Borchers Andrea T, Selmi Carlo, Cheema Gurtej, Keen Carl L, Shoenfeld Yehuda, Gershwin M Eric
Department of Nutrition, USA.
Autoimmun Rev. 2006 Apr;5(4):279-98. doi: 10.1016/j.autrev.2005.09.011. Epub 2005 Oct 27.
One of the most enigmatic problems in rheumatology has been juvenile idiopathic arthritis (JIA). Firstly, the classification has often depended on clinical features that have variations between patients. Secondly, there are different classification schemes in usage and there are few objective serologic tests that help to resolve the differences between the criteria sets. Thirdly, only recently have significant advances been made in understanding the immunology and immunopathology of JIA and, in particular, new treatment options. In this review, we will define the historical basis of JIA and emphasize not only the clinical features, but also the immunological characteristics, the pathogenesis, and treatment options. We will also discuss, in particular, quality of life, psychosocial functioning, socioeconomic outcomes and the difficult area of mortality. Finally, this review will attempt to bridge genetic observations with clinical presentation. JIA represents a relatively common syndrome of pediatric onset rheumatologic disease and a better understanding of the clinical definition, the relationship to autoimmunity, and novel treatments with biologic agents are critical for improved patient care.
青少年特发性关节炎（JIA）一直是风湿病学中最具谜团的问题之一。首先，分类常常依赖于患者之间存在差异的临床特征。其次，目前使用着不同的分类方案，且有助于解决不同标准集之间差异的客观血清学检测很少。第三，直到最近，在理解JIA的免疫学和免疫病理学，尤其是新的治疗选择方面才取得了重大进展。在这篇综述中，我们将定义JIA的历史基础，不仅强调其临床特征，还包括免疫学特征、发病机制和治疗选择。我们还将特别讨论生活质量、心理社会功能、社会经济结果以及死亡率这一难题领域。最后，本综述将尝试将遗传学观察结果与临床表现联系起来。JIA是一种相对常见的儿童期起病的风湿性疾病综合征，更好地理解临床定义、与自身免疫的关系以及生物制剂的新型治疗方法对于改善患者护理至关重要。
