Rheumatoid arthritis (RA) is a systemic autoimmune disease with known extra-articular manifestations, including potential involvement of the gastrointestinal (GI) tract. While prior studies have explored malignancy risks in RA, limited large-scale data exist on the association between RA and both cancerous and non-cancerous GI comorbidities. This retrospective nested case-control study utilized Taiwan's National Health Insurance Research Database (NHIRD) from 2000 to 2019. A total of 75 670 individuals newly diagnosed with RA were matched 1:4 by age and sex to 302 680 controls without RA. The prevalence and adjusted odds ratios (aOR) for GI conditions-including gastric ulcer, duodenal ulcer, GERD, irritable bowel syndrome, inflammatory bowel diseases, and various GI cancers-were evaluated using conditional logistic regression. Patients with RA demonstrated significantly higher odds of several benign GI conditions, including peptic ulcer disease (aOR: 1.72, 95% CI: 1.66-1.79), gastric ulcer (aOR: 1.52, 95% CI: 1.44-1.60), GERD (aOR: 1.49, 95% CI: 1.41-1.57), and inflammatory bowel diseases. These associations remained robust across age- and sex-stratified analyses. In contrast, most GI cancers were not significantly associated with RA. Notably, inverse associations were observed for stomach cancer (aOR: 0.66, 95% CI: 0.49-0.87) and liver and bile duct cancer in females (aOR: 0.74, 95% CI: 0.58-0.95). RA is significantly associated with a higher prevalence of benign GI comorbidities but not with most GI malignancies. These findings highlight the importance of comprehensive GI screening in RA management and support the relevance of the gut-joint axis in autoimmune disease pathogenesis.

Systemic lupus erythematosus (SLE) is a chronic multisystem autoimmune disease. Endothelial dysfunction is an early change in atherosclerosis. Endocan is a new indicator of endothelial dysfunction and is probably involved in proinflammatory processes in SLE. This study aimed to assess the serum endocan level in SLE patients and its relation to disease activity, endothelial dysfunction, and subclinical atherosclerosis. This study included 60 SLE patients and 60 healthy controls. Demographic data were collected, and disease activity was assessed using the SLEDAI score for SLE patients. Functional assessment was done using the Health Assessment Questionnaire (HAQ). Serum endocan level was measured, and subclinical atherosclerosis was assessed using brachial artery flow-mediated dilation (FMD) and carotid intima-media thickness (cIMT). Endocan levels in the SLE group (632.2 ± 70.58 ng/L) were significantly higher than controls (125.83 ± 16.23 ng/L). cIMT was significantly higher in SLE patients (8.18 ± 1.13 mm) than in controls (6.43 ± 0.54), and the mean flow-mediated dilation value in SLE patients was 9.57 ± 2.59, whereas in the control group, it was 21.8 ± 4.27. The serum level of endocan was significantly correlated with the duration of the disease, triglycerides, and cIMT, and it had a significant negative correlation with flow-mediated dilation. cIMT and flow-mediated dilation were significantly correlated with age, disease duration, and triglycerides. Elevated serum levels of endocan in SLE patients may be associated with subclinical atherosclerosis and endothelial dysfunction.

Recent evidence suggests that education on the pain-relieving effects of exercise may enhance exercise-induced hypoalgesia (EIH) in healthy individuals. However, its impact in populations with osteoarthritis (OA), where EIH responses are more variable, remains unclear. This study examined whether positive pre-exercise education enhances EIH in individuals with knee OA. A double-blind, randomized controlled trial was conducted with 42 participants allocated to either a positive pre-exercise education group (n = 21) or a control education group (n = 21). Each group received two individual education sessions 24-72 h apart. OA- and EIH-related knowledge and beliefs were assessed pre- and post-education. EIH was evaluated following a single submaximal isometric quadriceps contraction to failure by measuring changes in pressure pain thresholds (PPTs), resting pain, and pain during stepping. Group differences were analyzed using ANCOVA. The positive pre-exercise education group demonstrated greater improvements in EIH-related knowledge and beliefs compared to the control group (p = 0.001, d = 0.50, ANCOVA between-group analysis), while OA-related knowledge and beliefs remained unchanged (p = 0.34, d = 0.15). However, ANCOVA results showed no significant between-group differences in pre- to post-exercise changes in PPTs, resting pain, or pain during stepping (all p > 0.11, d = 0.04-0.25). Despite enhancing beliefs about exercise-induced pain relief, positive pre-exercise education did not enhance EIH compared to control education. These findings highlight the need for alternative strategies to optimize exercise-induced pain relief in OA.

Available evidence has shown a genetic association with systemic lupus erythematosus (SLE) pathogenesis. Interleukin-38 (IL-38) has been found to correlate with SLE development. However, whether IL-38 gene polymorphisms relate to SLE risk needs clarification. A total of 390 age- and sex-matched SLE patients and 390 healthy controls were recruited from the Affiliated Hospital of Southwest Medical University. Blood samples were collected from all the participants. Clinical and laboratory characteristics were collected and evaluated. DNA samples were extracted, and their quality was assessed. Six IL-38 gene polymorphisms (rs3811058, rs3811051, rs3811050, rs28992498, rs28992497, and rs7599662) were screened. Genotyping was performed using KASP methods. All the six polymorphisms conformed to the Hardy-Weinberg's expectation test. The frequencies of genotypes TT and TT + TC of rs3811058 were lower in SLE patients compared to healthy controls (OR = 1.518, OR = 1.461). Similarly, for rs7599662, the frequencies of genotypes TT, TT + TC, and allele T were lower in SLE patients than in healthy controls (OR = 2.052, OR = 2.494, OR = 1.645). Conversely, the frequency of genotype TC in SLE patients was higher than that in healthy controls (OR = 1.972). Subgroup analysis showed that these gene polymorphisms were associated with various clinical and laboratory features in SLE patients. Notably, the TT + TC genotype of rs3811058 was negatively associated with lupus headache and pyuria. Furthermore, patients with the TT + TC genotype of rs3811058 had higher IgA levels, whereas SLE patients with the CC + CA genotype of rs28992498 showed lower RF and IgG expression. IL-38 gene polymorphisms (rs3811058 and rs7599662) are associated with SLE susceptibility, and are partially associated with clinical and laboratory features.

