Update on the pathogenesis and treatment of juvenile idiopathic arthritis

被引:36
作者
Giancane, Gabriella
Alongi, Alessandra
Ravelli, Angelo
机构
[1] Univ Genoa, Genoa, Italy
[2] Ist Giannina Gaslini, Genoa, Italy
关键词
juvenile idiopathic arthritis; pathogenesis; treatment; MACROPHAGE ACTIVATION SYNDROME; ENTHESITIS-RELATED ARTHRITIS; DISEASE-ACTIVITY; PSORIATIC-ARTHRITIS; ETANERCEPT; ONSET; METHOTREXATE; TOCILIZUMAB; EXPRESSION; CHILDREN;
D O I
10.1097/BOR.0000000000000417
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Purpose of review To provide an overview of recently published studies on pathogenesis and management of juvenile idiopathic arthritis (JIA). Recent findings In the past year, the potential role of network analysis in the understanding of the molecular phenotype of individual JIA subgroups has been highlighted. In addition, potential new targets for pharmacologic interventions have been identified through the elucidation of mechanisms that modulate the function of cells involved in the inflammatory process. There is a growing interest for the role of the gut microbiome in disease pathogenesis, which may open the way to future therapeutic manipulations of fecal microbial population. Recent therapeutic studies have provided important information in large patient samples on the effectiveness and toxicity profile of biologic medications used in JIA. Concomitant administration of methotrexate was found to increase the effectiveness of intra-articular corticosteroid therapy in children with oligoarticular JIA. Summary A great deal of work is being conducted to better define the molecular phenotype of the individual subsets of JIA and to identify potential new targets for therapeutic interventions. The results of the ongoing large-scale international data collections will help establish the long-term safety profiles of biologic medications, in particular the risk of malignancy.
引用
收藏
页码:523 / 529
页数:7
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