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Hypovitaminosis D, encompassing both vitamin D insufficiency and deficiency, is highly prevalent in the general population and has potentially deleterious musculoskeletal effects. In this Review, the authors focus on the pathophysiology, clinical correlates, evaluation and treatment of hypovitaminosis D.
In light of the impressive efficacy of tumor necrosis factor blockers in the treatment of ankylosing spondylitis, particularly in patients with short disease duration, defining outcome parameters to monitor the structural damage of the disease has become more pertinent. In this Viewpoint the authors explore the relevance of osteoproliferation amongst other outcome parameters.
For many years, patients with chronic inflammatory disease of joints or muscles were advised to rest; however, exercise is now known to result in improved muscle performance, soft tissue integrity and health outcomes in these patients. In this Review, Dr Lundberg and Dr Nader discuss the systemic effects of exercise, as well as local effects in skeletal muscle and cartilage, in patients with rheumatic disease.
Osteoarthritis is a progressively degenerative joint condition that is influenced by various metabolic and structural factors. In this third in a series of three Reviews on Wnt–β-catenin signaling, Dr Corr provides insights into recent advances in research into the role of Wnt signaling in the pathogenesis of osteoarthritis, and discusses some of the genetic and regulatory factors involved.
This Case Study describes a 13-year-old girl with systemic juvenile idiopathic arthritis who developed features consistent with macrophage activation syndrome. The patient's disease remained active following treatment with high-dose steroids, immunoglobulin and ciclosporin, but was successfully controlled following the introduction of anakinra.
The role of dietary antioxidants in the prevention and amelioration of symptoms in inflammatory joint disease has been of interest for many years. In this Review, the authors provide an overview of current evidence and discuss the potential prophylactic and therapeutic effects of antioxidants in arthritis.
Rheumatic diseases are typified by aberrant cellular immune responses. The advent of antibody engineering has now led to the development of anti-inflammatory therapy to target these responses. In this Review, Rothe and colleagues highlight advances in recombinant technologies for the development of novel biologic therapies in rheumatology.