Bozzalla-Cassione Emanuele, Grignaschi Silvia, Xoxi Blerina, Luvaro Terenzj, Greco Maria Immacolata, Mazzucchelli Iolanda, Bugatti Serena, Montecucco Carlomaurizio, Manzo Antonio
Rheumatology and Translational Immunology Research Laboratories, Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.
Front Med (Lausanne). 2022 Mar 17;9:852220. doi: 10.3389/fmed.2022.852220. eCollection 2022.
Identification of a pathological change in the course of systemic chronic immune-inflammatory diseases is key to delivering effective treatment strategies. In this context, one of the most compelling issues is the concept of flare. The multifaceted expression of disease activity in rheumatoid arthritis (RA) makes it challenging to provide an omni-comprehensive definition of flare, encompassing the pathology's different objective and subjective domains. Our incomplete understanding of the pathophysiological mechanisms underlying this process contributes to the partial comprehension of its potential clinical expression. This review focuses on the proposed pathophysiological processes underlying disease recrudescence in RA and the variable definitions adopted to capture flare in clinical practice through its objective, subjective, and temporal domains. Overall, what emerges is a complex landscape far from being unraveled.
识别系统性慢性免疫炎症性疾病过程中的病理变化是实施有效治疗策略的关键。在这种背景下，最引人注目的问题之一是病情复发的概念。类风湿关节炎（RA）中疾病活动的多方面表现使得提供一个全面的病情复发定义具有挑战性，该定义需涵盖病理的不同客观和主观领域。我们对这一过程潜在的临床表达的理解不完整，这导致了对其病理生理机制的部分理解。本综述聚焦于类风湿关节炎病情复发潜在的病理生理过程，以及在临床实践中通过客观、主观和时间维度来捕捉病情复发所采用的不同定义。总体而言，呈现出的是一个远未被解开的复杂局面。
