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The use of biologic therapies for off-label conditions in daily clinical practice is increasing, yet few studies have detailed the safety of these agents with regards to infection in patients with systemic autoimmune disease. New research offers a glimpse at the infection rates in these vulnerable patients.
Assigning osteoporosis treatment on the basis of bone mineral density alone is difficult, and incorporating even simple clinical risk factors into the decision-making process is challenging. When launched, the FRAX® risk assessment tool was met, unsurprisingly, with both enthusiasm and skepticism; despite improvements, some obstacles still prevent its universal implementation.
The precise role that basic calcium phosphate microcrystals have in the pathogenesis of osteoarthritis (OA) is controversial. The recent paper by Jin et al. provides new insights into the potential mechanisms that link these microcrystals to joint damage, and highlights the role of the NLRP3 inflammasome in the pathogenesis of OA.
Neutrophils, increasing evidence suggests, play an important part in the development and perpetuation of autoimmunity in patients with systemic lupus erythematosus (SLE). In this Review, the author highlights defects in the phenotype and function of SLE-derived neutrophils. Intriguing links between aberrant neutrophil death, production of proinflammatory mediators, and the presentation of and response to autoantigens are explored. The potential contribution of defective neutrophil activity to organ dysfunction is also discussed.
Targeted therapies for chronic joint diseases are now able to control many of the disease symptoms—the research focus has now shifted towards the structural damage that occurs in skeletal tissues. Lories provides a timely update on the current knowledge in osteoimmunology, with a discussion of the role of tissue repair and remodeling in chronic arthritis such as ankylosing spondylitis and rheumatoid arthritis.
The value of biomarkers in clinical decision marking is increasingly recognized, and numerous studies aimed at identifying or validating potential new biomarkers are underway. In this Review, the authors appraise six promising candidate biomarkers, covering diagnosis, disease activity assessment, and prognosis, in order to highlight study design features that are important for biomarker validation.
Psoriasis and psoriatic arthritis (PsA) are interrelated: PsA is a 'disease within a disease', and research into psoriasis can inform understanding of its less frequent inflammatory comorbidity. Genetic studies in both conditions are revealing substantial genetic heterogeneity in PsA, and how susceptibility, pathogenesis and treatment response are thereby affected, as summarized in this Review.
Increasing evidence suggests that extracellular DNA plays a part in the pathogenesis of systemic lupus erythematosus (SLE) independently of the involvement of anti-DNA autoantibodies. In this Perspectives article, the authors discuss the findings that have led to this conclusion, and explore the new therapeutic avenues that this discovery has opened. Specifically, the interesting prospect of targeting treatments at the structural manipulation of extracellular DNA is introduced and the strategies for achieving this goal that have shown promise in animal studies are presented.
