{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T21:33:38Z","timestamp":1775770418205,"version":"3.50.1"},"reference-count":59,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,15]],"date-time":"2022-04-15T00:00:00Z","timestamp":1649980800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cells"],"abstract":"<jats:p>Autophagy is a lysosomal pathway for the degradation of damaged proteins and intracellular components that promotes cell survival under specific conditions. Apoptosis is, in contrast, a critical programmed cell death mechanism, and the relationship between these two processes influences cell fate. Recent evidence suggests that autophagy and apoptosis are involved in the self-tolerance promotion and in the regulatory mechanisms contributing to disease susceptibility and immune regulation in rheumatic diseases. The aim of this review is to discuss how the balance between autophagy and apoptosis may be dysregulated in multiple rheumatic diseases and to dissect the role of autophagy in the pathogenesis of rheumatoid arthritis, systemic lupus erythematosus, and Sj\u00f6gren\u2019s syndrome. Furthermore, to discuss the potential capacity of currently used disease-modifying antirheumatic drugs (DMARDs) to target and modulate autophagic processes.<\/jats:p>","DOI":"10.3390\/cells11081359","type":"journal-article","created":{"date-parts":[[2022,4,16]],"date-time":"2022-04-16T07:42:41Z","timestamp":1650094961000},"page":"1359","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Autophagy in Rheumatic Diseases: Role in the Pathogenesis and Therapeutic Approaches"],"prefix":"10.3390","volume":"11","author":[{"given":"Alessandra Ida","family":"Celia","sequence":"first","affiliation":[{"name":"Rheumatology Unit, Department of Clinical Internal, Anaesthesiolagical and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Colafrancesco","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Clinical Internal, Anaesthesiolagical and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Cristiana","family":"Barbati","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Clinical Internal, Anaesthesiolagical and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4149-5321","authenticated-orcid":false,"given":"Cristiano","family":"Alessandri","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Clinical Internal, Anaesthesiolagical and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Conti","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Clinical Internal, Anaesthesiolagical and Cardiovascular Sciences, Sapienza University of Rome, 00161 Rome, Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"323","DOI":"10.1038\/nature09782","article-title":"Autophagy in immunity and inflammation","volume":"469","author":"Levine","year":"2011","journal-title":"Nature"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1146\/annurev.nutr.27.061406.093749","article-title":"Protein turnover via autophagy: Implications for metabolism","volume":"27","author":"Mizushima","year":"2007","journal-title":"Annu. 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