{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T02:01:58Z","timestamp":1760148118507,"version":"build-2065373602"},"reference-count":94,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T00:00:00Z","timestamp":1680134400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The University of Oradea, Romania"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JPM"],"abstract":"<jats:p>Lymphangioleiomyomatosis (LAM) represents an uncommon disorder characterized by cystic lung destruction and chronic respiratory failure. Lung damage caused by various mechanisms may represent a hypothesis for studying the association between LAM and rheumatoid arthritis (RA), which is the most prevalent autoinflammatory rheumatic disease and may affect the lungs as an extra-articular manifestation. Despite their distinct clinical presentations, the pathophysiology of both disorders includes dysregulated immunological function, abnormal cellular development, and inflammation. Current research suggests a potential relationship between RA and LAM, as some RA patients have been reported to develop LAM. However, the association of RA and LAM raises important therapeutic dilemmas. For this reason, the trajectory of a patient who was identified in our medical records as suffering from both LAM and RA, treated with many novel molecules and biological therapy, but with a negative outcome due to respiratory and multiorgan failure, has been exemplified. The delay in the diagnosis of LAM is due to a correlation between RA and LAM, worsening the vital prognosis and also hindering pulmonary transplantation. In addition, extensive research is essential for understanding the potential connection between these two disorders and discovering any similar mechanisms involved that may underlie their occurrence. This may contribute to the development of new therapeutic options that target shared pathways implicated in the pathogenesis of RA and LAM.<\/jats:p>","DOI":"10.3390\/jpm13040607","type":"journal-article","created":{"date-parts":[[2023,3,30]],"date-time":"2023-03-30T05:22:14Z","timestamp":1680153734000},"page":"607","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["An Evidence-Based Update on the Potential Association between Rheumatoid Arthritis and Lymphangioleiomyomatosis"],"prefix":"10.3390","volume":"13","author":[{"given":"Nicoleta Anamaria","family":"Pascalau","sequence":"first","affiliation":[{"name":"Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrei-Flavius","family":"Radu","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6485-7180","authenticated-orcid":false,"given":"Delia Carmen Nistor","family":"Cseppento","sequence":"additional","affiliation":[{"name":"Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5670-3456","authenticated-orcid":false,"given":"Felicia Liana","family":"Andronie-Cioara","sequence":"additional","affiliation":[{"name":"Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anamaria","family":"Jurcau","sequence":"additional","affiliation":[{"name":"Department of Psycho Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Calin","family":"Mos","sequence":"additional","affiliation":[{"name":"Department of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alexa Florina","family":"Bungau","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Preclinical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3236-1292","authenticated-orcid":false,"given":"Simona Gabriela","family":"Bungau","sequence":"additional","affiliation":[{"name":"Doctoral School of Biomedical Sciences, University of Oradea, 410087 Oradea, Romania"},{"name":"Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2023,3,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"113614","DOI":"10.1016\/j.biopha.2022.113614","article-title":"In-depth bibliometric analysis and current scientific mapping research in the context of rheumatoid arthritis pharmacotherapy","volume":"154","author":"Radu","year":"2022","journal-title":"Biomed. Pharmacother."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"15","DOI":"10.1038\/s41413-018-0016-9","article-title":"Rheumatoid arthritis: Pathological mechanisms and modern pharmacologic therapies","volume":"6","author":"Guo","year":"2018","journal-title":"Bone Res."