Dr. Che-Tzu Chang, MD, MS (AIR Jack)

7 years passed......

#APLAR2018_Kaohsiung
#ACR2025_Chicago

#ACR2025

Prof. Michelle Petri

A risk score for proteinuria in the next 10 years that would allow clinicians to identify a high risk subset of SLE pts to target for more frequent measurement of urine protein to Cr AND to consider earlier renal bx at even low levels of proteinuria.

Congrats to Prof. König.

Unlike traditional CAR T (e.g., Anti-CD19) targets CD19 on all B cells, which causing indiscriminate depletion, Anti-9G4 CAR-T and cTCR-T cells offer superior precision.
This significantly reduces the risks of infection and CRS.

Wonderful!
#ACR2025

Efficacy and safety of tripterygium wilfordii Hook F plus TNF inhibitor for active rheumatoid arthritis: A multicentre, randomized, double-blind, triple-dummy controlled trial - PubMed An investigator-initiated, multicentre, randomized, double-blind, triple-dummy, controlled trial was conducted at 14 tertiary rheumatology centers in China to evaluate the efficacy and safety of Tripterygium wilfordii Hook F (TwHF) with recombinant human TNF receptor IgGFc fusion protein (rhTNFR-Fc) …

YISTAR RCT: combo with TNFi (4 arms; also looked at benefit of +/- MTX)

pubmed.ncbi.nlm.nih.gov/37657525/

#ACR25 #GlobalSummit

a plant with little white flowers = Tripterygium wilfordii

This is a cheap treatment used for centuries for inflammation

MoA has been studied: inhibition of NFKB; inhibition of IL-1 and IL-6 production

#ACR25 #GlobalSummit

TNFi vs Toci in severe refractory disease

ACR: TNFi over Toci. Toci RCT data is from GCA (GIACTA).

#ACR25 #GlobalSummit

🪟Is there a window of opportunity in Still's Disease?

1⃣ A rationale for using first-line biologics

🔴Take-home points from Dr Nigrovic's talk on Still's Disease

#ACR25
#GlobalSummit

Not All Macrophage Activation Syndromes Are Still's Disease

🔴Take-home points from Dr Nigrovic's talk on Still's Disease
🔴 R/O other causes like infection and malignancy

#ACR25
#GlobalSummit

🧯How to treat Macrophage Activation Syndrome in 2025

🔴Take-home points from Dr Nigrovic's talk on Still's Disease
1- Methylprednisolone + Anakinra
2- + Ruxolitinib
+/- Tacrolimnus / IVIG / Rituximab
3- Emapalumab
4- Etoposide + Dexamethasone

#ACR25
#GlobalSummit

In Vivo CD19 CAR T-Cell Therapy for Refractory Systemic Lupus Erythematosus | NEJM In patients with refractory systemic lupus erythematosus, in vivo generation of CD19 CAR T cells by means of lipid nanoparticles led to B-cell depletion, reduced disease activity, and no major toxi...

In Vivo CD19 CAR T-Cell Therapy for Refractory Systemic Lupus Erythematosus | New England Journal of Medicine www.nejm.org/doi/full/10....

This is a schematic of key pathways affected in mesothelioma cells https://www.nature.c...

USP5 deubiquitylates and stabilizes FcεRIγ to enhance IgE-induced mast cell activation and allergic inflammation Targeting a modifier of the immunoglobulin E receptor in mast cells inhibits allergic responses in mice.

USP5 deubiquitylates and stabilizes FcεRIγ to enhance IgE-induced mast cell activation and allergic inflammation | Science Signaling www.science.org/doi/10.1126/...

Respiratory viral infections awaken metastatic breast cancer cells in lungs - Nature Mouse models show that respiratory infections from viruses such as influenza and SARS-CoV-2 can trigger metastasis of dormant breast cancer cells in the lungs, a finding supported by epidemiological data from two large human cohorts.

Nature research paper: Respiratory viral infections awaken metastatic breast cancer cells in lungs

go.nature.com/4odw172

Why do only certain molecules drive allergies? A feature now identified among some allergy-causing proteins is their ability to form pores in cells. @nature.com
www.nature.com/articles/d41...
www.nature.com/articles/s41...

Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III‐C Report: Assessment of Patient Scenarios (Derivation Cohort) and Refinement of Definitions Objective The 2023 ACR/EULAR Antiphospholipid Syndrome (APS) Classification criteria aim to identify patients with high likelihood of APS for research. Phases I/II of our four-phase methodological a...

