Immunology

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Uricase-Targeted Therapies in Gout

Jack Cush, MD

In most mammals, uricase catalyzes the oxidation of uric acid to allantoin, a highly soluble compound easily excreted by the kidneys. But humans lack functional uricase, leaving xanthine oxidase inhibitors (allopurinol/febuxostat) as first-line urate-lowering therapy (ULT). Uricase-based

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Chikungunya Club Meeting (7.24.2026)

Jack Cush, MD

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

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Sjogren,board

Interferon-α as an Immunologic Driver of Sjögren's Disease

Jack Cush, MD

Using data from a Sjogren's registry, researchers have shown that IFNα drives Sjögren's disease, and
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51 yoM w/ 2 yrs of FUO, unintentional 32-kg wt loss, LN, diffuse myalgias, but no GI Sxs or arthralgia. Neg MRIs, CT, PET scan, EGD, colonoscopy. Abnl labs: CRP 173 mg/L, ESR 46, anemia & ^ WBC. Cell-free DNA next-generation sequencing dx Tropheryma whipplei, & Whipple disease https://t.co/nJLa4l7Ers
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2 Still's dz cohorts (96 Shanghai, 28 Erlangen0 compared response to biolgics vs DMARDs (MTX, CNI,JAKi). in 124 AOSD pts, biologic had more sustained event-free remission and event-free state (P 0.0065, P 0.0096) & more steroid D/C vs MTX/CNI (p < 0.05). https://t.co/lJaI9nhPYr

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Metanalysis of 31 studies (14,548 pts) looked at infection in idiopathic inflamm myopathy (IIMs). Infection prevalence was 24%, primarily Respiratory tract. PJP, aspergillosis, H zoster most prevalent pathogens. Risk factors: older age, male, DM, HTN,MDA5+ (OR 3.41), rapidly https://t.co/GvOvAVRkRv
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RheumIQ: True or False: In an international consortium of RA patients, MACE risk was significantly associated with disease activity but not ACPA positivity. Test your knowledge here: https://t.co/LATb1P18Sh https://t.co/Bs1ReJk0OY

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CAR-T Therapy: EULAR 2026 Conference Recap https://t.co/3CUp5MTN2Y https://t.co/agk5HNUSwg

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ARTIC trial enrolled 234 DMARD naive RA (<2yrs) pts; 15.4% (36) were seronegative (SNRA). @enrollment SNRA worse than SPRA(+) w/ higher SJC (17 vs 8, p<0.001), DAS28 (3.9 vs 3.4, p=0.03), US scores (55 vs 25, p<0.001), MD global (49 vs 39, p=0.006). No diff in Sharp score, https://t.co/xDxQKY8ZG2
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Intl consortium (10 EU countries) of 3952 RA pts, 184 MACE events seen 1985-2012. MACE risk signif assoc w/ DAS28 (HR 1.18;1.03-1.35), but NOT RF (HR 1.26; 0.82 to 1.94) or ACPA (HR 1.25; 0.85 to 1.83). RA activity assoc w/ MACE seen in seronegative and double positive https://t.co/RGO5IAM5oL
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Congratulations to Dr. Chandra Mohan and Univ. of Houston for receiving a $4 million NIH grant for a 10-year longitudinal study to identify the earliest biological triggers of autoimmune disease https://t.co/6kMcv9PD5r https://t.co/CsY8QAxrXR

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CAR-T Therapy: EULAR 2026 Conference Recap https://t.co/XALrMFReOe https://t.co/TK0ot8MZb6

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RZV (Shingrix) response in 76 immunosuppressed SSc & 304 controls (CG) recv two RZV doses. High seroconversion seen in SSc but signif lower than CG (92.6% vs 99.7%, P 0.001), w/ lower concentration but comparable CMI, lower AE (74% vs 86%) https://t.co/ALlnVEZIAt https://t.co/kYYy2JIo2J

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New research shows synovial lining enriched in macrophages expressing SPP1 (encoding osteopontin) in proximity to fibroblasts and fibrin deposits. SPP1+ macrophages degrade fibrin & promote fibroblast proliferation that deposit collagen & does the damage, joint remodeling. A new https://t.co/yFxwAYFPPb
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Gout Cavalcade (7.10.2026)

Jack Cush, MD

Dr. Jack Cush reviews the news, journal articles and regulatory decisions from the past week. July is Gout: More than Flares month.

