Current Rheumatology Reviews - Volume 6, Issue 4, 2010

Sir William Osler stated that in its more aggravated forms diffuse scleroderma is one of the most terrible of human ills. Like Tithonus to “wither slowly”and like him to be “beaten down and marred and wasted”, until one is literally a mummy, encased in an evershrinking, slowly contracting “skin of steel” is a fate not pictured in any tragedy ancient or modern [1]. While we have come a truly long way in our understanding of Read More

Osteoarthritis (OA) is the most common form of arthritis and results in substantial morbidity and disability in the elderly and imposes a great economic burden on society. While there are drugs available on the market that mitigate pain and improve function, there are no drugs that can cure, reverse or halt disease progression, partly because there is no reliable method that we can use to identify early OA changes. Ther Read More

Osteoarthritis (OA) is a complex, age dependent disease in which various factors, including metabolic changes, are all major contributors to its onset and progression. Anatomically, OA embraces the whole joint, i.e. articular cartilage, subchondral bone alterations and joint-lining synovial membrane. Correspondingly, OA development involves elaborate interactions of cartilaginous tissue metabolism and maintenance, oste Read More

Knee osteoarthritis (OA) is a common and significant cause of disability. Until recently, the major investigation to help establish a diagnosis of knee OA was the joint radiograph. This imaging modality offers only a two-dimensional image of a three-dimensional structure, and can only crudely identify major joint abnormalities at the later stage of disease. Moreover, joint radiographs cannot fully characterise subtle changes in in Read More

Osteoarthritis (OA) is a chronic arthropathy, in which cartilage loss, osteophyte formation, and subchondral bone sclerosis lead to pain, disability, and a reduction in quality of life. OA is a multifactorial disease and OA cases are affected by both genetics and environment to varying degrees. Strong familial aggregation and heritabilities have been reported for OA at the hip, knee, hand and spine. Candidate gene studies and g Read More

While there is an acknowledged need for biomarkers to progress arthritis research, imaging biomarkers for the spine have lagged behind those for peripheral joint osteoarthritis. Progress has been slow for a number of reasons. First and perhaps most importantly, there is currently no international agreement on definition of spine osteoarthritis (OA), either histologically or on imaging. Secondly, spine OA comprises two Read More

Systemic sclerosis (SSc) is a chronic, multisystemic disease of unknown etiology. Twin studies and the presence of geographical clusters of the SSc suggest that environmental factors play a major role in the development of this disease. The main characteristics of SSc are extensive deposition of extracellular matrix in skin and internal organs, microvasculopathy, and immune activation. These changes may cause devastating com Read More

Systemic sclerosis (SSc) is characterized by activation of fibroblasts with extensive deposition of collagen, by small vessel vasculopathy with fibrointimal proliferation, and activation of the immune system, with hyper-γ- globulinaemia and autoantibodies. Twin studies have shown that genetic factors play a minor role in SSc development. Serum autoantibodies and skin lymphocytic infiltrates and small vessel damage oc Read More

The most severe clinical and pathologic manifestations of systemic sclerosis (SSc) are the result of a fibrotic process characterized by the excessive and often progressive deposition of collagen and other connective tissue macromolecules in skin and numerous internal organs. The mechanisms involved in the initiation and progression of the remarkable fibrotic process in SSc remain largely unknown. Extensive recent studies hav Read More

Systemic sclerosis (SSc) is a severe autoimmune disease that involves skin and internal organs. Clinical manifestations of SSc are very heterogeneous and derive from microvascular, inflammatory and fibrotic tissue changes. Besides the skin, lung, gastrointestinal tract, heart and kidneys are mainly affected. Over the last years, a progress in the treatment was made, especially in the field of renal involvement and Read More

In the last years, several key-pathways for the aberrant activation of fibroblasts in SSc have been identified in pre-clinical studies. This review summarizes recently identified molecular targets for novel anti-fibrotic approaches in systemic sclerosis (SSc) and other fibrotic disorders. We will focus on pathways that can be targeted by drugs that are either already approved for other indications or that are currently evaluated i Read More