Abstract

BackgroundJuvenile Idiopathic Arthritis (JIA) is the most common chronic arthritis in children worldwide. Among anti-inflammatory cytokines, interleukin-10 (IL-10) is a key immunosuppressive cytokine involved in the pathogenesis of JIA. To date, only a few studies concerned the association of interleukin-10 gene polymorphisms with JIA. In this study, we aimed to investigate 3 cytokine single-nucleotide polymorphisms situated at positions -1082(G/A), −819(C/T), and −592(C/A) in the promoter region of the IL-10 gene to determine whether this polymorphism could be a marker of susceptibility to JIA in Egyptian children and adolescents. We also measured the serum level of IL-10 to assess its relation to such polymorphism.MethodsThis was a case-control study included 100 patients diagnosed with JIA, and matched with age, gender, ethnicity 100 healthy control subjects.Interleukin-10 −1082(G/A), −819(C/T), and −592(C/A) polymorphisms were genotyped by amplification refractory mutation system- polymerase chain reaction (ARMS)-PCR methodology, while the serum IL10 levels were measured by ELISA method.ResultsCompared to the controls subjects, the frequency of IL-10- AA genotype and A allele at the –1082 position were overrepresented in patients with JIA (OR = 2.7; 95% CI: 1.1–6.4 for the AA genotype; P <0.05 and OR: 1.5; 95% CI: 1.03–2.3 for the A allele; P <0.05 respectively). On the other hand, no significant differences were found between the 2 groups in the genotype or allele frequencies for the –819 and –592 positions. Of note, we found a significant positive association between the IL-10 (-1082) AA genotype and susceptibility to polyarticular JIA (OR: 4.3; 95% CI: 1.5–12.7; P <0.01). We observed that patients with the IL-10 (-1082) AA genotype had significantly lower serum IL-10 levels (2.3 ± 0.9 pg/ml) compared to those with AG genotype (7.6 ± 1.5 pg/ml) and GG genotype (9.5 ± 1.2 pg/ml); P < 0.01, respectively.ConclusionWe demonstrate for the first time, to the best of our knowledge, that the presence of an A allele or AA gene variant at the –1082 position of the promoter region of the interleukin-10 gene may constitute risk factors for developing JIA in Egyptian children and adolescents. Moreover, we observed a significant positive association between the IL10 –1082 AA gene variant and susceptibility to polyarticular JIA.

Highlights

  • Juvenile Idiopathic Arthritis (JIA) is the most common chronic arthritis in children worldwide

  • 16% of JIA patients were receiving a non-steroidal antiinflammatory agent (NSAIDS), 29% were on NSAIDS and methotrexate(MTX), 28% were on NSAIDS and steroids,24% were on triple therapy of NSAIDS, MTX, steroids, and 3% were on NSAIDS, MTX, biologic agents (Table 1)

  • We found a significant increase in the frequency of the A allele (57.5%, odds ratio (OR): 1.5; 95% Confidence interval (CI): 1.03–2.3; P

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Summary

Introduction

Juvenile Idiopathic Arthritis (JIA) is the most common chronic arthritis in children worldwide. JIA is the most common autoimmune inflammatory joint disease, with an incidence of 2.6 to 23 cases per 100,000 children per year [2]. A central feature of JIA is a relative imbalance of cytokine profile, with a relative excess of pro-inflammatory molecules including interleukin-1, interleukin -6, and tumor necrosis factor (TNF-α) compared with anti-inflammatory mediators such as interleukin -10 [7].

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