},{"doi-asserted-by":"crossref","unstructured":"Radu, A.F., and Bungau, S.G. (2021). Management of Rheumatoid Arthritis: An Overview. Cells, 10.","key":"ref_3","DOI":"10.3390\/cells10112857"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"212","DOI":"10.1196\/annals.1351.019","article-title":"Epidemiological aspects of rheumatoid arthritis: The sex ratio","volume":"1069","author":"Kvien","year":"2006","journal-title":"Ann. N. Y. Acad. Sci."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e000536","DOI":"10.1136\/rmdopen-2017-000536","article-title":"Glucocorticoids in rheumatoid arthritis: Current status and future studies","volume":"6","author":"Hua","year":"2020","journal-title":"RMD Open"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"411","DOI":"10.31925\/farmacia.2019.3.5","article-title":"Comparative study of the clinical response of patients to different treatment regimens in rheumatoid arthritis","volume":"67","author":"Teaha","year":"2019","journal-title":"Farmacia"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1002\/msc.66","article-title":"Rehabilitation in rheumatoid arthritis: A critical review","volume":"2","author":"Hammond","year":"2004","journal-title":"Musculoskeletal Care"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1850","DOI":"10.3899\/jrheum.130118","article-title":"Orthopedic surgery in rheumatoid arthritis in the era of biologic therapy","volume":"40","author":"Leon","year":"2013","journal-title":"J. Rheumatol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1016\/j.ejrad.2009.04.050","article-title":"Treatment strategies in surgery for rheumatoid arthritis","volume":"71","author":"Trieb","year":"2009","journal-title":"Eur. J. Radiol."},{"doi-asserted-by":"crossref","unstructured":"Bungau, S.G., Behl, T., Singh, A., Sehgal, A., Singh, S., Chigurupati, S., Vijayabalan, S., Das, S., and Palanimuthu, V.R. (2021). Targeting Probiotics in Rheumatoid Arthritis. Nutrients, 13.","key":"ref_10","DOI":"10.3390\/nu13103376"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2140","DOI":"10.2174\/1381612828666220324124720","article-title":"Circumstantial Insights into the Potential of Traditional Chinese Medicinal Plants as a Therapeutic Approach in Rheumatoid Arthritis","volume":"28","author":"Sharma","year":"2022","journal-title":"Curr. Pharm. Des."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"114368","DOI":"10.1016\/j.jep.2021.114368","article-title":"Traditional herbal medicine: Therapeutic potential in rheumatoid arthritis","volume":"279","author":"Wang","year":"2021","journal-title":"J. Ethnopharmacol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"5372","DOI":"10.1080\/10408398.2021.1924613","article-title":"Exploring the role of polyphenols in rheumatoid arthritis","volume":"62","author":"Behl","year":"2021","journal-title":"Crit. Rev. Food Sci. Nutr."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"469","DOI":"10.1097\/MCP.0000000000000502","article-title":"Recent advances in the pathobiology and clinical management of lymphangioleiomyomatosis","volume":"24","author":"Harari","year":"2018","journal-title":"Curr. Opin. Pulm. Med."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.healun.2014.06.014","article-title":"A consensus document for the selection of lung transplant candidates: 2014\u2014An update from the Pulmonary Transplantation Council of the International Society for Heart and Lung Transplantation","volume":"34","author":"Weill","year":"2015","journal-title":"J. Heart Lung Transpl."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2569","DOI":"10.1002\/art.27584","article-title":"2010 Rheumatoid arthritis classification criteria: An American College of Rheumatology\/European League Against Rheumatism collaborative initiative","volume":"62","author":"Aletaha","year":"2010","journal-title":"Arthritis Rheum."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"685","DOI":"10.1136\/annrheumdis-2019-216655","article-title":"EULAR recommendations for the management of rheumatoid arthritis with synthetic and biological disease-modifying antirheumatic drugs: 2019 update","volume":"79","author":"Smolen","year":"2020","journal-title":"Ann. Rheum. Dis."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"114","DOI":"10.1136\/annrheumdis-2013-203284","article-title":"Performance of the 2010 ACR\/EULAR classification criteria for rheumatoid arthritis: A systematic literature review","volume":"73","author":"Radner","year":"2014","journal-title":"Ann. Rheum. Dis."