The Role Of Inflammation In Juvenile Idiopathic Arthritis

First PartThe Clinical Features Of189Cases With Juvenile Idiopathic ArthritisObjectiveTo investigate the characteristics of clinical manifestation, classification, laboratory tests and the effect of inflammatory indices in clinical assessment of juvenile idiopathic arthritis (JIA).MethodsReviewing their clinical features according to the International League of Association for Rheumatology (ILAR) classification criteria, collected data of189children with JIA. A clinical retrospective analysis was carried out.Results1、Of189cases, including100male and89female,119cases with systemic JIA (62.9%),13cases with oligoarthritis (6.9%),16cases with polyarthritis RF positive (8.5%),15cases with polyarthritis RF negative (7.9%),3cases with psoriatic arthritis (1.6%),13cases with enthesitis-related JIA (6.9%) and10cases with undefined JIA (5.3%).2、Systemic JIA (SJIA) was non-specific in terms of clinical manifestations, including fever, rash, lymphadenopathy, hepatomegaly and (or) splenomegaly et al, the clinical course was more than one year and excluded tumor and other diseases.3、Systemic JIA laboratory tests showed a marked inflammatory response with leucytosis, very high CRP and ESR, a decrease in hemoglobin and serum albumin concentrations.4、There were different positive rate for RF, ANA, HLA-B27and anti-CCP in the other subsets.5、Serum albumin as a negative acute-phase protein was correlated inversely with WBC count and ESR, correlated positively with hemoglobin.Conclusions 1、Patients with systemic JIA were most common; some cases absent arthritis should be diagnosed after more than one year, and excluded other diseases.2、Laboratory test showed a marked inflammatory response in SJIA, serum albumin as a negative acute-phase protein and WBC count, ESR, hemoglobin should be used in clinical assessment of SJIA. Second and third PartThe role of inflammation in systemic juvenile idiopathic arthritis AbstractObject:To detected the serum levels of TNF-α IL-1β、IL-6and IL-18.T0investigate whether single nucleotide polymorphisms (SNPs) within the gene NLRP3, which are known to contribute to the risk of autoinflammortary diseases, confer an increased risk of susceptibility to systemic JIA.Method:26cases with SJIA and39healthy individuals were enrolled. All the9exons were directly sequenced to identify and characterize the single nucleotide polymorphisms in SJIA. The genotypic and allelic frequencies of SNPS were analyzed with case-control study, both cases and controls were detected the serum levels of TNF-α、IL-1β、IL-6and IL-18.Results:1. The serum concentrations of TNF-a and IL-1β were no different in patients and controls.2. The serum concentrations of IL-6and IL-18were significantly higher in patients than that in controls. The patients were divided into two groups, one with arthritis, and the other with non-arthritis. The serum concentrations of IL-6and IL-18were no different in the two groups.3. Serum concentration of IL-6was positively correlated with ESR and IL-18was positively correlated with ESR and WBC.4. Three SNPS in exon3of NLRP3were identified, rs35829419C>A, rs7525979C> T, rs3806268G>A.5. The allele frequency was no significant differences in SJIA patients and controls (p>0.05).Conclusion1. The serum levels of IL-6and IL-18were correlated positively with WBC and ESR, maybe presented the activity of S JIA.2. More research were need to carry out to confirm the NLRP3associated with the susceptibility of S JIA.