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Researchers have been able to see what happens in the inflamed joints of children with arthritis, giving insight into why treatments affect children differently.

Mapping out the architecture of inflamed joints in children. The light blue blood vessels bring new immune cells into the joint that overwhelm the pink vessel’s ability to remove them.

A new groundbreaking study has revealed important clues into what is driving disease in children with arthritis. Cutting-edge techniques have allowed scientists for the first time to uncover the unique architecture of cells and signals inside the joint as inflammation takes hold.

The new study published in Science Translational Medicine looks at arthritis in children, caused by the immune system mistakenly attacking joints. Juvenile idiopathic arthritis affects more than 10,000 children in the UK. It causes swelling, stiffness and pain in the joints over years or decades, leading to damage of the joints and long-term disability. Whilst treatments are available to manage the condition, and in some cases achieve remission, there is no cure. It can take time to find which treatment works for each person. Treatments don’t work in the same way for every child, suggesting there are hidden differences between individuals that we are only beginning to understand.

Deepening the scientific and clinical community’s understanding of the condition is vital if more effective treatments are to be found, and undertaking biopsies in young children provides a new way forward. Working with families of children with arthritis opened the door to this study, as the families advocated for the potential of the study, agreeing that the procedure would be acceptable to families, especially compared to living with a chronic inflammatory disease.

In a world first, tiny tissue samples were collected from the joint lining when children were having medicine injected into the joint. These samples were then analysed with advanced imaging and gene-profiling technologies. The fine resolution maps of the joints revealed differences between children of different ages and cell changes in those with more severe disease. These unique cellular fingerprints may help researchers understand why some drugs work better for some children, and not others. The joints of children with arthritis looked significantly different to those with adults, demonstrating the need to understand arthritis in children better. 

 

Read the full story on the Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences website.