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Predictors of fibrogenesis in children with JIA: a single-center pilot study
Olga Pavlova1, Natalia Shevchenko2,3, Sergey Pavlov4
1Department of Pediatrics, School of Medicine, V. N. Karazin Kharkiv National University, Yuvileinyi Avenue, 52-A, Kharkiv, 61153, Ukraine. pavlova07ga@gmail.com.
Insights
Juvenile idiopathic arthritis (JIA) patients show elevated fibrosis markers, basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF). Higher levels correlate with later onset and disease activity, aiding early fibrosis risk identification in children.
Area of Science:
- Pediatric Rheumatology
- Fibrosis Research
- Biomarker Discovery
Background:
- Rheumatological diseases carry a high risk of irreversible fibrotic changes.
- Chronic inflammation in these conditions leads to significant tissue damage.
- Early identification of fibrosis markers in juvenile idiopathic arthritis (JIA) is crucial.
Purpose of the Study:
- To investigate early markers of fibrosis formation in pediatric patients with JIA.
- To assess the levels of basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) in children with JIA.
Main Methods:
- A 4-year prospective study included 70 children with JIA (polyarthritis and oligoarthritis variants).
- Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) levels were measured using ELISA kits.
- Patient data included age at onset, disease variant, disease activity, and methotrexate (MTX) administration.
Main Results:
- Children with JIA exhibited elevated bFGF and VEGF levels.
- Higher VEGF levels were associated with JIA onset after 15 years and high disease activity.
- Increased bFGF levels were observed in children over 14 years, with JIA onset after 15 years, and moderate disease activity in the oligoarticular variant.
Conclusions:
- Elevated bFGF and VEGF levels in children with JIA suggest their potential as early fibrosis predictors.
- These markers are particularly heightened with JIA onset after 15 years and depend on disease activity.
- Laboratory screening for these fibrosis predictors can help identify at-risk pediatric patients.
Background:
Patients with rheumatological diseases are at high risk of developing irreversible fibrotic changes, both articular and extra-articular, as a result of tissue damage caused by the chronic phase of persistent inflammation. Thus, our purpose was to study early markers of fibrosis formation in children with juvenile idiopathic arthritis (JIA).
Methods:
Seventy patients with juvenile idiopathic arthritis, namely, polyarthritis (64.29%) and oligoarthritis (35.71%) variant JIA (mean age 13.3 years, 64.29% girls, 35.71% boys), were included in this 4-year prospective study. Basic fibroblast growth factor (bFGF) and vascular endothelial growth factor (VEGF) levels were determined by ELISA kits.
Results:
We evaluated bFGF (mean: 7478.21 pg/ml; min: 4171.56 pg/ml; max: 18,011.25 pg/ml) and VEGF (mean: 342.47 pg/ml; min: 23.68 pg/ml; max: 2158.91 pg/ml) levels in children with JIA. Children with JIA had a higher VEGF level when JIA onset occurred after 15 years of age and they had a high disease activity; additionally, a higher bFGF level was observed in children older than 14 years and in those with a JIA onset after 15 years of age, the oligoarticular variant, a moderate disease activity and regardless of MTX administration but more often when MTX was administered at a dosage from 10 to 12.5 mg/m2/week.
Conclusions:
Laboratory screening of fibrosis formation predictors could help identify patients who may be at greater risk of adverse outcomes. Children with JIA had higher bFGF and VEGF levels when JIA onset occurred after 15 years of age, depending on disease activity.
