Risk factors of cytomegalovirus reactivation in patients with rheumatic musculoskeletal diseases undergoing remission induction therapy with high-dose glucocorticoids; a prospective short-term cohort study.

Objective: To elucidate the risk factors of cytomegalovirus (CMV) infection and the involvement of immunity status in CMV infection in patients with rheumatic musculoskeletal disease during remission induction therapy.

Methods: Patients with rheumatic musculoskeletal disease who underwent induction therapy with high-dose glucocorticoids were consecutively enrolled. All patients were screened for CMV-IgG at baseline and monitored weekly for CMV pp65 antigen in polymorphonuclear leukocytes from peripheral blood until discharge.

An IL-6 inhibitor subsides iatrogenic aortitis induced by granulocyte-colony stimulating factor without interruption of chemotherapy.

Recombinant human granulocyte-colony stimulating factor (G-CSF) is widely used for primary or secondary leukopenia induced by chemotherapy with strong anticancer drugs. Recently, there have been rare but accumulating cases of aortitis in patients receiving G-CSF agents, which are usually treated with glucocorticoids. Here, we report a case of G-CSF-induced aortitis complicated with intensive chemotherapy for Ewing's sarcoma, which was successfully treated with one bolus of intravenous tocilizumab, an anti-interleukin-6 inhibitor, resulting in early suppression of aortic inflammation and prompt resumption of chemotherapy.

Apo-state structure of the metabotropic glutamate receptor 5 transmembrane domain obtained using a photoswitchable ligand.

Metabotropic glutamate receptor 5 (mGlu5) is implicated in various neurodegenerative disorders, making it an attractive drug target. Although several ligand-bound crystal structures of mGlu5 exist, their apo-state crystal structure remains unknown. Here, we study mGlu5 structural changes using the photochemical affinity switch, alloswitch-1, in combination with time-resolved freeze-trapping methods.

Polyangiitis overlap syndrome is a high-risk clinical phenotype for relapse: Case series from the KEIO-vasculitis cohort.

Background: Polyangiitis overlap syndrome, characterized by the coexistence of giant cell arteritis (GCA) and anti-neutrophil cytoplasmic antibody-associated vasculitis (AAV), is a rare and poorly understood condition. Clinical features, treatment responses, and long-term prognosis of this entity remain unclear. This study aimed to elucidate clinical characteristics, relapse patterns, and potential therapeutic strategies for polyangiitis overlap syndrome.

Achievement and Usefulness of Intermediate Treatment Targets for Still Disease Proposed by the European Alliance of Associations for Rheumatology and the Paediatric Rheumatology European Society.

Objective: Intermediate treatment targets in Still disease have been proposed by the European Alliance of Associations for Rheumatology (EULAR) and the Paediatric Rheumatology European Society (PReS) in 2024. This study aimed to evaluate the utility of the targets in clinical practice.

Methods: Consecutive patients with adult-onset Still disease (AOSD) based on the Yamaguchi criteria who visited Keio University Hospital from April 2012 until May 2024 were retrospectively reviewed.

CX3CR1 age-associated CD4 T cells contribute to synovial inflammation in late-onset rheumatoid arthritis.

Background: Recent evidence suggests that clonally expanded cytotoxic T cells play a role in various autoimmune diseases. Late-onset rheumatoid arthritis (LORA) exhibits unique characteristics compared to other RA forms, suggesting distinct immunological mechanisms. This study aimed to examine the involvement of cytotoxic T cells in LORA.

Photoswitch dissociation from a G protein-coupled receptor resolved by time-resolved serial crystallography.

G protein-coupled receptors (GPCRs) are the largest family of cell surface receptors in humans. The binding and dissociation of ligands tunes the inherent conformational flexibility of these important drug targets towards distinct functional states. Here we show how to trigger and resolve protein-ligand interaction dynamics within the human adenosine A receptor.

Contrast of muscle magnetic resonance imaging and pathological findings of muscle tissue in patients with anti-aminoacyl transfer RNA synthetase antibodies.

Objectives: To determine whether magnetic resonance imaging (MRI) findings reflect the pathological features of inflammatory myopathies.

Methods: Patients with idiopathic inflammatory myopathies (IIMs) diagnosed using the 2017 European League Against Rheumatism/American College of Rheumatology classification criteria in our university between 2005 and 2020 were retrospectively reviewed. IIMs were subclassified into the anti-aminoacyl transfer RNA synthetase syndrome [anti-synthetase syndrome (ASSD)], immune-mediated necrotizing myositis, dermatomyositis (DM), and others.

