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Diagnosis and Treatment of Rheumatic Diseases
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Diagnosis and Treatment of Rheumatic Diseases

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Immunology".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 2202

Special Issue Editors

Dr. Răzvan Gabriel Drăgoi

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Guest Editor
Department of Balneology, Medical Rehabilitation and Rheumatology, Center for Assessment of Movement, Functionality and Disability, “Victor Babes” University of Medicine and Pharmacy, 300041 Timisoara, Romania
Interests: rheumatic diseases; patient reported outcomes; assessment; diagnosis; arthritis; functional impairment
Prof. Dr. Codrina Ancuta

E-Mail Website
Guest Editor
1. Faculty of Dental Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
2. Department of Rheumatology, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy, 700115 Iasi, Romania
Interests: immune-mediated rheumatic disorders; biological therapy; rheumatoid arthritis; lupus; systemic sclerosis; spondylarthritis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

We are delighted to announce a Special Issue of the Journal of Clinical Medicine titled “Diagnosis and Treatment of Rheumatic Diseases”. Rheumatic diseases continue to pose a significant challenge to patients and healthcare providers alike, with recent decades witnessing major advancements in their diagnosis and treatment. Despite this progress, the classification of these conditions remains complex, as the underlying causes are still not fully understood.

This Special Issue will showcase the latest developments in the diagnosis and treatment of rheumatic diseases, focusing on their immunological and inflammatory mechanisms, patient-reported outcomes, functional impairments, and disabilities. Special attention will be given to biological and targeted synthetic therapies, which have significantly changed the treatment landscape for these conditions.

We request original research articles and reviews on the pathogenesis, diagnosis, and management of rheumatic diseases. Contributions exploring the effectiveness of existing and emerging therapies, including biological and targeted synthetic therapies, through observational studies, and clinical trials, are especially encouraged.

Dr. Răzvan Gabriel Drăgoi
Prof. Dr. Codrina Ancuta
Guest Editors

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • rheumatic diseases
  • patient-reported outcomes
  • assessment
  • arthritis
  • impairment
  • connective tissue diseases
  • biological and targeted synthetic therapies
  • impairment

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Published Papers (3 papers)

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16 pages, 1654 KiB  
Article
Anti-Inflammatory Interleukin Levels Reflect Th1/Th2 Imbalance in Spondyloarthritis Patients with Concomitant Atopy Under Biological Therapy
by Georgiana Strugariu, Cristina Pomirleanu, Mara Russu, Vladia Lapuste, Daniela Constantinescu, Petru Cianga and Codrina Ancuta
J. Clin. Med. 2025, 14(9), 3094; https://doi.org/10.3390/jcm14093094 (registering DOI) - 30 Apr 2025
Abstract
Background/Objectives: Atopy and spondyloarthritis (SpA) are immune-mediated diseases driven by distinct T-helper (Th) cell pathways—Th2 for atopy and Th1/Th17 for SpA. The coexistence of these divergent immune responses is increasingly recognized, particularly in the context of biological therapies that target pro-inflammatory cytokines. [...] Read more.
Background/Objectives: Atopy and spondyloarthritis (SpA) are immune-mediated diseases driven by distinct T-helper (Th) cell pathways—Th2 for atopy and Th1/Th17 for SpA. The coexistence of these divergent immune responses is increasingly recognized, particularly in the context of biological therapies that target pro-inflammatory cytokines. This study aimed to investigate Th2 cytokine profiles (IL-4, IL-5, IL-13) in atopic SpA patients receiving biological therapy to better understand how such treatment may influence immune regulation in this complex clinical setting. Methods: We conducted a prospective observational cross-sectional study on 136 SpA patients stratified by biological therapy and atopy status. Serum IL-4, IL-5, and IL-13 levels were quantified using LUMINEX immunoassays. Patients were grouped into biologically treated (BT) and Bio-Naïve (BN) cohorts and further sub-categorized by atopic phenotype (allergic rhinitis, asthma, dermatitis). Statistical comparisons of cytokine levels were made using SPSS IBM version 26 to explore associations with clinical and demographic variables. Results: IL-13 levels were significantly elevated in BT-atopic patients, particularly those with allergic rhinitis and atopic dermatitis, suggesting biological therapy may modulate Th2 responses. IL-5 remained elevated in allergic asthma cases despite treatment, indicating persistent eosinophilic activity. No significant correlation was found between cytokine levels and disease duration or therapy length. Conclusions: Biological therapy in SpA may influence Th2 cytokine expression, notably IL-13, in atopic patients. These findings underscore the importance of immune profiling in guiding personalized treatment strategies and highlight the need for further investigation into the long-term immunomodulatory effects of biologics in patients with overlapping Th1/Th2-driven diseases. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Rheumatic Diseases)
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13 pages, 591 KiB  
Article
Serum Uric Acid Is Associated with Insulin Resistance in Non-Diabetic Subjects
by Janis Timsans, Jenni Kauppi, Vappu Rantalaiho, Anne Kerola, Kia Hakkarainen, Tiina Lehto, Hannu Kautiainen and Markku Kauppi
J. Clin. Med. 2025, 14(8), 2621; https://doi.org/10.3390/jcm14082621 - 11 Apr 2025
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Abstract
Background: Glucose metabolism disorders are major contributors to morbidity and mortality. Elevated serum uric acid (SUA) is closely linked to the cardiometabolic consequences of glucose metabolism disorders, various other comorbidities, and mortality. In this study, we explore the relationship between SUA and [...] Read more.
Background: Glucose metabolism disorders are major contributors to morbidity and mortality. Elevated serum uric acid (SUA) is closely linked to the cardiometabolic consequences of glucose metabolism disorders, various other comorbidities, and mortality. In this study, we explore the relationship between SUA and fasting plasma glucose (FPG), insulin levels, and insulin resistance in an older Finnish adult cohort. Methods: We used data from the GOAL (GOod Ageing in Lahti region) study—a prospective, population-based study of Finnish individuals aged 52–76 years. A total of 2322 non-diabetic subjects were included in the study. Data of SUA, FPG, and other laboratory parameters, comorbidities, lifestyle habits, and socioeconomic factors were collected. Subjects with SUA values of >410 μmol/L (≈6.9 mg/dL; 75th percentile) were regarded as hyperuricemic. We investigated the relationship between SUA and FPG, insulin levels, and insulin resistance [homeostatic model assessment of insulin resistance (HOMA-IR) ≥2.65]. Results: We found statistically significant sex-, age- and BMI-adjusted small to moderate relationships (Cohen’s standard for β values above 0.10 and 0.30, respectively) between SUA and FPG, insulin levels, and insulin resistance in the whole study population as well as in the female and male subgroups. The higher the SUA level, the higher the HOMA-IR [(adjusted β = 0.21 (95% CI: 0.17 to 0.25)], and it rises drastically if SUA is above 400 μmol/L (≈6.7 mg/dL). The probability of a subject having insulin resistance is related to SUA level. Conclusions: Hyperuricemia is associated with elevated FPG and insulin resistance, emphasizing the importance of addressing both conditions. Further research may explore hyperuricemia treatment’s role in preventing glucose metabolism disorders and their cardiometabolic consequences. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Rheumatic Diseases)
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Other

