Volume 7 Issue 2, February 2011

From evidence pointing to a possible etiologic role for microbes to the development of new strategies and agents to treat early and established disease, 2010 has seen the publication of several interesting findings in the field of rheumatoid arthritis.

How can we optimize the management of osteoarthritis? Recent studies into the efficacy and mechanisms of interventions that target nociceptive mechanisms, lower-extremity musculature and ligament integrity reflect the progress being made in this field.

Important advances have been made in gout therapeutics in 2010. In addition to the development of novel biologic agents, progress has been made in the safe prescribing of colchicine. However, colchicine also became the subject of considerable controversy in the USA when one brand of this drug was granted exclusivity.

Novel findings shed light on the role of tumor necrosis factor in ankylosis and inflammation, pointing to new indications for blockade of this cytokine in treating spondyloarthritis. At the same time, the identification of other potential targets for therapy could expand the treatment options for this family of inflammatory disorders.

In several areas of investigation, the results of a bumper year in osteoporosis research are set to stoke rather than settle debate. From the origins of bone health to the use of established and experimental therapies, the new findings will be discussed into 2011 and beyond.

In 2010, important research into the systemic autoinflammatory diseases has confirmed and extended the role of IL-1 inhibition in hereditary autoinflammatory disorders, demonstrated a novel treatment for a dangerous complication, and expanded the spectrum of systemic autoinflammatory diseases while further implicating autoinflammation in the complications of the metabolic syndrome.

Advances in the field of MRI have given rise to sophisticated imaging modalities that allow the visualization of molecular pathologic processes that might precede overt structural damage seen on conventional imaging. In this Review, the authors summarize these advances and new directions in MRI in the context of synovial, bone and cartilage changes in rheumatoid arthritis.

Chondrocalcinosis, the calcification of cartilage, is caused by the deposition of calcium pyrophosphate crystals (CPPD). This Review describes regulators of pyrophosphate metabolism, and discusses the mutations and mechanisms that underlie familial CPPD.

Familial Mediterranean fever (FMF) is characterized by episodes of acute inflammation; however, in approximately 30% of patients with FMF inflammation persists even during the attack-free periods. In this Review, the authors discuss the markers and risk factors for persistent chronic inflammation in these patients, summarize the clinical outcomes of such inflammation, and suggest a new potential treatment strategy.

The adduction moment generated during walking is associated with the development and progression of knee osteoarthritis. Nonsurgical biomechanical approaches aim to reduce the knee adduction moment. In this Review the authors discuss various such strategies, including footwear interventions and gait modification approaches as well as the use of valgus knee braces.

Pregnancy in women with systemic lupus erythematosus (SLE) can be associated with substantial morbidity and mortality for both the mother and the unborn fetus. Findings from several studies have indicated that CD4⁺CD25⁺regulatory T cells have an important role in supporting a healthy pregnancy. In this article, the authors provide an overview of how regulatory T cells function in both SLE and pregnancy, as well as providing an insight into how therapeutic agents that induce these cells could promote successful pregnancy in women with SLE.