Childhood Arthritis and Rheumatology Research for Dreams Come True Remission

A special issue of Children (ISSN 2227-9067).

Deadline for manuscript submissions: 10 January 2025 | Viewed by 3941

Special Issue Editors


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Guest Editor
Department of Pediatrics, Yamaguchi University Graduate School of Medicine, Ube 755-8505, Japan
Interests: allergy; immunology; juvenile dermatomyositis; Kawasaki disease; pediatric rheumatology; rheumatology

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Guest Editor
Professor Emeritus, Department of Pediatrics, Graduate School of Medical and Dental Sciences, Kagoshima University, Kagoshima 890-8520, Japan
Interests: dreams come true remission; juvenile dermatomyositis; juvenile idiopathic arthritis; pediatric rheumatology; Sjögren’s syndrome; systemic lupus erythematosus

Special Issue Information

Dear Colleagues,

Pediatric rheumatic diseases (PRDs) are chronic inflammatory systemic diseases caused by autoimmune responses which develop in childhood and are represented by juvenile idiopathic arthritis, systemic lupus erythematosus, dermatomyositis, Sjögren’s syndrome, and autoinflammatory diseases.

Recent advances in the treatment of PRDs have been remarkable and will continue to develop. In the past, the prognosis of PRDs in children was poor, and disease- and treatment-related complications and sequelae were major problems. Nowadays, various biologics and molecular-targeted drugs are available, and remission of PRDs is possible in many children.

On the other hand, the treatment of PRDs aimed at attaining “dreams come true” remission is expected in the future. The concept of “dreams come true” remission, first introduced by Prof. Takei, is a kind of remission that enables children with PRDs to realize their future dreams without being disrupted by their diseases. Naturally, this cannot be achieved with conventional treatment aimed at clinical, structural, and functional remission. For a treatment to achieve “dreams come true” remission, it must first encourage children to make their own dreams.

This Special Issue invites the latest reviews and original articles in pediatric rheumatology for the realization of future “dreams come true” remission.

Dr. Hiroyuki Wakiguchi
Prof. Dr. Syuji Takei
Guest Editors

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Keywords

  • pediatric rheumatic diseases
  • juvenile idiopathic arthritis
  • systemic lupus erythematosus
  • dermatomyositis
  • Sjögren’s syndrome
  • autoinflammatory diseases
  • biological disease-modifying antirheumatic drugs
  • targeted synthetic disease-modifying antirheumatic drugs
  • prognosis
  • “Dreams come true” remission

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Published Papers (3 papers)

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Editorial

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3 pages, 159 KiB  
Editorial
Childhood Arthritis and Rheumatology Research for Dreams Come True Remission
by Syuji Takei
Children 2022, 9(3), 324; https://doi.org/10.3390/children9030324 - 1 Mar 2022
Cited by 2 | Viewed by 1852
Abstract
In recent years, newly developed therapeutic agents have brought clinical, structural, and functional remission to many pediatric patients with rheumatic diseases that were refractory to conventional therapy. However, achieving these remissions alone is insufficient as a treatment goal, especially for adolescent patients, because [...] Read more.
In recent years, newly developed therapeutic agents have brought clinical, structural, and functional remission to many pediatric patients with rheumatic diseases that were refractory to conventional therapy. However, achieving these remissions alone is insufficient as a treatment goal, especially for adolescent patients, because advanced therapies have not always encouraged their psychosocial stability and mental maturity. Consequently, various problems have arisen during the puberty and transition period from pediatrics to adult medical care. “Dreams come true remission” is a state of remission that allows patients to have clear dreams for the future in childhood and to increase the potential that their dreams will be realized in adulthood. This new treatment goal may empower children with chronic diseases such as PRDs to overcome the problems occurred during puberty and transition period. Full article

