Research Progress Related to Juvenile Idiopathic Arthritis (JIA)

The NIAMS supports translational and clinical research at universities and other organizations throughout the country that are studying JIA. Researchers at these research centers and at the NIH are continuing work to understand what causes the disease, which may help them identify new treatment strategies. An active area of investigation is the search for genetic factors that may underlie the various forms of the disease. Many efforts are also aimed at testing the effectiveness of biologic response modifiers, which target specific inflammatory pathways that have been implicated in JIA.

Following are some examples of other types of studies that are ongoing.

• Children with JIA must be screened frequently for uveitis (inflammation of the middle of the eye). To improve uveitis monitoring, researchers are developing a risk estimator tool based on genetic variations, biomarkers, demographics, and clinical factors. By helping to identify those at high risk, the tool will help doctors initiate treatment early on, reducing the chance of vision loss.
• The causes of JIA are not known, but disturbances of the microbiome (the collection of all the microbes that inhabit the human body) have been linked to other inflammatory diseases. Scientists are studying the potential impact of antibiotics, infections, and microbiome imbalances on the development and activity of JIA.
• Macrophage activation syndrome (MAS) is a rare, but dangerous, complication of systemic JIA. It involves uncontrolled activation of immune cells called macrophages and T-cells, which leads to an overwhelming inflammatory response. Investigators are studying the changes that occur to macrophages during MAS so that they can find new ways to prevent and treat it.
• With the current array of therapies available, many children with JIA achieve long-term remission. Research is underway to understand whether and how to taper patients off of their medications once the disease becomes inactive.
• HLA-B27 is a protein associated with enthesitis-related JIA and certain other inflammatory diseases. The protein has the tendency to misfold inside cells, which can trigger inflammation. By working to understand how cells respond to HLA-B27 misfolding, investigators hope to find ways to mitigate inflammation and possibly find new ways to treat the disease.
• In an effort to better understand the causes of JIA, researchers are conducting a trial in which they follow a set of patients with systemic JIA over time. Using information gathered from periodic health evaluations and laboratory tests, the investigators expect to learn more about the genes and environmental factors involved in the disease, which may lead to new diagnostics or therapeutic strategies.