Search

Psoriatic arthritis (PsA) is an inflammatory arthritis belonging to spondyloarthritides (SpA), a group of rheumatologic diseases characterised bya wide spectrum of different clinical manifestations that tend to associate with various comorbidities and that may significantly compromise the quality of life of patients. Nowadays, it is well known how PsA may manifest in different clinical domains, in particular peripheral articular and periarticular involvement, axial involvement, skin and nail psoriasis. Moreover, the majority of patients with PsA develop comorbidities such as inflammatory bowel diseases, uveitis, but also cardiovascular diseases, psychiatric or pulmonary pathologies. The therapeutical armamentarium of PsA has been enriched during the last years, in relation to an advance in the knowledge of the immunological mechanisms at the basis of the disease; in particular, the future frontier of "personalised medicine" could lead to a further improvement in the quality of care of this group of patients. In this paper we review the literature on PsA of 2019 (Medline search of articles published from 1st January 2019 to 31st December 2019).

Spondyloarthritis (SpA) is the umbrella term for a broad spectrum of inflammatory rheumatic diseases with typical but also rather different clinical manifestations, limited laboratory abnormalities and characteristic imaging features. For classification purposes, a so-called non-radiographic form (nr-axSpA) is differentiated from a radiographic one (r-axSpA) which is almost identical to the classical ankylosing spondylitis (AS) that is genetically strongly associated with the major histocompatibility complex class 1 antigen HLA-B27. In axSpA, the axial skeleton is affected by both inflammation and new bone formation, and joints might be affected. Rather typical musculoskeletal manifestations of SpA are enthesitis and dactylitis, the latter mainly in psoriatic arthritis (PsA). Extra-articular manifestations such as acute anterior uveitis (AAU), psoriasis (PsO) and inflammatory bowel disease (IBD) are also typical of SpA. In this paper we review the literature on axial SpA (ax-SpA) of 2018 (Medline search of articles published from 1st January 2018 to 31st January 2019).

Systemic lupus erythematosus (SLE) is an autoimmune connective-tissue disorder with a wide range of clinical manifestations that predominantly affect women. Many aspects of its pathogenesis are still unclear, and new therapeutic strategies are progressively emerging. Thus, in this review we aim to summarise the most relevant data on SLE that emerged during 2018, following the previous annual review of this series. In particular, the review will focus on new insights in SLE regarding new pathogenetic pathways, new biomarkers, new data on clinical manifestations, clinical outcomes and comorbidities and what has emerged on new drugs and new therapeutic strategies.

Spondyloarthritis (SpA) is an inflammatory condition characterised by a broad spectrum of clinical manifestations, laboratory abnormalities and imaging features that genetically tend to be associated with the major histocompatibility complex class 1 antigen, HLA-B27, and in which both peripheral and axial joints might be affected. In addition to arthritis, the typical musculoskeletal manifestations are enthesitis and dactylitis. Extraarticular manifestations such as acute anterior uveitis (AAU), psoriasis (PsO) and inflammatory bowel disease (IBD) are also typical of SpA. In this article we have reviewed the literature of the past year on one of the most important variants of SpA, i.e. psoriatic arthritis (PsA) (Medline search of articles published from 1st January 2018 to 31st January 2019).

Rheumatoid arthritis (RA) is a chronic inflammatory autoimmune disease that primarily affects joints. The several mechanisms involved in the development of the disease are not completely understood. It has been proposed that different environmental factors, such as cigarette smoking, occupational and atmospheric agents act as trigger stimuli for the development of RA in genetically predisposed individuals, leading to synovial hyperplasia and bone destruction. The initial disease stage of RA is associated with alteration of innate and adaptive immune system with consequent production of autoantibodies, targeting various molecules including modified self-epitopes. In the following stages of the disease, both the innate (e.g. dendritic cells, macrophages and neutrophils) and adaptive immune cells (e.g. B and T lymphocytes) contribute to the amplification and perpetuation of the chronic inflammatory state. The recognition of key cells, mediators and mechanisms implicated in the pathogenesis of RA could provide the basis for the development of new and precise disease-modifying anti-rheumatic drugs. Therefore, we reviewed the literature of the last year in order to find the new insights in RA pathogenesis.

Systemic vasculitis are heterogeneous, complex and disabling disorders. Following the previous annual reviews of this series, this paper gives a brief overview on current knowledge about recent literature on small- and large-vessel systemic vasculitis, with a specific focus on pathogenetic and clinical aspects, novel possible disease-related biomarkers and current and future therapies that are in the pipeline.

Systemic lupus erythematosus (SLE) is a systemic autoimmune disease with a highly variable course and prognosis. The management of the disease is still a clinical challenge for the treating physicians as many aspects regarding the disease pathogenesis, clinical picture and outcomes remain to be elucidated. New and interesting data are emerging; here the recent literature on SLE pathogenesis, clinical and laboratory aspects, as well as treatments and comorbidities, are reviewed and the main findings summarised in order to provide a bird's eye on the relevant papers on these topics.

Androstenedione (delta), oestradiol-17beta (Oe2), 5alpha-dihydrotestosterone (DHT), progesterone (P) and testosterone (T) concentrations have been measured by radioimmunoassay in ovarian and peripheral venous blood from 15 women in the luteal phase of the cycle. The ovarian blood samples were obtained during surgical intervention from 15 ovaries containing the corpus luteum and from 5 contralateral ovaries. The mean concentration of DHT in ovarian venous blood was not higher than that found in the cubital vein. However in some cases with high concentrations of testosterone in ovarian venous blood, a small but significant DHT gradient was found.

An original method for 5-androsten-3beta,17beta-diol (A-diol) measurement using an antiserum against A-diol-16-CMO-BSA is described. A-diol and testosterone (T) were determined by radioimmunoassay methods in spermatic and peripheral venous plasma of nine normal subjects during surgical intervention for inguinal hernia repair. In spermatic venous plasma the levels of T and A-diol were, respectively, 25.9 +/- 13.3 and 4.8 +/- 5.1 microgram/100ml (mean +/- SD) with an A-diol/T ratio of 0.19 +/- 0.15 (mean +/- SD); in peripheral plasma the levels of T and A-diol were, respectively, 269 +/- 58 and 91 +/- 25 ng/100 ml (mean +/- SD) with an A-diol/T ratio of 0.35 +/- 0.12 (mean +/- SD) significantly different from spermatic venous plasma (p less than 0.01). From these data a mean testicular A-diol secretion of about 0.70 mg/24 h can be calculated: this value corresponds approximately to the 50% of the blood production rate (BPR) of this steroid. So it can be assumed that a large amount of A-diol in systemic blood comes from sources outside the male gonad.