Rheumatology Medical News about polyarticular JIA;clinical remission

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The meaning of clinical remission in polyarticular juvenile idiopathic arthritis: Gene expression profiling in peripheral blood mononuclear cells identifies distinct disease states
Arthritis & Rheumatism, 03/09/09

Knowlton N et al. – Study proposes that the clinically derived criteria for juvenile idiopathic arthritis (JIA) disease states reflect underlying biology. Neither clinical remission on medication (CRM) nor clinical remission off medication (CR) status results in resolution of the underlying inflammatory process, but are more likely to be states of balanced homeostasis between proinflammatory and antiinflammatory mechanisms.

Methods

Study was to develop biomarkers to predict response to therapy in polyarticular JIA in pediatric rheumatology
Gene transcriptional profiling performed in children with active disease (n=14), with CRM (n=9), CR (n=6), and healthy control children (n=13)
Transcriptional profiles in peripheral blood mononuclear cells (PBMCs) obtained using Affymetrix U133 Plus 2.0 arrays

Results

Clinically derived criteria represent biologically distinct states
Minimal differences seen between children with active disease and in CRM
Thus, underlying immune/inflammatory abnormalities persist despite a response to therapy
The PBMC transcriptional profiles of children whose disease was in remission did not return to normal but revealed networks of proinflammatory and antiinflammatory genes
This suggested that remission is a state of homeostasis, not a return to a normal state

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