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Single-cell proteomic techniques that use elemental (heavy metal) reporter ions increase the number of parameters that can be studied at once in whole tissues. This Review discusses the practical aspects of using such technologies in rheumatic disease research.
Use of prescription opioids is prevalent in patients with rheumatic diseases. Studies in 2019 reported the trends and safety of opioids in patients with rheumatoid arthritis or osteoarthritis. Treating underlying disease processes must be the rheumatologists’ priority. Without better long-term safety and effectiveness data, opioid use should be generally limited.
The synovium is the main target tissue of inflammatory arthritides such as rheumatoid arthritis and psoriatic arthritis. In 2019, new technologies for examining the molecular characteristics of specific cell subsets have enabled advances in our understanding of the architecture of synovial lymphoid aggregates, macrophage infiltrates and synovial fibroblast subsets.
The availability of biosimilars to treat inflammatory diseases has generated concern about changing patients from a bio-originator to its biosimilar to save costs. Studies published in 2019 support the effectiveness and safety of ‘nonmedical switching’ and highlight the benefits of communicating information about biosimilars to patients in a positive light.
Dysregulation in the formation and/or clearance of neutrophil extracellular traps (NETs) is important in immune dysregulation and organ damage in chronic inflammatory conditions. Studies in 2019 have shown how certain genetic susceptibilities to autoimmunity can promote NET-mediated inflammation, and expanded the role for NETs in vascular damage and premature atherosclerosis.
Repurposing of drugs for and among rheumatic autoimmune inflammatory diseases can introduce promising new treatments. New knowledge about these diseases and the development of data-driven techniques are identifying new pathways and targets for repurposing.
Asymptomatic hyperuricaemia precedes and potentially contributes to the development of gout and other chronic diseases. This review summarizes what is known about the effects of uric acid on pro-inflammatory responses.
Behavioural economics uses psychological and economical insights to explain decision making by individuals to understand the predictable way in which individuals behave irrationally. Concepts from this field can be applied to promote healthy behaviours and could be applicable to rheumatology.
Myofibroblasts are important mediators of wound healing but can also perpetuate fibrosis in diseases such as systemic sclerosis by evading apoptosis. Therapeutic targeting of the survival mechanisms used by these cells in fibrotic disease holds promise for the reversal of fibrosis.