Serum protein signatures differentiate paediatric autoimmune/ inflammatory disorders

Because of their rarity, limited awareness among non-specialists, and significant overlaps in their clinical presentation, childhood autoimmune/inflammatory conditions represent a diagnostic and therapeutic challenge. Juvenile idiopathic arthritis (JIA), with its 7 sub-forms, is the most common paediatric rheumatic disease. Juvenile-onset systemic lupus erythematosus (jSLE) is a severe autoimmune/inflammatory disease that can affect any organ system and shares clinical features with JIA. To overcome issues around diagnostic approaches in the context of clinical overlap, we aimed at the definition of disease sub-form specific cytokine and chemokine profiles. Serum samples from patients with JIA (n = 77) and jSLE (n = 48), as well as healthy controls (n = 30), were collected. Samples were analysed using the Meso Scale Discovery (MSD) U-PLEX Biomarker Group 1 (hu) panel. Distinct serum protein signatures associate with JIA vs jSLE disease groups. Proteins with high discriminatory ability include IL-23, MIP-1 beta, MCP-1, M-CSF and MDC. Furthermore, serum IL-18, MIF, MIP-5 and YKL40 discriminate between systemic JIA and other JIA subtypes. Thus, simultaneous quantification of serum proteins in a panel format may provide an avenue for the diagnosis and monitoring of childhood autoimmune/ inflammatory conditions.

Automated summary

Childhood autoimmune/inflammatory conditions pose a diagnostic and therapeutic challenge due to their rarity and overlapping clinical presentations. Research focused on defining disease-specific cytokine and chemokine profiles to differentiate between Juvenile Idiopathic Arthritis (JIA) and Juvenile-onset Systemic Lupus Erythematosus (jSLE). Analysis of serum samples revealed distinct protein signatures that could serve as diagnostic and monitoring markers for these conditions.