Publications by authors named "H J Girschick"
Background: There is considerable practice variation in labelling, diagnosis and treatment of adults with sterile bone inflammation. We developed a expert consensus recommendations on the disease definition, diagnosis and treatment of this rare condition.
Methods: Systematic literature review and Grading of Recommendations, Assessment, Development and Evaluations-based appraisal of evidence, two Delphi surveys and three digital and in-person consensus meetings with a multidisciplinary expert panel and patient representatives.
Unlabelled: Chronic non-bacterial osteomyelitis (CNO) is caused by aseptic inflammation of bones, primarily driven by the innate immune system. CNO may display different clinical presentations (acute vs chronic, uni- vs multifocal) and is accompanied by other inflammatory disorders in up to a third of patients. Once considered a rare disorder, it has become clear that many patients were underdiagnosed.
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- The study investigates Antibiotic-Refractory Lyme Arthritis (ARLA), focusing on the complex T cell responses that initially target the Lyme bacteria and potentially shift to attacking the body's own proteins, but the exact mechanisms remain unclear.
- Researchers utilized flow cytometry, T cell receptor sequencing, and single-cell RNA sequencing to analyze T helper cells from patients' inflamed joints in Europe, discovering a specific TCR-β motif linked to ARLA that was not common in North American patients.
- The findings reveal a distinct TCR response in ARLA patients that drives the growth of pathogenic T helper cells, providing insights into the immune system's maladaptive responses and aiding future identification of key antigens involved in
Bacterial arthritis and osteomyelitis are usually acute diseases, which in this way differ from the often insidious course of nonbacterial osteomyelitis; however, there is often an overlap both in less acute courses of bacterial illnesses and also in nonbacterial osteitis. The overlapping clinical phenomena can be explained by similar pathophysiological processes. In bacteria-related illnesses the identification of the pathogen and empirical or targeted anti-infectious treatment are prioritized, whereas no triggering agent is known for nonbacterial diseases.
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