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Biomedicines
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Pathogenesis and Novel Diagnostic in Juvenile Idiopathic Arthritis
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Pathogenesis and Novel Diagnostic in Juvenile Idiopathic Arthritis

A special issue of Biomedicines (ISSN 2227-9059). This special issue belongs to the section "Molecular and Translational Medicine".

Deadline for manuscript submissions: closed (31 December 2022) | Viewed by 13023

Special Issue Editor

Prof. Dr. Katarzyna Winsz-Szczotka

E-Mail Website
Guest Editor
Laboratory Diagnostics, Department of Clinical Chemistry, Faculty of Pharmaceutical Sciences in Sosnowiec, Medical University of Silesia, Sosnowiec, Poland
Interests: connective tissue diseases; pathology of the extracellular matrix; growth factors; juvenile idiopathic arthritis
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

The term ‘juvenile idiopathic arthritis’ (JIA) defines a heterogeneous collection of autoimmune or autoinflammatory forms of chronic arthritis with onset in childhood, with origins that are not yet entirely understood.

There are no pathognomonic symptom or examination findings for JIA, and the diagnosis is made by exclusion and differentiation. JIA that is diagnosed too late or treated poorly treated may contribute to the disability of an afflicted child, due to disturbances in the structure and function of the osteoarticular system.  Hence, prompt detection of structural disorders of articular cartilage would allow clinicians to initiate appropriate therapies, which is essential for the course of the arthropathy in question. Too late application of appropriate treatment, resulting from the lack of specific diagnostic biomarkers, may result in the perpetuation of pathological changes in the motor system in patients, or the development of systemic disorders, especially in those with high disease activity who require an aggressive therapy.

It is therefore crucial that we continue to research the pathogenesis of JIA, seeking new biomarkers of the disease and effective therapeutic methods. We invite researchers to submit original work or review articles covering significant development in the pathogenesis of children’s arthritis, as well as novel diagnostic and therapeutic methods.

Prof. Dr. Katarzyna Winsz-Szczotka
Guest Editor

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Keywords

  • juvenile idiopathic arthritis
  • pathogenesis
  • cartilage and bone anabolism and catabolism
  • diagnostics
  • treatment
  • prevention

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Published Papers (5 papers)

