Infectious disease: T-cell subset links anti-TNF response and TB risk | PDF (150 KB)
p353 | doi:10.1038/nrrheum.2009.115
Table of contents
July 2009 Vol 5 No 7
Research Highlights
Stem cells: Exposing gaps in our knowledge of stem cell therapy | PDF (99 KB)
p354 | doi:10.1038/nrrheum.2009.109
Connective tissue diseases: Is epigenetic modification the future of antifibrotic therapy? | PDF (57 KB)
p354 | doi:10.1038/nrrheum.2009.110
B-cell repletion studies in RA | PDF (49 KB)
p355 | doi:10.1038/nrrheum.2009.111
Inflammatory myopathies: Intravenous immunoglobulin for myositis-associated lung disease? | PDF (47 KB)
p355 | doi:10.1038/nrrheum.2009.112
Connective tissue diseases: Oral anti-CD3 antibodies for SLE | PDF (53 KB)
p355 | doi:10.1038/nrrheum.2009.114
Therapy: Resistance to adalimumab: is it predictable? | PDF (243 KB)
p356 | doi:10.1038/nrrheum.2009.116
In brief
Pain | Complementary and alternative therapy | Bone diseases | Rheumatoid arthritis | PDF (47 KB)
p356 | doi:10.1038/nrrheum.2009.117
News and Views
Connective tissue diseases: Immunosuppressive therapy in SSc: what is the target?
Francesco Boin & Fredrick Wigley
p357 | doi:10.1038/nrrheum.2009.108
Despite a lack of definitive evidence supporting their efficacy, nonselective immunosuppressive drugs are frequently prescribed for patients with systemic sclerosis (SSc). An analysis of data collected for a German registry provides a review of their experience with the use of these medications.
Osteoarthritis: Hyaluronic acid is not effective in symptomatic hip OA
David J. Hunter
p359 | doi:10.1038/nrrheum.2009.119
Consistent with evidence from trials in osteoarthritis of the knee, the results of a randomized controlled trial demonstrate that, for symptomatic hip osteoarthritis, a single intra-articular injection of hyaluronic acid is no better than placebo at alleviating pain.
Connective tissue diseases: Is combined oral contraceptive use linked to SLE incidence?
Chi Chiu Mok
p360 | doi:10.1038/nrrheum.2009.118
The link between exposure to exogenous estrogen and the incidence of systemic lupus erythematosus is controversial, but new data suggest that the use of combined oral contraceptives could increase the risk of developing the disease.
Therapy: The risk of herpes zoster: another cost of anti-TNF therapy?
Tim Bongartz & Robert Orenstein
p361 | doi:10.1038/nrrheum.2009.120
Several studies have shown that tumor necrosis factor (TNF) inhibitors are associated with an overall increased risk of serious infections compared with standard immunosuppressive regimens in patients with rheumatoid arthritis (RA). A study by Strangfeld et al. adds specificity by showing a moderately increased risk of herpes zoster in patients receiving anti-TNF antibody treatment, and raises the question of whether live zoster vaccines should be utilized in this patient group.
Osteoarthritis: A single injection of anakinra for treating knee OA?
Johanne Martel-Pelletier & Jean-Pierre Pelletier
p363 | doi:10.1038/nrrheum.2009.121
According to a study by Chevalier and colleagues, a single intra-articular injection of anakinra is no more effective than placebo for treating the symptoms of knee osteoarthritis (OA). This result, however, should not deter future investigations of this agent for the treatment of patients with symptomatic knee OA.
Reviews
Fat targets for skeletal health
Masanobu Kawai, Maureen J. Devlin & Clifford J. Rosen
p365 | doi:10.1038/nrrheum.2009.102
The homeostatic processes of adipogenesis and osteoblastogenesis are tightly linked, as discussed in this Review. Research into the bone–fat network has led to the elucidation of pathways that could be pharmacologically targeted in an attempt to enhance bone mass and reduce osteoporotic fracture risk.
Hierarchical microimaging of bone structure and function
Ralph Müller
p373 | doi:10.1038/nrrheum.2009.107
The use of high-resolution imaging techniques will lead to a better understanding of the relative contribution of the different hierarchical levels to bone competence. Such information could help improve predictions of fracture risk, clarify the pathophysiology of skeletal diseases, and define the response to therapy. This Review focuses on three-dimensional approaches to hierarchical biomechanical imaging in the study of microstructural and ultrastructural bone failure.
Management of RA medications in pregnant patients
Monika Østensen & Frauke Förger
p382 | doi:10.1038/nrrheum.2009.103
The treatment strategy for a patient with rheumatoid arthritis who plans to conceive or is already pregnant must be tailored according to not only disease activity but also which drugs are compatible with pregnancy. The safety of various therapeutic agents during pregnancy is discussed in this Review, as well as issues of handling inadvertent exposure to potentially fetotoxic drugs and managing flares of disease activity during pregnancy.
Mesenchymal stem cells: innovative therapeutic tools for rheumatic diseases
Farida Djouad, Carine Bouffi, Soufiane Ghannam, Danièle Noël & Christian Jorgensen
p392 | doi:10.1038/nrrheum.2009.104
Mesenchymal stem cells (MSCs) are able to differentiate into chondrocytes, osteoblasts and adipocytes. As well as their potential use in tissue engineering, however, MSCs also potently modulate immune responses, exhibit healing capacities, improve angiogenesis and prevent fibrosis, at least partly by secreting several cytokines and growth factors.
The socioeconomic burden of SLE
Chak Sing Lau & Anselm Mak
p400 | doi:10.1038/nrrheum.2009.106
Although major improvements have been made in the management of systemic lupus erythematosus, the numerous burdens associated with long-term disease have a significant impact both on individual patients and society as a whole.
Perspectives
Opinion
Preventing and treating biologic-associated opportunistic infections
Kevin L. Winthrop & Tom Chiller
p405 | doi:10.1038/nrrheum.2009.105
Owing to the critical role of tumor necrosis factor in host immunity, patients receiving tumor necrosis factor inhibitors for the treatment of autoimmune disorders are at significantly increased risk of infection from a variety of pathogens. The authors review the evidence and provide expert opinion on how best to prevent opportunistic infections in this setting.
