Objective: This study aimed to evaluate the impact of anti-TNF (biological) therapies on the incidence and progression of diabetic retinopathy. Materials and methods: A cross-sectional analysis of 50 diabetic patients with rheumatic diseases (group 1) was performed. An age-, sex-, and HbA1c-matched control group (group 2) was formed from a pool of diabetic patients who underwent regular eye examinations. The presence or absence of diabetic retinopathy was also assessed. Comorbidities such as hypertension, coronary artery disease, and hyperlipidemia were also evaluated as possible confounding factors. Results: Hundred eyes of 50 patients were evaluated in each group. Only three patients in group 1 had non-proliferative retinopathy. The median duration of rheumatic disease was 9 years, whereas that of diabetes was 11 years. The mean duration of anti-TNF therapy was 4 years. In the control group of diabetes-only patients, 13 patients developed some form of newly diagnosed diabetic retinopathy during the last five years. The calculated retinopathy occurrence between the groups was statistically significant (p < 0.05). In this study, the incidence rate ratio for patients receiving anti-TNF treatment was calculated as 0.4 in the study. Conclusion: TNF inhibitors, with their anti-inflammatory effects, positively impact diabetic complications by reducing the incidence of retinopathy. To our knowledge, this is the first study to evaluate retinopathy development after anti-TNF therapy.

Background: The study aimed to investigate novel biomarkers from the C1q TNF superfamily and evaluate their role in autoimmune inflammatory rheumatic diseases with the goal of identifying an effective biomarker to measure clinical disease activity and assess treatment efficacy. Methods: Sixty-one Axial spondyloarthritis (AxSpa) patients and 30 healthy controls were enrolled in the study. The serum biomarkers subfatin, CTHRC1, CTRP3, CTRP6, IL-6, IL-17, and TNF-α and the disease indices BASDAI, BASFI, MASES, and ASDAS–ESR/CRP were evaluated and compared. The patients were then classified, and their serum biomarkers were assessed according to their ASDAS scores and their treatment regimens. Results: Among the studied biomarkers, none showed a significant difference between the patients and the healthy controls. Although the difference was not statistically significant, the median values of serum subfatin, CTHRC1, CTRP3, CTRP6, IL-6, IL-17, and TNF-α were all found to be lower in the AxSpa patients than in the healthy controls. Furthermore, once the patients were classified regarding their disease activity, no correlation between the study biomarkers and levels of clinical disease indices was observed. Finally, biological treatments were found to affect the serum concentration of these biomarkers regardless of the level of disease activity. Conclusion: Novel adipokines and known modulators of inflammation, circulating subfatin, CTHRC1, CTRP3, CTRP6, IL-6, IL-17, and TNF-α levels may play a role in assessing treatment efficacy, especially in those treated with TNF-inhibitors. However, we failed to demonstrate a correlation between clinical disease activity and serum biomarker levels.

This study aimed to evaluate the effectiveness of Airofit PRO^™, a mobile respiratory trainer device, on pulmonary function, chest expansion, and functional status in patients with ankylosing spondylitis (AS) compared to a conventional pursed-lip breathing (PLB) exercise program. A randomized controlled trial was conducted with 70 patients with AS who were allocated into two groups: the mobile device exercise (MDE) group (n = 36), using Airofit PRO^™, and the PLB control group (n = 34). The participants underwent a 12-week exercise regimen consisting of three 6-minute daily sessions. Pulmonary function tests (PFTs), including forced vital capacity (FVC), forced expiratory volume in one second (FEV1), forced expiratory flow between 25-75% (FEF25-75), peak expiratory flow (PEF), chest expansion, and the Bath Ankylosing Spondylitis Functional Index (BASFI) scores, were measured pre- and post-intervention. Significant improvements were observed in the MDE group compared to the PLB group. Male patients in the MDE group exhibited statistically significant improvements in FEV1, FVC, FEF25-75, and PEF (p < 0.05). Female patients in the MDE group demonstrated significant improvements in PFT parameters and chest expansion (p < 0.05). No significant improvement was observed in the PLB group. The compliance rates were similar between the groups, and no significant adverse effects were reported. The Airofit PRO^™ respiratory trainer significantly improved pulmonary function parameters and chest expansion in AS patients , demonstrating greater effectiveness compared to conventional PLB exercises. These findings suggest that mobile respiratory trainers may provide a promising adjunctive therapeutic option for the pulmonary rehabilitation of patients with AS.

To examine the relation between histopathology, ANA subtypes, and high-resolution dry eye analysis in treatment-naive patients evaluated for Sjögren’s disease suspicion in a referral center. Between October 2022 and December 2023, 231 patients who underwent minor salivary gland biopsies were included in the study. Patients were grouped according to their Chisholm and Mason (CM) biopsy scores. Non-invasive ocular surface evaluations and ANA subtype analysis, according to the International Consensus on ANA Patterns (ICAP), were also conducted. Meibomian gland (MG) atrophy was significantly higher (p 0.02) in the positive biopsy group (OR 1.02), although it was a weaker predictor than other parameters. Anti-SSA positivity was markedly correlated with positive biopsy results. However, subtype analysis did not show any significant correlation. In predicting CM scores > 2, ANA positivity was 2.1-fold, SSA positivity was 3.6-fold, Schirmer positivity was 12, fivefold, positive ocular OSS scores were fourfold, limbal redness, and NiBUT less than 10 s were 2.4-fold more significant determinant factors. Our results confirm that the Schirmer test and classical serologic markers are still irreplaceable. We believe that novel measurement techniques that enable faster, non-invasive analyses with advanced technology will facilitate the differential diagnosis of Sjögren’s disease in patients with dry eyes.

Most RA-ILD biomarker studies enroll patients receiving treatment, which may alter inflammatory activity. We investigated whether calprotectin, sialic acid, and pannexin-1 show treatment-adjusted cross-sectional associations with ILD status in patients receiving treatment for RA. This cross-sectional case-control study included 154 participants (49 patients with HRCT-confirmed RA-ILD, 55 RA patients without ILD, 50 healthy controls). Serum biomarkers were measured by ELISA. The primary multivariate logistic regression model for ILD status within the RA cohort was adjusted for age, sex, smoking status, and binary biologic DMARD and corticosteroid use, with VIF, L1/L2 penalized, parsimonious model, rituximab-exclusion resampling, and bootstrap-CI ROC sensitivity analyses. In Bonferroni-corrected pairwise testing between RA-ILD and RA without ILD, no biomarker reached p<0.017 (ESR p=0.97, CRP p=0.72, calprotectin p=0.092, sialic acid p=0.90, pannexin-1 p=0.066). After adjustment, three biomarkers showed independent associations with ILD: lower calprotectin (OR=0.21, 95% CI 0.08–0.57, p=0.002, q=0.006), higher age-adjusted sialic acid (OR=2.57, 1.22–5.45, p=0.013, q=0.020), and lower pannexin-1 (OR=0.52, 0.28–0.94, p=0.029, q=0.029). All VIFs were below 1.25; Ridge and Lasso regression retained the same three biomarkers. AUCs were modest, with all five 95% CIs including 0.50 (pannexin-1 0.61; calprotectin 0.60). These findings indicate that serum calprotectin, sialic acid, and pannexin-1 carry weak conditional associations with ILD status in patients receiving RA treatment. However, their discriminatory performance is insufficient for standalone clinical use.