The 2020 Pediatric Rheumatology Symposium, originally scheduled for April 29 – May 2, was postponed due to COVID-19; therefore, abstracts were not presented as scheduled.
Session Type: ACR Abstract Session
Session Time: 4:15PM-5:15PM
Background/Purpose: JIA is a heterogeneous group of patients with varying types of biomarkers detected in a small percentage of patients. More specific biomarkers would help in diagnosis and lead to possible different therapeutic regimens. Anti-cyclic citrulinated peptide antibodies (∝-CCP) may play a role in the inflammatory process in JIA. ∝-CCP antibodies have been detected in JIA patients with more severe disease. Other chemical reactions other than citrullination have also been detected, such as carbamylation, which has also shown to produce auto-antibodies (∝- carbamylated proteins (∝-CarP antibodies)). These, also, may play a part in the inflammatory process. Also, 14-3-3η (eTa) proteins, which are chaperonins found in all eukaryotic cells, have been implicated as having diagnostic potential in inflammatory arthritides.
Methods: ∝-CCP isotypic antibodies ,∝-CarP antibodies, and eTa proteins were assayed by ELISA in 29-47 rheumatoid factor (RF) + and 29-37 RF – polyarticular JIA patients, 34-42 oligoarticular, and 12-20 systemic-onset JIA patients depending on the assay.
Results: At least one ∝-CCP antibody isotype was detected in 60% of JIA patients ( IgA in 38%, IgM in 36%, and IgG in 24%). JIA patients that had all 3 isotypes were found to have more aggressive disease. These isotypes further evaluated showed multiple citrullinated epitopes including antibodies to citrullinated fibrinogen, alpha-enolase, citrullinated vimentin, and citrullinated type II collagen. ∝-CarP antibodies were detected in only 20%, predominately in oligoarticular-onset JIA (31%) patients. eTa proteins were detected in 30% of polyarticular RF+/RF- JIA patients and were associated with erosive disease. eTa proteins presence also may be a forerunner of +RF development.
Conclusion: Minor biomarkers, such as ∝-CCP antibodies, ∝-CarP antibodies, and eTa proteins may be found in a small percentage of JIA patients. Their presence, however, if detected may indicate a more aggressive disease, which may evolve into a polyarticular, erosive disease.. The possible use of hydroxychloroquine in these patients may help stabilize the disease in these patients.
To cite this abstract in AMA style:Moore T, Dalrymple A, Feller L, Tuttle P. Minor Biomarkers in Juvenile Idiopathic Arthritis (JIA) [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 4). https://acrabstracts.org/abstract/minor-biomarkers-in-juvenile-idiopathic-arthritis-jia/. Accessed December 2, 2022.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/minor-biomarkers-in-juvenile-idiopathic-arthritis-jia/