Abstract
Juvenile idiopathic arthritis (JIA) is an umbrella term for seven distinct chronic immune-mediated diseases. Disease-modifying anti-rheumatic drugs (DMARD) are used to treat the underlying joint inflammation as well as extra-articular manifestations. Immunosuppression is a considerable side effect of the drugs. The main goal of this study was to investigate the effect of different JIA therapies on leukocyte subpopulations, which play a role in immune-defense. Three study groups were established. The first group consisted of JIA patients treated with methotrexate solely, the second one received a combination of methotrexate (MTX) and adalimumab (ADA). The control group was made up of the patients' healthy siblings. A total of 63 children were recruited. Fourty-one children with JIA and 22 healthy controls were included in the study. The absolute number of CD3+ T-cells was significantly elevated in patients treated with biological therapy compared to healthy controls (p2 = 0.017). In contrast, the number of CD56+ natural killer cells was significantly lower in children receiving biological therapy in comparison with healthy donors (p2 = 0.039). A significant alteration was also demonstrated between patients treated with MTX and MTX/ADA group concerning CD 19+ B-cells (p3 = 0.042). This is the first study that demonstrates significant alterations in the number of B-cells and T-cells with a relative decrease of NK-cell ratios in JIA patients receiving different DMARD therapy.Clinical Trial Registration: NCT03833271. 21.01.2019.
Highlights
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of unclear etiology and pathophysiology in childhood
Fourty-one children with JIA and 22 healthy controls were enrolled in the analysis: 15 (23.8%) patients treated with a stable dose of MTX (15 mg/m2/week per oral)
We focused on two distinct, but relatively homogeneous subsets of patients with JIA in remission: 25 (61%) children with oligoarthritis (OA) and 16 (39%) with polyarthritis (PA)
Summary
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease of unclear etiology and pathophysiology in childhood. After initial non-steroid anti-inflammatory drug therapy, conventional treatment is a synthetic disease-modifying antirheumatic drug (sDMARD). The efficacy and safety of MTX were confirmed in numerous clinical trials [6, 7]. Blocking TNF-alfa molecule in the inflammatory cascade triggers remission, better disease control and cessation of the clinical symptoms. Anti-TNF-alfa agents used in the treatment of JIA are infliximab (INX), adalimumab (ADA), certolizumab pegol, golimumab, and etanercept (ETA). These drugs are confirmed to be extremely efficacious in numerous trials [8,9,10,11]. Their immunosuppressive effect has to be taken into account
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
