Volume 12 Issue 11, November 2016

Adalimumab, an anti-TNF monoclonal antibody used to treat rheumatoid arthritis and other autoimmune disorders, paradoxically enhances the capacity of TNF to expand TNF receptor type II-expressing regulatory T cells. This provocative finding opens a new avenue for exploring the mechanisms that underlie efficacy, non-responsiveness and adverse effects associated with therapeutic targeting of TNF signalling.

Despite a multitude of confounding variables, common themes are emerging in metabolomic studies of systemic lupus erythematosus (SLE). Newly revealed metabolites and pathways are likely to complement the biomarkers and insights into SLE pathogenesis that are emerging from genomic, transcriptomic and proteomic studies.

Many of the 2016 updated EULAR recommendations for the management of gout lack robust evidence and rely on expert opinion, indicating gaps in our understanding of this common disease. More research is needed to fill these gaps, move towards an evidence-based approach, and improve patient care.

Historically, rheumatic diseases have received little attention in Africa and rheumatologists have been few and far between. Now, supported by the global rheumatology community, interest in the specialty is growing, despite the formidable challenges faced by those practicing rheumatology in Africa.

In this Review, the authors summarize the changes that occur in the biocomposite formed by articular cartilage and bone during the evolution of osteoarthritis (OA). They also discuss how an improved understanding of these changes could be exploited to develop new therapies for patients with OA.

Reverse translation of data obtained from trials of B-cell-targeted therapies in systemic lupus erythematosus (SLE), along with advances in understanding of B-cell intracellular signalling pathways and post-activation status, highlight pathogenic roles for autoantigen-presenting B cells and regulatory B cells in autoimmune diseases. These insights could lead to innovative treatments for SLE based on modulation of B-cell activation and regulatory functions.

Several lymphocyte subsets have innate-like characteristics. In this Review, the authors summarize the roles of these innate lymphocytes in autoimmunity, emphasizing that further improvements in our understanding could identify novel therapeutic targets for autoimmune diseases.

Alarmins are endogenous molecules that have host-protective roles but have also been implicated in the pathogenesis of joint diseases. This Review summarizes the roles of alarmins in osteoarthritis and inflammatory arthritis, highlighting them as novel therapeutic targets in these diseases.

Biobanks are important tools for researchers investigating paediatric rheumatic diseases. In this Opinion article, the authors outline how standardization can improve sample and data sharing, providing examples from international biorepository networks.