osteoarthritis, pulmonary thromboembolism, asthma, chronic obstructive pulmonary disease, and many types of cancer. They may also be useful as a guide to disease activity and monitoring in pSS.

Background/Aims: Catestatin (CST) is a bioactive peptide with wellestablished cardiovascular roles, including anti-inflammatory and metabolic effects. This study aimed to compare the serum CST levels in patients with ankylosing spondylitis (AS) and healthy control subjects. Materials and Methods: This cross-sectional study included 95 patients with AS who met the Assessment of SpondyloArthritis International Society classification criteria for AS and 85 healthy individuals. Demographic, clinical, and laboratory parameters were recorded. Serum CST levels were measured by commercially available enzyme-linked immunosorbent assay kits. Results: Median serum CST levels were significantly lower in patients with AS compared to the control group (2.57 [1.74-4.58] vs 9.4 [3.55-26.6] ng/mL, P < .001). Catestatin levels were lower in the active AS group than in the inactive AS and control groups (P < .05). Significant negative correlations were found between CST and age, ankylosing spondylitis disease activity score-C-reactive protein (ASDAS-CRP), and C-reactive protein. Multiple linear regression analysis demonstrated that serum CST levels were significantly associated with the ASDAS-CRP group variable after model adjustment for sex, age, body mass index, HLA-B27 status, disease duration, and medications. Conclusion: These findings suggest that CST may play a role in the complex pathophysiology of AS. However, future multicenter longitudinal studies are necessary to further elucidate the relationship between CST and AS.

Background/Aims: The aim of this study was to compare the acute effects of 2 different elastic neoprene knee sleeves, 1 equipped with 4 metal supports, on balance and pain in patients with knee osteoarthritis (KOA). Materials and Methods: A total of 60 patients (50 females, 10 males; age mean = 61.13 ± 8.6 years) diagnosed with KOA were randomly divided into 2 groups. Group 1(n = 30): wearing an elastic neoprene knee sleeve, and group 2 (n = 30): wearing a neoprene knee sleeve with 4 metal supports. The Berg Balance Scale (BBS), Timed Up and Go, Functional Reach Test, and Fall Index, calculated using posturography (Tetrax® ;), and the Visual Analogue Scale were employed for the assessment of balance and pain. Clinical assessments were performed before and after wearing the knee sleeves. The sample size was determined by power analysis using balance data (α = 0.05, power = 0.99). Results: Both groups exhibited statistically significant improvement in intragroup comparisons of all assessment parameters (P < .05). However, the changes in BBS score after wearing the knee sleeve were better in favor of group 2, approaching statistical significance (P= .056). Conclusion: Both types of neoprene knee sleeves provided immediate benefits in balance and pain among patients with KOA. While the neoprene knee sleeve with 4 metal supports showed slightly greater balance improvement, the difference was not statistically significant. Further longterm studies with larger samples are needed to clarify the effects of different knee sleeves on balance and pain in patients with KOA.

Background/Aims: Radiographic axial spondyloarthritis (r-axSpA) is a chronic inflammatory arthritis associated with an increased cardiovascular (CV) risk due to persistent inflammation. Sestrin-1, a stress-inducible protein with antioxidant and anti-inflammatory properties, has been implicated in cardiovascular protection. This study aimed to investigate the relationship between Sestrin-1 levels, cardiovascular markers, and echocardiographic findings in r-axSpA patients. Materials and Methods: This controlled study included 48 r-axSpA patients diagnosed according to the modified New York criteria and 48 age- and sex-matched healthy controls. Demographic, biochemical, and echocardiographic data were collected. Sestrin-1 levels were measured using an enzyme-linked immunosorbent assay kit, and carotid intima-media thickness (CIMT) was assessed via ultrasound. Statistical analyses evaluated differences between groups, as well as correlations between Sestrin-1 levels and inflammatory and cardiovascular parameters. Results: r-axSpA patients exhibited significantly lower Sestrin-1 levels compared to controls (P= .003). Sestrin-1 levels were negatively correlated with C-reactive protein (CRP) (r =-0.42) and erythrocyte sedimentation rate (ESR) (r =-0.38). Echocardiographic findings revealed increased CIMT (P < .001), reduced right ventricular systolic motion (RVSM), and lower tricuspid annular plane systolic excursion (TAPSE) in r-axSpA patients. No significant correlation was observed between Sestrin-1 levels and disease activity, as measured by the Ankylosing Spondylitis Disease Activity Score (ASDAS)-CRP. Conclusion: r-axSpA patients exhibit reduced Sestrin-1 levels and significant subclinical cardiovascular changes, including increased CIMT and impaired right ventricular function. These findings suggest that diminished Sestrin-1 may exacerbate oxidative stress and inflammation, thereby contributing to cardiovascular risk in r-axSpA. Further research is needed to explore the potential of Sestrin-1 as a biomarker for cardiovascular complications in r-axSpA.

Background/Aims: This study aimed to evaluate the potential anti-inflammatory and therapeutic effects of tacrolimus in ankylosing spondylitis (AS). Materials and Methods: Peripheral blood mononuclear cells (PBMCs) and synovial fluid mononuclear cells (SFMCs) from AS patients were treated with tacrolimus and analyzed via flow cytometry to measure inflammatory cytokine-producing cells (IFN-γ, IL-17A, and GM-CSF). Additionally, cytokine levels (IFN-γ, IL-17A, TNF-α, and GM-CSF) in ex vivo cultured PBMC supernatants were quantified using enzyme-linked immunosorbent assay (ELISA). The in vivo effects of tacrolimus were assessed in an AS mouse model by evaluating clinical arthritis scores and analyzing inflammatory cytokine-producing cells (IFN-γ, IL-17A, and TNF-α) via flow cytometry. Results: Tacrolimus significantly suppressed the production of inflammatory cytokines (IFN-γ, IL-17A, and GM-CSF) in PBMCs and SFMCs from AS patients. Cytokine levels (IFN-γ, IL-17A, TNF-α, and GM-CSF) in ex vivo PBMC cultures were also markedly reduced with tacrolimus treatment. In the AS mouse model, tacrolimus treatment resulted in significantly lower clinical arthritis scores and reduced production of inflammatory cytokines (IFN-γ, IL-17A, and TNF-α). Conclusion: Tacrolimus demonstrates potential as a therapeutic agent for AS by suppressing inflammatory cytokine production in PBMCs and SFMCs from AS patients and exhibiting anti-inflammatory effects in an arthritis mouse model.