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Personalized Medicine in Rheumatology—towards Adapting Our Care to Manifold Patient Phenotypes

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A special issue of Journal of Personalized Medicine (ISSN 2075-4426). This special issue belongs to the section "Personalized Therapy and Drug Delivery".

Deadline for manuscript submissions: closed (25 October 2023) | Viewed by 6653

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Special Issue Editors

Dr. Paul Studenic

E-Mail Website1 Website2
Guest Editor

1. Division of Rheumatology, Department of Internal Medicine 3, Medical University of Vienna, 1090 Vienna, Austria
2. Division of Rheumatology, Department of Medicine Solna, Karolinska Institutet, 171 76 Stockholm, Sweden
Interests: outcomes research; clinical and observational trials; digital health; collaborative research; autoantibodies; inflammatory arthritis

Dr. Tue Wenzel Kragstrup

E-Mail Website
Guest Editor

1. Department of Biomedicine, Aarhus University, Aarhus, Denmark
2. Department of Rheumatology, Silkeborg Regional Hospital, Silkeborg, Denmark
Interests: translational research; basic science; drug discovery; biomarkers; pharmacology; development of treatment recommendations; inflammatory arthritis

Special Issue Information

Dear Colleagues,

Rheumatologic and musculoskeletal diseases are a worldwide burden in terms of quality of life and socioeconomics, with effects reaching beyond those affected directly to also impact society at large. During the past several decades, treatment advances have improved the therapeutic options for many rheumatic conditions. Inflammatory arthritis and rheumatoid arthritis represent the most prevalent of these conditions, and people affected with these conditions have benefitted greatly from modern therapeutic options. Despite the tremendous increase in the treatment armamentarium and better and harmonized definitions of outcomes, in order to facilitate comparability between trials, a significant proportion of patients struggle with the condition and common associated comorbidities. The ideal treatment option for an individual patient remains as only one of the most urgent puzzles to solve, in order to be able to assist patients in abating disease activity as soon as possible. At this point, research is needed on all areas related to this topic, starting from the prevention of disease or pre-disease stages as well as the prevention of difficult-to-treat cases.

The proposed Special Issue aims to collect the most recent insights into clinical and translational research, as well as works describing the implementation of novel methodological approaches for advances in personalized medicine. It may address unmet needs in rare rheumatologic autoimmune diseases, connective tissue diseases and the full spectrum of arthritic disorders to help in the further guidance of tailored patient care.

No specific restriction on the heterogeneity of rheumatic conditions applies. We are especially interested in the management of care, specific targeted therapies, treatment selection, patient stratification, the application of artificial intelligence to manage the increasing data influx in various patients as well as disease characteristics and associated -omics profiling.

We invite the submission of quantitative as well as qualitative clinical research or translational research of original work in the above outlined arena. Reviews or systematic literature reviews summarizing the complexity of this arena are also welcome.

Dr. Paul Studenic
Dr. Tue Wenzel Kragstrup
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 Personalized Medicine is an international peer-reviewed open access monthly 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

treatment choice
artificial intelligence
prevention
patient-centered care
drug monitoring
adherence
-omics
patient preference

Published Papers (3 papers)

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Research

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17 pages, 5194 KiB

Open AccessArticle

Naïve Inflammatory Proteome Profiles of Glucocorticoid Responsive Polymyalgia Rheumatica and Rheumatic Arthritis Patients—Links to Triggers and Proteomic Manifestations

by Allan Stensballe, Jacob Skallerup Andersen, Christopher Aboo, Anders Borg Andersen, Jie Ren, Michael Kruse Meyer, Kate Lykke Lambertsen and Peter Derek Christian Leutscher

J. Pers. Med. 2024, 14(5), 449; https://doi.org/10.3390/jpm14050449 - 25 Apr 2024

Viewed by 447

Abstract

Polymyalgia rheumatica (PMR) is an inflammatory disorder of unknown etiology, sharing symptoms with giant cell arthritis (GCA) and rheumatoid arthritis (RA). The pathogenic inflammatory roots are still not well understood, and there is a lack of extensive biomarker studies to explain the disease debut and post-acute phase. This study aimed to deeply analyze the serum proteome and inflammatory response of PMR patients before and after glucocorticoid treatment. We included treatment-naïve PMR patients, collecting samples before and after 3 months of treatment. For comparison, disease-modifying antirheumatic drug (DMARD)-naïve RA patients were included and matched to healthy controls (CTL). The serum proteome was examined using label-free quantitative mass spectrometry, while inflammation levels were assessed using multiplex inflammatory cytokine and cell-free DNA assays. The serum proteomes of the four groups comprised acute phase reactants, coagulation factors, complement proteins, immunoglobulins, and apolipoproteins. Serum amyloid A (SAA1) was significantly reduced by active PMR treatment. Cell-free DNA levels in PMR and RA groups were significantly higher than in healthy controls due to acute inflammation. Complement factors had minimal changes post-treatment. The individual serum proteome in PMR patients showed over 100 abundantly variable proteins, emphasizing the systemic impact of PMR disease debut and the effect of treatment. Interleukin (IL)-6 and interferon-gamma (IFN-γ) were significantly impacted by glucocorticoid treatment. Our study defines the PMR serum proteome during glucocorticoid treatment and highlights the role of SAA1, IL-6, and IFN-γ in treatment responses. An involvement of PGLYRP2 in acute PMR could indicate a response to bacterial infection, highlighting its role in the acute phase of the immune response. The results suggest that PMR may be an aberrant response to a bacterial infection with an exacerbated IL-6 and acute phase inflammatory response and molecular attempts to limit the inflammation. Full article

