Suresh N, Spoorthy Raj DR, Patil H
… +2 more, Arora D, Mamadapur M
Int J Rheum Dis
· 2026 Mar · PMID 41821208
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BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an emerging therapeutic strategy for severe autoimmune rheumatic diseases (AIRD) where conventional therapies often fail to achieve long-term remission. This...BACKGROUND: Hematopoietic stem cell transplantation (HSCT) is an emerging therapeutic strategy for severe autoimmune rheumatic diseases (AIRD) where conventional therapies often fail to achieve long-term remission. This review focuses on the role of HSCT in specific AIRD, including systemic sclerosis (SSc), systemic lupus erythematosus (SLE), rheumatoid arthritis (RA), deficiency of adenosine deaminase 2 (DADA2), antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis, Takayasu arteritis (TA), and juvenile idiopathic arthritis (JIA). OBJECTIVE: The objective was to evaluate the efficacy, immunological mechanisms, patient selection criteria, conditioning regimens, and outcomes of HSCT in the management of these specific AIRD, with a focus on systemic sclerosis-associated interstitial lung disease (SSc-ILD). METHODS: A comprehensive literature review was conducted, analyzing clinical trials, observational studies, and preclinical research on HSCT in the following AIRD: SSc, SLE, RA, DADA2, ANCA-associated vasculitis, TA, and JIA. The review examined pulmonary outcomes, immune reconstitution, CD34+ cell selection, and post-transplant immunosuppression. Keywords used in the search included SSc, SLE, RA, DADA2, ANCA-associated vasculitis, Takayasu arteritis, and JIA. RESULTS: HSCT has demonstrated promising outcomes, particularly in diffuse cutaneous SSc with ILD improvement and in refractory cases of SLE, RA, and JIA. In DADA2, HSCT can reverse hematological, immunological, and vascular phenotypes. While effective in some cases of ANCA-associated vasculitis and TA, relapses and complications remain a concern. Immunological benefits include the regeneration of a self-tolerant immune system. However, early transplant-related mortality (TRM) necessitates careful patient selection and reduced toxicity conditioning. CONCLUSIONS: HSCT offers a transformative approach for select patients with refractory SSc, SLE, RA, DADA2, ANCA-associated vasculitis, TA, and JIA, achieving long-term, drug-free remission in some. Future research should optimize conditioning protocols, refine patient selection, and assess long-term outcomes to maximize HSCT benefits and minimize risks.
Türkuçar S, Sözeri B, Sönmez HE
… +24 more, Şahin N, Açarı C, Dundar HA, İşgüder R, Gücenmez ÖA, Taşkın SN, Çakan M, Demir F, Şener S, Karadağ ŞG, Yıldırım DG, Kazanasmaz H, Öztürk K, Yener GO, Tanatar A, Doğantan Ş, Taşkın RB, Bağlan E, Demir BK, Bora B, Kalyoncu M, Bakkaloğlu S, Ünsal E, Yüksel S
Int J Rheum Dis
· 2026 Mar · PMID 41821199
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INTRODUCTION: Juvenile spondyloarthropathies (JSpA) are a group of chronic inflammatory diseases that differ in their clinical features and course from adult spondyloarthropathies and other subtypes of juvenile idiopathi...INTRODUCTION: Juvenile spondyloarthropathies (JSpA) are a group of chronic inflammatory diseases that differ in their clinical features and course from adult spondyloarthropathies and other subtypes of juvenile idiopathic arthritis (JIA). Therefore, defining disease inactivity in JSpA requires specific criteria. This Delphi study aimed to establish a national consensus on its core clinical, laboratory, and radiological domains. METHODS: A total of 27 pediatric rheumatologists participated in the Delphi survey, conducted in two rounds. Participants were asked multiple-choice and Likert-type questions regarding their preferences for using domains including anamnesis, laboratory findings, imaging methods, and predefined disease activity scores for assessing inactivity. At the end of each round, the study coordinators determined the "strong consensus" items based on a power analysis of these parameters. RESULTS: The absence of "pain or tenderness in the peripheral joints, lower back and entheseal regions" in anamnesis domain and "tenderness in the peripheral joints, entheseal areas, and hip examination"; "swelling in the peripheral joints; tenderness on sacroiliac compression testing"; and "no reduction in hip RoM examination" in physical examination domain received the highest scores and were accepted as strong consensus. Furthermore, normalization of MRI findings of SIJ and hip/peripheral joint and "physician global score = 0" reached the specified thresholds, resulting in strong consensus following the second round. CONCLUSIONS: This Delphi study highlights the need for a multidimensional approach that integrates clinical, radiological, and physician assessments to define disease inactivity in patients with JSpA. The resulting consensus provides a more specific assessment on inactivity defining JSpA patients and reflects a national consensus.