Coexistence of anti-KS and anti-TIF1-γ antibodies in clinically amyopathic dermatomyositis presenting with rapid progression of interstitial lung disease.

Polymyositis/dermatomyositis (DM) is an idiopathic inflammatory myopathy manifesting mainly as symmetrical proximal muscle weakness and/or typical cutaneous features due to autoimmune mechanisms. Clinically amyopathic dermatomyositis (CADM) is a subset of DM that exhibits only the typical cutaneous features without any clinical muscle symptoms. Several autoantibodies have been found specifically in patients with polymyositis/DM, including CADM patients.

Tocilizumab discontinuation after remission achievement in patients with adult-onset Still's disease.

Objectives: Tocilizumab, an IL-6 inhibitor, has been proven effective in patients with adult-onset Still's disease (AOSD). This study aimed to clarify whether tocilizumab can be discontinued after achieving remission and to identify factors relevant to its successful discontinuation.

Methods: Consecutive patients with AOSD diagnosed according to Yamaguchi's criteria from April 2012 to July 2022, who were treated with tocilizumab, were retrospectively reviewed.

Successful Treatment of Rosai-Dorfman Disease with Cutaneous Involvement and Arthritis with Methotrexate and Infliximab.

Rosai-Dorfman disease (RDD) is a rare histiocytic proliferative disorder characterized by lymphadenopathy and extra-nodal manifestations. Some patients with RDD require systemic treatment, but there is no consensus on the treatment strategy owing to its extreme rarity. Overexpression of tumor necrosis factor α (TNF-α) has been reported in lesions of patients with RDD and is thought to be involved in its pathogenesis.

Successful Immunosuppressive Therapy for Interstitial Lung Disease Associated with Sjögren's Syndrome with Double-positive Anti-SS-A and Anti-centromere Antibodies.

Sjögren's syndrome (SS) can present with extraglandular organs, such as interstitial lung disease (ILD). Anti-SS-A antibody is frequently found in SS cases, whereas anti-centromere antibody (ACA) is detected in some SS cases. Notably, the anti-SS-A and ACA double-positive cases exhibited distinct features with a higher prevalence of ILD.

Risk of disease flares after SARS-CoV-2 mRNA vaccination in patients with systemic lupus erythematosus.

This study aims to elucidate the effectiveness and safety of SARS-CoV-2 mRNA vaccination in patients with systemic lupus erythematosus (SLE). We enrolled uninfected SLE patients who received two vaccine doses (BNT162b2 or mRNA-1273) and historical unvaccinated patients. Neutralizing antibodies, adverse reactions, and disease flares were evaluated 4 weeks after the second vaccination.

A multi-reservoir extruder for time-resolved serial protein crystallography and compound screening at X-ray free-electron lasers.

Serial crystallography at X-ray free-electron lasers (XFELs) permits the determination of radiation-damage free static as well as time-resolved protein structures at room temperature. Efficient sample delivery is a key factor for such experiments. Here, we describe a multi-reservoir, high viscosity extruder as a step towards automation of sample delivery at XFELs.

Effectiveness and safety of rituximab in special types of rheumatoid arthritis.

Objectives: To elucidate the efficacy and safety of rituximab in special types of rheumatoid arthritis.

Methods: We retrospectively reviewed all patients with rheumatoid arthritis with lymphoproliferative disorder or vasculitis treated with rituximab between April 2010 and June 2022 at Keio University Hospital. We assessed the effectiveness of rituximab using the Disease Activity Score for 28 joints-erythrocyte sedimentation rate (DAS28-ESR), Clinical Disease Activity Index (CDAI), and safety of rituximab during the disease course.

Sarcopenia in patients with rheumatic musculoskeletal diseases.

Aim: To investigate the impact of high-dose glucocorticoid therapy on sarcopenia in hospitalized patients with rheumatic musculoskeletal diseases (RMDs).

Methods: We included patients with RMDs who were hospitalized between 2020 and 2022 for remission induction treatment and collected information on skeletal mass index (SMI) before high-dose glucocorticoid therapy and 1 month later. We divided the patients into 2 groups according to the progression of sarcopenia, defined as a >10% decrease in SMI, and compared their clinical characteristics.