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How Does Your Garden Grow (9.26.2025)
Dr. Jack Cush reviews the news and journal articles from RheumNow.com. Pool therapy, Fibrosis, NSIE's and what's best for knee OA.
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#ACR25 Abstr#2601 At single cell level using CyTOF, metabolic activity varied btw HC & autoimmune groups but clusters in At-Risk ANA+ve appeared closer to #SLE. ANA+ve who progressed to AI-CTD showed Plasmablast expansion & enhanced glycolysis. Could be used as target @RheumNow https://t.co/jtrM1wvQLk
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
A new genetic score for ILD prediction! 🫁
Developed in the Veterans RA cohort and Validation in a Swedish cohort
Model using classic RA-ILD risk factors and a cocktail of genetic risk
A cut off of 0.05 in this cohort would exclude 36% from HRCT or PFTs
Good performance https://t.co/6UsoSQAtyK
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#1723 Why is systemic autoimmunity more common in females?
Loss of X-chromosome inactivation maintenance in B cells (not T cells) amplifies interferon-driven disease, with increased autoantibodies, inflammation and renal injury. Key mechanistic advance. @RheumNow #ACR25
Mrinalini Dey DrMiniDey ( View Tweet)
#ACR25 SMILE RCT of Incomplete #SLE (ANA+ but not meeting SLICC) showed HCQ didn’t slow down SLE progression. But multiplex arrays showed reduction in autoantibodies with HCQ that were distinct from abs assoc. w progression. Would biomarker endpoints be the answer? @RheumNow https://t.co/XcvacgObVo
Md Yuzaiful Md Yusof Yuz6Yusof ( View Tweet)
Short chain fatty acids (SCFA) and the relevant microbiome have been linked to RA development and severity.
Study of monozygotic twins, where only one has RA, two diff cohorts:
lower SCFA
lower SCFA microbiome
Biomarkers, or even therapeutic target?
#ACR25 ABST0442 @RheumNow https://t.co/HW1YfkfOG3
David Liew drdavidliew ( View Tweet)
#0794 LLMs can accelerate qualitative lupus pregnancy research. Using AI to translate & analyze interviews from Portuguese, GPT-4 achieved top accuracy & coherence vs human themes. LLMs may expand inclusion & equity in rheum research. @RheumNow #ACR25 https://t.co/TAxg6Qyk0L
Mrinalini Dey DrMiniDey ( View Tweet)
Fascinating: tDR-1, a microbial sRNA, appears protective for RA in at risk ACPA+ pts:
- tDR-1 higher = less develop RA
- can predict seropos RA development
- in vitro type 1 IFN mapping checks out
Useful in itself, but importantly: why does it happen?
#ACR25 ABST0775 @RheumNow https://t.co/ep99dNAzFV
Links:
David Liew drdavidliew ( View Tweet)
tRNA-derived RNA (tDR-1), circulating microbial RNA
Associated w/ reduction in risk of RA conversion in asymptomatic CCP+ individuals (60 vs. 120+ ctrls),
‼️ tDR-1 alone over performs prediction model w/ smoking shared episode and RF w/ AUC 0.86
What is the mechanism? tDR-1 https://t.co/fuyk4NeOyA
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
What can we learn from longitudinal peripheral blood multi-omic profiling in at-risk individuals?
50 RA converters vs. non converters from StopRA study
Decision tree showing highest risk for conversion to clinical RA in Individuals w/
-CCP3 ≥108 units
-T peripheral helpers https://t.co/jw53EB6tI6
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
#0774
Multi-omic profiling of anti-CCP3+ “at-risk” individuals reveals Tph & cytotoxic CD8+ expansions, altered gene/chromatin profiles and predictive model (AUC 0.77) for RA conversion
PTPN22 locus accessibility & Tph ≥ 2.45% identify highest risk. @RheumNow #ACR25 https://t.co/JDSMkdmoGv
Mrinalini Dey DrMiniDey ( View Tweet)
A new marker for stratification of ILD in dermatomyositis: Anti MDA5 antibodies!
Japanese study
MDA5 (201-300) positivity associated w/
Lower 6-month progression-free survival (43% vs. 74%)
Lower 5-year survival rates (34% vs. 66%)
Validation in other populations awaited https://t.co/IBiYyATer4
Links:
Aurelie Najm AurelieRheumo ( View Tweet)
Clinical and Genetic Effects of Neuropsychiatric Lupus
The clinical features and genetic abnormalities of neuropsychiatric systemic lupus erythematosus shows that NPSLE often means more severe lupus and more organ involvement beyond the central nervous system. https://t.co/7Ujo6Kaf1N
Dr. John Cush RheumNow ( View Tweet)
Sequencing DNA to find new lupus treatments
MUSC geneticist Betty Tsao, Ph.D., will lead a five-year project to identify rare mutations associated with childhood-onset SLE, or lupus, with more than $3.5 million in funding from the National Institute of Arthritis and https://t.co/1vfQ4fK6FX
Dr. John Cush RheumNow ( View Tweet)
HLA-B27: still the most important genetic factor in axSpA susceptibility, but has lower frequency African American, South American & Middle Eastern pop. B27 discerns clinical subsets of SpA and PsA, particularly acute anterior uveitis or axSpA with psoriasis, https://t.co/S4s0NvuwNY
Dr. John Cush RheumNow ( View Tweet)
Inception SLE study of 674 pts (without LN), mean age 34 yrs - 154 (23%) developed new proteinuria (LN) after median of 3.6 yr. Cumulative antimalarial exposure did NOT lower risk of LN (HR 0.98; 0.94-1.02); same for those w/ serologically active SLE (HR 0.97) https://t.co/8OU3yJAvhN
Dr. John Cush RheumNow ( View Tweet)
Juvenile Lupus: some new mechanistic data
Circulating Treg population are expanded in SLE and in particular in Lupus Nephritis compared to HC
Naive Treg display specific molecular features in particular over expression of FCRL3 and TLR5 showing new pathways to explore in https://t.co/RuMtWRkpYB
Aurelie Najm AurelieRheumo ( View Tweet)
Italian Systemic sclerosis (SPRING-SIR) registry - 1157/1538 (75%) SSc pts were in menopause, 632 (50%) had pre-menop SSc onset, 130 (14.4%) had early menopause. Post-menop. had more CREST, centromere Abs, ILD & GI Sxs. Pre-menop. had more diffuse Dz & peripheral vasculopathy. https://t.co/Jz2v5CkH0Y
Dr. John Cush RheumNow ( View Tweet)
Interesting data shared by Dr. Sandhya Pulukool on Asian pts with SjD vs. Caucasians:
- Younger age of onset except in Japan
- Higher female to male ratio
@RheumNow #APLAR25 https://t.co/RPM9zI4tVQ
sheila RHEUMarampa ( View Tweet)
Peter Taylor on Pre-RA:
If Pre-RA is too late for interception, shall we start screening general population?
We have to remember RA is a RARE disease
Pre-test of RA per year per person would be 0.00025% for primary prevention:
A needle in a haystack?
@RheumNow @APLAR_org https://t.co/LKGtz1P7sl
Aurelie Najm AurelieRheumo ( View Tweet)
