Volume 10 Issue 12, December 2014

Patients with rheumatoid arthritis who are hemiplegic, and also mice with denervated hindpaws and experimentally-induced arthritis, can develop unilateral arthritis. But is a specific branch of the nervous system involved in this asymmetry, or does a lack of innervation alter the microvasculature and promote vascular impermeability?

The strongest evidence yet that hypertrophic chondrocytes can turn into osteoblasts could affect not only our understanding of skeletal development, but also the use of research tools thought to be cartilage-specific.

A group of experts in rheumatology and dermatology has identified many unmet needs in the care of patients with psoriatic arthritis and offered potential solutions. But do their recommendations go far enough?

Transforming growth factor-β (TGF-β), a key component in altered vascular and connective tissue homeostasis, is often linked with the pathogenesis of fibrotic diseases such as systemic sclerosis (SSc). In this Review, Lafyatis highlights the known mechanisms ofin situTGF-β activation and summarizes the evidence that place TGF-β at the centre of SSc pathogenesis.

IL-6 has been linked to numerous inflammatory conditions (such as rheumatoid arthritis), and many IL-6-directed therapies are currently in development. The authors outline the basic biology of IL-6 and IL-6 signalling pathways before discussing the clinical implications of targeting IL-6 in the context of rheumatic diseases. Current and future indications for the use of IL-6-targeted therapies and safety of these agents are discussed.

Pulmonary complications are an important extra-articular manifestation of connective tissue disease (CTD) and a major cause of mortality. Here, the authors provide a broad overview of interstitial lung disease in the context of CTD, providing insights into pathogenesis, classification and management of the disease.

Sex steroid hormones are likely to influence risk and expression of autoimmune diseases through modulation of key immune pathways. In this Review, Hughes and Choubey discuss the immunomodulatory mechanisms behind the sexual dimorphism observed in patients with systemic lupus erythematosus and rheumatoid arthritis, and focus on how oestrogen and progesterone affect manifestation of these diseases.

A screening program for hyperuricaemia and gout would aim to identify those individuals with elevated serum urate and thus enable intervention to prevent the onset of gout. However, the data supporting a role for screening in this setting is far from complete. Stamp and Dalbeth outline the important issues around a screening programme for hyperuricaemia and gout, and highlight areas where further research is required before such a programme could be considered.