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Biomarkers in juvenile idiopathic arthritis: towards precision diagnosis and personalized therapy?
Luciana Breda1, Saverio La Bella, Armando Di Ludovico
1Department of Pediatrics, Pediatric Rheumatology Unit, University of Chieti "G D'Annunzio", Chieti, Italy.
Insights
Biomarkers are crucial for diagnosing and managing juvenile idiopathic arthritis (JIA). New markers like calprotectin and microRNAs offer improved monitoring, prediction, and personalized treatment for children with JIA.
Area of Science:
- Rheumatology
- Pediatric Medicine
- Immunology
Background:
- Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, presenting with persistent joint inflammation and diverse clinical subtypes.
- Timely diagnosis and tailored treatments are essential for optimizing long-term outcomes in JIA patients.
- Recent advancements focus on identifying and validating biomarkers to improve diagnostic accuracy, predict disease progression, and inform therapeutic strategies.
Purpose of the Study:
- To review the role and potential of biomarkers in the diagnosis, prognosis, and management of juvenile idiopathic arthritis.
- To highlight emerging biomarkers and their clinical utility in enhancing precision medicine for JIA.
Main Methods:
- Review of current literature on biomarkers in JIA.
- Analysis of studies investigating calprotectin, microRNAs, and other molecular markers.
- Evaluation of proteomic and metabolomic profiling approaches for biomarker discovery.
Main Results:
- Calprotectin (S100A8/A9) levels in serum and synovial fluid correlate with JIA activity, potentially surpassing traditional markers like CRP and ESR.
- Elevated calprotectin may predict disease flares and subclinical inflammation, aiding in monitoring and prognosis.
- Emerging biomarkers, including microRNAs and candidates from proteomic/metabolomic studies, show promise for subtype differentiation, early diagnosis, and personalized treatment.
Conclusions:
- Biomarkers are indispensable tools in JIA management, facilitating therapeutic decisions and long-term patient monitoring.
- A comprehensive biomarker framework is anticipated to enhance early diagnosis, guide personalized treatment plans, and improve outcome prediction.
- The future of JIA care lies in leveraging biomarkers for more effective and individualized patient management.
Purpose To Review:
Juvenile idiopathic arthritis (JIA) is the most common chronic rheumatic disease in children, characterized by persistent joint inflammation with heterogeneous clinical subtypes. Early diagnosis and targeted treatment remain critical to improving long-term outcomes. In recent years, research has increasingly focused on the identification and validation of biomarkers to enhance diagnostic precision, predict disease course, and guide therapeutic decisions.
Recent Findings:
Calprotectin (S100A8/A9) is a pro-inflammatory protein complex released by activated neutrophils and monocytes. In JIA, serum and synovial fluid calprotectin levels correlate with disease activity and may outperform traditional markers like C-reactive protein and erythrocyte sedimentation rate. Evidence suggests that elevated calprotectin levels can predict flares and subclinical inflammation, making it a promising biomarker for monitoring and prognosis in JIA. Novel biomarkers including microRNAs show potential for differentiating disease subtypes and monitoring treatment response. Proteomic and metabolomic profiling are also uncovering candidates that may improve early diagnosis and personalized management.
Summary:
Biomarkers have emerged as pivotal tools in the management of JIA, offering significant advantages in both therapeutic decision-making and long-term monitoring. In the future, a robust biomarker framework holds the potential to improve early diagnosis, guide personalized treatment strategies, and enhance outcome prediction-ultimately contributing to more effective and individualized care for patients with JIA.
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