Articles in 2012

Anaemia as a result of chronic inflammation is common in patients with rheumatic disease. In this Review, Weiss and Schett provide a broad overview of the topic, covering the pathogenesis, diagnosis, treatment and management of anaemia in inflammatory rheumatic disease, offering practical guidance for clinicians.

The management of patients with systemic sclerosis (SSc) is often challenging. As curative therapies are not yet available, the current goal in clinical practice is prevention of disease progression and end-organ damage. In this Review, the authors discuss approaches to screening patients with SSc for internal organ involvement and monitoring disease activity, as well as the management of patients with SSc and specific complications, including interstitial lung disease, pulmonary arterial hypertension and gastrointestinal disease.

Spinal osteoarthritis primarily manifests as disease of the facet joints of the posterior spine. This Review presents the latest information about the prevalence, presentation, and nature of facet joint osteoarthritis, an important cause of spinal pain that should be viewed as failure of the whole joint rather than a disease of articular cartilage loss and bony hypertrophy.

The IL-12 family cytokines contribute to immune-mediated inflammation and have an important role in determining T-cell fate. Evidence from preclinical and clinical studies suggests a role of these cytokines in the pathogenesis of rheumatoid arthritis (RA). The authors discuss these data and their potential clinical implications for patients with RA.

Small interfering RNAs (siRNAs) are a useful experimental tool to silence gene activity. The challenge, however, remains to optimize delivery and imbue 'drug-like' properties to siRNAs for therapeutic use. Here, the authors discuss advances in siRNA therapeutics and their potential application in treating rheumatic disease.

This article provides an overview on the structure and function of the syndecan family of transmembrane proteoglycans. The authors discuss the regulation of these molecules and their roles in the developing joint as well as in cartilage breakdown and synovial inflammation.

Following a decade of substantial improvements in sensitivity and usability, MRI is increasingly used to assess primary outcomes of therapeutic trials in rheumatoid arthritis (RA). In the wake of an MRI-based evaluation of treatment efficacy, what lessons are emerging about the clinical value of this technique for patients with RA?

Early diagnosis of psoriatic arthritis will prevent joint damage and improve long-term patient outcome. For dermatologists and general practitioners, early recognition of the diverse musculoskeletal manifestations can prove problematic. Screening tools and biomarkers offer great promise—the recent description and initial validation of the EARP tool is an encouraging development.

Crosstalk between the skeletal and immune systems—especially immunomodulation of bone turnover, but increasingly also regulation of immune functions by bone cells—was recognized during research into arthritis and has evolved into the discipline of osteoimmunology. Hiroshi Takayanagi presents an update of advances in this area, focusing on the influences of T cells on bone remodelling, and relationships between osteoblasts and haematopoiesis.

Aberrant expression of microRNAs is associated with the pathogenesis of systemic lupus erythematosus (SLE). In this Review, Shen and colleagues discuss the potential of microRNAs to act as biomarkers for the diagnosis and assessment of patients with SLE, as well as the future therapeutic potential of targeting miRNAs in the management of patients with SLE.

Increasing evidence points towards the skeleton as having an endocrine role in humans. In this Review, DiGirolamo and colleagues introduce the concept of the skeleton as an endocrine organ, summarizing the evolution of skeletal endocrine networks and the role of the skeleton in phosphate and glucose homeostasis.

Despite their association with loss of bone mass and increased fracture risk, glucocorticoids have been an important component of rheumatoid arthritis therapy for more than 60 years. In this article, Ulrike Baschant and colleagues describe the tissue-specific, molecular and cellular mechanisms of glucocorticoid action, and suggest new criteria for selective glucocorticoid receptor agonists, which could have similar anti-inflammatory efficacy to traditional glucocorticoids without the adverse effects.