(This article belongs to the Special Issue Personalized Medicine in Rheumatology—towards Adapting Our Care to Manifold Patient Phenotypes)

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16 pages, 3720 KiB

Open AccessArticle

CD169+ Monocyte and Regulatory T Cell Subsets Are Associated with Disease Activity in Rheumatoid Arthritis

by Amanda J. Eakin, Tahanver Ahmed, Cathy M. McGeough, Stephen Drain, H. Denis Alexander, Gary D. Wright, Philip V. Gardiner, Dawn Small, Anthony J. Bjourson and David S. Gibson

J. Pers. Med. 2022, 12(11), 1875; https://doi.org/10.3390/jpm12111875 - 9 Nov 2022

Cited by 1 | Viewed by 1702

Abstract

Disease activity in rheumatoid arthritis (RA) is influenced by activation of circulating and synovial immune cells. Regulatory T cells (Tregs) and monocytes are key cells that drive inflammation in RA. This study investigated if a relationship exists between disease activity in RA and circulating Treg and monocyte numbers and phenotypes. A potential sialic acid (Sia) mediated link between Tregs and monocytes was also probed in vitro. Peripheral blood mononuclear cells (PBMCs) were isolated from RA patient (n = 62) and healthy control (n = 21) blood using density gradient separation. Flow cytometry was used to count and phenotype Treg and monocyte subsets, and to sort healthy control Tregs for Sia cell culture experiments. The effects of Sia on activated Treg FoxP3 and NFκB expression was assessed by flow cytometry and concentrations of secreted TNFα, IL-10 and IFNγ determined by ELISA. High disease activity RA patients who were unresponsive to disease modifying anti-rheumatic drugs (n = 31), have significantly lower relative numbers (percentages) of CD4⁺CD25⁺CD127⁻ Tregs (p < 0.01) and memory CD45RA⁻FoxP3⁺ Tregs (p < 0.01), compared to low disease activity responders (n = 24). Relative numbers of non-classical CD169⁺ monocytes are associated with disease activity in RA (p = 0.012). Sia reduced Treg expression of FoxP3, NFκB and cytokines in vitro. A strong association has been identified between non-classical CD169⁺ monocytes and post-treatment disease activity in RA. This study also indicates that Sia can reduce Treg activation and cytokine release. We postulate that such a reduction could be mediated by interaction with sialyted proteins captured by CD169⁺ monocytes. Full article

(This article belongs to the Special Issue Personalized Medicine in Rheumatology—towards Adapting Our Care to Manifold Patient Phenotypes)

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Review

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10 pages, 626 KiB

Open AccessReview

The Effect of Meditation, Mindfulness, and Yoga in Patients with Rheumatoid Arthritis

by Laura Slagter, Koen Demyttenaere, Patrick Verschueren and Diederik De Cock

J. Pers. Med. 2022, 12(11), 1905; https://doi.org/10.3390/jpm12111905 - 15 Nov 2022

Cited by 9 | Viewed by 3569

Abstract

Objectives: Mind–body therapies (MBTs), including meditation, yoga, and mindfulness, create an interaction between the mind and body to enhance health. MBTs are perceived by both patients and healthcare professionals as valuable in the management of rheumatoid arthritis (RA), but the extent of this contribution is unclear, as are the patient subgroups who benefit most from MBTs. Therefore, this systematic literature review investigates the effects of meditation, mindfulness, and yoga in patients with RA. Methods: We searched four databases (PubMed, Embase, Web of Science (core collection, Chinese and Korean collection), and CINAHL). All studies were screened by two independent reviewers via the title/abstract/full text. The studies included any form of meditation/mindfulness/yoga as an intervention for RA. Animal studies, case reports, non-English articles, qualitative studies, conference abstracts, and articles without full-text access were excluded. Each study was assessed for its quality. Results: Out of 1527 potentially eligible records, 23 studies were included. All three MBTs showed various effects on patient-reported outcomes, such as vitality, functioning, and mental health, as well as on disease activity markers. Mindfulness-based interventions mainly reduced the subjective disease activity parameters (e.g., joint tenderness, morning stiffness, and pain), rather than the objective disease activity parameters (e.g., swollen joints and C-reactive protein (CRP)). RA patients with recurrent depression may benefit more from these non-pharmacological therapies than patients without recurrent depression. Discussion: This systematic literature review found that MBTs show added value in RA management, especially for patients with depressive symptoms. These non-pharmacological approaches, when used in addition to medication, might diminish polypharmacy in specific RA patient populations. Lay Summary: In recent decades, more attention has been given to the management of rheumatoid arthritis (RA) with options other than solely using medication. Such alternative options for patients to increase their quality of life are, for instance, meditation, yoga, and mindfulness. These examples of mind–body therapies (MBTs) are techniques that create an interaction between the mind and the bodily functions in order to obtain relaxation and enhance overall health. Although it is believed that these mind–body techniques are valuable in the management of RA, the extent of their contribution is still unclear, as is the question of if certain subgroups of patients benefit more from these complementary therapies. This systematic literature review investigated the effects of meditation, mindfulness, and yoga in patients with rheumatoid arthritis. A literature search was systematically performed within four different scientific databases by two independent reviewers. Out of 1527 potentially eligible articles, 23 studies were included. All three MBTs showed beneficial effects, which were mostly on the vitality, functioning, and mental health of patients with RA, but also on symptoms related to disease activity. RA patients with recurrent depression seemed to benefit more from these non-pharmacological therapies than patients without recurrent depression. Hence, we can conclude that MBTs show added value in the management of RA. Full article

(This article belongs to the Special Issue Personalized Medicine in Rheumatology—towards Adapting Our Care to Manifold Patient Phenotypes)

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