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Clinical Manifestations and Treatment of Autoimmune Diseases: 2nd Edition

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A special issue of Life (ISSN 2075-1729). This special issue belongs to the section "Medical Research".

Deadline for manuscript submissions: 28 February 2026 | Viewed by 5083

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Special Issue Editors

Dr. Stelvio Tonello

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Guest Editor

Department of Translational Medicine, Università del Piemonte Orientale UPO, 28100 Novara, Italy
Interests: inflammation; innate immunity; immunity; cancer biology; cellular immunology; toxicology
Special Issues, Collections and Topics in MDPI journals

Dr. Daniele Sola

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Guest Editor

Department of Translational Medicine, University of Eastern Piedmont, Novara, Italy
Interests: rare immunological diseases; vasculitis; immunodeficiencies; connective tissue disease; leukocyte biology
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Special Issue Information

Dear Colleagues,

The first volume of this Special Issue was a great success, publishing 12 peer-reviewed articles of recognized high scientific value [https://www.mdpi.com/journal/life/special_issues/VP89JRZU6T]; therefore, we invite you to publish your research in the second volume of this Special Issue.

Autoimmunity is one of the most common ways in which the immune system can fail. The mechanisms by which the human immune system protects us and can harm us are complex and fascinating. Autoimmune diseases are numerous and involve any medical specialty, ranging from mild to serious, chronic and tumultuous conditions. The field of autoimmune diseases is particularly active; in recent years, many interesting discoveries have been made regarding disease classification criteria, biological markers of inflammation activity, and synthetic and biological therapies. A further boost to research in this context was driven by the SARS-CoV-2 pandemic and consequent vaccinations. This is a good time to draw state-of-the-art lines in this field. With this Special Issue, we aim to fill these gaps, at least in part, by inviting researchers to contribute to improving the understanding and treatment of autoimmune diseases step by step. Articles may include any topic related to autoimmunity, from the biology and physiology of the immune system to clinical diseases, autoimmunity as an epiphenomenon of other conditions, response to vaccines and therapy. I hope that this Special Issue is greeted with productivity and enthusiasm as everyone's help is needed to make further progress in this crucial topic of human health.

Dr. Stelvio Tonello
Dr. Daniele Sola
Guest Editors

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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. Life is an international peer-reviewed open access monthly journal published by MDPI.

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Keywords

autoimmunity
immunobiology
vaccine
leucocytes
immune system

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Published Papers (5 papers)

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Research

14 pages, 259 KB

Open AccessArticle

Sexual Dysfunction Is Common in Reproductive-Age Women with Systemic Sclerosis

by Lingling Salang, Pranom Buppasiri, Arporn Jutiviboonsuk and Chingching Foocharoen

Life 2025, 15(9), 1441; https://doi.org/10.3390/life15091441 - 14 Sep 2025

Viewed by 436

Abstract

Background: Female sexual dysfunction (FSD) is an underrecognized issue in women with systemic sclerosis (SSc), influenced by physical and psychological factors. Data on FSD in reproductive-age SSc patients, especially those with diffuse cutaneous SSc (dcSSc), remain limited. Objectives: This study aimed to determine the prevalence of FSD and identify its associated factors among reproductive-age women with SSc. Methods: A cross-sectional study (May 2019–March 2020) included sexually active women with SSc aged 18–45. Patients with surgical amenorrhea, prior radiation, hormonal contraceptive use within 12 weeks, or pregnancy were excluded. Sexual function was assessed using the Female Sexual Function Index (FSFI). Results: Among 27 women of reproductive age, 66.7% had the dcSSc subset. The mean age was 39.4 ± 5.2 years (range: 22–45 years), with a mean disease duration of 9.9 ± 7.9 years. FSD was identified in 51.9% of patients (95%CI: 31.9–71.3), with a higher prevalence in the dcSSc subset (71.4%) compared to limited cutaneous SSc (28.6%). Patients with FSD were more likely to be older at disease onset, exhibit telangiectasia, and have longer exposure to cyclophosphamide (CYC), although these findings were not statistically significant. Women with FSD showed significantly lower FSFI scores in arousal, lubrication, orgasm, sexual satisfaction, and total sexual function (p < 0.01 for all). Conclusions: FSD is highly prevalent among SSc women of reproductive age, particularly in those with dcSSc. Disease severity, older age at onset, and prolonged CYC treatment may contribute to the risk of FSD. Early recognition and management of sexual health issues are essential in this patient population. Full article

