Juvenile chronic arthritis, chronic iridocyclitis, and reactivity to histones

Article Abstract:

Autoimmune rheumatic diseases (in which there is inappropriate production of antibodies against the body's own tissues) in childhood differ substantially from those in adulthood. Most children do not have rheumatoid factor (a group of antibodies directed against the stem structure common to all antibodies). Rather, children more often tend to have antinuclear antibodies, which recognize molecules from the cell nucleus. Of the children positive for these antibodies who have involvement of only a few joints, up to 70 percent of those whose disorder begins under the age of five develop iridocyclitis (inflammation of the iris and ciliary body in the eye) or uveitis, which can cause blindness. It is thought that these tissues may be initially damaged by trauma, infection, or other injury, which exposes molecules that are usually hidden to the immune cells that trigger antibody production. Further attack by triggered autoantibodies or deposition of complexes containing molecules from the immune system may be responsible for continuing damage. Research on antibodies to a variety of nuclear structures has produced much information, and attention has recently shifted toward antibodies against histones, tightly organized proteins which surround DNA coils in the cell nucleus. Although antinuclear antibodies have been known to be associated with uveitis for almost 20 years, a disease-causing role has not been established. Eye disease seems most related to antibodies against histone H3. In animal studies, antibodies against yeast histones seem to initiate the autoimmune process associated with uveitis. Further research is needed to establish whether the mechanisms underlying uveitis are directly related to antibodies to histone. (Consumer Summary produced by Reliance Medical Information, Inc.)

Autoantibodies, Histones, Uveitis

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Clinical, HLA, and roentgenological follow up study of patients with juvenile arthritis: comparison between the long term outcome of transient and persistent arthritis in children

Article Abstract:

Juvenile chronic arthritis (JCA) is a group of related diseases which may cause damage to the joints or connective tissues and lesions of the inner organs. Transient arthritis (TA), or arthritis of short duration, is characterized by brief attacks of joint inflammation, accompanied by pain and changes in joint structure. Fifty-two patients with JCA and 22 patients with TA were followed for an average of 18 years, from the time of disease onset to about age 25. Nineteen patients with JCA developed either peripheral arthritis, an inflammation of the joints in the limbs, or muscle contractures, and one patient required treatment with corticosteroids. Most of the male patients complained of back pain and/or limitations in movement and range of motion. Sacroiliitis, the inflammation of the sacroiliac joint at the base of the spine, occurred in 39 of 46 patients with JCA and 16 of 21 patients with TA. Histocompatibility antigens (HLA), which are normally present on all body cells that have a nucleus, activate immune responses and are controlled by a specialized set of genes called the major histocompatibility complex (MHC). Specific types of HLA are detected in certain diseases, including rheumatic disorders. HLA-A2 and HLA-DRw8 were detected in patients with JCA, whereas HLA-DR7 was decreased in pauciarticular JCA, a form of the disease. There was also a low prevalence of HLA-B27 in women with JCA and advanced sacroiliitis. (Consumer Summary produced by Reliance Medical Information, Inc.)

Measurement, Prognosis, HLA antigens, Histocompatibility antigens

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Reduced bone mineral content and normal serum osteocalcin in non-steroid-treated patients with juvenile rheumatoid arthritis

Article Abstract:

Juvenile rheumatoid arthritis (JRA), rather than corticosteroid therapy for JRA, may be responsible for low bone mineral content (BMC). A study of 20 children with active JRA who had never received corticosteroids found that their BMC was reduced compared to normal children. Reduced BMC was significantly associated with lower than normal height. The degree of bone demineralization was greater than the degree of height reduction. Children with systemic JRA, involving the whole body, had the lowest BMC. Children with JRA affecting several joints had a moderate reduction in BMC, and children with just a few affected joints had a normal BMC. Calcium, phosphate and osteocalcin levels in the blood were normal in all patients.

Bones, Bone density

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