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Research

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7 pages, 1466 KiB  
Communication
Increased Immunity against the Oral Germs Porphyromonas gingivalis and Prevotella intermedia in Different Categories of Juvenile Idiopathic Arthritis
by Franck Zekre, Rolando Cimaz, Mireille Paul, Teresa Giani, Louis Waeckel, Anne-Emmanuelle Berger, Jean-Louis Stephan, Myriam Normand, Stéphane Paul and Hubert Marotte
Biomedicines 2022, 10(10), 2613; https://doi.org/10.3390/biomedicines10102613 - 18 Oct 2022
Cited by 5 | Viewed by 1816
Abstract
(1) Background: The link between periodontal disease and rheumatoid arthritis (RA) is now widely reported. Several studies suggest the role of Porphyromonas gingivalis (P. gingivalis) in the pathophysiology of RA and some observations highlight the improvement of the disease activity induced [...] Read more.
(1) Background: The link between periodontal disease and rheumatoid arthritis (RA) is now widely reported. Several studies suggest the role of Porphyromonas gingivalis (P. gingivalis) in the pathophysiology of RA and some observations highlight the improvement of the disease activity induced by therapies against P. gingivalis. We have very little data on the prevalence of P. gingivalis carriage in patients with juvenile idiopathic arthritis (JIA) and its possible involvement in the pathophysiology of inflammatory joint diseases in children. (2) Methods: The specific IgG responses against P. gingivalis and Prevotella intermedia (P. intermedia) were determined in a cohort of 101 patients with JIA and 19 patients with other autoimmune diseases (inflammatory bowel disease and type 1 diabetes). (3) Results: Specific anti-P. gingivalis and anti-P. intermedia IgG titers were higher in JIA group than in control groups. These differences were mainly observed in the oligoarthritis group. The same pattern was observed in enthesitis-related arthritis (ERA). (4) Conclusions: Children with oligoarticular and ERA subsets had higher IgG titers to P. gingivalis and P. intermedia. These results suggest involvement of an oral dysbiosis in the occurrence of JIA in these subgroups. Full article
(This article belongs to the Special Issue Pathogenesis and Novel Diagnostic in Juvenile Idiopathic Arthritis)
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14 pages, 461 KiB  
Article
Plasma Glycosaminoglycans in Children with Juvenile Idiopathic Arthritis Being Treated with Etanercept as Potential Biomarkers of Joint Dysfunction
by Magdalena Wojdas, Klaudia Dąbkowska, Kornelia Kuźnik-Trocha, Grzegorz Wisowski, Iwona Lachór-Motyka, Katarzyna Komosińska-Vassev, Krystyna Olczyk and Katarzyna Winsz-Szczotka
Biomedicines 2022, 10(8), 1845; https://doi.org/10.3390/biomedicines10081845 - 31 Jul 2022
Cited by 3 | Viewed by 1815
Abstract
We assessed the effect of two-year etanercept (ETA) therapy on the metabolism of the cartilage extracellular matrix (ECM) in patients with juvenile idiopathic arthritis (JIA). Methods: We performed a quantitative evaluation of glycosaminoglycans (GAGs) (performed by the multistage extraction and purification method) in [...] Read more.
We assessed the effect of two-year etanercept (ETA) therapy on the metabolism of the cartilage extracellular matrix (ECM) in patients with juvenile idiopathic arthritis (JIA). Methods: We performed a quantitative evaluation of glycosaminoglycans (GAGs) (performed by the multistage extraction and purification method) in blood obtained from patients before and during 24 months of ETA treatment, as potential biomarker of joint dysfunction and indicators of biological effectiveness of therapy. Since the metabolism of GAGs is related to the activity of proteolytic enzymes and prooxidant–antioxidant factors, we decided to evaluate the relationship between GAGs and the levels of metalloproteinases (MMP), i.e., MMP-1 and MMP-3 (using immunoenzymatic methods), as well as the total antioxidative status (TAS) (using the colorimetric method) in blood of the JIA patients. Results: When compared to the controls, GAGs and TAS concentrations were significantly lower in patients with an aggressive course of JIA qualified for ETA treatment. MMP-1 and MMP-3 levels were significantly higher versus control values. An anti-cytokine therapy leading to clinical improvement does not lead to the normalization of any of the assessed parameters. GAGs concentration is significantly related to MMP-1, MMP-3, TAS, TOS, and CRP levels. Conclusion: The results of the present study indicate the necessity of constant monitoring of the dynamics of destructive processes of articular cartilage in children with JIA. We suggest that GAGs may be a useful biomarker to assess the clinical status of the extracellular matrix of joints. Full article
(This article belongs to the Special Issue Pathogenesis and Novel Diagnostic in Juvenile Idiopathic Arthritis)
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14 pages, 312 KiB  
Article
Longitudinal Study of Cognitive Functioning in Adults with Juvenile Idiopathic Arthritis
by Natalia Mena-Vázquez, Fernando Ortiz-Márquez, Pablo Cabezudo-García, Claudia Padilla-Leiva, Gisela Diaz-Cordovés Rego, Luis Muñoz-Becerra, Teresa Ramírez-García, Jose Manuel Lisbona-Montañez, Sara Manrique-Arija, Arkaitz Mucientes, Esmeralda Núñez-Cuadros, Rocío Galindo Zavala, Pedro Jesús Serrano-Castro and Antonio Fernández-Nebro
Biomedicines 2022, 10(7), 1729; https://doi.org/10.3390/biomedicines10071729 - 18 Jul 2022
Cited by 2 | Viewed by 2164
Abstract
Objective: To prospectively evaluate possible decline of cognitive functions in adult patients with juvenile idiopathic arthritis (JIA) and identify associated factors. Patients and methods: We performed a 24-month prospective observational study of adults (≥16 years) with JIA. The primary outcome measure was decline [...] Read more.
Objective: To prospectively evaluate possible decline of cognitive functions in adult patients with juvenile idiopathic arthritis (JIA) and identify associated factors. Patients and methods: We performed a 24-month prospective observational study of adults (≥16 years) with JIA. The primary outcome measure was decline in cognitive function defined as a worsening of ≥2 points on the scales of the subsets administered to evaluate the different cognitive areas using the Wechsler Adult Intelligence Scale (WAIS) after 24 months: attention/concentration (digit span); verbal function (vocabulary); visual-spatial organization (block design); working memory (letter-number sequencing); and problem solving (similarities). Other variables included average inflammatory activity using C-reactive protein and composite activity indexes, comorbidity, and treatment. Logistic regression was performed to identify factors associated with cognitive decline. Results: The study population comprised 52 patients with JIA. Of these, 15 (28.8%) had cognitive decline at V24. The most affected functions were working memory (17.3%), attention/concentration (9.6%), verbal function (7.7%), visual-spatial organization (7.7%), and problem solving (3.8%). There were no significant differences in the median direct or scale scores for the cognitive functions evaluated between V0 and V24 for the whole sample. The factors associated with cognitive decline in patients with JIA were average C-reactive protein (OR [95% CI], 1.377 [1.060–1.921]; p = 0.039), depression (OR [95% CI], 3.691 [1.294–10.534]; p = 0.015), and treatment with biologics (OR [95% CI], 0.188 [0.039–0.998]; p = 0.046). Conclusion: Cognitive decline was detected in almost one third of adults with JIA after 24 months of follow-up. Systemic inflammatory activity in JIA patients was related to cognitive decline. Patients treated with biologics had a lower risk of decline in cognitive functions. Full article
(This article belongs to the Special Issue Pathogenesis and Novel Diagnostic in Juvenile Idiopathic Arthritis)

