Uncovering the link between arthritis and sight loss in children

20 May 22

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Scientists are investigating how and why arthritis in children under 16 years of age is associated with eye inflammation, and sometimes sight loss, in some- but not all –patients.

Jointly funded by Fight for Sight and Versus Arthritis UK, the project will identify how changes and dysfunction in white blood cells, called B-cells, can lead to the development of uveitis, an inflammatory disorder of the eye, in patients with Juvenile Idiopathic Arthritis (JIA).

The aim of the project is to find new ways to identify and treat JIA patients at-risk of developing uveitis. Improving identification of at-risk children could reduce screening times and therefore the amount of missed school time. It could also eventually prevent the progression of eye inflammation into sight loss, improving quality of life.

A major unmet need

 JIA, characterised as joint swelling that lasts at least six weeks in under 16-year olds, affects one in 1,000 children in the UK.

In patients with the condition, the body’s healthy joints are attacked by white blood cells, the cells that normally fight disease.

For unknown reasons, some JIA patients also develop uveitis.

In a select group of JIA-uveitis patients, this can lead to long-term loss of sight if they do not respond to therapy.

There is a major unmet need for studies that investigate why some JIA patients develop uveitis and others do not – clinical monitoring of at-risk children is therefore crucial in helping improve treatment outcomes.

Current treatment

Treatment for JIA-uveitis involves blocking the function of immune cells that cause inflammation. 

However, there is evidence that JIA-uveitis development could be driven by a specific population of white blood cells called B-cells.

During infections, B-cells produce molecules called antibodies, which help clear bacteria and viruses from the body. However, in children with JIA, the production of antibodies that interact with the proteins that package our DNA, are a risk factor for uveitis development.

Early onset of JIA (at approx. 2-3 years of age) is also another risk factor for JIA-uveitis; studies have shown that in early onset JIA there are changes in biological signatures associated with B cells in the peripheral blood compared to children with later onset JIA.

Project co-leads Professor Lucy Wedderburn and Dr Elizabeth Rosser from UCL told us:

“Joint ache and sight loss caused by JIA-uveitis can lead to lasting damage in young children. The outcomes of this project could therefore have a huge impact on young people and could hugely improve current treatment methods and quality of life. Beyond this, it could provide evidence for the wider application of B-cell targeting drugs and could help us establish a ‘uveitis fingerprint’ in peripheral blood to identify ‘at risk’ patients. I am grateful to Fight for Sight for funding a PhD studentship to support the project and help us advance our crucial findings.”