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Microparticles derived from immune cells and platelets are plentiful in the joints of patients with inflammatory arthritis. New research points to a novel role for platelet-derived microparticles in the pathogenesis of rheumatoid arthritis.
Many epidemiological studies have implicated hyperuricemia as an independent risk factor for cardiovascular morbidity. Gout, the clinical manifestation of hyperuricemia, has rarely been studied in the same way. A population-based cohort study now provides evidence that gout is an additional risk factor for myocardial infarction, particularly in elderly women.
The nonbiologic DMARD leflunomide was approved for use in the treatment of rheumatoid arthritis in 1998. After being in use for more than a decade, which has also seen the introduction of highly effective biologic agents, a review of the benefits and risks of leflunomide therapy sheds light on the role of this drug in the treatment arsenal.
In terms of quality of healthcare, standards of care establish the basic principles and infrastructure required to achieve optimal health outcomes for a specific patient population. In the UK, the British Society for Pediatric and Adolescent Rheumatology (BSPAR) standards of care for juvenile idiopathic arthritis (JIA) are an excellent example of this foundational work.
MicroRNAs have a central role in the regulation of gene expression and are important in a wide range of physiological and pathological processes. As discussed in this Review, they might also be promising as candidate biomarkers of diagnosis, prognosis, disease activity and severity in rheumatic diseases.
Numerous hypotheses abound with regards to the mechanisms involved in the pathogenesis of ankylosing spondylitis, which is, at its core, a genetic disease. This Review outlines the main theories and also provides a deeper look at the processes of bone erosion and syndesmophyte formation that are key to disease progression.
Takayasu arteritis is associated with considerable morbidity and premature mortality, which could potentially be avoided if this rare granulomatous vasculitis could be diagnosed and treated at an earlier stage. The challenges currently faced in the diagnosis and management of Takayasu arteritis are discussed here, with a focus of the potential utility of noninvasive imaging techniques.
Amyloidosis is a potential complication of chronic rheumatic diseases, particularly rheumatoid arthritis; in addition, patients with systemic amyloidosis can develop musculoskeletal and articular symptoms. This Review discusses the clinical features and therapy of systemic amyloidosis in light of novel approaches to diagnosis and treatment.
Patients with systemic sclerosis have a better prognosis now than they did 30 years ago, and the frequency of renal-crisis-related death has decreased markedly. As a result, there is an increasing burden of cardiovascular disease in these patients. In this article, the authors describe the techniques that can be used to assess vascular damage, and outline the requirements of future research in this area.