Int J Rheum Dis
· 2026 Mar · PMID 41821197
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AIM: Artificial intelligence and machine learning have been increasingly employed in medical image diagnosis, but face the challenge of database acquisition. Hence, this study applies the You Only Look Once (YOLO) techni...AIM: Artificial intelligence and machine learning have been increasingly employed in medical image diagnosis, but face the challenge of database acquisition. Hence, this study applies the You Only Look Once (YOLO) technique, a real-time object detection system, to construct the inference model, including the image preprocessing and labeling, model training, and the prediction of unknown data to detect objects. METHODS: We implement the YOLOv4 technique to classify osteoporosis and detect compression fractures. Trabecular characteristics of osteoporosis are extracted from caput femoris in X-ray images, and compression fractures are observed in lateral spine images. All the datasets are derived from the clinical practice of the collaborated teaching hospital. RESULTS: We construct the YOLOv4 model to classify osteoporosis and detect compression fractures with prediction accuracy of 78.1% and 68.3%, respectively. X-ray could be a screening tool to predict osteoporosis and select patients for DXA, especially in settings where the DXA facility is unavailable. CONCLUSION: We find it promising to apply the developed approach to medical diagnosis with an accuracy of near 80%, and this deep learning model could preliminarily help to screen possible positives from abundant radiographs.
Toomey D, Lewis G, Tuck N
… +3 more, Darlow B, Rashid U, Rice D
Int J Rheum Dis
· 2026 Mar · PMID 41804569
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OBJECTIVE: Recent evidence suggests that education on the pain-relieving effects of exercise may enhance exercise-induced hypoalgesia (EIH) in healthy individuals. However, its impact in populations with osteoarthritis (...OBJECTIVE: Recent evidence suggests that education on the pain-relieving effects of exercise may enhance exercise-induced hypoalgesia (EIH) in healthy individuals. However, its impact in populations with osteoarthritis (OA), where EIH responses are more variable, remains unclear. This study examined whether positive pre-exercise education enhances EIH in individuals with knee OA. METHODS: A double-blind, randomized controlled trial was conducted with 42 participants allocated to either a positive pre-exercise education group (n = 21) or a control education group (n = 21). Each group received two individual education sessions 24-72 h apart. OA- and EIH-related knowledge and beliefs were assessed pre- and post-education. EIH was evaluated following a single submaximal isometric quadriceps contraction to failure by measuring changes in pressure pain thresholds (PPTs), resting pain, and pain during stepping. Group differences were analyzed using ANCOVA. RESULTS: The positive pre-exercise education group demonstrated greater improvements in EIH-related knowledge and beliefs compared to the control group (p = 0.001, d = 0.50, ANCOVA between-group analysis), while OA-related knowledge and beliefs remained unchanged (p = 0.34, d = 0.15). However, ANCOVA results showed no significant between-group differences in pre- to post-exercise changes in PPTs, resting pain, or pain during stepping (all p > 0.11, d = 0.04-0.25). CONCLUSION: Despite enhancing beliefs about exercise-induced pain relief, positive pre-exercise education did not enhance EIH compared to control education. These findings highlight the need for alternative strategies to optimize exercise-induced pain relief in OA.
Salcedo-Soto DA, Bardán-Inchaustegui AC, Ortiz-Nuño MF
… +7 more, Carrazco-Chapa A, Garza-Elizondo AK, Lara-Mendez DM, Villarreal-Alarcon MA, la Garza JAC, Galarza-Delgado DA, Flores-Alvardo DE
Int J Rheum Dis
· 2026 Mar · PMID 41803628
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Int J Rheum Dis
· 2026 Mar · PMID 41803619
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BACKGROUND: Limited evidence exists regarding medication regimens for infection-prone patients with systemic lupus erythematosus (SLE) undergoing peritoneal dialysis (PD). This study evaluated the association between med...BACKGROUND: Limited evidence exists regarding medication regimens for infection-prone patients with systemic lupus erythematosus (SLE) undergoing peritoneal dialysis (PD). This study evaluated the association between medication use and peritonitis in patients with SLE on PD and compared peritonitis rates between patients with and without SLE. METHODS: We retrospectively studied patients who underwent PD between 2007 and 2023. Using propensity score matching, we compared 46 patients with SLE and 46 non-SLE controls matched by sex, date of PD initiation, diabetes mellitus, and age at PD initiation. Peritonitis incidence and risk ratios were calculated using Poisson regression. Time-dependent Cox proportional hazards model identified risk factors for peritonitis. RESULTS: Incidence of peritonitis was higher in patients with SLE at 0.32 episodes per patient-year compared with 0.25 in the controls (risk ratio 1.30, p = 0.15). Time to first peritonitis episode, peritonitis-associated catheter removal, and mortality rates were similar between the groups. Independent risk factors for peritonitis included male sex (hazard ratio [HR]: 2.29, 95% confidence interval [CI]: 1.22-4.27, p = 0.009), gastric acid suppressants (GAS, HR: 8.71, 95% CI: 2.53-30.05, p < 0.001), and glucocorticoid (GC, HR: 1.16, 95% CI: 1.08-1.26, p < 0.001) in patients with SLE on PD. A significant number of peritonitis was still observed in patients not receiving GC. CONCLUSION: PD is a safe dialysis modality for patients with SLE, with comparable outcomes to non-SLE controls. Nevertheless, the risk of peritonitis in patients with SLE undergoing PD may be increased by the administration of GAS and GC, as well as male sex.
