Autoimmune Diseases: Advances and Challenges

A special issue of Medicina (ISSN 1648-9144). This special issue belongs to the section "Hematology and Immunology".

Deadline for manuscript submissions: 31 August 2025 | Viewed by 1844

Special Issue Editors


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Guest Editor Assistant
1. Internal Medicine B, Sheba Medical Center, Tel-Hashomer, Ramat Gan 52621, Israel
2. Faculty of Medicine, Tel Aviv University, Tel Aviv 69978, Israel
Interests: ankylosing spondylitis; psoriatic arthritis; inflammatory bowel disease (IBD); spondyloarthropathy; inflammation; autoimmunity; dermatology; rheumatology

Special Issue Information

Dear Colleagues,

Autoimmune diseases are the result of the immune system mistakenly attacking the body's own tissues and encompass a vast spectrum of disorders. These conditions, ranging from systemic lupus erythematosus and rheumatoid arthritis to organ-specific diseases like type 1 diabetes and Hashimoto’s thyroiditis, affect millions worldwide and pose significant diagnostic, therapeutic, and research challenges.

This Special Issue, “Autoimmune Diseases: Advances and Challenges”, seeks to bring together cutting-edge research and clinical insights to enhance our understanding of autoimmune pathophysiology, explore emerging therapeutic strategies, and address unresolved controversies. We welcome submissions of original research articles, epidemiologic studies, compelling case reports, case series, and comprehensive reviews.

Key topics of interest include breakthroughs in immunomodulatory therapies, the role of environmental and genetic factors, innovative diagnostic tools, and the interplay between autoimmunity and comorbid conditions such as cardiovascular diseases and malignancies. By contributing to this issue, authors can help to shape the conversation on the future of autoimmune disease management and contribute to improving outcomes for patients.

We invite clinicians, researchers, and healthcare professionals to submit their work in order to foster collaboration and drive innovation in this vital field.

Prof. Dr. Abdulla Watad
Dr. Kassem Sharif
Guest Editors

Dr. Niv Ben-Shabat
Guest Editor Assistant

Manuscript Submission Information

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Keywords

  • autoimmunity
  • inflammation
  • arthritis
  • psoriasis
  • metabolic syndrome
  • lupus
  • thyroiditis
  • vasculitis
  • autoinflammatory conditions

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Published Papers (2 papers)

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Research

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13 pages, 1353 KiB  
Article
Mortality in Antinuclear Antibody-Positive Patients with and Without Rheumatologic Immune-Related Disorders: A Large-Scale Population-Based Study
by Uria Shani, Paula David, Ilana Balassiano Strosberg, Ohad Regev, Mohamad Yihia, Niv Ben-Shabat, Dennis McGonagle, Orly Weinstein, Howard Amital and Abdulla Watad
Medicina 2025, 61(1), 60; https://doi.org/10.3390/medicina61010060 - 2 Jan 2025
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Abstract
Background & Objectives: To explore the potential association between positive ANA serology and all-cause mortality in a large cohort of patients, including those with and without rheumatological conditions and other immune-related diseases. Material and Methods: A retrospective cohort study analyzed all-cause [...] Read more.
Background & Objectives: To explore the potential association between positive ANA serology and all-cause mortality in a large cohort of patients, including those with and without rheumatological conditions and other immune-related diseases. Material and Methods: A retrospective cohort study analyzed all-cause mortality among 205,862 patients from Clalit Health Services (CHS), Israel’s largest health maintenance organization (HMO). We compared patients aged 18 and older with positive ANA serology (n = 102,931) to an equal number of ANA-negative controls (n = 102,931). Multivariable Cox regression models were used to assess hazard ratios (HR) for mortality, adjusting for demographic and clinical factors. Results: ANA positivity was strongly associated with increased mortality (adjusted HR [aHR] 4.62; 95% CI 4.5–4.7, p < 0.001). Significant predictors of mortality included male gender (39.2% vs. 24.4%, p < 0.001), older age at testing (72.4 ± 13.0 vs. 50.1 ± 17.3 years, p < 0.001), and Jewish ethnicity (89.6% vs. 83.2%, p < 0.001). Certain ANA patterns, such as mitochondrial (and dense fine speckled (DFS-AC2)), were highly predictive of mortality, with aHRs of 36.14 (95% CI 29.78–43.85) and 29.77 (95% CI 26.58–33.34), respectively. ANA-positive patients with comorbid rheumatological immune-related disorders (RIRDs) demonstrated a higher survival rate compared to those without such a condition (aHR 0.9, 95% CI 0.86–0.95, p < 0.001). This finding remained significant after adjusting for several parameters, including age. Conclusions: ANA positivity is associated with increased all-cause mortality, particularly in individuals without rheumatologic disorders, after adjusting for confounders such as age. This may indicate occult malignancies, cardiovascular pathology, or chronic inflammatory states, necessitating more vigilant surveillance Full article
(This article belongs to the Special Issue Autoimmune Diseases: Advances and Challenges)
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Case Report
Expanding the Genetic Framework: Insights into Non-HLA-B27 Contributions to Axial Spondylarthritis
by Ruxandra-Elena Nagit, Ioana Bratoiu, Corina Cianga, Mariana Pavel-Tanasa, Elena Rezus and Petru Cianga
Medicina 2025, 61(5), 793; https://doi.org/10.3390/medicina61050793 - 25 Apr 2025
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Abstract
Background and Objectives: Spondylarthritis is a complex group of inflammatory diseases closely associated with the HLA-B27 antigen. However, the role of non-HLA-B27 alleles in the disease’s pathogenesis has gained significant scholarly attention in recent years. Case presentation: This case study presents a [...] Read more.
Background and Objectives: Spondylarthritis is a complex group of inflammatory diseases closely associated with the HLA-B27 antigen. However, the role of non-HLA-B27 alleles in the disease’s pathogenesis has gained significant scholarly attention in recent years. Case presentation: This case study presents a 49-year-old male with a history of progressive inflammatory back pain, characterized by morning stiffness and restricted spinal mobility developed over several years. Initially presenting with non-specific symptoms, the patient eventually experienced persistent axial pain and deteriorating functional limitations, which required further evaluation. Radiographic imaging supported the diagnosis of ankylosing spondylitis (AS) by identifying bilateral sacroiliitis. HLA genotyping revealed a negative result for HLA-B27 but positive results for HLA-B13 and HLA-B37. This finding serves as a foundation for exploring alternative genetic factors contributing to spondylarthritis (SpA). HLA-B13 and HLA-B37 exhibit structural and functional similarities to HLA-B27, particularly in their peptide-binding grooves. This resemblance may lead to overlapping peptide repertoires and increased T cell cross-reactivity. Moreover, these alleles belong to overlapping cross-reactive groups (CREGs) and share the Bw4 epitope. This suggests that they may contribute to disease pathogenesis via similar mechanisms, such as molecular mimicry and the dysregulation of natural killer (NK) cell interactions, as observed in HLA-B27. Conclusions: This case emphasizes the necessity of expanding diagnostic criteria to incorporate non-HLA-B27 markers, particularly for patients who are HLA-B27-negative. Enhancing our understanding of the roles of alternative genetic markers can improve diagnostic accuracy, enable personalized treatment approaches, and enhance outcomes for the diverse SpA patient population. Full article
(This article belongs to the Special Issue Autoimmune Diseases: Advances and Challenges)
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