Review

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18 pages, 8369 KiB  
Review
Advances in Musculoskeletal Imaging in Juvenile Idiopathic Arthritis
by Iwona Sudoł-Szopińska, Nele Herregods, Andrea S. Doria, Mihra S. Taljanovic, Piotr Gietka, Nikolay Tzaribachev and Andrea Sabine Klauser
Biomedicines 2022, 10(10), 2417; https://doi.org/10.3390/biomedicines10102417 - 27 Sep 2022
Cited by 9 | Viewed by 3381
Abstract
Over the past decade, imaging of inflammatory arthritis in juvenile arthropathies has significantly advanced due to technological improvements in the imaging modalities and elaboration of imaging recommendations and protocols through systematic international collaboration. This review presents the latest developments in ultrasound (US) and [...] Read more.
Over the past decade, imaging of inflammatory arthritis in juvenile arthropathies has significantly advanced due to technological improvements in the imaging modalities and elaboration of imaging recommendations and protocols through systematic international collaboration. This review presents the latest developments in ultrasound (US) and magnetic resonance imaging (MRI) of the peripheral and axial joints in juvenile idiopathic arthritis. In the field of US, the ultra-wideband and ultra-high-frequency transducers provide outstanding spatial resolution. The more sensitive Doppler options further improve the assessment and quantification of the vascularization of inflamed tissues, and shear wave elastography enables the diagnosis of tissue stiffness. Concerning MRI, substantial progress has been achieved due to technological improvements in combination with the development of semiquantitative scoring systems for the assessment of inflammation and the introduction of new definitions addressing the pediatric population. New solutions, such as superb microflow imaging, shear wave elastography, volume-interpolated breath-hold examination, and MRI-based synthetic computed tomography open new diagnostic possibilities and, at the same time, pose new challenges in terms of clinical applications and the interpretation of findings. Full article
(This article belongs to the Special Issue Pathogenesis and Novel Diagnostic in Juvenile Idiopathic Arthritis)
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Other

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17 pages, 693 KiB  
Case Report
Juvenile Idiopathic Arthritis, Uveitis and Multiple Sclerosis: Description of Two Patients and Literature Review
by Cecilia Beatrice Chighizola, Matteo Ferrito, Luca Marelli, Irene Pontikaki, Paolo Nucci, Elisabetta Miserocchi and Roberto Caporali
Biomedicines 2022, 10(8), 2041; https://doi.org/10.3390/biomedicines10082041 - 21 Aug 2022
Cited by 1 | Viewed by 2955
Abstract
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood, while multiple sclerosis (MS) is a demyelinating disease of the central nervous system, characterized by remission and exacerbation phases. An association between MS and rheumatologic diseases, in particular rheumatoid arthritis, has [...] Read more.
Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in childhood, while multiple sclerosis (MS) is a demyelinating disease of the central nervous system, characterized by remission and exacerbation phases. An association between MS and rheumatologic diseases, in particular rheumatoid arthritis, has been described and numerous studies acknowledge anti-TNF-α drugs as MS triggers. Conversely, the association between MS and JIA has been reported merely in five cases in the literature. We describe two cases of adult patients with longstanding JIA and JIA-associated uveitis, who developed MS. The first patient was on methotrexate and adalimumab when she developed dizziness and nausea. Characteristic MRI lesions and oligoclonal bands in cerebrospinal fluid led to MS diagnosis. Adalimumab was discontinued, and she was treated with three pulses of intravenous methylprednisolone. After a few months, rituximab was started. The second patient had been treated with anti-TNF-α and then switched to abatacept. She complained of unilateral arm and facial paraesthesias; brain MRI showed characteristic lesions, and MS was diagnosed. Three pulses of intravenous methylprednisolone were administered; neurological disease remained stable, and abatacept was reintroduced. Further studies are warranted to define if there is an association between JIA and MS, if MS represents JIA comorbidity or if anti-TNF-α underpins MS development. Full article
(This article belongs to the Special Issue Pathogenesis and Novel Diagnostic in Juvenile Idiopathic Arthritis)
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