(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases: 2nd Edition)

11 pages, 2475 KB

Open AccessArticle

Comparing Performance of NAF and NT-2013 to SGA as Nutritional Assessment Tools in Systemic Sclerosis Patients

by Kittipadh Boonyavarakul, Chingching Foocharoen, Orathai Wantha and Veeradej Pisprasert

Life 2025, 15(8), 1325; https://doi.org/10.3390/life15081325 - 20 Aug 2025

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Abstract

Malnutrition is one of the common complications of patients with systemic sclerosis (SSc). However, several nutritional assessment tools are implemented in Thailand. The study aimed to compare the performance of nutritional assessment tools including Nutritional Assessment Form (NAF) and Nutritional Triage 2013 (NT-2013) to Subjective Global Assessment (SGA) in SSc patients. A cross-sectional diagnostic study was conducted in adult SSc patients at Srinagarind Hospital, Thailand. To elucidate the efficacy and correlations of these tools, descriptive statistics, Pearson correlation analyses, and kappa coefficient of agreement were employed. A total of 208 SSc patients were included, of which 70.7% were females. The respective mean age and body mass index was 59.3 years and 21.1 kg/m². Nearly half (45.7%) were malnourished based on SGA. Malnutrition diagnosis using the NAF and NT-2013 criteria were found in 80.3% and 34.6%, respectively. The respective sensitivity and specificity of NAF for diagnosis of malnutrition was 93.7% and 31.9%, while NT-2013 was 60.0% and 90.3%. Both NAF and NT-2013 had slight agreement with SGA with a kappa of 0.149 for NAF and 0.131 for NT-2013. Adjusting the cut-off points of NAF and NT-2013 could enhance sensitivity, specificity, and improve agreement for diagnosis with SGA. Full article

(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases: 2nd Edition)

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14 pages, 429 KB

Open AccessArticle

Effects of a Self-Management Telehealth Program on Improving Strength and Hand Function in Systemic Sclerosis Patients: A Randomized Controlled Trial

by Orathai Wantha, Ajanee Mahakkanukrauh, Siraphop Suwannaroj, Kwankaew Tuydaung, Nonglak Methakanjanasak, Kannika Srichomphu, Jinnaphat Kraipoj and Chingching Foocharoen

Life 2025, 15(7), 1087; https://doi.org/10.3390/life15071087 - 10 Jul 2025

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Abstract

Objective: A self-management telehealth program to improve hand strength and function in systemic sclerosis (SSc) patients may improve their quality of life, so we investigated its efficacy. Methods: A 6-week prospective randomized controlled study was conducted in adults with SSc with a hand mobility in scleroderma (HAMIS) score > 1 or a limited range of motion in at least one hand joint. Participants were randomly allocated into three groups for six weeks of health education: (a) typical education, (b) watching video guides as needed, in addition to typical education, and (c) watching video guides and receiving weekly telephone notifications, in addition to typical education. The endpoints were the differences in self-management behavior, HAMIS scores, hand grip strength (HGS), and quality of life (QoL) using the European Quality of Life-5 Dimensions between groups, as well as the changes in these parameters compared to baseline. Results: A total of 24 patients per group were enrolled, with the majority diagnosed with diffuse cutaneous SSc (79.2%). Six weeks post-intervention, HGS improved significantly in both the video guide and telephone notification groups compared to typical education in both hands (p = 0.028, p = 0.044). Pincer grip differed between the groups in the non-dominant hand. Household modifications were more frequent in the video guide and telephone notification groups than in the typical education group (p = 0.023). All groups showed significant improvements in HGS and HAMIS scores in both hands, as well as in self-management behaviors, compared to baseline. QoL, as measured using a visual analog scale, improved significantly after the intervention in both the video guide and telephone notification groups, but not in the typical education group. Conclusions: Self-management telehealth programs effectively enhance hand strength, function, and self-management behaviors in patients with SSc with limited hand function. Weekly telephone notifications further reinforced continuity and engagement in these patients. Full article