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10 pages, 2054 KiB  
Case Report
Systemic Lupus Erythematosus (SLE) Induced by ASIA Syndrome After the Aesthetic Medicine Procedures—A Case Report
by Michalina Knapik, Agnieszka Owczarczyk-Saczonek, Łukasz Jaśkiewicz, Jakub Kuna, Grzegorz Chmielewski and Magdalena Krajewska-Włodarczyk
J. Clin. Med. 2025, 14(1), 119; https://doi.org/10.3390/jcm14010119 - 28 Dec 2024
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Abstract
Introduction: The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a rare condition caused by an immune response associated with over-reactivity of the immune system, triggered by adjuvants. The most common adjuvants are aluminium salts but can also be bioimplants or infectious agents. It [...] Read more.
Introduction: The autoimmune/inflammatory syndrome induced by adjuvants (ASIA) is a rare condition caused by an immune response associated with over-reactivity of the immune system, triggered by adjuvants. The most common adjuvants are aluminium salts but can also be bioimplants or infectious agents. It may lead to the development of various autoimmunologic diseases. Case Report: In the following article, we present the case of a 26-year-old woman who developed SLE likely induced by ASIA syndrome after the aesthetic medicine procedures. The patient was admitted because of arthralgia and fever. She also presented with a butterfly-shaped erythema on her face and erythematous and infiltrative skin lesions on the posterior surface of the thighs and buttocks. We performed numerous diagnostic tests, including laboratory tests, immunological tests, imaging diagnostics such as chest X-ray and USG of the abdomen and joints, and the biopsy of the skin lesion on the left thigh. The results of the diagnostic process led us to diagnose SLE. The patient fulfilled the ACR/EULAR 2019 classification criteria of the SLE. Laboratory results also led to the diagnosis of autoimmune haemolytic anaemia. Due to exposure to numerous adjuvants like tattoo ink, hyaluronic acid, and piercing and the development of the delayed inflammatory reaction (DIR) to hyaluronic acid (HAF), the patient also fulfilled the criteria of ASIA. In the treatment process we applied antibiotics, non-steroidal anti-inflammatory drugs (NSAIDs), steroids, hydroxychloroquine, and cyclosporine. The treatment resulted in an improvement in the general condition, resolution of swelling and joint pain, and improvement in skin lesions. Conclusions: ASIA syndrome after bioimplantation is still underdiagnosed, probably due to ignorance or diagnostic difficulties, as symptoms are uncharacteristic and there is no immunological marker for this syndrome. In addition, as in the presented case, it can develop several years after the procedure, and it is difficult for both patient and physician to become aware of the connection. Early diagnosis requires a multidisciplinary approach and may require immunosuppressive treatment in specific cases. Full article
(This article belongs to the Special Issue Diagnosis and Treatment of Rheumatic Diseases)
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