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A new patient self-assessment tool shows promise as a simple measure of the overall impact of rheumatoid arthritis on a patient, but will it be able to gain the international acceptance required to become a clinical standard?
Early symptoms of arthritis either resolve spontaneously or progress into erosive disease; being able to predict the disease course would inform decisions about intensive early therapy. One predictive factor, according to a new multicenter study, is the season of first symptoms—so how does the Earth's movement influence disease progression?
A new single cell detection technology allows simultaneous measurement of up to 100 surface markers and signaling proteins of immune cells. This method provides the opportunity to make great advances into the scientific understanding of rheumatic disease and the provision of individualized patient care.
New guidelines for the management of ankylosis spondylitis provide evidence-based disease management recommendations, which aim to be the ideal standard practice. How robust are these suggestions and are they applicable to the worldwide community of rheumatologists practicing in very different clinics around the globe?
The use of biologic agents has revolutionized treatment in a number of rheumatic and non-rheumatic autoimmune and inflammatory disorders. In this Review, the authors discuss whether rheumatologists can learn lessons from the application of biologic agents in non-rheumatic diseases such as psoriasis, asthma and multiple sclerosis.
As much as the pathology of fibromyalgia has informed therapy, the treatment of this disorder has provided insights into its underlying pathophysiology. In this article, the authors provide an overview of key aspects of the epidemiology and pathophysiology of fibromyalgia, and discuss both pharmacological and nonpharmacological treatment options.
Our understanding of the role of adipokines in inflammation and the immune response has improved markedly in the past decade. These proteins, produced by adipose tissue, form complex networks that contribute to the pathogenesis of rheumatic diseases. In this Review, the authors provide an update on the current state of adipokine research in these diseases, with a focus on rheumatoid arthritis and osteoarthritis.
Who will not respond adequately to traditional DMARDs? Which patients would benefit most from expensive, sometimes-effective biologic agents, and who is most likely to experience adverse events? Although firm answers to these questions are pending, pharmacogenetic studies offer insight into how an individual's genetic identity determines the metabolic fate and outcome of drug therapies. In this article the authors summarize the extent of such knowledge in rheumatology today, and discuss the hurdles remaining before the ultimate goal of personalized therapy can be achieved.
Autoantibodies, produced by autoreactive B cells, are involved in the pathology of rheumatic diseases including systemic lupus erythematosus (SLE). Modulation of B-cell function by inhibiting cytokines active on B cells or even eliminating B-cell populations can effectively treat SLE and other diseases. So far so simple, yet—as explored in this Perspective—the relationships between the effects of such therapies on B cells, the levels of individual autoantibodies, and clinical outcomes are fiendishly complex. Better knowledge of B-cell biology is needed to understand the effects of agents that target B cells, and to increase their efficacy.
