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Stem and progenitor cells that contribute to tissue repair reside within various niches in the synovial joints of adult mammals. Understanding of the origins, identities and functions of these cells will guide the development of pro-regenerative therapeutic strategies.
Hasegawa et al. reveal how synovial joints detect systemic inflammation through specialized fenestrated blood vessels at the synovial periphery. Three distinct macrophage populations and nociceptor neurons form a sentinel unit around these vessels, coordinating immune responses and pain signalling through interleukin-1β (IL-1β) and calcitonin gene-related peptide (CGRP) signalling.
The first expert consensus recommendations for the treatment and diagnosis of adult sterile bone inflammation have been developed, in which the term ‘chronic non-bacterial osteitis’ is proposed as a disease definition. Will these recommendations pave the way for better diagnosis, management and treatment of this rare disease?
The diagnosis, treatment and management of systemic sclerosis (SSc) remains challenging, owing to the complexity of this disease. In this Perspective, an international group of experts discuss the future of SSc research and how the advent of innovative technologies will advance research into and understanding of SSc.
Garrido-Mesa and Brown review findings from TCR profiling studies in rheumatic diseases and discuss how improved study design might help elicit information about autoreactive T cell clones and their contribution to disease pathogenesis.
The mechanisms that drive the diverse disease manifestations and increased cancer risk associated with systemic sclerosis are unclear. Investigating the genomic alterations observed in patients with systemic sclerosis could contribute towards untangling this complex disease.
This Review discusses the current evidence for the association between occupational exposures, particularly silica dust and solvents, and the risk of developing systemic autoimmune rheumatic diseases. The authors emphasize the importance of considering occupational history in the rheumatology clinic.
This Review summarizes lessons learned from the use of rituximab in patients with systemic lupus erythematosus, and discusses the future of B cell targeting therapies, highlighting therapeutic options after rituximab failure and opportunities for personalized treatment.
This Review discusses obstacles to health care equity in rheumatic disease, including access to health care and the use of inaccurate language when labelling population groups. The authors also highlight the siloing of biological and epidemiological research in rheumatology. They conclude with recommendations for achieving equitable precision medicine.
In 2024, studies using more advanced methods to calculate the minimal important change have described how different methods and timings of estimating minimal important changes can affect the estimates.
Results of the STEP 9 trial show that semaglutide leads to improvements in knee osteoarthritis-related symptoms. The findings support weight-management pharmacotherapies as a feasible option for management of knee osteoarthritis, but cost-effectiveness, risk of toxicity and likelihood of rebound must be considered.
Emerging research in intervertebral disc degeneration in 2024 highlights microbial, immune and inflammatory mechanisms that drive chronic low back pain. These insights pave the way for potential transformative therapies that address the root causes of intervertebral disc degeneration and could improve patient outcomes.
The updated 2023 EULAR recommendations for treatment of systemic sclerosis bring notable changes to recommendations for skin, peripheral vascular disease, interstitial lung disease and pulmonary arterial hypertension therapies, based on newer evidence. These updates provide the first glimmer of personalized patient management.
Here, we highlight three publications in 2024 that have advanced the field of molecular and immunological profiling, for the diagnosis, prognosis and treatment of patients with systemic autoimmune rheumatic diseases.
In this Review the author summarizes the current approaches for antigen-specific therapies in the treatment of autoimmune disease and highlights the challenges that need to be addressed for successful use of this therapeutic strategy.
The role of proteases in cartilage degradation and the development of osteoarthritis is undeniable. Despite over two decades of research on protease inhibitors, however, the transition from preclinical promise to clinical success remains elusive, underscoring the urgent need to critically appraise the challenges and limitations inherent in preclinical studies.
In this Review, Nigrovic and colleagues examine potential mechanisms underlying the paradoxical continuation of inflammation in arthritis, despite the increased numbers of regulatory T cells in inflamed joints, and discuss the implications for regulatory T cell-targeted therapeutic interventions in inflammatory arthritis.
The identification of shared molecular mechanisms across systemic inflammatory autoimmune diseases with overlapping clinical manifestations has prompted research into the underlying genetics that could be driving these manifestations; elucidating these genes could aid in the diagnosis, treatment and outcome prediction of these complex diseases.
This Review provides an update on the evidence for the three main hypotheses of HLA-B27 in the pathogenesis of spondyloarthritis. The authors discuss the current understanding of the effect of HLA-B27 on innate and adaptive immunity and how this drives disease.
This Review provides a comprehensive update on dysregulated type I interferon production and signalling in autoinflammatory interferonopathies, monogenic systemic lupus erythematosus and conditions that present with broad immune dysregulation and interferon signatures. The authors provide a classification for autoinflammatory interferonopathies based on disease mechanisms of increased type I interferon production and signalling and overlapping clinical phenotypes.
