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Biological classification of childhood arthritis: roadmap to a molecular nomenclature

Peter A Nigrovic1,2, Robert A Colbert3, V Michael Holers4

  • 1Division of Immunology, Boston Children's Hospital, Department of Pediatrics, Harvard Medical School, Boston, MA, USA. peter.nigrovic@childrens.harvard.edu.

Nature Reviews. Rheumatology
|March 18, 2021
PubMed

Insights

Childhood chronic inflammatory arthritis, or juvenile idiopathic arthritis (JIA), needs a unified classification system. Current JIA categories lack overlap with adult arthritis, hindering research and treatment.

Area of Science:

  • Pediatric Rheumatology
  • Immunology
  • Genetics

Background:

  • Childhood chronic inflammatory arthritis is diverse, with many forms resembling adult-onset arthritis.
  • Current classification of juvenile idiopathic arthritis (JIA) is separate from adult arthritis, creating terminological inconsistencies.
  • Existing JIA nomenclature lacks overlap with adult-onset arthritis classifications.

Purpose of the Study:

  • To review evidence for distinct biological subgroups within childhood arthritis.
  • To identify childhood arthritis forms that are contiguous with adult-onset arthritis.
  • To explore integrative strategies for classifying inflammatory arthritis across all age groups.

Main Methods:

  • Literature review of clinical, genetic, and mechanistic data.
  • Analysis of current JIA nomenclature and adult arthritis classifications.
  • Consideration of bioinformatic approaches for subgroup identification.

Main Results:

  • Significant clinical and genetic similarities exist between JIA and adult-onset arthritis.
  • Current JIA classification system presents limitations due to lack of terminological overlap.
  • Evidence suggests potential biological subgroups within JIA.

Conclusions:

  • A unified approach to classifying inflammatory arthritis is necessary.
  • Integrative genetic and bioinformatic strategies can define discrete entities across age groups.
  • Revising JIA classification is crucial for advancing research and patient care.

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