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Immunology

US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/C42QMd2zap
Dr. John Cush @RheumNow( View Tweet )
US guided lymph node Bx compared 25 controls, 14 ACPA (+) & 45 ACPA (-) RA pts. ACPA+ LN Bx showed upregulated adaptive imm. genes, but ACPA neg LN Bx showed higher innate imm genes - especially w/ higher neutrophil presence & incr CD15 + PMNs irrespective of ACPA status https://t.co/h8trTxt5t1
Dr. John Cush @RheumNow( View Tweet )

2024 Management of Familial Mediterranean Fever Recommendations

A EULAR/PReS combined task force has developed recommendations for the management of Familial Mediterranean fever (FMF), the most common monogenic autoinflammatory disease worldwide. These evidence-based recommendations update the 2016 recommendations developed for rheumatologists and other HCPs

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Vitamin D for Prevention of Disease

JAMA has published a clinical guideline on the use of vitamin D to prevent disease in children and adults. Guideline committee experts, included adult and pediatric endocrinology, internal medicine, obstetrics/gynecology, nutrition, and epidemiology) advise that healthy nonpregnant persons

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Post-treatment Lyme Syndrome

EurekAlert!

Symptoms that persist long after Lyme disease is treated are not uncommon — a 2022 study found that 14% of patients who were diagnosed and treated early with antibiotic therapy would still develop Post Treatment Lyme Disease (PTLD). Yet doctors puzzle over the condition’s causes and how to

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Osteoarthritis Risky Business (4.18.2025)

Dr. Jack Cush reviews the news and Journal reports from this week on RheumNow.com.  Osteoarthritis patients have unique risks and synovial fluid WBC numbers can tell you when to worry about septic arthritis in gout and pseudogout patients.

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In a murine model of Kawasaki Dz vasculitis- depleting gut microbiota reduces KD like vasculitis. CV lesions were assoc w/ decrease in Akkermansia muciniphila and Faecalibacterium prausnitzii. Replacement attenuated these findings. https://t.co/uAfInA5MAq https://t.co/3AjMRQnmts
Dr. John Cush @RheumNow( View Tweet )

Genetic Sequencing in Rheumatology

Genetic sequencing as a research and diagnostic tool has expanded in medicine and rheumatology. An interesting review in Arthritis and Rheumatology suggests that despite currently modest use, there will be an expanded role for genetic sequencing in the field of rheumatology. 

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Distinguishing Septic and Gouty Arthritis

A single center, retrospective review of patients undergoing knee joint fluid aspirations for presumed crystalline arthritis (CA) showed that synovial WBC may provide a useful diagnostic marker for SA with an optimal threshold of 50,000 cells/mm3.

Distinguishing septic arthritis (SA)

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Predictors of Developing RA

A prospective cohort study of seropositive arthralgia patients demonstrated that baseline characteristics and labs can be used to predict which arthralgia patients are at highest risk of developing rheumatoid arthritis (RA).
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RA Prevention through Deep Immunophenotyping Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for RA. They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to https://t.co/AEo0GOr7Kn
Dr. John Cush @RheumNow( View Tweet )

RA Prevention through Deep Immunophenotyping

Researchers at the University of Colorado have identified pathogenic immune phenotypes in at-risk populations for rheumatoid arthritis (RA). They have found the expansion of specific T cell subtypes, in the at-risk group, and postulate this could lead to future immunospecific prevention

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Uveitis Risk with Slow Adalimumab Weaning

MedPage Today

Patients with pediatric non-infectious uveitis (NIU) who achieved remission on adalimumab (Humira) had lower recurrence rates when the drug was withdrawn more gradually, a retrospective cohort analysis indicated.

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Mindfulness and CBT improve chronic low back pain

EurekAlert!

Behavioral interventions were associated with reduced pain and daily opioid use and improved function and quality of life for up to 12 months among adults with opioid-treated chronic low back pain, according to a new randomized clinical trial.

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Vamorolone: a New Steroid on the Horizon?

Vamorolone is a potentially new alternative to traditional glucocorticoids for use in inflammatory diseases. It is a dissociated steroidal compound with reduced side effects, and in an animal model of inflammation has shown effective antiinflammatory properties and reduced systemic

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1st Line Biologics vs csDMARDs in Adult Still's Disease

A German multicentre, retrospective study assessed the first-line efficacy of biologics and conventional synthetic DMARD therapy in patients with adult-onset Still's disease and found biologic agents were significantly better with sustained, event-free remissions and fewer complications.

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If COVID was responsible for causing autoimmune Dz (AD), it is possible that Molecular mimicry was in play. Study shows 10nsequence homology between SARS-CoV-2 & AD epitopes; 2) similar MHC binding; 3) of high empirical immunogenicity. https://t.co/WO3gjxhVBw https://t.co/QdqtQMHcpL
Dr. John Cush @RheumNow( View Tweet )
Researchers have developed a machine learning model capable of predicting rheumatoid arthritis progression from seronegative undifferentiated arthritis. In the KURAMA cohort of 210 SN patients, 57 (27%) progressed to RA. The FNN model excelled with an AUC of 0.924 and 81% https://t.co/b8G2AzMZ7m
Dr. John Cush @RheumNow( View Tweet )

Cancer Survival with TNF Inhibitors (3.28.2025)

Dr. Jack Cush reviews the news and journal reports from this past week on RheumNow.com

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A comprehensive examination of the pathogenesis and recent advancements in Familial Mediterranean Fever (FMF). This condition results from autosomal recessive mutations in the MEFV gene, which codes for Pyrin, a crucial component of the NLRP3 inflammasome. These genetic https://t.co/XNV89LW893
Dr. John Cush @RheumNow( View Tweet )
A study in mice shows that JAK inhibition In mice model of status epilepticus (SE) didnt prevent initial SE but when did effect chronic phase of Sz weeks after SE induction of SE, suppressing seizures, and epilepsy-associated histopathological alterations. Sz suppression lasted https://t.co/GMIPCtoc7x
Dr. John Cush @RheumNow( View Tweet )
ACPA specificity and recognition motifs examined in 6,907 patients with RA from 5 Scandinavian cohorts. ACPA targeting non-glycine citrulline motifs assoc. more strongly w/ HLA-SE; ACPA to glycine citrulline motifs assoc. w/ smoking and IgA ACPA A&R https://t.co/PmKv3dZLc4 https://t.co/NdPG4Orfj4
ACR_Journals @ACR_Journals( View Tweet )
#Thrombocytopenia is common in #antiphospholipid syndrome (APS), and is likely associated with more severe disease. Although the pathophysiology underlying thrombocytopenia in APS has yet to be definitively revealed, mechanisms that play a role (at least in subsets of patients) https://t.co/pUXmb1irbw
Alberto Giraldo @alb_giraldo( View Tweet )
55 myositis (IIM) pts studied Nailfold Capillaries, MSAbs, cytokines & IFN genes. MDA5(+) pts signif more dilated (DIL), giant & abnl morphology caps, w/ microhemorrhages (MH) vs ARS (+) pts. MH & DIL assoc w/ MX1, IFI27, IP-10, RANTES, GROα. Giant caps assoc w/ IFI27, SDF-1α, https://t.co/3WQL8Sw0rq
Dr. John Cush @RheumNow( View Tweet )

Autoimmune Disease Impact Report

Integrated Benefit Institute, a nonprofit independent research organization, has published its 2025 Autoimmune Disease Impact Report, which examines the health and productivity impacts of five prevalent and costly autoimmune conditions: rheumatoid arthritis, multiple sclerosis,

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