Volume 9 Issue 12, December 2013

Pulmonary arterial hypertension (PAH) is a lethal complication in connective tissue diseases (CTDs) with varying frequency of occurrence; the highest incidence is in systemic sclerosis. Data for PAH screening by echocardiography in other CTDs are not strong. Should we only investigate symptomatic patients or perform regular screening for PAH in CTDs?

Musculoskeletal ultrasonography is a routine diagnostic tool in rheumatological practice. The technique has only recently been used to evaluate articular and periarticular structures. In systemic sclerosis, different aspects of hand and wrist involvement have now been described, offering hope for the transfer of ultrasonography for this condition to the clinic.

Evidence of possible molecular crosstalk between inflammation and insulin resistance suggests that treatments for diabetes might be useful in patients with rheumatoid arthritis (RA), or vice versa. However, in a new trial of a PPARγ agonist in RA, the clinical effect was at most modest. So, does such an approach have a future?

Despite substantial improvements, our current treatments for systemic lupus erythematosus (SLE) still have many limitations, so will new biologic agents be the answer? In this comprehensive Review, William Stohl discusses the myriad opportunities biologic agents provide for targeting B cells, T cells and cytokines, and their future potential in SLE therapy.

Platelet-rich plasma has anti-inflammatory properties and is an important source of molecules that are involved in the repair and regeneration of tissues. PRP therapy, therefore, has great potential for aiding the healing response and repairing joint damage in patients with osteoarthritis. In this comprehensive Review, the authors describe the biological processes of PRP tissue engineering as well as the novel applications and approaches of PRP therapy in the context of targeting joint degeneration.

Giant cell arteritis (GCA) is the most frequent form of large-vessel vasculitis. In this Review, Weyand and Goronzy discuss the aberrant immune pathways that underlie medium and large-vessel vasculitis, focusing on new understanding of the IL-6–IL-17 and IL-12–IFN-γ cytokine clusters in the development of GCA. Immunostromal interactions are introduced as mechanisms of tissue tropism and disease amplification, and therapeutic interventions targeting vascular instead of immune cells are considered.

Diffuse idiopathic skeletal hyperostosis (DISH) is a poorly understood condition characterized by ossification of ligaments and entheses. This comprehensive Review explains the epidemiology and clinical manifestations of DISH, as well as highlighting the latest insights into pathogenic mechanisms. The authors also argue for the development of new classification criteria that can identify early disease.

Fibromyalgia is a controversial condition, and opinions are divided over whether psychocultural factors explain fibromyalgia content or whether it is largely a product of disordered central pain processing. In this article, Wolfe and Walitt describe how the definition of fibromyalgia has changed during its history, and discuss the factors that have enabled it to persist despite the ongoing debate.