• Significant findings of the study: This study evaluated subjective residual symptoms and imaging findings using musculoskeletal ultrasound and magnetic resonance imaging in patients with rheumatoid arthritis (RA) who achieved clinical remission.

• What this study adds: A Health Assessment Questionnaire Disability Index score of ≤0.25 may indicate reduced severity of residual synovitis in patients with RA following clinical remission.

• Serum protein analysis by high-precision proteomic technology is a feasible method to identify novel citrullinated epitopes in RA patients.

• Anti-cLBP antibodies are associated with disease severity and infection in RA patients.

Significant findings of the study:

• Seropositive rheumatoid arthritis (RA) evolves over years before the development of clinically apparent inflammatory arthritis.

• Emerging data support a model wherein mucosal inflammation precedes the development of systemic autoimmunity, followed by the development of synovitis.

• The development of RA may entail multiple “endotypes” across individuals who ultimately develop clinical disease.

What this study adds:

• Mechanisms that should normally constrain RA-related autoimmunity at specific checkpoints, including mucosal and systemic processes that limit autoimmunity, appear to fail during the preclinical development of RA.

• By understanding and targeting these failed mechanisms, it may be possible to prevent, or minimally ameliorate, the development of classified RA.

• Autoimmune diseases (ADs) can be classified into organ-specific or nonorgan-specific, that is, tissue specificity (e.g., thyroid in Hashimoto's thyroiditis) or against widely expressed antigens (e.g., nuclear antigens in systemic lupus erythematosus [SLE]).

• SLE is distinguished by the presence of circulating autoantibodies and immune complex deposition, both of which can induce inflammatory damage to the organs.

• Rheumatoid arthritis (RA), also known as inflammatory arthritis, is a systemic AD that affects the joints and causes synovitis.

• Multiple sclerosis (MS) is a central nervous system inflammatory disease with various neurological and autoimmune symptoms.

• Familial inheritance and genetic links have been reported between RA and SLE, and Type 1 diabetes mellitus and MS.

• Identification of shared major genes and biological pathways would be useful as a potential therapeutic targets and biomarkers in dual ADs.

• Gingiva-derived mesenchymal stem cells (GMSCs) suppress the proliferation and invasion of rheumatoid arthritis fibroblast-like synoviocytes (RA FLSs) from RA patients.

• GMSCs are effective in treating experimental arthritis.

• The percentage of patients willing to receive the COVID-19 vaccine greatly increased when vaccination was recommended by a physician.

• Gender, marital status, age of the patients' children, smoking, trust in the safety and efficacy of the vaccine, and previous vaccinations had significant effects on the willingness of patients with AIIRDs to receive the COVID-19 vaccine.

• The data from vaccinated patients indicated no aggravation of AIIRD or additional adverse events.

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  Host immune-mediated upregulation of RNA editing APOBEC3G/F and ADAR1 genes leads to the viral genome and host transcriptome editing during SARS-CoV-2 infections and paves the way for the generation of autoantigens.

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  Such autoantigens will be presented as foreign by the host immune system to generate autoantibodies followed by induction of auto immunogenicity and the onset of transient or sustained autoimmune diseases as an aftermath of SARS-CoV-2 infections.

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  The preventive measures and strategies are postulated to combat future SARS-CoV-2 infections and their aftermaths and to minimize and/or preclude SARS-CoV-2 mediated ill effects like autoimmune diseases.

• Myocarditis and pericarditis are recognized side effects of the messenger RNA (mRNA) vaccines Comirnaty (Pfizer/BioNTech) and Spikevax (Moderna).

• Our observations support the theory that patients with autoimmune inflammatory rheumatic diseases that predisposes them to develop myocarditis/pericarditis, might put them at increased risk of developing this complication after the mRNA vaccine.

• The molecular mechanisms involved in viral evolution are enlightened. Such information will help to better understand the root causes for the emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants, their pathophysiology, and the mechanism(s) of infection.

• Precision medicine-based strategies may help to eliminate and/or minimize the onset of future aftermaths of SARS-CoV-2 infections and their deleterious effects.

• Ultimately, such efforts may pave the way for developing better vaccines and therapeutic regimens to control and/or prevent SARS-CoV-2 infections as well as the onset of associated autoimmune and other diseases in susceptible individuals.

• Immunosuppressive treatment reduced the immunogenicity of the inactivated COVID-19 vaccine without increasing autoantibody titers or the flare rate in patients with rheumatic and musculoskeletal diseases (RMDs).

