期刊
NATURE REVIEWS RHEUMATOLOGY
卷 17, 期 5, 页码 257-269出版社
NATURE PORTFOLIO
DOI: 10.1038/s41584-021-00590-6
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资金
- US National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) [2R01 AR065538, R01 AR075906, R01 AR073201, P30 AR070253, R21 AR076630]
- US National Heart, Lung, and Blood Institute [R21 HL150575]
- Fundacion Bechara
- Arbuckle Family Fund for Arthritis Research
- NIAMS Intramural Research Program [Z01AR041184]
- US National Institutes of Health [UH2 AR067681, U01 AI101981, U01 AI130830, U01 HL152405, R01 DK125823, R01 AR051749, UM2 AR067678]
- Janssen RD [ICD845278]
- Pfizer [WI237571]
- NIAMS [P30 AR070549]
- US National Institute of Child Health and Human Development [R01 HD089928]
- US National Eye Institute [EY030521]
- Center for Pediatric Genomics at Cincinnati Children's Hospital Medical Center
- UK Research and Innovation Medical Research Council [MR/R013926/1]
- Great Ormond Street Hospital (GOSH) Children's Charity
- UK National Institute for Health Research Biomedical Research Centre at GOSH
- Hak-Ming and Deborah Chiu Chair in Paediatric Translational Research at the Hospital for Sick Children, University of Toronto
- Canadian Institutes for Health Research [381280]
- Genome Canada
- Samara Jan Turkel Center for Pediatric Autoimmune Diseases at Boston Children's Hospital
- Q32 Bio [SRA-001]
- Versus Arthritis [22084, 21593]
- Netherlands Organization for Health Research and Development
- Reumafonds
- Arthritis Society
- Province of Ontario
- Genome Alberta
- Childhood Arthritis and Rheumatology Research Alliance
- Alberta Children's Hospital Research Institute
- Hospital for Sick Children Foundation
- MRC [MR/R013926/1] Funding Source: UKRI
Childhood-onset arthritis is heterogeneous and may share similarities with adult-onset arthritis while also having unique features. The current classification approach has limitations, requiring a new strategy to define biological categories within JIA.
Chronic inflammatory arthritis in childhood is heterogeneous in presentation and course. Most forms exhibit clinical and genetic similarity to arthritis of adult onset, although at least one phenotype might be restricted to children. Nevertheless, paediatric and adult rheumatologists have historically addressed disease classification separately, yielding a juvenile idiopathic arthritis (JIA) nomenclature that exhibits no terminological overlap with adult-onset arthritis. Accumulating clinical, genetic and mechanistic data reveal the critical limitations of this strategy, necessitating a new approach to defining biological categories within JIA. In this Review, we provide an overview of the current evidence for biological subgroups of arthritis in children, delineate forms that seem contiguous with adult-onset arthritis, and consider integrative genetic and bioinformatic strategies to identify discrete entities within inflammatory arthritis across all ages. Childhood-onset arthritis has historically been treated as a separate entity to adult-onset arthritis, with its own nomenclature and classification system. Biological evidence has revealed the limitations of the current approach, necessitating a fresh look at the classification of paediatric arthritis.
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