Review Article | Published:

Advances in biomarkers for paediatric rheumatic diseases

Nature Reviews Rheumatology volume 11, pages 265275 (2015) | Download Citation

Abstract

The search for biomarkers in paediatric rheumatic diseases, particularly juvenile idiopathic arthritis (JIA), childhood lupus nephritis (LN), and juvenile idiopathic inflammatory myopathies (JIIMs) is attracting increased interest. In JIA, a number of biomarkers have shown potential for predicting clinical phenotype, disease activity and severity, clinical remission and relapse, response to treatment, and disease course over time. In systemic JIA, measurement of biomarkers that reflect the degree of activation and expansion of T cells and macrophages might be helpful for detecting subclinical macrophage activation syndrome. Urine biomarkers for childhood LN hold promise for facilitating early diagnosis and improving disease monitoring and assessment of response to therapy. Myositis-specific autoantibodies define distinct serological subgroups of JIIMs, albeit with similar clinical features, responses to therapy, and prognoses. Use of biomarkers may potentially help to avoid invasive procedures, such as renal biopsy in systemic lupus erythematosus and muscle biopsy in juvenile dermatomyositis. Incorporation of effective and reliable biomarkers into routine practice might facilitate adoption of a stratified approach to investigation and management, foster the implementation of research into the design of personalized and targeted therapies, and ultimately lead to more rational and effective clinical care.

Key points

  • The search for biomarkers in paediatric rheumatic diseases is attracting increased interest

  • Several biomarkers have potential to predict the clinical phenotype, disease activity, response to treatment and course of disease in juvenile idiopathic arthritis

  • Biomarkers that reflect the degree of activation and expansion of T cells and macrophages could help to identify subclinical macrophage activation syndrome

  • Novel urine biomarkers for childhood lupus nephritis hold promise for facilitating early diagnosis, improving disease monitoring and assessment of response to therapy

  • Myositis-specific autoantibodies define distinct serological subgroups of juvenile idiopathic inflammatory myositis, albeit with similar clinical characteristics

  • The diagnostic power of biomarkers might help to avoid invasive procedures, such as renal biopsy in systemic lupus erythematosus, and muscle biopsy in juvenile dermatomyositis

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Affiliations

  1. Università degli Studi di Genova, Via Balbi 5, 16126 Genoa, Italy.

    • Alessandro Consolaro
    •  & Giulia C. Varnier
  2. Pediatria II, Istituto Giannina Gaslini, Via G. Gaslini 5, 16147 Genoa, Italy.

    • Alberto Martini
    •  & Angelo Ravelli

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Contributions

A.R. and A.C. wrote the manuscript and contributed substantially to discussions of its content. All authors (A.R., A.C., G.C.V. and A.M.) researched data for the article and undertook review or editing of the manuscript before submission.

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The authors declare no competing financial interests.

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Correspondence to Angelo Ravelli.

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DOI

https://doi.org/10.1038/nrrheum.2014.208

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