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Gout is more than an episodic arthritis, it's a systemic inflammatory disease. Watch Dr. Robert Terkeltaub discuss 3 New Things it Pays to Know About Gout Pathobiology, including emerging insights that are shaping how we understand and manage gout. Watch now on RheumNow: https://t.co/nri3WDz7kS
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New research shows synovial lining enriched in macrophages expressing SPP1 (encoding osteopontin) in proximity to fibroblasts and fibrin deposits. SPP1+ macrophages degrade fibrin & promote fibroblast proliferation that deposit collagen & does the damage, joint remodeling. A new https://t.co/hrJoQXpAH8
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EULAR26: ANCHOR-RA Study of RA-ILD People with rheumatoid arthritis are at risk of developing interstitial lung disease (RA-ILD), which is associated with high mortality. ANCHOR-RA is a large, international cross-sectional prospective study that will enable the development of a https://t.co/tsOpA4SAZP
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ICYMI: B Cells at the Brink in Sjögren Disease The current issue of Arthritis & Rheumatology reviews current understanding of the immunopathogenesis of Sjögren disease (SjD) and how that has influenced the quest for drug development for this most systemic autoimmune disorder. https://t.co/OBFqHYof5m
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RT @minidey #OP0342 Interim real-world ASTER data showed anifrolumab improved overall SLEDAI-2K scores & reduced disease activity across multiple organ systems over 12 months, particularly mucocutaneous &amp; MSK domains. Nearly 30% achieved SLEDAI-2K=0 at 1 year. #EULAR2026

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Vexas

ICYMI: VEXAS Syndrome - A Review

Jack Cush, MD

Beck et al has published a review of the VEXAS syndrome in The Lancet, focusing on the pathogenesis, spectrum, and treatment strategies.

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Eosinophil

ICYMI: EGPA Review

Jack Cush, MD

A current review of eosinophilic granulomatosis with polyangiitis (EGPA) provides current recommendations on diagnosis and management.

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ICYMI: B Cells at the Brink in Sjögren Disease

Jack Cush, MD

A recent issue of Arthritis & Rheumatology reviews current understanding of the immunopathogenesis of Sjögren disease (SjD) and how that has influenced the quest for drug development for this most systemic autoimmune disorder.

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Prospective study of 6 newly Dx RA pts starting MTX shows MTX causes a decline in T follicular helper (Tfh) cells and plasmablasts (@ wk 3 before clin response), selectively in responders but not nonresponders. MTX shifts cellular & gene expression towards a more physiological https://t.co/scmfAAE9XA
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Is there a path to precision medicine in #RA? Theres a substantial unmet need. Immunoengineering is possible thru nanotechnological delivery vectors, cellular therapeutics, & biomaterial scaffolds, with compelling preclinical and early clinical support. https://t.co/gL56EOlt7p https://t.co/31IRNXckym

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Recent Blogs

rheumthought

CNS Lupus (NPSLE)

Jack Cush, MD
Cush RhTh CNS
29 yr. old woman with SLE and transverse myelitis. Is this NPSLE; how to diagnose?
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Unpopular opinion: spinach can be bad for you

Lara El Khoury, MD
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PMR might be one of the most rewarding diagnoses to make in real practice: the patient comes to you in severe debilitating pain, and you prescribe steroids, giving them their lives back! As much as this impressive response makes your intervention appear almost magical, there is the often-forgotten story about the implications of such a diagnosis and treatment on patients' daily lives. 
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What Goes Wrong with the Immune System in PMR?

Kornelis van der Geest, MD, PhD
PMR,pathogenesis.JIM2022
Polymyalgia rheumatica (PMR) is a common inflammatory rheumatic disease. The exact trigger for PMR onset remains unknown. However, immunology studies and clinical trials with biological DMARDs now shed light on the immune pathways involved in PMR.
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