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"340","DOI":"10.1097\/BOR.0b013e3282f798ed","article-title":"Lung disease in rheumatoid arthritis","volume":"20","author":"Nannini","year":"2008","journal-title":"Curr. Opin. Rheumatol."},{"doi-asserted-by":"crossref","unstructured":"Yamakawa, H., Ogura, T., Kameda, H., Kishaba, T., Iwasawa, T., Takemura, T., and Kuwano, K. (2021). Decision-Making Strategy for the Treatment of Rheumatoid Arthritis-Associated Interstitial Lung Disease (RA-ILD). J. Clin. Med., 10.","key":"ref_20","DOI":"10.3390\/jcm10173806"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/j.chest.2018.08.1029","article-title":"Circulating Biomarkers From the Phase 1 Trial of Sirolimus and Autophagy Inhibition for Patients With Lymphangioleiomyomatosis","volume":"154","author":"Lamattina","year":"2018","journal-title":"Chest"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"374","DOI":"10.1097\/MCP.0b013e328349ac8c","article-title":"Current management of lymphangioleiomyomatosis","volume":"17","author":"Borie","year":"2011","journal-title":"Curr. Opin. Pulm. Med."},{"unstructured":"National Heart, Lung, and Blood Institute (2023, March 25). Lymphangioleiomyomatosis-Symptoms, Available online: https:\/\/www.nhlbi.nih.gov\/health\/lam\/symptoms.","key":"ref_23"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"200007","DOI":"10.1183\/20734735.0007-2020","article-title":"Lymphangioleiomyomatosis: A clinical review","volume":"16","author":"Lynn","year":"2020","journal-title":"Breathe"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"288","DOI":"10.1016\/j.chest.2018.06.016","article-title":"The NHLBI LAM Registry: Prognostic Physiologic and Radiologic Biomarkers Emerge From a 15-Year Prospective Longitudinal Analysis","volume":"155","author":"Gupta","year":"2019","journal-title":"Chest"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1183\/09031936.00076209","article-title":"European Respiratory Society guidelines for the diagnosis and management of lymphangioleiomyomatosis","volume":"35","author":"Johnson","year":"2010","journal-title":"Eur. Respir. J."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1136\/thx.2004.023283","article-title":"Survival and disease progression in UK patients with lymphangioleiomyomatosis","volume":"59","author":"Johnson","year":"2004","journal-title":"Thorax"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"96","DOI":"10.1378\/chest.85.1.96","article-title":"Steroid receptors in pulmonary lymphangiomyomatosis","volume":"85","author":"Brentani","year":"1984","journal-title":"Chest"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"398","DOI":"10.1165\/rcmb.2006-0372TR","article-title":"Molecular pathogenesis of lymphangioleiomyomatosis: Lessons learned from orphans","volume":"36","author":"Juvet","year":"2006","journal-title":"Am. J. Respir. Cell Mol. Biol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"276","DOI":"10.1177\/107327480601300405","article-title":"Lymphangioleiomyomatosis","volume":"13","author":"Steagall","year":"2006","journal-title":"Cancer Control"},{"doi-asserted-by":"crossref","unstructured":"Lin, Y.J., Anzaghe, M., and Sch\u00fclke, S. (2020). Update on the Pathomechanism, Diagnosis, and Treatment Options for Rheumatoid Arthritis. Cells, 9.","key":"ref_31","DOI":"10.3390\/cells9040880"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1313","DOI":"10.1016\/S2213-2600(21)00228-9","article-title":"Lymphangioleiomyomatosis: Pathogenesis, clinical features, diagnosis, and management","volume":"9","author":"McCarthy","year":"2021","journal-title":"Lancet Respir. Med."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"102400","DOI":"10.1016\/j.jaut.2019.102400","article-title":"The etiology of rheumatoid arthritis","volume":"110","author":"Scherer","year":"2020","journal-title":"J. Autoimmun."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"2255","DOI":"10.1016\/j.immuni.2022.11.009","article-title":"The pathogenesis of rheumatoid arthritis","volume":"55","author":"Alivernini","year":"2022","journal-title":"Immunity"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"867","DOI":"10.1016\/j.semarthrit.2020.06.021","article-title":"Definition of B cell helper T cells in rheumatoid arthritis and their behavior during treatment","volume":"50","author":"Lucas","year":"2020","journal-title":"Semin. Arthritis Rheum."