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Methotrexate is commonly used in the treatment of inflammatory rheumatic diseases. In this Review, the authors discuss the potential hepatotoxicity of methotrexate, with particular consideration of the role of chronic liver disease, and suggest screening and monitoring strategies for patients receiving methotrexate.
In this Review, the authors discuss vascular involvement in Behçet syndrome and how the unusual pathogenesis involving an impaired immune-inflammatory response influences the treatment approach, which differs from that of other vasculitides.
Cartilage calcification is a hallmark of osteoarthritis. In this Review, the authors discuss the molecular mechanisms of calcium crystal formation in chondrocytes, the effects of crystals on cells in the joint, and potential targets for the treatment of osteoarthritis and other calcification disorders.
Glycosylation is a common modification that can affect protein stability and interactions. In this Review, the authors discuss the role of glycosylation in rheumatic diseases, as well as the therapeutic potential of glycosylation-based interventions.
Various types of immune cells are dysregulated in systemic sclerosis and contribute to the initiation and progression of fibrosis. In this Review, the authors summarize various immune cell defects implicated in this disease that are current or potential targets for therapy.
In this Review, the authors describe the involvement of characteristic hallmarks of ageing in rheumatic diseases, suggesting that these chronic conditions can be considered to be diseases of premature or accelerated ageing, in which anti-ageing drugs may have therapeutic benefits.
In this Review, the authors discuss the use of immune-checkpoint inhibitors for treatment of cancer in patients with pre-existing autoimmune disease, including the possibility of the use of biologic DMARDs to enhance tumour responses while preventing severe immune-related adverse events.
This Review discusses how best to manage the reproductive health of patients with vasculitis, including the safety of contraception, the use of assisted reproductive technology, preservation of fertility during therapy, disease management in pregnancy and the use of medications compatible with pregnancy and lactation.
The mitochondrion has multiple functions, including energy production, regulation of apoptosis and reactive oxygen species generation. Disruption of these mitochondrial processes can lead to pro-inflammatory immune responses. This Review discussions the role of mitochondria and mitochondrial dysfunction in rheumatic diseases.
In this Review, the authors discuss the roles of sex and gender in relation to axial spondyloarthritis. Although evidence now suggests that the disease has equal prevalence in men and women, important differences occur in phenotypes, response to therapy and outcomes.
In this Review, the authors summarize the genetic factors associated with anti-neutrophil cytoplasmic antibody (ANCA)-associated vasculitis (AAV). They describe the findings from genetic association studies, their pathogenic significance and their implications for the classification, management and prognosis of AAV.
In this Review, Psarras, Wittmann and Vital discuss evidence of the production of type I interferons by cells and tissues other than haematopoietic cells. These interferons can have local effects, and their roles in the pathogenesis of systemic lupus erythematosus suggest the value of interferon-blocking therapies for treatment of this condition.
In this Review, the authors summarize and discuss regional differences in the prevalence and incidence of rheumatoid arthritis (RA), and describe temporal trends associated with the disease as well as evidence related to risk factors.
Gout can be effectively treated with long-term urate-lowering therapy. Current guidelines advocate the use of a treat-to-target serum urate strategy, with a target serum urate concentration of <5 mg/dl (<0.30 mmol/l) or <6 mg/dl (<0.36 mmol/l), but specific targets are under debate. In this Review, the authors consider the rationale and evidence for the recommendations.
In this Review, the authors discuss age-related arthropathy and the similarities and differences between childhood loss of immune tolerance and adult development of immune-mediated arthritis, and develop three hypotheses describing age-related mechanisms that contribute to the onset of arthritis.
This Review summarizes our understanding of sex- and gender-related differences in psoriatic arthritis, with a focus on disease progression and outcomes, underlying mechanisms and response to therapies.
Assessing systemic sclerosis (SSc) disease activity is challenging, and improved outcome measures are needed. This Review describes clinical and biochemical outcome measures of distinct features of SSc, with an emphasis on the dermatological manifestations and interstitial lung disease, including insights into biomarkers gained from single-cell RNA sequencing.
In this Review, the authors summarize the pathophysiological mechanisms of IL-1-mediated autoinflammation. They describe the epidemiological and clinical features of autoinflammatory diseases, challenges associated with diagnostics and disease management, and current and future therapies for targeting the IL-1 pathway.
In this Review, the authors provide an overview of the mechanisms contributing to joint damage in rheumatoid arthritis, particularly the interactions among immune cells, fibroblasts and bone, and discuss how this knowledge could inform the development of novel therapies.
In this Review, the authors discuss the characterization of distinct synovial tissue macrophage (STM) populations and their functions in the context of the healthy and arthritic joint. They also describe how distinct STMs are specified, how they respond to danger signals and the clinical implications of understanding STM heterogeneity.