Review

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21 pages, 621 KiB  
Review
Advances in Juvenile Dermatomyositis: Pathophysiology, Diagnosis, Treatment and Interstitial Lung Diseases—A Narrative Review
by Ichiro Kobayashi
Children 2024, 11(9), 1046; https://doi.org/10.3390/children11091046 - 27 Aug 2024
Viewed by 318
Abstract
Juvenile idiopathic inflammatory myopathy (JIIM) is a rare systemic autoimmune disease characterized by skeletal muscle weakness with or without a skin rash. Juvenile dermatomyositis (JDM) is the most common subtype of JIIM, accounting for 80% of JIIM. Recent studies identified several myositis-specific autoantibodies [...] Read more.
Juvenile idiopathic inflammatory myopathy (JIIM) is a rare systemic autoimmune disease characterized by skeletal muscle weakness with or without a skin rash. Juvenile dermatomyositis (JDM) is the most common subtype of JIIM, accounting for 80% of JIIM. Recent studies identified several myositis-specific autoantibodies (MSAs) and myositis-associated autoantibodies (MAAs). Each MSA or MAA is associated with distinct clinical features and outcomes, although there are several differences in the prevalence of MSA/MAA and autoantibody–phenotype relationships between age and ethnic groups. Histopathological studies have revealed critical roles of type I interferons and vasculopathy in the development of JDM. Serological classification mostly corresponds to clinicopathological classification. Novel therapeutic agents, such as biologics and Janus kinase inhibitors (JAKi), have been developed; however, to date, there is a lack of high-level evidence. As advances in treatment have reduced the mortality rate of JIIM, recent studies have focused on medium- and long-term outcomes. However, rapidly progressive interstitial lung disease (RP-ILD) remains a major cause of death in anti-melanoma differentiation gene 5 autoantibody-positive JDM. Early diagnosis and intervention using a multi-drug regimen is critical for the treatment of RP-ILD. Rituximab and JAKi may reduce mortality in patients with JDM-associated RP-ILD refractory to conventional therapy. Full article
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9 pages, 725 KiB  
Review
Overview of the Treatment Goal, the Method of Evaluating Disease Activity/Physical Function, Activities of Daily Living, and Traditional Care for Systemic or Articular Juvenile Idiopathic Arthritis in Japan
by Masaaki Mori
Children 2024, 11(8), 952; https://doi.org/10.3390/children11080952 - 6 Aug 2024
Viewed by 521
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic arthritis of unknown cause that develops in patients younger than 16 years of age and persists for at least 6 weeks. It is an important cause of short- and long-term physical and mental impairments in children. [...] Read more.
Juvenile idiopathic arthritis (JIA) is a chronic arthritis of unknown cause that develops in patients younger than 16 years of age and persists for at least 6 weeks. It is an important cause of short- and long-term physical and mental impairments in children. The goal of treatment for JIA is remission. A T2T (treatment-to-target) has been proposed and practiced as a means of achieving remission. The method of evaluating the disease activity of JIA depends on the disease type. For systemic JIA, disease activity is determined by comprehensively considering joint findings, systemic inflammatory findings, changes in inflammatory and synovitis markers, imaging findings, and other factors. For articular JIA other than systemic JIA, the Juvenile Arthritis Disease Activity Score (JADAS-27) is used to evaluate disease activity. The CHAQ (Childhood Health Assessment Questionnaire) and the Japanese version of the modified Rankin Scale (mRS) are mainly used to assess the physical function and ADL. The CHAQ is a global standard assessment method with the advantage that it can be transitioned to the HAQ used in adults, making it useful for international comparisons. The mRS is used to classify the severity of JIA as a chronic disease, and is an indispensable evaluation method in the specific disease procedure in Japan. It is necessary to have pediatric-specific knowledge of growth and development and routine childhood immunizations and to consider transition support tailored to the patient’s situation. Ultimately, the goal is to foster the patient’s independence and to provide an uninterrupted follow-up in the adult care department. Continuous follow-up will be provided during the schooling (and later, employment) period, and the relationship with the patient will be tailored to their developmental stage. It is also important to understand and communicate the importance of contraception and the drugs that cannot be used during pregnancy. Full article
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