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1038\/nrrheum.2015.171","article-title":"Cytokines in rheumatoid arthritis\u2014shaping the immunological landscape","volume":"12","author":"McInnes","year":"2016","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"43","DOI":"10.2147\/ITT.S243636","article-title":"Role of Chemokines and Chemokine Receptors in Rheumatoid Arthritis","volume":"9","author":"Elemam","year":"2020","journal-title":"ImmunoTargets Ther."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1177\/1759720X12438080","article-title":"The role of RANK ligand\/osteoprotegerin in rheumatoid arthritis","volume":"4","author":"Geusens","year":"2012","journal-title":"Ther. Adv. Musculoskelet. Dis."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"879","DOI":"10.1080\/14728222.2018.1526924","article-title":"The potential of PTPN22 as a therapeutic target for rheumatoid arthritis","volume":"22","author":"Carmona","year":"2018","journal-title":"Expert Opin. Ther. Targets"},{"key":"ref_40","first-page":"708","article-title":"Functional evaluation of TNFAIP3 (A20) in rheumatoid arthritis","volume":"28","author":"Elsby","year":"2010","journal-title":"Clin. Exp. Rheumatol."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1097\/BOR.0b013e328336ba63","article-title":"The rheumatoid arthritis HLA-DRB1 shared epitope","volume":"22","author":"Holoshitz","year":"2010","journal-title":"Curr. Opin. Rheumatol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"369","DOI":"10.1517\/21678707.2016.1148597","article-title":"Epidemiology, pathogenesis and diagnosis of lymphangioleiomyomatosis","volume":"4","author":"Moss","year":"2016","journal-title":"Expert Opin. Orphan Drugs"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1089\/lrb.2009.0031","article-title":"Lymphangioleiomyomatosis and TSC2\u2212\/\u2212 cells","volume":"8","author":"Darling","year":"2010","journal-title":"Lymphat. Res. Biol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"7788","DOI":"10.3748\/wjg.v19.i43.7788","article-title":"Insulin-like growth factor-1 induces lymphangiogenesis and facilitates lymphatic metastasis in colorectal cancer","volume":"19","author":"Li","year":"2013","journal-title":"World J. Gastroenterol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1089\/lrb.2006.4.143","article-title":"Vascular endothelial growth factor-D is increased in serum of patients with lymphangioleiomyomatosis","volume":"4","author":"Seyama","year":"2006","journal-title":"Lymphat. Res. Biol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"1242","DOI":"10.1053\/hupa.2000.18500","article-title":"Extrapulmonary lymphangioleiomyomatosis (LAM): Clinicopathologic features in 22 cases","volume":"31","author":"Matsui","year":"2000","journal-title":"Hum. Pathol."},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"391","DOI":"10.1111\/imm.12162","article-title":"The mTOR pathway and integrating immune regulation","volume":"140","author":"Cobbold","year":"2013","journal-title":"Immunology"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"25","DOI":"10.1378\/chest.117.1.25","article-title":"Frequent estrogen and progesterone receptor immunoreactivity in renal angiomyolipomas from women with pulmonary lymphangioleiomyomatosis","volume":"117","author":"Logginidou","year":"2000","journal-title":"Chest"},{"key":"ref_49","first-page":"3353","article-title":"Immunohistochemical evaluation of pulmonary lymphangioleiomyomatosis","volume":"35","author":"Grzegorek","year":"2015","journal-title":"Anticancer Res."},{"key":"ref_50","doi-asserted-by":"crossref","first-page":"948","DOI":"10.1136\/annrheumdis-2016-210602","article-title":"2016 update of the EULAR recommendations for the management of early arthritis","volume":"76","author":"Combe","year":"2017","journal-title":"Ann. Rheum. Dis."