Development of the 2023 ACR/EULAR Antiphospholipid Syndrome Classification Criteria, Phase III‐C Report: Assessment of Patient Scenarios (Derivation Cohort) and Refinement of Definitions - Barbhaiya - Arthritis Care & Research
acrjournals.onlinelibrary.wiley.com/doi/10.1002/...

Medical Media Center: New England Journal of Medicine Much of the food consumed in the United States is ultraprocessed. Evidence indicates that ultraprocessed food, as a class, has contributed to high rates of chronic diseases.

Ultraprocessed foods have "contributed to high rates of chronic disease in the United States"
They need to be regulated. @nejm.org today, the ways they can be reined in.
www.nejm.org/media/doi/fu...

Histologic features of aPL Nephropathy

A blood-based DNA methylation epigenetic predictor of age-related decline in mental/physical capacity that pinpoints immune system dysfunction as a key driver of intrinsic capacity decline @buckinstitute.org @nataging.nature.com
www.nature.org/articles/s43...
www.nature.org/articles/s43...

In 2021 the global rheumatoid arthritis market was valued at USD 22.77 billion and is expected to reach USD 33.30 billion by 2030. buff.ly/wklFNih

Use of CD19-targeted Immune Modulation to Eradicate AAV Neutralizing Antibodies @moltherapy.bsky.social
www.cell.com/molecular-th...

Microbiota in inflammatory bowel disease: mechanisms of disease and therapeutic opportunities - Nature Reviews Microbiology In this Review, Iliev, Ananthakrishnan and Guo explore the gut microbiota in inflammatory bowel disease, highlighting bacterial and fungal components, immune mechanisms, metabolites, links between the...

Review @naturerevmicro.bsky.social
Microbiota in inflammatory bowel disease: mechanisms of disease and therapeutic opportunities
www.nature.com/articles/s41...

On our Cover: Kolachala & Kugathasan et al. @emorydeptofmed.bsky.social use a first-in-kind, multi-omic approach to uncover cell type-specific shifts within the Crohn’s disease tissue microenvironment- verifying the molecular and cellular networks underlying active CD: buff.ly/qb3GGCH

a man in a black jacket and white shirt says " that is the um " ALT: a man in a black jacket and white shirt says " that is the um "

The final region of #RheumMadness 2025 is out!

Check out the scouting reports for the B-Cell Breakaway Region, including:
-Obinutuzumab for #Lupus nephritis
-CD19 CAR T cells in #Rheumatology
-STRAP Trials on biopsy-guided Rx

Scouting reports 👇
sites.duke.edu/rheummadness/

Schematic of the work done to diagnose several different conditions with B and T cell receptor sequencing

One of the most impressive papers I have seen in immunology for a long time. Will be posting a Ground Truths about it soon.
Thanks @scottboydlab.bsky.social and collaborators for this exceptional contribution

Disease diagnostics using machine learning of B cell and T cell receptor sequences Clinical diagnosis typically incorporates physical examination, patient history, various laboratory tests, and imaging studies but makes limited use of the human immune system’s own record of antigen ...

Disease diagnostics using machine learning of B cell and T cell receptor sequences | Science www.science.org/doi/10.1126/...

Our March issue is live!

Including research on #ILD in #RheumatoidArthritis and #SystemicSclerosis, cardiovascular protection in #gout, and the burden of #arthritis in Australia, plus much more! www.thelancet.com/journals/lan...
Cover by Sara Gironi Carnevale #Medsky #Rheumsky

#NephMadness 2025: CAR-T for Kidney Disease Region Submit your picks! | @NephMadness | @nephmadness.bsky.social | NephMadness 2025 Selection Committee Member: Jeffrey Sparks @jeffsparks @jeffsparks.bsky.social Jeffrey A. Sparks is a rheumatologist …

#NephMadness 2025: CAR-T for Kidney Disease Region

buff.ly/iEgImMW

Teams:
- CAR-T for Autoimmune Disease
- CAR-T Side Effects

Expert: @jeffsparks.bsky.social
Writer: Yara Mouawad
Execs: Dia Waguespack & @annaburgner.bsky.social

Review @annualreviews.bsky.social
Engineering Mice to Study Human Immunity
www.annualreviews.org/content/jour...

TRBV9-Targeted Bispecific T Cell-Engaging Antibodies to Reset the Autoreactive T Cell Compartment in Spondyloarthritis and HLA-DQ8 Celiac Disease - ACR Meeting Abstracts Background/Purpose: Therapies that indiscriminately deplete all T cells carry a high risk of opportunistic infection, precluding their widespread use in T cell-mediated autoimmune diseases. Targeting ...

acrabstracts.org/abstract/trb...