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The 2016 ACR–EULAR classification criteria for primary Sjögren syndrome, which are intended to facilitate uniform classification of patients for enrolment in clinical studies, combine features of previous criteria sets. These new criteria are a step in the right direction, but further refinement would increase their utility.
How and why systemic autoimmunity targets the joints in rheumatoid arthritis remains a major unanswered question. In this Review, Catrina et al. discuss the evidence for a driving role for osteoclasts in the homing of autoimmunity to the joints.
New criteria have been proposed to enable a rapid diagnosis of cryopyrin-associated periodic syndromes (CAPS) in children and adults. Will these diagnostic criteria advance the management of autoinflammatory syndromes, or will physicians now think of zebras rather than horses when they hear hoofbeats?
Although an imbalance between proinflammatory and anti-inflammatory cytokines has been implicated in rheumatoid arthritis (RA), the identification of specific cytokines regulating RA pathophysiology is still challenging. Modelling cytokine signalling networks and evaluating associated pathway activities might facilitate the effective identification of cytokines for treatment and prevention of RA.
The endoplasmic reticulum (ER) is vital for cellular function and differentiation in every organ system. In this Review, the authors discuss how cells respond to ER stress and outline the ways that this stress can contribute towards rheumatic diseases.
The transition of HIV and AIDS from a death sentence to a chronic disease has not come without problems. Rheumatologists need to be aware of the full spectrum of rheumatic diseases seen in patients with HIV and AIDS, and know the best strategies for disease management.
In this Review, the authors discuss the use of mass spectrometry imaging in rheumatology. This technique enables the identification and spatial localization of molecules in tissues, with potential applications in both clinical and research settings.
Despite conflicting evidence from clinical trials, rituximab continues to be used off-label in the treatment of systemic lupus erythematosus (SLE). A new study has now investigated the use of this drug for SLE in Europe, including indications for use and patient characteristics.
In this Review, Tsokos et al. describe recent advances in our understanding of systemic lupus erythematosus (SLE) that are driving repurposing of existing drugs as well as development of new treatments. Cytokines, tolerance pathways, local tissue mediators, and epigenetic mechanisms all show promise as novel targeted therapies that could lead to individualized care in SLE.