},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1360","DOI":"10.1001\/jama.2018.13103","article-title":"Diagnosis and Management of Rheumatoid Arthritis: A Review","volume":"320","author":"Aletaha","year":"2018","journal-title":"JAMA"},{"key":"ref_52","doi-asserted-by":"crossref","first-page":"731","DOI":"10.1016\/j.rdc.2009.10.007","article-title":"Laboratory Tests to Assess Patients with Rheumatoid Arthritis: Advantages and Limitations","volume":"35","author":"Pincus","year":"2009","journal-title":"Rheum. Dis. Clin. N. Am."},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"586","DOI":"10.1016\/j.berh.2016.10.011","article-title":"Diagnosis and management of rheumatoid arthritis; What is the current role of established and new imaging techniques in clinical practice?","volume":"30","author":"Haavardsholm","year":"2016","journal-title":"Best Pract. Res. Clin. Rheumatol."},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"691","DOI":"10.2147\/TCRM.S50784","article-title":"Lymphangioleiomyomatosis: Differential diagnosis and optimal management","volume":"10","author":"Xu","year":"2014","journal-title":"Ther. Clin. Risk Manag."},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1016\/j.humpath.2015.11.002","article-title":"Bronchial involvement in advanced stage lymphangioleiomyomatosis: Histopathologic and molecular analyses","volume":"50","author":"Hayashi","year":"2016","journal-title":"Hum. Pathol."},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"1196","DOI":"10.1183\/13993003.00570-2015","article-title":"Accuracy of chest high-resolution computed tomography in diagnosing diffuse cystic lung diseases","volume":"46","author":"Gupta","year":"2015","journal-title":"Eur. Respir. J."},{"key":"ref_57","doi-asserted-by":"crossref","first-page":"523","DOI":"10.1111\/j.1440-1843.2007.01101.x","article-title":"The epidemiology of lymphangioleiomyomatosis in Japan: A nationwide cross-sectional study of presenting features and prognostic factors","volume":"12","author":"Hayashida","year":"2007","journal-title":"Respirology"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"175","DOI":"10.1016\/j.resinv.2013.03.002","article-title":"Efficacy and safety of low-dose sirolimus for treatment of lymphangioleiomyomatosis","volume":"51","author":"Ando","year":"2013","journal-title":"Respir. Investig."},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"1595","DOI":"10.1056\/NEJMoa1100391","article-title":"Efficacy and safety of sirolimus in lymphangioleiomyomatosis","volume":"364","author":"McCormack","year":"2011","journal-title":"N. Engl. J. Med."},{"unstructured":"Rapamune\u00ae (sirolimus) (2023, March 03). Orphan Medicinal Product for the Treatment of Sporadic Lymphangioleiomyomatosis. Available online: https:\/\/www.ema.europa.eu\/en\/medicines\/human\/orphan-designations\/eu-3-16-1704.","key":"ref_60"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"748","DOI":"10.1164\/rccm.201607-1384ST","article-title":"Official American Thoracic Society\/Japanese Respiratory Society Clinical Practice Guidelines: Lymphangioleiomyomatosis Diagnosis and Management","volume":"194","author":"McCormack","year":"2016","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"217","DOI":"10.1042\/BST0370217","article-title":"A complex interplay between Akt, TSC2 and the two mTOR complexes","volume":"37","author":"Huang","year":"2009","journal-title":"Biochem. Soc. Trans."},{"key":"ref_63","doi-asserted-by":"crossref","first-page":"35","DOI":"10.1007\/s00408-012-9419-3","article-title":"Clinical predictors of mortality and cause of death in lymphangioleiomyomatosis: A population-based registry","volume":"191","author":"Oprescu","year":"2013","journal-title":"Lung"},{"key":"ref_64","first-page":"224","article-title":"Pulmonary Lymphangioleiomyomatosis: A Case Report and Literature Review","volume":"79","author":"Sathirareuangchai","year":"2020","journal-title":"Hawai\u2019i J. Health Soc. Welf."},{"key":"ref_65","doi-asserted-by":"crossref","first-page":"204","DOI":"10.1186\/s13023-018-0946-8","article-title":"Efficacy and safety of low-dose Sirolimus in Lymphangioleiomyomatosis","volume":"13","author":"Yoon","year":"2018","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_66","doi-asserted-by":"crossref","first-page":"55","DOI":"10.1186\/s12931-020-1316-3","article-title":"The efficacy and safety of pharmacological treatments for lymphangioleiomyomatosis","volume":"21","author":"Wang","year":"2020","journal-title":"Respir. Res."