Juvenile idiopathic arthritis characteristics: Etiology and pathophysiology

Spiegel, Lynn; Kristensen, Kasper Dahl; Herlin, Troels

doi:10.1053/j.sodo.2015.02.003

Cited by 7 publications

(10 citation statements)

References 62 publications

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“…Strong evidence supports HLA class I and II alleles as having an important role in the pathogenesis of different subtypes of JIA [ 60 ]. Several studies have shown significant correlations between the antigens associated with early-onset oligoarticular, RF-negative polyarticular, and RF-positive polyarticular JIA [ 60 ]. There are also a number of non-HLA genes that have been tested for the association with JIA, most of them belonging to the immunity-related genes [ 59 ].…”

Section: Introductionmentioning

confidence: 99%

Contemporary management of TMJ involvement in JIA patients and its orofacial consequences

et al. 2016

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Juvenile idiopathic arthritis is the most common chronic rheumatic condition during childhood. Temporomandibular joint arthritis is frequently asymptomatic. When it takes place during childhood, it may affect condylar growth; therefore, these children are at risk of unfavorable long-term outcomes from the associated joint damage. The etiology is not completely understood, but it is considered as multifactorial with both genetic and environmental factors involved.The standardized examination and imaging protocols serve important purpose to diagnose temporomandibular joint (TMJ) arthritis not only to establish an early interventional strategy but also to assess craniofacial growth and the progression of signs and symptoms in those patients. Although the treatment of juvenile idiopathic arthritis (JIA) has changed dramatically over the last decades due to new therapeutic options, TMJ arthritis still can develop during the course of the disease. In clinical experience, TMJs appear to respond less well to the standard of care used to treat other joints. More individualized approach to the patient’s treatment serves as the main goal of personalized medicine. It could be achieved by adopting new methods of medical imaging such as conebeam computer tomography as well as developing reliable biomarkers which may assist with predicting disease type, course, or severity and predicting response to medication.This article provides an overview of current information on orofacial complications in JIA and its management. Based on information provided in this review, more precise diagnosis, proper tools for recognizing people at risk, and more efficient treatment approaches could be implemented. This may lead to more personalized treatment management strategies of TMJ complications of JIA patients.

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Section: Introductionmentioning

confidence: 99%

Contemporary management of TMJ involvement in JIA patients and its orofacial consequences

et al. 2016

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“…JIA, especially when systemic, may lead to joint destruction, limitation of growth, osteoporosis and serious disability, as well as significant emotional and social consequences 2 . Various etiological mechanisms have been proposed involving both genetic and environmental factors 4 , 5 …”

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confidence: 99%

“…[1][2][3][4] The term describes a heterogenous group of diseases associated with persistent joint inflammation lasting more than 6 weeks. [3][4][5][6] JIA may be manifested as systemic arthritis, oligoarthritis (persistent or extended), polyarthritis (rheumatoid factor negative or positive), psoriatic arthritis, enthesitis-related arthritis or undifferentiated arthritis, 2,4,7 but oligoarthritis is by far the most prevalent. 2,4 JIA, especially when systemic, may lead to joint destruction, limitation of growth, osteoporosis and serious disability, as well as significant emotional and social consequences.…”

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confidence: 99%

“…2 Various etiological mechanisms have been proposed involving both genetic and environmental factors. 4,5 Inflammatory processes in the synovial membrane of the articular cavity lead to elevation of the volume of the synovial fluid (SF) and changes to its composition. Enlarged vascular permeability contributes to significant increases in levels of cytokines, enzymes, acute-phase proteins and auto-antibodies.…”

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confidence: 99%

“…Its incidence is estimated at 2–20 cases per 100 000 children and its prevalence up to 150/100 000 1 , 2 , 3 , 4 . The term describes a heterogenous group of diseases associated with persistent joint inflammation lasting more than 6 weeks 3 , 4 , 5 , 6 . JIA may be manifested as systemic arthritis, oligoarthritis (persistent or extended), polyarthritis (rheumatoid factor negative or positive), psoriatic arthritis, enthesitis‐related arthritis or undifferentiated arthritis, 2 , 4 , 7 but oligoarthritis is by far the most prevalent 2 , 4 .…”