(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases: 2nd Edition)

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19 pages, 719 KB

Open AccessArticle

Redefining Systemic Sclerosis Classification: Anti-Topoisomerase Antibody as a Superior Predictor of Interstitial Lung Disease and Skin Progression Compared to Limited Cutaneous Systemic Sclerosis Subset

by Chana Chaovanitkul, Tippawan Onchan, Patnarin Pongkulkiat, Ajanee Mahakkanukrauh, Siraphop Suwannaroj and Chingching Foocharoen

Life 2025, 15(7), 1067; https://doi.org/10.3390/life15071067 - 4 Jul 2025

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Abstract

Background: Currently, no information exists on the clinical course of anti-topoisomerase I antibody (ATA)-positive limited cutaneous systemic sclerosis (lcSSc). We aimed to evaluate the incidence of and time to the development of interstitial lung disease (ILD), pulmonary hypertension (PHT), scleroderma renal crisis (SRC), and maximal modified Rodnan skin score (max-mRSS) in patients with lcSSc and dcSSc, with and without ATA. Methods: This cohort study included 522 patients with systemic sclerosis (SSc). The incidence of and time to the development of ILD, PHT, SRC, and max-mRSS were assessed. Results: ATA-positive dcSSc (dcSSc-posATA) was the most common presentation among Thai patients (321 cases; 61.5%). The median time to the development of ILD was shorter than that in lcSSc-posATA, comparable to that in dcSSc-posATA (1.0 vs. 1.8 years, p = 0.21), and shorter than that in ATA-negative dcSSc (dcSSc-negATA) (1.0 vs. 4.8 years, p = 0.001). The time to max-mRSS in lcSSc-posATA was comparable to that in dcSSc-posATA (p = 0.17) but shorter than that in dcSSc-negATA (p < 0.001). Conclusions: Patients with lcSSc-posATA had a similar risk of ILD development and time to reach max-mRSS as those with dcSSc, regardless of the presence of ATA, but had earlier ILD development and max-mRSS compared to those with dcSSc-negATA. Their prognosis appeared to be better than that of dcSSc-posATA. Full article

(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases: 2nd Edition)

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17 pages, 751 KB

Open AccessArticle

Efficacy of Cannabis Oil in Improving Subjective Sleep Quality in Systemic Sclerosis: A Prospective Placebo-Controlled Study

by Apichart So-ngern, Bungon Sripanichkulchai, Ajanee Mahakkanukrauh, Siraphop Suwannaroj, Patnarin Pongkulkiat, Tippawan Onchan, Somdej Kanokmedhakul and Chingching Foocharoen

Life 2025, 15(5), 727; https://doi.org/10.3390/life15050727 - 30 Apr 2025

Cited by 1 | Viewed by 2056

Abstract

Objective: We aimed to investigate the efficacy of cannabis oil in improving sleep quality, as evaluated using the Pittsburgh Sleep Quality Index (PSQI), in patients with systemic sclerosis (SSc) compared to placebo. Methods: An experimental investigation was conducted in patients with SSc aged 18–70 years. The treatment group received a cannabis preparation containing 2.7 mg/mL tetrahydrocannabinol (THC) and 2.5 mg/mL cannabidiol (CBD) sublingually for 4 weeks. Results: Twenty-seven participants were included in the study. One case was withdrawn due to a serious adverse event, leaving 13 participants in each group. The mean difference in PSQI scores decreased more in the treatment group than in the placebo group from baseline to post-treatment, but this difference was not statistically significant (p = 0.09). Increases in sleep duration were more frequently observed in the treatment group than in the placebo group, along with decreases in sleep disturbance, sleep medication use, and daytime dysfunction; however, these were not statistically significant. Conclusions: Cannabis oil showed some positive trends; however, our study did not provide conclusive evidence supporting the efficacy of cannabis oil in improving sleep quality. More rigorous studies are needed to confirm these findings and expand the clinical applicability of cannabinoids for sleep disorders. Full article

(This article belongs to the Special Issue Clinical Manifestations and Treatment of Autoimmune Diseases: 2nd Edition)

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