},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"507","DOI":"10.1016\/j.ccm.2021.04.014","article-title":"Lung Diseases Unique to Women","volume":"42","author":"Criner","year":"2021","journal-title":"Clin. Chest Med."},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"2621","DOI":"10.1056\/NEJMc053410","article-title":"Doxycycline treatment for lymphangioleiomyomatosis with urinary monitoring for MMPs","volume":"354","author":"Moses","year":"2006","journal-title":"N. Engl. J. Med."},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1136\/thoraxjnl-2019-213338","article-title":"Cross-sectional study of reversible airway obstruction in LAM: Better evidence is needed for bronchodilator and inhaled steroid use","volume":"74","author":"Johnson","year":"2019","journal-title":"Thorax"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"105898","DOI":"10.1016\/j.rmed.2020.105898","article-title":"A phase II clinical trial of the Safety Of Simvastatin (SOS) in patients with pulmonary lymphangioleiomyomatosis and with tuberous sclerosis complex","volume":"163","author":"Krymskaya","year":"2020","journal-title":"Respir. Med."},{"key":"ref_71","doi-asserted-by":"crossref","first-page":"1902370","DOI":"10.1183\/13993003.02370-2019","article-title":"Celecoxib in lymphangioleiomyomatosis: Results of a phase I clinical trial","volume":"55","author":"Bagwe","year":"2020","journal-title":"Eur. Respir. J."},{"key":"ref_72","doi-asserted-by":"crossref","first-page":"854","DOI":"10.1164\/rccm.201412-2170LE","article-title":"Genetic heterogeneity of circulating cells from patients with lymphangioleiomyomatosis with and without lung transplantation","volume":"191","author":"Steagall","year":"2015","journal-title":"Am. J. Respir. Crit. Care Med."},{"doi-asserted-by":"crossref","unstructured":"Committee on Hospital Care, Section on Surgery, and Section on Critical Care (2010). Policy statement\u2014Pediatric organ donation and transplantation. Pediatrics, 125, 822\u2013828.","key":"ref_73","DOI":"10.1542\/peds.2010-0081"},{"key":"ref_74","doi-asserted-by":"crossref","first-page":"1538","DOI":"10.21037\/jtd.2018.02.50","article-title":"Comparison of short-term outcomes for connective tissue disease-related interstitial lung disease and idiopathic pulmonary fibrosis after lung transplantation","volume":"10","author":"Park","year":"2018","journal-title":"J. Thorac. Dis."},{"key":"ref_75","doi-asserted-by":"crossref","first-page":"949","DOI":"10.1016\/j.healun.2019.06.015","article-title":"Clinical outcomes and survival following lung transplantation in patients with lymphangioleiomyomatosis","volume":"38","author":"Khawar","year":"2019","journal-title":"J. Heart Lung Transplant."},{"key":"ref_76","doi-asserted-by":"crossref","first-page":"944","DOI":"10.1007\/s00595-018-1678-z","article-title":"Single lung transplantation for lymphangioleiomyomatosis: A single-center experience in Japan","volume":"48","author":"Oishi","year":"2018","journal-title":"Surg. Today"},{"key":"ref_77","doi-asserted-by":"crossref","first-page":"1247","DOI":"10.1016\/j.healun.2004.09.013","article-title":"The US experience with lung transplantation for pulmonary lymphangioleiomyomatosis","volume":"24","author":"Kpodonu","year":"2005","journal-title":"J. Heart Lung Transplant."},{"key":"ref_78","first-page":"267","article-title":"Vitamin D and disease activity in rheumatoid arthritis patients: A retrospective study in a Romanian cohort","volume":"67","author":"Sirbu","year":"2020","journal-title":"Acta Biochim. Pol."},{"unstructured":"(2023, February 27). Organ Transplant Reporting and Waiting List in Romania. Available online: http:\/\/transplant.ro\/wp-content\/uploads\/2022\/03\/Lista-asteptare-2021.pdf.","key":"ref_79"},{"doi-asserted-by":"crossref","unstructured":"Behl, T., Upadhyay, T., Singh, S., Chigurupati, S., Alsubayiel, A.M., Mani, V., Vargas-De-la-cruz, C., Uivarosan, D., Bustea, C., and Sava, C. (2021). Polyphenols Targeting MAPK Mediated Oxidative Stress and Inflammation in Rheumatoid Arthritis. Molecules, 26.","key":"ref_80","DOI":"10.3390\/molecules26216570"},{"key":"ref_81","doi-asserted-by":"crossref","first-page":"585","DOI":"10.1038\/s41584-021-00652-9","article-title":"Autoinflammation and autoimmunity across rheumatic and musculoskeletal diseases","volume":"17","author":"Szekanecz","year":"2021","journal-title":"Nat. Rev. Rheumatol."