• Immunosuppressive therapy selectively increased CD19⁺IgG⁻IgG1⁺ cells and decreased CD19⁺CD27⁺IgG⁺ and CD19⁺IgG⁺IgG1⁺ B cells, but not CD4⁺ T-cell subsets in RMD patients.

• IL-21R is expressed in human monocytic THP-1 derived macrophages.

• IL-21 up-regulates the gene expression and protein secretion of TNF-α, IL-6, and IL-10 in LPS-mediated THP-1 derived macrophages.

• IL-21 plays a two-way regulatory role in THP-1 derived macrophage polarization.

• Different liver damage caused by different modeling types will further explain the role of Th17/Treg imbalance in autoimmune hepatitis, and this imbalance has important implications for changes in immune status and disease progression.

• In this study, α-galactosylceramide was used to establish the autoimmune hepatitis model, which shows similar pathological manifestations as that in human autoimmune hepatitis.

• Paul Ehrlich coined the term “horror autotoxicus” for autoimmunity and emphasized how the immune system distinguishes foreign from self.

• The discoveries of allergy and anaphylaxis were the first signs that the immune system was capable of self-damage. The studies on chronic thyroiditis and clinical laboratory breakthroughs led to the acceptance of autoimmune disease in the 1950s.

• The first autoantibodies were discovered in the 1940s when antinuclear antibodies and rheumatoid factors were recognized as the diagnostic features of systemic lupus erythematosus and rheumatoid arthritis, respectively.

• Frank Macfarlane Burnet founded the science of autoimmunity and developed the clonal selection theory of forbidden clones.

• Autoantibodies play a vital role in the pathogenesis of autoimmune diseases and are responsible for systemic inflammation and tissue injury.

• The combination of hemolytic anemia and acute kidney injury following the concomitant use of ciprofloxacin and hydrochlorothiazide is a rare and severe complication presented in this study.

• Healthcare providers should be aware of the life-threatening drug-induced autoimmune hemolytic anemia that may occur with commonly used drugs.

• The treatment mainly includes cessation of the offending drug, steroid therapy, blood transfusion if needed, and supportive care.

• Immunoglobulin G4-related disease (IgG4-RD) is a systemic immune-mediated fibroinflammatory condition. Previous studies have indicated relationships between malignancy and autoimmunity.

• This retrospective cohort study found that a family history of malignancy was present in 13.1% of IgG4-RD patients.

• Family history of malignancy may be associated with IgG4-RD development and genetic susceptibility may be involved in the pathogenesis of IgG4-RD, but further studies are needed to test this hypothesis and explore possible susceptibility genes.

• There are currently a lack of randomised controlled trials comparing the efficacy between manual acupuncture and electroacupuncture.

• This is a protocol for a randomised controlled trial comparing the efficacy between manual and electroacupuncture in patients with axial spondyloarthritis with inadequate response to conventional western medications.

• The mean difference in Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) score between the two groups over 12 weeks will serve as the primary outcome.

• HLA-B27 was more frequently found in AS patients (60.4%) than in controls (8.3%).

• The combination of HLA-B27 and HLA-B60 was only found in AS patients.

• No association between ERAP1 SNP rs30187 and HLA-B27 was observed in Bangladeshi AS patients.

• First HLA-B27 association in Bangladesh.

• Limitation: Single tertiary level hospital-based study.

• Our successful feasibility study distinguished individuals with and without Sjogren's syndrome (SS) according to novel relationships between salivary properties and participant-reported perceptions of swallowing.

• Salivary analyte profiling in SS may enable biomarker-based approaches to early identification, differential diagnosis, and bespoke treatment of dysphagia, while also informing the diagnostic process for SS and other chronic, autoimmune conditions.

• Two hundred and thirty-two and 110 differentially expressed genes (DEGs) were screened in systemic lupus erythematosus (SLE) and primary Sjögren's syndrome (pSS) peripheral blood mononuclear cells RNA-seq data sets, respectively.

• Thirty-two shared DEGs were screened in SLE and pSS data sets, which were all upregulated in patients compared to controls.

• These 32 shared DEGs were mainly enrichment in biological progress associated with type I interferon signaling pathway, defense response to virus, response to virus, negative regulation of viral genome replication, and immune response.

• Multicentric reticulohistiocytosis (MRH) is a rare, multisystemic disease that can be distinctly characterized by the presence of papulonodular lesions appearing over the distal fingers and periungual area, typically described as having a “coral beads” pattern.