Limited evidence exists regarding medication regimens for infection-prone patients with systemic lupus erythematosus (SLE) undergoing peritoneal dialysis (PD). This study evaluated the association between medication use and peritonitis in patients with SLE on PD and compared peritonitis rates between patients with and without SLE. We retrospectively studied patients who underwent PD between 2007 and 2023. Using propensity score matching, we compared 46 patients with SLE and 46 non-SLE controls matched by sex, date of PD initiation, diabetes mellitus, and age at PD initiation. Peritonitis incidence and risk ratios were calculated using Poisson regression. Time-dependent Cox proportional hazards model identified risk factors for peritonitis. Incidence of peritonitis was higher in patients with SLE at 0.32 episodes per patient-year compared with 0.25 in the controls (risk ratio 1.30, p = 0.15). Time to first peritonitis episode, peritonitis-associated catheter removal, and mortality rates were similar between the groups. Independent risk factors for peritonitis included male sex (hazard ratio [HR]: 2.29, 95% confidence interval [CI]: 1.22-4.27, p = 0.009), gastric acid suppressants (GAS, HR: 8.71, 95% CI: 2.53-30.05, p < 0.001), and glucocorticoid (GC, HR: 1.16, 95% CI: 1.08-1.26, p < 0.001) in patients with SLE on PD. A significant number of peritonitis was still observed in patients not receiving GC. PD is a safe dialysis modality for patients with SLE, with comparable outcomes to non-SLE controls. Nevertheless, the risk of peritonitis in patients with SLE undergoing PD may be increased by the administration of GAS and GC, as well as male sex.

The relationship of gout with the risk of dementia has been a subject of importance in current studies. There is no comprehensive meta-analysis regarding their association. Hence, our team performed a systematic review and meta-analysis to examine the relationship of gout with the risk of dementia. We searched PubMed, EMBASE, Scopus, and Web of Science beginning at database commencement till 1 December 2022. For systematic review and meta-analysis, 2 independent reviewers comprised observational researches that assessed the relationship of gout with risk of dementia. This research pursued the Preferred Reporting Items for Systematic reviews and Meta-Analyses summarizing guidelines to extract and synthesize data. Our team applied the random-effects model to determine pooled risk ratios (RRs) with 95% confidence intervals (CIs). Our study covered 5 observational studies. The pooled RR for the risk of overall dementia was 0.80 (95% CI: 0.58-1.10) with no evidence of publication bias. Moreover, the pooled RR demonstrated lesser risk of Alzheimer's disease (AD) at 0.70 (95% CI: 0.62-0.78) and vascular dementia at 0.68 (95% CI: 0.48-0.95) among patients with gout. An inverse association was observed in Asian people, but there was no relationship of gout with dementia among Western people. In this meta-analysis of observational studies, gout was not significantly associated with overall dementia risk, although inverse associations were observed for AD and vascular dementia. These findings suggest potential heterogeneity by dementia subtype and population but should be interpreted cautiously given the observational design. Well-designed prospective studies and randomized trials are needed to clarify causality and underlying mechanisms. International Platform of Registered Systematic Review and Meta-analysis Protocols INPLASY2025110018; https://doi.org/10.37766/inplasy2025.11.0018.

To explore the association of mitochondrial DNA (mtDNA) genetic variants, including single nucleotide variants (SNVs), insertions and deletions (InDels), and copy number variations (CNVs), with depression and anxiety in Chinese patients with systemic lupus erythematosus (SLE). A two-stage study of 530 patients with SLE was conducted to explore the association between mtDNA genetic variants (SNVs and InDels) and depression and anxiety. A total of 499 patients with SLE were recruited to explore the association between mtDNA CNVs and depression and anxiety. Meanwhile, the patients were followed up for 12 weeks to observe the improvement of depression and anxiety. The levels of reactive oxygen species (ROS), adenosine triphosphate (ATP), interleukin-6 (IL-6), and interleukin-1β (IL-1β) were detected. Two mtDNA SNVs (C16291T, A16399G) in the displacement loop (D-loop) region were associated with depression in patients with SLE (PBH = 0.003, PBH = 0.007). Two mtDNA SNVs (T9950C, T16140C) in the cytochrome c oxidase subunit III (COX3) gene and D-loop region were associated with anxiety in patients with SLE (PBH = 0.001; PBH = 0.003). Associations of mtDNA CNVs with depression and anxiety in SLE were observed in several subgroups (Padj < 0.05). T9950C and T16140C variants were related to the improvement of anxiety in SLE (PBH < 0.05). An inverse U-shaped non-linear association was observed between mtDNA CNVs and the improvement of anxiety in the body mass index (BMI) ≥ 24 subgroup of SLE (Pnon-linear = 0.038). The levels of ROS (p = 0.040) and IL-6 (p = 0.039) were increased and ATP level (p = 0.034) was decreased in the COX3 gene variation group. mtDNA genetic variants may be associated with depression and anxiety in Chinese patients with SLE. This study provides a new idea for improving depression and anxiety in SLE.