Advances in Pediatric Rheumatology: Focus on Juvenile Idiopathic Arthritis
A special issue of Children (ISSN 2227-9067). This special issue belongs to the section "Pediatric Allergy and Immunology".
Deadline for manuscript submissions: 15 November 2025 | Viewed by 297
Special Issue Editor
Special Issue Information
Dear Colleagues,
Recent developments in pediatric rheumatology have significantly advanced the understanding and treatment of juvenile idiopathic arthritis (JIA), and biomarkers are crucial in guiding diagnosis and therapeutic decisions. Notable biomarkers such as MRP8/14 (S100A8/A9) have emerged as valuable tools to monitor disease activity, particularly in systemic JIA (sJIA). Elevated levels of MRP8/14 can predict flares and are closely related to inflammation in active disease. Similarly, interleukin-18 (IL-18) has shown promise as a biomarker, especially in systemic JIA, where high levels of IL-18 correlate with disease severity and macrophage activation syndrome (MAS), a life-threatening complication of JIA.
In terms of complications, uveitis, a common extra-articular manifestation in JIA, has seen improved management through early biologic interventions. Adalimumab, a TNF inhibitor, has been particularly effective in controlling JIA-associated uveitis resistant to conventional treatments such as methotrexate. Early and aggressive use of these biologics, often in combination with methotrexate, has dramatically reduced the risk of long-term ocular complications such as cataracts and glaucoma. Second-line biologics, such as abatacept and tocilizumab, have provided additional options for patients with refractory uveitis, improving overall visual outcomes.
Early biologic therapies, including TNF inhibitors (etanercept, adalimumab), IL-1 blockers (anakinra, canakinumab), and IL-6 inhibitors (tocilizumab), continue to be transformative, mainly when initiated early in disease progression. This approach has led to better disease control, reduced long-term joint damage, and improved quality of life for patients. The introduction of JAK inhibitors, such as tofacitinib, has provided additional therapeutic options for patients who do not respond to traditional biologics, offering more personalized treatment strategies.
Furthermore, newer therapies, such as IL-17 inhibitors (secukinumab), have improved the treatment of juvenile spondyloarthropathies (JSPA). These drugs specifically target the inflammatory pathways involved in arthritis related to enthesitis, improving disease outcomes for patients with more resistant forms of JIA.
In general, advances in biomarkers such as MRP8/14 and IL-18, combined with early interventions and novel treatments, have significantly changed the landscape of JIA management. These developments enable precise disease monitoring, personalized therapies, and better long-term outcomes for pediatric patients.
Dr. Tamas Constantin
Guest Editor
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Keywords
- juvenile idiopathic arthritis
- pediatric rheumatology
- Uveitis
- MRP8/14 (S100A8/A9)
- interleukin-18 (IL-18)
- TNF inhibitors (etanercept, adalimumab)
- IL-1 blockers (anakinra, canakinumab)
- IL-6 inhibitors (tocilizumab)
- JAK inhibitors
- IL-17 inhibitors (secukinumab)
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