Outcomes of children with juvenile idiopathic arthritis-associated uveitis

幼年特发性关节炎相关葡萄膜炎儿童的结局

• 批准号: 8913977
• 负责人: Sheila Therese Angeles-Han
• 金额: $ 14.76万
• 依托单位: EMORY UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2011
• 资助国家: 美国
• 起止时间: 2011-09-01 至 2016-11-07
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8913977
• 关键词: Academy; Affect; African; African American; Age; Algorithms; Alleles; American; Antinuclear Antibodies; Arthritis; Autoimmune Diseases; Autoimmune Process; Award; Blindness; Cataract; Cells; Characteristics; Child; Childhood; Chronic Childhood Arthritis; Chronic Disease; Clinical; Cohort Studies; Complement; Complication; Data; Databases; Detection; Development; Diagnosis; Disease; Early Diagnosis; Epidemiology; Etiology; European; Evaluation; Eye; Eye diseases; Flare; Genetic; Genetic Polymorphism; Genetic Risk; Glaucoma; Goals; Guidelines; HLA-B27 Antigen; HLA-DR1 Antigen; Health; Healthcare; Impact evaluation; Impairment; Inflammatory; Institution; Intervention; Lead; Master of Science; Measurement; Measures; Medical Records; Mentors; Monitor; Onset of illness; Ophthalmologist; Ophthalmology; Outcome; Outcome Measure; Outcomes Research; Pathogenesis; Patient-Focused Outcomes; Patients; Pediatrics; Physically Handicapped; Play; Population; Predisposition; Prospective Studies; Proteins; Psyche structure; Quality of life; Questionnaires; Race; Research; Resources; Rheumatism; Rheumatology; Risk; Risk Factors; Risk Marker; Role; Scheme; Scientist; Secondary to; Severities; Severity of illness; Social Functioning; Standardization; Stratification; Symptoms; Therapeutic; United States; Universities; Update; Uveitis; Variant; Vision; Vision Disorders; Visit; Visual; Visual Acuity; Visual impairment; aggressive therapy; base; career; clinical epidemiology; clinical investigation; clinical risk; cohort; design; disability; disorder risk; experience; genetic risk factor; global health; illness length; improved; longitudinal course; prevent; professor; prospective; psychologic; psychosocial; rheumatologist; risk variant; screening; tertiary care; tool

Project Summary Juvenile idiopathic arthritis-associated uveitis (JIA-U) is an inflammatory eye disease that affects 20% of children with JIA and can lead to cataracts, glaucoma, vision loss and blindness. Current screening guidelines are designed to identify children at risk for eye disease in JIA. However, pediatric rheumatologists' and ophthalmologists' ability to provide comprehensive screening for uveitis is limited because the guidelines have not been updated to include all juvenile arthritis subtypes and other known risk factors for vision-limiting complications of JIA. Screening in JIA and other related autoimmune diseases of childhood is crucial because early uveitis detection can prevent visual complications and influence therapeutic management. Likewise, institution of early aggressive therapy when needed may avert serious visual complications. To improve health outcomes and quality of life of children with JIA-U, we need a better understanding of risk factors for uveitis, long-term visual outcomes, and the effects of visual and physical disability on children's lives. Early and accurate identification of JIA-U through the identification of risk factors for susceptibility and severity of uveitis, standardization of outcome measures, and elucidation of the significance of HLA risk alleles would improve the evaluation of the impact of JIA-U and the understanding of disease etiology, pathogenesis and outcome. Likewise, an improved risk stratification scheme could reduce unnecessary ophthalmology visits and help us identify children at greater risk for severe eye disease and complications. The objectives of this study are to 1) Identify differences in the clinical characteristics and course of JIA-U in patients of European and African descent in children with JIA to identify clinical and genetic risk markers for uveitis, 2) Examine the risk factors identified over a 4-year prospective study of a cohort of children diagnosed with early JIA to determine which factors are associated with eventual development of uveitis, and provide data on their longitudinal profile, 3) Determine the impact of having both arthritis and uveitis on physical and visual disability, vision-specific QOL, and overall QOL using subjective and objective measures. Using a comprehensive biologic, genetic and psychosocial approach, we hope to develop more widely applicable risk stratification schemes based on JIA subtype, and to identify new risk factors that will identify the populations of children at greatest risk for severe disability and blindness so that interventions can be developed to improve their overall outcome. The candidate is a pediatric rheumatologist and an assistant professor of pediatrics at Emory University. She has obtained a Masters of Science in Clinical Investigation. She is devoted to a career in clinical outcomes research in children with autoimmune eye diseases. She has assembled an outstanding mentoring team with experience in pediatric rheumatology, pediatric ophthalmology, pediatric epidemiology, outcomes research and measurement, which are relevant to her objectives. This mentored award will help her become a successful independent clinician scientist.

项目总结