El Shintenawy AA, Elshintenawy E, Awny RM
… +1 more, Tabra SA
Int J Rheum Dis
· 2026 Mar · PMID 41800495
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INTRODUCTION: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease. Endothelial dysfunction is an early change in atherosclerosis. Endocan is a new indicator of endothelial dysfunction and is pr...INTRODUCTION: Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease. Endothelial dysfunction is an early change in atherosclerosis. Endocan is a new indicator of endothelial dysfunction and is probably involved in proinflammatory processes in SLE. This study aimed to assess the serum endocan level in SLE patients and its relation to disease activity, endothelial dysfunction, and subclinical atherosclerosis. METHODS: This study included 60 SLE patients and 60 healthy controls. Demographic data were collected, and disease activity was assessed using the SLEDAI score for SLE patients. Functional assessment was done using the Health Assessment Questionnaire (HAQ). Serum endocan level was measured, and subclinical atherosclerosis was assessed using brachial artery flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT). RESULTS: Endocan levels in the SLE group (632.2 ± 70.58 ng/L) were significantly higher than controls (125.83 ± 16.23 ng/L). cIMT was significantly higher in SLE patients (8.18 ± 1.13 mm) than in controls (6.43 ± 0.54), and the mean flow-mediated dilation value in SLE patients was 9.57 ± 2.59, whereas in the control group, it was 21.8 ± 4.27. The serum level of endocan was significantly correlated with the duration of the disease, triglycerides, and cIMT, and it had a significant negative correlation with flow-mediated dilation. cIMT and flow-mediated dilation were significantly correlated with age, disease duration, and triglycerides. CONCLUSIONS: Elevated serum levels of endocan in SLE patients may be associated with subclinical atherosclerosis and endothelial dysfunction.
Huang LH, Wang YH, Wu TJ
… +3 more, Lin FY, Chen CY, Leong PY
Int J Rheum Dis
· 2026 Mar · PMID 41795863
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BACKGROUND: Rheumatoid arthritis (RA) is a systemic autoimmune disease with known extra-articular manifestations, including potential involvement of the gastrointestinal (GI) tract. While prior studies have explored mali...BACKGROUND: Rheumatoid arthritis (RA) is a systemic autoimmune disease with known extra-articular manifestations, including potential involvement of the gastrointestinal (GI) tract. While prior studies have explored malignancy risks in RA, limited large-scale data exist on the association between RA and both cancerous and non-cancerous GI comorbidities. METHODS: This retrospective nested case-control study utilized Taiwan's National Health Insurance Research Database (NHIRD) from 2000 to 2019. A total of 75 670 individuals newly diagnosed with RA were matched 1:4 by age and sex to 302 680 controls without RA. The prevalence and adjusted odds ratios (aOR) for GI conditions-including gastric ulcer, duodenal ulcer, GERD, irritable bowel syndrome, inflammatory bowel diseases, and various GI cancers-were evaluated using conditional logistic regression. RESULTS: Patients with RA demonstrated significantly higher odds of several benign GI conditions, including peptic ulcer disease (aOR: 1.72, 95% CI: 1.66-1.79), gastric ulcer (aOR: 1.52, 95% CI: 1.44-1.60), GERD (aOR: 1.49, 95% CI: 1.41-1.57), and inflammatory bowel diseases. These associations remained robust across age- and sex-stratified analyses. In contrast, most GI cancers were not significantly associated with RA. Notably, inverse associations were observed for stomach cancer (aOR: 0.66, 95% CI: 0.49-0.87) and liver and bile duct cancer in females (aOR: 0.74, 95% CI: 0.58-0.95). CONCLUSION: RA is significantly associated with a higher prevalence of benign GI comorbidities but not with most GI malignancies. These findings highlight the importance of comprehensive GI screening in RA management and support the relevance of the gut-joint axis in autoimmune disease pathogenesis.
