Predicting uveitis onset in children with juvenile idiopathic arthritis

项目总结 幼年特发性关节炎相关性葡萄膜炎(JIA-U)是一种慢性炎症性眼病，影响20%的 患有JIA的儿童，可导致威胁视力的并发症。儿童定期眼科筛查 由于早期检测葡萄膜炎可以预防视力并发症并影响治疗，因此JIA是至关重要的 管理层。我们的长期目标是通过以下方式预防JIA-U儿童的视力威胁眼损伤 改进葡萄膜炎的检测和治疗。 这项研究是一项多点纵向翻译研究，是专家们在 眼科学、风湿学、蛋白质组学、化验发展、遗传学和生物统计学。的目标 这项研究的目的是：1)描述泪液中的生物标记物，识别患JIA-U风险增加的儿童，2) 在患有JIA的儿童中确定早期诊断葡萄膜炎的遗传危险因素，以及3)发生葡萄膜炎的风险 综合人口学、临床因素、JIA-U生物标志物和遗传变异的估计者。我们将招收 250名新近诊断为JIA的儿童，没有葡萄膜炎的临床证据，并进行前瞻性随访。 将在连续时间点比较患有JIA-U和未患JIA-U的儿童的生物标记物水平 发展为葡萄膜炎，以了解检测的窗口。我们还将进行基于SNP的遗传关联 研究包括750名患有JIA(无葡萄膜炎)的儿童和750名患有JIA-U的儿童，以确定 与生物标记物水平有关，也与眼病的遗传倾向有关。使用一种综合方法 考虑到临床、生物和遗传因素，我们将生成葡萄膜炎的风险估计器，以确定 儿童患眼病的风险增加。我们预计在疾病早期应用这一新工具将使 用于早期干预和改善视力结果。

PROJECT SUMMARY Juvenile idiopathic arthritis-associated uveitis (JIA-U) is a chronic inflammatory eye disease that affects 20% of children with JIA and can lead to sight-threatening complications. Regular ophthalmic screening of children with JIA is crucial because early uveitis detection can prevent visual complications and influence therapeutic management. Our long-term goal is to prevent sight-threatening ocular damage in children with JIA-U by improving uveitis detection and treatment. This investigation is a multi-site longitudinal translational study that is a collaborative effort between experts in ophthalmology, rheumatology, proteomics, assay development, genetics, and biostatistics. The objectives of this study are to: 1) Delineate a biomarker profile in tears that identifies children at increased risk for JIA-U, 2) Identify genetic risk factors for early uveitis diagnosis among children with JIA, and 3) Develop a uveitis risk estimator integrating demographics, clinical factors, JIA-U biomarkers, and genetic variations. We will enroll 250 children with recently diagnosed JIA, without clinical evidence of uveitis, and follow them prospectively. Levels of biomarkers will be compared at serial time points in children with JIA-U and those who do not develop uveitis to understand the window of detection. We will also conduct SNP-based genetic association studies that include 750 children with JIA (no uveitis) and 750 with JIA-U to identify genetic variations that are related to biomarker levels and also to genetic predilection to eye disease. Using an integrative approach that considers clinical, biological, and genetic factors, we will generate a risk estimator for uveitis that will identify children at elevated risk for eye disease. We expect that application of this new tool early in disease will allow for early intervention and improved vision outcomes.