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In rheumatoid arthritis, bone involvement presents as generalized osteoporosis, periarticular osteoporosis and erosions. Prof. Haugeberg discusses evidence for all three features resulting from increased activation of the osteoclast, and suggests that potent anti-inflammatory treatment, or direct inhibition of the osteoclast, might protect against all of these types of bone damage seen in patients with rheumatoid arthritis.
The vitamin D system has both pathophysiological and therapeutic importance for autoimmune disease. In this Review, the authors discuss the role of the vitamin D system in autoimmunity, the mechanistic basis for this role, and present the potential of vitamin D receptor agonists to treat or prevent autoimmune diseases.
The canonical Wnt/β-catenin signaling pathway regulates multiple biological events, including embryonic bone development and fracture repair. In this Review, the authors discuss the role of this pathway in fracture repair at the molecular, cellular and physiological levels, and its potential as a therapeutic target.
High concentrations of intact aggrecan are required for effective weight-bearing in healthy cartilage. Aggrecanases from the ADAMTS (a disintegrin and metalloproteinase with thrombospondin motifs) enzyme family, particularly ADAMTS-4 and ADAMTS-5, are thought to be involved in the pathogenesis of osteoarthritis. In this Review, Drs Fosang and Little discuss potential disease-modifying agents for osteoarthritis that could trigger the downregulation of ADAMTS enzymes.
The impact of the global HIV pandemic continues to grow and rheumatologists need to be aware of the spectrum of rheumatic diseases that occur in HIV-positive individuals, as outlined in this Review. Changes in the patterns of rheumatic diseases that have developed since the introduction of highly active antiretroviral therapy and the management of treatment of rheumatic diseases in HIV-positive patients are also discussed.
Drs Asherson, Giampaolo and Strimling describe a middle-aged patient with total alopecia, muscular spasms, diarrhea and gastric ulceration. She is only the fifth reported case of adult-onset Satoyoshi syndrome (usual age of onset is 5–19 years), and the first person reported to have a combination of Satoyoshi syndrome, gastric ulceration, and eosinophilic enteritis.