Zong Q, Li Y, Wang Y
… +17 more, Feng Y, Yu Y, Zhang M, Tang Y, Cui L, Cai L, Xu Y, Sun H, Gong X, Liu Y, Liu S, Chen Y, Li W, Pan H, Pan F, Su H, Zou Y
Int J Rheum Dis
· 2026 Mar · PMID 41792945
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OBJECTIVE: To explore the association of mitochondrial DNA (mtDNA) genetic variants, including single nucleotide variants (SNVs), insertions and deletions (InDels), and copy number variations (CNVs), with depression and...OBJECTIVE: To explore the association of mitochondrial DNA (mtDNA) genetic variants, including single nucleotide variants (SNVs), insertions and deletions (InDels), and copy number variations (CNVs), with depression and anxiety in Chinese patients with systemic lupus erythematosus (SLE). METHODS: A two-stage study of 530 patients with SLE was conducted to explore the association between mtDNA genetic variants (SNVs and InDels) and depression and anxiety. A total of 499 patients with SLE were recruited to explore the association between mtDNA CNVs and depression and anxiety. Meanwhile, the patients were followed up for 12 weeks to observe the improvement of depression and anxiety. The levels of reactive oxygen species (ROS), adenosine triphosphate (ATP), interleukin-6 (IL-6), and interleukin-1β (IL-1β) were detected. RESULTS: Two mtDNA SNVs (C16291T, A16399G) in the displacement loop (D-loop) region were associated with depression in patients with SLE (P = 0.003, P = 0.007). Two mtDNA SNVs (T9950C, T16140C) in the cytochrome c oxidase subunit III (COX3) gene and D-loop region were associated with anxiety in patients with SLE (P = 0.001; P = 0.003). Associations of mtDNA CNVs with depression and anxiety in SLE were observed in several subgroups (P < 0.05). T9950C and T16140C variants were related to the improvement of anxiety in SLE (P < 0.05). An inverse U-shaped non-linear association was observed between mtDNA CNVs and the improvement of anxiety in the body mass index (BMI) ≥ 24 subgroup of SLE (P = 0.038). The levels of ROS (p = 0.040) and IL-6 (p = 0.039) were increased and ATP level (p = 0.034) was decreased in the COX3 gene variation group. CONCLUSION: mtDNA genetic variants may be associated with depression and anxiety in Chinese patients with SLE. This study provides a new idea for improving depression and anxiety in SLE.
Liou IH, Huang WY, Tuan SH
… +3 more, Chang WH, Yu LH, Sun SF
Int J Rheum Dis
· 2026 Mar · PMID 41787759
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BACKGROUND: Osteoporosis is increasingly recognized as a systemic disease influenced by chronic inflammation. The interdisciplinary nature of research in this field necessitates a comprehensive mapping of its evolution,...BACKGROUND: Osteoporosis is increasingly recognized as a systemic disease influenced by chronic inflammation. The interdisciplinary nature of research in this field necessitates a comprehensive mapping of its evolution, contributors, and thematic trends. AIM: To perform a bibliometric analysis of global research on osteoporosis and chronic inflammation from 1994 to 2025, identifying publication patterns, key contributors, and emerging research themes. METHODS: Publications were retrieved from Scopus using the terms "chronic inflamm*" and "osteoporo*." Eligible records included original research articles, reviews, conference papers, and editorials. Data were analyzed using bibliometrix (biblioshiny), VOSviewer, and Harzing's Publish or Perish to assess publication trends, geographical contributions, authorship patterns, journal metrics, keyword co-occurrence, and thematic evolution. RESULTS: A total of 1464 documents from 855 journals were analyzed, authored by 6777 individuals. The average annual growth rate was 13.45%, with a collaboration index of 5.13 and an international collaboration rate of 16.8%. The United States of America led in total citations, while Malaysia, Lebanon, and Austria had the highest average article citations. Most prolific authors and top-cited works were concentrated in academic or governmental institutions, with limited industry-affiliated corresponding author representation identified in the dataset. Osteoporosis-focused journals achieved higher citation impact compared to multidisciplinary journals. Keyword analysis revealed three major thematic clusters: mechanistic/immunological underpinnings, clinical diagnostics/risk factors, and pharmacological interventions/comorbidities, with thematic evolution showing a shift toward interdisciplinary integration since 2014. CONCLUSION: Research on chronic inflammation and osteoporosis has expanded rapidly, integrating mechanistic, clinical, and translational perspectives. Our findings indicate that chronic inflammation has increasingly shifted from a peripheral topic toward a central organizing theme within osteoporosis research, reflecting growing integration between immunological and bone-centric research traditions.