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Lectin pathway factors in patients suffering from juvenile idiopathic arthritis

et al. 2017

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Both complement activation and certain infections (including those with Yersinia sp.) may contribute to the pathogenesis of juvenile idiopathic arthritis (JIA). We investigated factors specific for the lectin pathway of complement: mannose-binding lectin (MBL), ficolins and MBL-associated serine protease-2 (MASP-2), in 144 patients and 98 controls. One hundred and six patients had oligoarticular disease and 38 had polyarticular disease. In 51 patients (out of 133 tested), Yersinia-reactive antibodies were found (JIA Ye group). MBL deficiency was significantly more frequent in the JIA Ye group than in patients without Yersinia-reactive antibodies or in controls. Median serum ficolin-2 level was significantly lower (and proportion of values deemed ficolin-2 insufficient greater) in JIA patients irrespective of their Yersinia antibody status. The minority (C) allele at -64 of the FCN2 gene was less frequent among JIA patients than among control subjects. No differences were found in the frequency of FCN3 gene +1637delC or MASP2 +359 A>G mutations nor for median values of serum ficolin-1, ficolin-3 or MASP-2. However, high levels of serum ficolin-3 were under-represented in patients, in contrast to MBL. MBL, ficolin-1, ficolin-2, ficolin-3 and MASP-2 were also readily detectable in synovial fluid samples but at a considerably lower level than in serum. Our findings suggest a possible role for the lectin pathway in the pathogenesis of JIA, perhaps secondary to a role in host defence, and indicate that investigations on the specificity of lectin pathway recognition molecules towards specific infectious agents in JIA might be fruitful.

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Paediatric Rheumatology Fails to Meet Current Benchmarks, a Call for Health Equity for Children Living with Juvenile Idiopathic Arthritis, Using Digital Health Technologies

Butler,

Sculley,

Santos

et al. 2024

Curr Rheumatol Rep

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Purpose of Review This critical review begins by presenting the history of Juvenile Idiopathic Arthritis (JIA) management. To move the conversation forward in addressing the current shortcomings that exist in the clinical management of children living with JIA, we argue that to date, the advancement of successful treatments for JIA has been historically slow. Factors implicated in this situation include a lack of rigorous research, JIA being considered a rare disease, and JIA’s idiopathic and complex pathophysiology. Recent Findings Despite the well-intended legislative changes to increase paediatric research, and the major advancements seen in molecular medicine over the last 30 years, globally, paediatric rheumatology services are still failing to meet the current benchmarks of best practice. Provoking questions on how the longstanding health care disparities of poor access and delayed treatment for children living with JIA can be improved, to improve healthcare outcomes. Summary Globally, paediatric rheumatology services are failing to meet the current benchmarks of best practice. Raising awareness of the barriers hindering JIA management is the first step in reducing the current health inequalities experienced by children living with JIA. Action must be taken now, to train and well-equip the paediatric rheumatology interdisciplinary workforce. We propose, a resource-efficient way to improve the quality of care provided could be achieved by embedding digital health into clinical practice, to create an integrative care model between the children, general practice and the paediatric rheumatology team. To improve fragmented service delivery and the coordination of interdisciplinary care, across the healthcare system.

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Juvenile idiopathic arthritis characteristics: Etiology and pathophysiology

Cited by 7 publications

References 62 publications

Contemporary management of TMJ involvement in JIA patients and its orofacial consequences

Contemporary management of TMJ involvement in JIA patients and its orofacial consequences

Lectin pathway factors in patients suffering from juvenile idiopathic arthritis

Paediatric Rheumatology Fails to Meet Current Benchmarks, a Call for Health Equity for Children Living with Juvenile Idiopathic Arthritis, Using Digital Health Technologies

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