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RHEUMATOLOGY Elucidating the role of B cells in granulomatous tissue injury would not only underpin the rationale for using B-cell depletion in granulomatous complications of GPA, but also inspire new B-cell directed drugs. Ulti mately, however, we will need to understand why B-cell-rich germinal center-like structures arise within GPA lesions, and how B cells are (dys)regulated by the local innate immune response. Promisingly, several genes involved in innate immunity have recently been implicated in GPA. 10 Only with more such studies will we begin to get to grips with the complex pathophysiology of this fascinating disease—and the true meaning of its name… Department of Rheumatology, University Hospital of Southampton NHS Foundation Trust, University of Southampton, Southampton SO16 6YD, UK (S. D. Gadola). Department of Rheumatology, University Hospital of Don’t miss out! Sign up to free e-ALERTS and be notified when new articles are published in Nature Reviews Rheumatology. Research Highlights, News & Views, Reviews, and Perspectives—you won’t miss a thing! http://www.nature.com/register Schleswig-Holstein, Campus Lübeck, D-24576 Bad Bramstedt, Germany (W. L. Gross). Correspondence to: W. L. Gross w.gross@klinikumbb.de Competing interests The authors declare no competing interests. 1. Falk, R. J. et al. Granulomatosis with polyangiitis (Wegener’s): an alternative name for Wegener’s granulomatosis. Arthritis Rheum. 63, 863–864 (2011). 2. Linder, R. et al. Differentiation between Wegener’s granulomatosis and microscopic polyangiitis by an artificial neural network and by traditional methods. J. Rheumatol 38, 1039–1047 (2011). 3. Schmitt, W. H., Linder, R., Reinhold-Keller, E. & Gross, W. L. Improved differentiation between Churg-Strauss syndrome and Wegener’s granulomatosis by an artificial neural network. Arthritis Rheum. 44, 1887–1896 (2001). 4. Fujimoto, S. et al. Comparison of the epidemiology of anti-neutrophil cytoplasmic antibody-associated vasculitis between Japan and the UK. Rheumatology (Oxford) 50, 1916–1920 (2011). 5. Arning, L. et al. Are there specific genetic risk factors for the different forms of ANCAassociated vasculitis? Ann. Rheum. Dis. 70, 707–708 (2010). 6. Holle, J. U. et al. Prospective long-term follow-up of patients with localised Wegener’s granulomatosis: does it occur as persistent disease stage? Ann. Rheum. Dis. 69, 1934–1939 (2010). 7. Holle, J. U. et al. Rituximab for refractory granulomatosis with polyangiitis (Wegener’s granulomatosis): comparison of efficacy in granulomatous versus vasculitic manifestations. Ann. Rheum. Dis. http:// dx.doi.org/10.1136/ard.2011.153601 8. Holden, N. J. et al. ANCA-stimulated neutrophils release BLyS and promote B cell survival: a clinically relevant cellular process. Ann. Rheum. Dis. 70, 2229–2233 (2010). 9. Thurner, L. et al. Wegener’s granuloma harbour B lymphocytes with specificities against a proinflammatory transmembrane protein and a tetraspanin. J. Autoimmun. 36, 87–90 (2011). 10. Laudien, N. et al. Molecular signatures of a disturbed nasal barrier function in the primary tissue of Wegener’s granulomatosis. Mucosal Immunol. 4, 564–573 (2011). S76 | JANUARY 2012 www.nature.com/reviews
UROLOGY PROSTATE CANCER IN 2011 Redefining the therapeutic landscape for CRPC Carmel Pezaro and Gerhardt Attard 2011 was a breakthrough year for the treatment of castration-resistant prostate cancer. The encouraging results of two large clinical trials were reported, as well as data identifying a number of promising new therapeutic targets. Bone-modulating agents continued to show potential for the prevention of skeletal events. Pezaro, C. & Attard, G. Nat. Rev. Urol. 9, 63–64 (2012); published online 17 January 2012; doi:10.1038/nrurol.2011.235 A number of significant breakthroughs in the field of advanced prostate cancer were reported this year, both clinically and in translational and scientific research. Recently reported analy ses of the phase III studies of abiraterone acetate and MDV3100 provide irrefutable evidence that the androgen receptor (AR) is a critical target in castration- resistant prostate cancer (CRPC). 1 These agents entered clinical development 5–6 years ago and proceeded to large (>1,000 patients) phase III trials in docetaxel-treated patients. 2 MDV3100 is a novel potent AR antagonist, and abiraterone acetate specifically inhibits CYP17A1, a key enzyme in the testosterone bio synthesis pathway that converts adrenal and potentially intratumoral steroid precursors into androgens. Interim analysis of the abiraterone acetate trial revealed that abiraterone acetate plus prednisone improved survival by 3.9 months compared to placebo plus prednisone (HR 0.65; P
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January 2012 KEY ADVANCES IN MEDICI
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Cover image: Hippocrates of Cos ref
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CARDIOLOGY ACUTE CORONARY SYNDROMES
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5. Alexander, J. H. et al. Apixaban
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9. Lip, G. Y. H. et al. Bleeding ri
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HYPERTENSION IN 2011 New insights
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9. Bibbins-Domingo, K. et al. Proje
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CLINICAL ONCOLOGY OVARIAN CANCER IN
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malignancy and, until recently, doc
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in CLL. Four cases were analyzed an
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of patients. 1,2 The phase III BRIM
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metastasis has provided a new speci
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ENDOCRINOLOGY THYROID DISEASE IN PR
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gene that encodes steroid 11β-hydr
Page 29 and 30: using the Rotterdam cri teria (two
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Page 59 and 60: STROKE IN 2011 Major advances acros
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Page 67 and 68: Key advances ■ Early‑onset refr
Page 69 and 70: RHEUMATOLOGY RA IN 2011 Advances in
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Page 83 and 84: BLADDER CANCER IN 2011 The dawn of
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