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Recent studies have highlighted a potentially important role for Wnts as profibrotic mediators, and implicated increased Wnt activity in systemic sclerosis and other fibrotic diseases. Strikingly, new data indicates that Wnts have a central role in the profibrotic activity of TGF-β.
The attitudes and beliefs of older adults toward the role of exercise for knee pain suggest that considerable barriers need to be overcome if the benefits of exercise are to be realized.
Paediatric systemic lupus erythematosus (SLE) has higher morbidity and mortality than adult-onset SLE. Interestingly, a new paper reinforces these differences between adult and childhood disease, but reasons for the more severe phenotype in children are varied and poorly understood.
The concept of remission in rheumatoid arthritis can at present be defined by use of a number of different criteria, which often reflect different levels of disease control. Various factors, including how much emphasis is placed on the patient's perspective, can influence the usefulness of remission criteria in daily practice.
Although glucocorticoids are central to the treatment of idiopathic inflammatory myopathies, these drugs, paradoxically, have catabolic effects on skeletal muscle. Mechanisms that govern the beneficial and adverse effects of these agents are increasingly understood; as the authors explain, glucocorticoid therapy will be optimized as a result, but new targets that will lead to much-needed alternative therapeutic options are also expected to emerge.
The complement system is vital to both innate and adaptive immunity, but also has the potential to damage host tissues. In this Review, the authors focus on the mechanisms of action of complement in the pathogenesis of rheumatic diseases, and discuss the therapeutic potential that disrupting these actions might offer patients with these disorders.
Recent advances in pathogenesis and diagnosis of Raynaud phenomenon have driven, and are driving, new therapeutic strategies for this phenomenon. In this Review, Ariane Herrick provides an update of the pathogenesis, diagnosis and treatment of primary and systemic sclerosis-related Raynaud phenomenon. Current and future treatment approaches are discussed and key unanswered questions are highlighted.
Osteoporosis can be secondary to an underlying metabolic, nutritional, pharmacologic or disease-related cause; in such cases the triggering factor should be identified and treated. Approaches to the identification and management of patients with secondary osteoporosis are outlined in this Review, alongside mechanistic insights into the bone pathology.
Tissue engineering and regenerative medicine hold great promise for the treatment of joint and cartilage destruction in rheumatic disease. Here, the authors describe the progress in this field, focusing on the clinical aspects of these emerging therapies and exploring the scientific and regulatory challenges in translating these tissue engineering approaches to the clinic.
