Review Articles in 2024

In this Review the author summarizes the current approaches for antigen-specific therapies in the treatment of autoimmune disease and highlights the challenges that need to be addressed for successful use of this therapeutic strategy.

In this Review, Nigrovic and colleagues examine potential mechanisms underlying the paradoxical continuation of inflammation in arthritis, despite the increased numbers of regulatory T cells in inflamed joints, and discuss the implications for regulatory T cell-targeted therapeutic interventions in inflammatory arthritis.

This Review provides an update on the evidence for the three main hypotheses of HLA-B27 in the pathogenesis of spondyloarthritis. The authors discuss the current understanding of the effect of HLA-B27 on innate and adaptive immunity and how this drives disease.

This Review provides a comprehensive update on dysregulated type I interferon production and signalling in autoinflammatory interferonopathies, monogenic systemic lupus erythematosus and conditions that present with broad immune dysregulation and interferon signatures. The authors provide a classification for autoinflammatory interferonopathies based on disease mechanisms of increased type I interferon production and signalling and overlapping clinical phenotypes.

This Review provides an update on autoantibodies associated with idiopathic inflammatory myopathies in both adults and children. The authors also discuss methods of autoantibody detection and the advantages and limitations of each technique.

BCR-independent memory B cell reactivation via TLR7 or TLR8 activation, type I interferon production, immune complex formation and T helper cell signalling is central in SLE pathogenesis. Dörner and Lipsky discuss the potential of targeting these pathways to eliminate autoreactive memory B cells and plasma cells in SLE.

This Review provides an overview of the pathogenesis, classification and diagnosis of and treatment strategies for adult and paediatric rheumatology patients with uveitis. The authors highlight the importance of collaborations between ophthalmologists and rheumatologists to provide optimal treatment of uveitis, improve patient care and enhance future research.

Digital health has the potential to improve patient care in rheumatology and alleviate strain on the health-care system. This Review explores the current status of the transition from traditional health care to a model that harnesses the potential of digital health technologies, including discussion of the main benefits and barriers.

In this Review, López and Gualillo discuss the complex interrelationships between rheumatic diseases and the hypothalamic and autonomic mechanisms that regulate metabolism, and explore the therapeutic potential of targeting central regulators of energy balance.

Despite the availability of numerous treatment options, the management of rheumatoid arthritis remains suboptimal. In this Review, Konzett and Aletaha discuss strategies to advance clinical decision-making from trial-and-error to an informed process that considers more than just drug efficacy, and appropriately balances effort and success.

This Review discusses the involvement of early-stage and late-stage somatic mutations in the pathogenesis of both monogenic and multifactorial rheumatic diseases. The authors highlight new methods of detecting low-frequency variants and the implications for diagnosis and treatment in patients with rheumatic diseases.

Epstein–Barr virus (EBV) infection is associated with numerous autoimmune diseases, including rheumatic diseases. In this Review, Robinson and colleagues provide an overview of the biology of EBV, the potential mechanisms through which EBV could promote autoimmune diseases and how EBV might be targeted for the treatment of autoimmune disease.

Neuropsychiatric manifestations of systemic lupus erythematosus (SLE) are common and negatively impact health. Diagnosing neuropsychiatric SLE is challenging owing to a lack of reliable biomarkers, and current treatments rely on clinical experience. This Review covers recent clinical advances in this area and emphasizes the need for further research.

Each episode of lupus nephritis causes irreversible kidney injury, initiating and, subsequently, exacerbating chronic kidney disease. This Review discusses how interdisciplinary care that considers all immune and non-immune risk factors for chronic kidney disease progression can benefit patients with lupus nephritis.

This Review provides an update on developments in Janus kinase inhibitors, including new disease indications and adverse effects. The authors discuss issues surrounding selectivity and efficacy, as well as new routes for administration of Janus kinase inhibitors.

Holers and colleagues review current data linking immune mechanisms and dysbiosis at distinct mucosal sites to risk of rheumatoid arthritis (RA). Their newly introduced causal mucosal endotypes hypothesis suggests that lung-, gut-, or oral-associated endotypes might drive the pathogenesis and progression of RA, and highlights associated research directions towards preventive and therapeutic strategies in RA.

Emerging data suggest that resident cells and locally produced mediators interact with nerves in the joint to promote pain in rheumatoid arthritis. This Review discusses the potential neuro–immune–stromal interactions promoting joint pain and highlights the need for an interdisciplinary approach to therapeutic development.

This Review explores the genetic basis of systemic lupus erythematosus, including the role of enhancers in the MHC region, the 3D structure of DNA and various pathway-specific mechanisms. These findings enhance disease understanding and inform improved diagnosis and treatment strategies.

Cardiovascular involvement is one of the many manifestations of rheumatic immune-mediated inflammatory diseases (IMIDs) that increase mortality. The pathogenesis of atherosclerosis and inflammatory cardiomyopathies involves inflammatory pathways common with those operating and targeted in rheumatic IMIDs. Here, Maya Buch and colleagues discuss implications of these shared pathways for the prevention, detection and management of cardiovascular involvement in patients with rheumatic IMIDs, while highlighting complexities and open questions.

Ion channels have key functions in chondrocytes, bone cells, immune cells and neurons. Liu and colleagues discuss how these functions might contribute to cartilage degeneration, bone formation inflammation and pain in osteoarthritis, and highlight the therapeutic potential of ion channel modulators.