},{"key":"ref_82","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1016\/j.ccm.2010.04.003","article-title":"Pulmonary manifestations of rheumatoid arthritis","volume":"31","author":"Evans","year":"2010","journal-title":"Clin. Chest Med."},{"key":"ref_83","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1186\/s13023-018-0933-0","article-title":"Comorbid connective tissue diseases and autoantibodies in lymphangioleiomyomatosis: A retrospective cohort study","volume":"13","author":"Futami","year":"2018","journal-title":"Orphanet J. Rare Dis."},{"key":"ref_84","first-page":"9","article-title":"Pulmonary Lymphangioleiomyomatosis and Role of Pleurodesis: Rare Case Reports","volume":"15","author":"Shah","year":"2021","journal-title":"J. Clin. Diagn. Res."},{"key":"ref_85","doi-asserted-by":"crossref","first-page":"105","DOI":"10.1164\/rccm.200409-1298OC","article-title":"The NHLBI lymphangioleiomyomatosis registry: Characteristics of 230 patients at enrollment","volume":"173","author":"Ryu","year":"2006","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_86","doi-asserted-by":"crossref","first-page":"S99","DOI":"10.1186\/ar582","article-title":"VEGF and imaging of vessels in rheumatoid arthritis","volume":"4","author":"Taylor","year":"2002","journal-title":"Arthritis Res."},{"key":"ref_87","doi-asserted-by":"crossref","first-page":"1337","DOI":"10.1164\/rccm.201709-1965ST","article-title":"Lymphangioleiomyomatosis Diagnosis and Management: High-Resolution Chest Computed Tomography, Transbronchial Lung Biopsy, and Pleural Disease Management. An Official American Thoracic Society\/Japanese Respiratory Society Clinical Practice Guideline","volume":"196","author":"Gupta","year":"2017","journal-title":"Am. J. Respir. Crit. Care Med."},{"key":"ref_88","first-page":"195","article-title":"Rheumatoid arthritis: A female challenge","volume":"4","author":"Gerosa","year":"2008","journal-title":"Women\u2019s Health"},{"key":"ref_89","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1530\/ERC-15-0505","article-title":"Estrogen maintains myometrial tumors in a lymphangioleiomyomatosis model","volume":"23","author":"Prizant","year":"2016","journal-title":"Endocr. Relat. Cancer"},{"key":"ref_90","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1016\/bs.pmbts.2017.03.002","article-title":"Metalloproteinases in Rheumatoid Arthritis: Potential Therapeutic Targets to Improve Current Therapies","volume":"148","author":"Itoh","year":"2017","journal-title":"Prog. Mol. Biol. Transl. Sci."},{"key":"ref_91","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1272\/jnms.67.311","article-title":"Lymphangioleiomyomatosis (LAM): A review of clinical and morphological features","volume":"67","author":"Ferrans","year":"2000","journal-title":"J. Nippon Med. Sch."},{"key":"ref_92","doi-asserted-by":"crossref","first-page":"352","DOI":"10.2119\/molmed.2010.00049","article-title":"mTOR regulates the invasive properties of synovial fibroblasts in rheumatoid arthritis","volume":"16","author":"Laragione","year":"2010","journal-title":"Mol. Med."},{"key":"ref_93","doi-asserted-by":"crossref","first-page":"1216","DOI":"10.1002\/eji.201444908","article-title":"HMGB1 induces angiogenesis in rheumatoid arthritis via HIF-1\u03b1 activation","volume":"45","author":"Park","year":"2015","journal-title":"Eur. J. Immunol."},{"key":"ref_94","doi-asserted-by":"crossref","first-page":"2239","DOI":"10.1038\/onc.2014.164","article-title":"mTORC1 drives HIF-1\u03b1 and VEGF-A signalling via multiple mechanisms involving 4E-BP1, S6K1 and STAT3","volume":"34","author":"Dodd","year":"2015","journal-title":"Oncogene"}],"container-title":["Journal of Personalized Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/4\/607\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T19:07:03Z","timestamp":1760123223000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2075-4426\/13\/4\/607"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,30]]},"references-count":94,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2023,4]]}},"alternative-id":["jpm13040607"],"URL":"https:\/\/doi.org\/10.3390\/jpm13040607","relation":{},"ISSN":["2075-4426"],"issn-type":[{"type":"electronic","value":"2075-4426"}],"subject":[],"published":{"date-parts":[[2023,3,30]]}}}