Abstract
Juvenile idiopathic arthritis (JIA) is the most common childhood rheumatic disease. The development of associated uveitis represents a significant risk for serious complications, including permanent loss of vision. Initiation of early treatment is important for controlling JIA-uveitis, but the disease can appear asymptomatically, making frequent screening procedures necessary for patients at risk. As our understanding of pathogenic drivers is currently incomplete, it is difficult to assess which JIA patients are at risk of developing uveitis. Identification of specific risk factors for JIA-associated uveitis is an important field of research, and in this review, we highlight the genomic, transcriptomic, and proteomic factors identified as potential uveitis risk factors in JIA, and discuss therapeutic strategies.
Highlights
Juvenile idiopathic arthritis (JIA), the most common chronic rheumatic disease in children, has seven sub-forms with variable clinical presentation, disease course, and associated outcomes [1]
Non-biased proteomic and transcriptomic analyses of iris biopsies, aqueous humor (AqH), and serum from JIA-associated uveitis patients revealed differential expression of 136 genes and 56 proteins as compared to patients with primary open-angle glaucoma (POAG) [43], with multiple B-cell related genes upregulated in the uveitis group
In enthesitis-related arthritis (ERA) JIA, a type of uveitis characterized by acute onset and conjunctival injection, pain, and photophobia occurs in approximately 10% of patients within 6 months of disease onset [64]
Summary
Juvenile idiopathic arthritis (JIA), the most common chronic rheumatic disease in children, has seven sub-forms with variable clinical presentation, disease course, and associated outcomes [1]. In most cases, JIA precedes the development of uveitis, a minority of patients develop uveitis before the onset of JIA. Though frequently asymptomatic at onset, JIA-associated uveitis can lead to severe complications, including permanent loss of vision, especially if left untreated [2]. This highlights the urgent need for early detection and initiation of treatment. While the risk of developing uveitis varies between sub-forms of JIA, early diagnosis and treatment are complicated by the current lack of predictive markers for the development of uveitis in individual JIA patients.
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