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Neuropsychiatric manifestations are present in approximately 70% of patients with systemic lupus erythematosus, and are often associated with a poor prognosis. In this Viewpoint, Dr Strous and Dr Shoenfeld discuss the potential role for autoimmune factors in contributing to neuropsychiatric expressions via direct and indirect autoantibody-induced neuronal damage.
Although measuring pain in patients with low back pain is not simple, for pain to be effectively managed it needs first to be accurately assessed. In this Review, the authors describe the various instruments that have been developed for the evaluation of pain and provide recommendations for their use in daily clinical practice.
Regulatory T cells have a key role in immune homeostasis and in suppressing unwanted inflammatory responses toward self-antigens. In this Review the authors discuss the function of regulatory T cells in human autoimmune disease, focusing primarily on rheumatoid arthritis and systemic lupus erythematosus.
Inflammation of synovial tissue is a hallmark of rheumatoid arthritis. Synoviocytes express receptors for glucocorticoids, androgens and estrogens, which thereby creates a potential link between the immune reaction and the endocrine systems at a local level. There are also changes in the peripheral nervous system at the site of local inflammation. The complex interactions that occur between the endocrine, nervous and immune systems are outlined in this article.
Angiogenesis might have a key role in the pathogenesis of inflammatory disorders such as rheumatoid arthritis. The basic mechanisms, mediators and inhibitors of inflammation-associated angiogenesis are outlined in this Review, and the possible clinical application of therapeutics that target angiogenesis are discussed.
Studies on the genetics of rheumatic diseases, such as rheumatoid arthritis and systemic lupus erythematosus, have identified multiple polymorphisms related to disease susceptibility. The findings on rheumatoid arthritis-associated genes are reported in this Review, which focuses on the differences in the frequency of polymorphisms between various ethnic groups.
Cells can respond to diverse external stimuli through the transmission of information to their interior by signal transduction cascades. In some cases, the results can be detrimental and lead to chronic inflammatory disease. This article highlights several pathways involved in the pathogenesis of immune-mediated diseases, and their therapeutic potential.
Although randomized controlled trials and observational studies often reach the same conclusions, observational studies are often considered second rate. The uses, limitations, and methodological problems associated with observational studies are outlined in this article.
Patients with inflammatory bowel disease often suffer from joint inflammation; conversely, gut inflammation often occurs in patients with primary spondyloarthropathies. Pathogenic mechanisms common to these inflammatory diseases, and approaches to their treatment, are outlined in this Review.
This Case Study describes a patient with human T lymphotropic virus type I-associated adult T cell leukemia/lymphoma complicated by arthritis. Although the patient died as a result of the adult T cell leukemia/lymphoma, the associated synovial swelling had markedly improved with alemtuzumab treatment.