• There are no diagnostic laboratory tests for MRH, although the diagnosis is typically made by the presence of the pathognomonic papulonodular lesions with aggressive erosive arthritis seen predominantly in the distal interphalangeal joints, as well as a skin and/or synovial biopsy.

• Methotrexate has been considered as the most effective initial disease-modifying antirheumatic drug to use, although other options have also shown success including leflunomide, azathioprine, tumor necrosis factor inhibitors, thalidomide, interleukin (IL)-6 inhibitors, and IL-1 inhibitors.

• Statin-associated immune-mediated necrotizing myositis is a rare but important complication of statin use to recognize.

• Statin-associated immune-mediated necrotizing myositis and inclusion body myositis can present with unique clinical and pathological features.

• Statin-associated immune-mediated necrotizing myositis may improve with statin cessation and various immunosuppressive therapy while inclusion body myositis is typically refractory to therapy.

• Compared with healthy controls, 372 differentially expressed mRNAs were identified within the dermatomyositis group by performing RNA-sequencing, including 275 upregulated and 97 downregulated ones.

• Overall, 692 differentially expressed long noncoding RNAs were identified in the dermatomyositis group compared with healthy controls, of which 407 were upregulated and 285 were downregulated.

• ISG15, IFI6, IFIT1, OAS3, and MX1, five type-I interferon-stimulated genes were found to be significantly upregulated in dermatomyositis muscle tissues compared with the levels in healthy control tissues.

Telitacicept may be a safe and effective treatment for refractory thrombocytopenia in lupus and antiphospholipid syndrome patients.

• Anti-topoisomerase-I was the most prevalent autoantibody in patients with systemic sclerosis in Bangladesh.

• Coexistence of antiribonucleic acid polymerase-III and anti-U1-ribonucleoprotein was a common finding.

• Antiribonucleic acid polymerase-III antibody and anti-U1-ribonucleoprotein had significant associations with pulmonary arterial hypertension and restrictive lung disease, respectively.

• Systemic sclerosis carries a poor prognosis in South African systemic sclerosis patients and an estimated overall 5-year survival rate of 58%.

• Cardiorespiratory complications of interstitial lung disease with or without pulmonary hypertension were the most common cause of death.

• Cor pulmonale and renal dysfunction were independent predictors of death.

• Ultrasound detects almost twice as many tophi as rheumatologists observe visually.

• Some readily available clinical indicators can predict the presence of hidden tophi.

• An easy-to-use clinical prediction model was developed to facilitate the discovery of hidden tophi.

• The prevalence of soft tissue rheumatism in rural Nigeria is 11.0%.

• The commonest soft tissue rheumatic disorder found is adhesive capsulitis.

• Age, sex, and dyslipidemia have a significant association with soft tissue rheumatism.

• This study attempts to bridge the knowledge gap about soft tissue rheumatism in Nigeria due to the paucity of data, especially in rural regions.

• High-titer antimitochondrial M2 (AMA-M2) autoantibodies were present in immunoglobulin preparations.

• The AMA-M2 autoantibodies were transferred transiently into the circulation of patients with connective tissue diseases via intravenous immunoglobulin (IVIG) therapy.

• To avoid false clinical decisions based on postinfusion antibody titers, retesting 1–2 months after high-dose IVIG immunomodulatory treatment was recommended.

The prognosis of focal segmental glomerulosclerosis (FSGS) patients with nephrotic syndrome is poor. We investigated the effectiveness of treatment in 50 patients with primary FSGS. Low-density lipoprotein-apheresis (LDL-A) was performed in four patients who presented with steroid-resistant nephrotic syndrome. LDL-A therapy tended to be chosen for more critical cases. Although it may be effective at improving the remission rate, we believe that studies on more patients are required to elucidate the effect on long-term prognosis.

• There is a high mortality rate among CTD patients with PJP infection. Rapid and accurate diagnosis of PJP is important for successful treatment, but it remains challenging.

• BALF mNGS technology is highly effective in diagnosing PJP in CTD patients.

• BALF mNGS is a valuable diagnostic tool in these patients.

• This study showed that bosentan is more effective than sildenafil in the treatment of patients with severe pulmonary arterial hypertension associated with connective tissue diseases (CTD-PAH).

• The findings are important for the clinical choice of targeted vasodilators for CTD-PAH.