The JIA-Uveitis Study

The Biologic Basis of Co-existent Uveitis and Arthritis in Children: Towards Early Detection, Targeted Treatment, and Prevention

“Arthritis and uveitis are independently life altering; together they can have devastating consequences. Lack of mobility or loss of sight can quickly strip the innocence of childhood.”

Becki

Innovation

This research aims to explain the association of chronic joint and eye inflammation in children, a discrete clinical entity having potentially lifelong disabling consequences. We expect to show that arthritis with associated uveitis results from shared protein molecules that induce both arthritis and uveitis in the joint and eye. By generating a more thorough understanding of molecular interactions and immune targets that drive the relationship between joint and eye inflammation in children, this research will guide evidence-based strategies to diagnose, monitor, treat, and prevent the burdensome consequences of juvenile idiopathic arthritis (JIA)-uveitis.
Risk factors typifying JIA-uveitis include, female sex, young onset age, a limited number of involved joints, and a positive test for the presence of antibodies that target proteins in the nucleus of cells. However, even collectively these features lack precision in predicting JIA-uveitis onset, course, treatment response, and outcome. Our earlier proof-of-concept studies provide compelling support for the idea that JIA-uveitis is mediated by collagen-derived pathogenic peptides. Furthermore, this proposal aims to explain young onset age, female predilection, ANA positivity, and genetic vulnerability in JIA-uveitis.

Discovery

Patient enrollment has concluded for this study and various laboratory-based assays will be completed soon. Data analysis is underway. Preliminary analyses confirm the well-established associations of JIA-uveitis with female sex and positive tests for anti-nuclear antibodies. Applying advanced imaging and assay techniques we are analyzing data that is revealing distinct anti-nuclear antibody patterns in children with JIA-uveitis. Although some children with JIA-uveitis have immune reactions to collagen our analysis so far suggests that collagen might an important an immune target in only a small subset of children with JIA-uveitis.

Engagement

The Uveitis in JIA study is grateful to the 272 study participants enrolled in the study from 12 Canadian pediatric rheumatology centers.
The JIA in Uveitis project team includes investigators and patient and parent advisors from 12 Canadian pediatric rheumatology centers, Canadian pediatric ophthalmologists and collaborators from the United States and the Netherlands.
We are very grateful to parents and young adult patients with JIA-associated uveitis who have generously volunteered to serve on a Parent/Patient Advisory Committee for the project. The committee welcomes other parents and older teens/young adult patients to serve on the committee. COVID-related restrictions have slowed the project's progress. However, as COVID-impediments have eased, we look forward to convening a virtual meeting of the Advisory Committee soon.
Major funding for this research project is generously provided by a grant from The Arthritis Society. The support of the Arthritis Society and its donors is greatly appreciated. The College of Medicine, University of Saskatchewan also provides supplementary funding to support this project. The Saskatchewan Jim Pattison Children's Hospital Foundation provided funding for preliminary human and animal studies that helped generate data to strengthen the rationale for this project. The Pediatric Rheumatic Disease Research IDEA Lab, University of Saskatchewan, also receives support from the Kehrig Family Fund, The Rich Family Fund, and the Wiebe Family Fund, which support research projects that are producing results that are complementary to the JIA-Uveitis study.

The banner above is copied from the AMI website, which produces Becki Zerr's podcast series, "...is a not-for-profit media company that entertains, informs and empowers Canadians who are blind or partially sighted."(https://www.ami.ca/AMI-Mission-Vision).

Since age three years, Becki Zerr has endured the effects of JIA and associated uveitis. In a series of Blind Reality podcasts, Becki shares the story of her journey. Becki's elegant presentations are profoundly compelling, informative, insightful, and imbued with warmth and humor.
Please listen to Becki's podcasts, which will touch your hearts and minds. The Blind Reality podcasts, can be found here. In the podcasts Becki "...shares her unique life experience as a healthcare provider and client, as well as being a mom. Becki has lived with monocular vision, no vision at all, and various degrees of partial sight. In each episode, Becki tells honest stories of family, friendships, parenting, career, entrepreneurship, and repeatedly defying the odds."

Action

The data from the JIA-Uveitis Study are currently being analyzed. We anticipate that results will help provide insight into factors that might help explain the association of arthritis and uveitis in children. We also anticipate that results will help provide information and laboratory tests that might allow for more prompt diagnosis, guide therapy, and predict outcomes.